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Medicare Approval of Multi-Focal Cataract Lens

Move seen as boom for seniors, surgeons, and lens manufacturers.


lasik crystalens
The Crystalens changes focus by moving within the eye, mimicking natural vision.

 

lasik RLE
The AcraSof ReSTOR diffractive lens uses multiple focal rings to provide near and distance vision.

 

May 19, 2005 – The announcement by Medicare on May 3 that beneficiaries now may choose a cataract replacement lens that corrects close, intermediate and distance vision, rather than just the lens for distance vision correction, has caused excitement among senior citizens, eye doctors and certainly at the companies that makes the approved intraocular lens (IOL).

Crystalens, made by Eyeonics, Inc., is the only FDA-approved “naturally focusing vision-correction” lens replacement for adults with cataracts and presbyopia, says the company. Eyeonics claims they led the way in affecting this policy change, working with U.S. Congressman Christopher Cox ( Newport Beach, Calif. ), the Centers for Medicare & Medicaid Services, physicians and ophthalmic industry leaders.

"More than 2.2 million cataract surgeries are performed each year on patients age 65 and over," said J. Andy Corley, co-founder, chairman and CEO of Eyeonics. "Yet as vision technologies advanced, Medicare reimbursement did not keep pace."

"We applaud CMS for its decision to allow Medicare patients access to new technologies, like the recently approved AcrySof(R) ReSTOR(R) IOL," said Cary Rayment, chairman, president and chief executive officer, Alcon, Inc. "Physicians and patients now have the freedom to select technology to treat cataracts consistent with the patient's lifestyle needs."

Approved on March 21 by the FDA, AcrySof(R) ReSTOR(R) is “the first and only IOL that uses apodized diffractive technology to provide cataract patients with and without presbyopia a quality range of vision,” the company said. In clinical trials, 80 percent of AcrySof(R) ReSTOR(R) patients reported never wearing reading glasses or bifocals following bilateral cataract surgery.

"This policy change means that patients will have the right to choose a vision correction technology that best meets their lifestyle and visual demands. It also gives doctors the freedom to offer innovative technologies such as the crystalens for their Medicare patients," said ophthalmologist Steven J. Dell, MD, of the Texan Eye Care in Austin, Texas.

“The CMS ruling now opens the path for senior citizens, the same quality of premier care and quality vision as Lasik patients have enjoyed for a decade,” said Dr.Kerry Assil, of the Assil Sinskey Institute in Santa Monica, CA, a pioneer in modern cataract surgery and the primary investigator for the FDA, specializing in testing for lenses such as the ones used in this surgery. He is also frequently seen on television news as an expert reference and was the eye doctor on the FOX reality show “The Swan.”

Another eye doctor who regularly does cataract surgery said he is approaching the multi-focal lenses with caution. “I would like to see a higher patient satisfaction level,” he said.

The catch is that the new choice doesn’t come without a price.

The IOL is designed to treat two conditions: cataract removal with lens replacement ( a procedure covered by Medicare ) and presbyopia ( a non-covered service ). Patients who select IOL will receive the standard Medicare reimbursement for cataract surgery, and can now pay privately for the presbyopic portion of the treatment, which is estimated at about $2,500.

Medicare patients were excluded from receiving this type of lens before this ruling due to these lenses being produced at a greater cost than Medicare was willing to pay. They were not allowed for Medicare patients, even if they paid the extra cost.

Presbyopia is an inevitable age-related eye condition that makes it difficult to read or see objects up-close without the use of reading glasses. Presbyopia is the first sign of a cataract and is the most prevalent eye condition in America. It causes the crystalline lens to increasingly stiffen, lose flexibility and cloud, diminishing its focusing ability.

These lens correct vision at all distances and in most cases eliminates the need for glasses and contacts for everyday tasks. Its ability to focus at all distances frees most patients from the need for glasses following cataract surgery. In clinical trials, nearly three-times the number of patients ( 85 percent ) who received the crystalens could see at all distances compared to a standard IOL, according to the company.

Eye doctors see this as a business boom that is a good reason to hang on to Medicare patients that many had considered dropping due to Medicare payment levels.

The vast majority of cataract surgery patients - over two million a year - are on Medicare, since the problem usually develops late in life. A cataract is a clouding of the eye’s lens that usually occurs as part of the aging process. Cataracts affect about 50% of Americans between the age of 65 and 75, and nearly 70% of people over 75.

Not all cataracts require surgery and the presence of cataracts does not always produce impairments, therefore cataract surgery should only be performed if the patient chooses.

About Crystalens

The crystalens is the result of more than 14 years of research and development by J. Stuart Cumming, M.D., F.A.C.S., and was approved by the FDA in November 2003. More than 24,000 lenses have been implanted worldwide to date. During clinical trials, all of the patients who received the crystalens greatly reduced their need for corrective lenses or eyeglasses. The patented crystalens technology is designed to allow the lens to move in the eye in a manner similar to the natural lens. By using the eye's muscle to move the lens back and forwards naturally, patients can focus through a continuous range of vision including near, far and everywhere in between. All other intraocular lenses are designed to remain fixed in the eye. For more information about the crystalens go to http://www.crystalens.com

About AcrySof(R) ReSTOR(R) IOL

The AcrySof(R) ReSTOR(R) IOL features a unique, proprietary apodized diffractive optic design that provides the ability to focus images from various distances correctly on the retina without mechanical movement of the lens. This optic design results in an increased range of quality vision that delivers a high level of spectacle freedom. Apodization improves image quality by optimizing light energy delivered to the retina by distributing the appropriate amounts of light to near and distant focal points, regardless of lighting situation. This new IOL is particularly well-suited for patients who wish to reduce their dependency on reading glasses and bifocals once their cataractous lens is removed. For more information on Alcon, Inc., visit the company's Web site at www.alconinc.com.


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