May 25, 2006
Laser Microbubbles May End Need For Reading Glasses

Here's a technological advance which will be popular when it reaches the market.

Presbyopia---the inability to focus on close objects resulting in blurred vision---affects 100 percent of people by age 50. Historically, laser correction of the intraocular lens for presbyopia has been proposed, but it is risky because there is no way to monitor the procedure---no way for ophthalmologists to see what they are doing to the lens being cut.

But a tool developed at the University of Michigan allows for a potentially noninvasive, painless fix to presbyopia using tiny bubbles that help ophthalmologists reshape the eye’s lens and restore its flexibility and focusing ability. Matthew O’Donnell, professor and chair of the U-M Department of Biomedical Research, along with Kyle Hollman, assistant research scientist and adjunct lecturer, and graduate student Todd Erpelding, developed the method. Recently, it was successful when tested in pig lenses.

Presbyopia usually starts around age 40, O’Donnell saays. The predominant belief is that fibers created in the intraocular lens accumulate and stiffen, thus making the lens less flexible. Without that flexibility, the lens can’t change shape to focus on near objects, a process called accommodation.

So, while a young eye is like an automatic focus camera, the presbyopic eye can be thought of as a fixed focus camera, he says. One way to potentially solve presbyopia is to laser away some fibers to restore flexibility, but there is no way to know how much or where to cut, he adds.

“There are no noninvasive or minimally invasive procedures for presbyopia,” said O’Donnell, 55, who explained that he started research on presbyopia when he began to notice his own near-sight failing. He held up his reading glasses: “I got sick of wearing these things.”

The U-M tool uses bubbles, ultrafast optics and ultrasound to measure the thickness and rigidity of the lens during laser surgery, thus guiding the surgeon as they reshape the lens. It’s a new application for microscale bubbles, which scientists have experimented with for years in the areas of drug delivery, tumor destruction and other medical applications.

For the treatment of presbyopia, the U-M team used ultrafast laser pulses to create tiny gas bubbles within the intraocular lens. Before the bubbles diffuse, researchers hit them with high frequency sound waves, which push the bubbles against neighboring lens fibers.

“Part of the sound is reflected, and from the characteristic of the reflection, you know where the bubble is,” O’Donnell said. “It uses exactly the same technology as ultrasound imaging.”

In this way, researchers measure how far the bubbles have moved based on the force applied, and thus measure the pliability of the lens.

“The bubbles show you where the laser should cut,” O’Donnell said. “If it’s still too hard, you cut some more. If it’s soft enough, you stop.”

The future plan is to automate the procedure to quickly cover the entire lens with bubbles, he said. The team, which will begin testing this year, is talking with several companies about commercial opportunities.

Growth or synthesis of replacement lenses may also eventually solve this problem.

How will the world look differently 20 years from now? In industrialized countries corrective glasses will be rare, obesity will be rare, and baldness and even hair graying will be rare. What else do you think will be obviously different in a stroll down a city street in the year 2026?

Share |      Randall Parker, 2006 May 25 12:17 AM  Biotech Therapies

Brett Bellmore said at May 25, 2006 4:21 AM:

I have heard that what actually happens in most cases, is that the lens keeps growing slowly through life, and eventually the muscles anchored to it's perimeter get too short to tug on it anymore. And, indeed, there is an operation implanting a ring in the white of the eye around where those muscles anchor, stretching it out, which restores accomidation.

Alas, due to the legalities of implanting anything in the body, it's far more expensive than Lasik, even though it's more easilly reversable, and safer.

sucker said at May 25, 2006 8:09 AM:

Randall Parker,

How sure are you that baldness will be rare in 20 yrs? (I have a personal stake in that one...)

As for me, I think that the energy problem will be solved by then. Cars that don't burn nothin--they're coming!

Kurt said at May 25, 2006 8:27 AM:

The fact that presbyopia still exists today is a perfect example of the gay bureaucracy that medicine has become in the last 50 years and why the conventional medical industry is competely worthless. I will add more later, but suffice to say for now that the tools and instruments necessary to determine exactly what causes presbyopia (that is, the molecular biology behind it) have been available for 50 years. The new instruments (AFM and nano-indentation) could answer this question in 1-2 DAYS of experiments. The fact that noone has bothered to do this at all in the past 50 years is indicative of the gay bureaucracy medicine has become.

One of the basic problems of conventional medicine is its assumption that the human body is a static construct, much like a building or a car, rather than being the dymanic entity, with self-repair and self-regeneration, that it really is. I believe that this erroneous assumption is at the root of the conventional dogma that the aging process itself is somehow immutable and, therefor, cannot be treated or cured in a cost effective manner.

Again, these assumptions persist because of the bureaucracy that medicine has become.

I will have more later.

Sheila said at May 25, 2006 12:39 PM:

A gay bureaucracy? What are you, 12?

Back on topic, I hope that a visible difference will be that the old people are not walking slowly because of their creaky painful joints. I see articles about advances in bone and cartiledge repair, and I hope that pans out as a treatment for osteo-artritis damage to joints.

Kurt said at May 25, 2006 2:24 PM:


You completely missed my point. I just had a similar coversation with a customer, who started out in the pharmaceutical industry, but switched to semiconductors because of less regulation. He is also of the opinion that regulation and bureaucracy are the greatest impediments to progress in medicine. The amount of regulation and red tape is simply insane. He also agreed with my assertion that the basic flaw of conventional medicine is the assumption that the body is a static structure (like in civil engineering), rather than as a dynamic system complete with self-repair, self-regeneration capability.

Presbyopia is caused by either AGE crosslinks (most likely) or by continual cell growth in the lens in the manner of nose and ear cartilage (less likely, but still possible). It cannot be caused by anything else. My point was that the experimental apparatus that could determine which of these two causes are correct has existed for nearly a century. Apparently, noone in the medical field can be bothered to actually figure this out. They don't feel that it is important. Determining which is the cause would lead to effective, non-invasive cure for the problem.

If its continual cell growth, the proper manipulation of hormones and enzymes should eliminate presbyopia. If the cause is due to AGE crosslinks, there are crosslink breaker compounds in development that should eliminate presbyopia. One of these compounds (ALT-711) is supposed to be in the marketplace in the next 3 years or so.

The fact that the medical community fails to determine the molecular biological cause of a particular condition, despite having available the tools and technology to do so - for many decades, should indicate to you that our medical industry is completely dysfunctional.

That you choose to be hung up on my use of the phrase "gay bureaucracy" rather than discuss the issue I brought up tells me alot about you as well.

To everyone else:

In addition to the excessive regulation and bureaucracy, I believe that a major problem in medicine is the assumption by MDs that the body is a static structure instead of a dynamic system. Your body, as well as any other biological organism, is dynamic with self-repair and self-regeneration capability. Cells are constantly created and destroyed by your body. Inside the cells are various nano-machines like ribosomes and various enzymes that facilate and regulate various activities in the body. You do not have a single cell in your body that you had 10 years ago. This alone should tell you that the system is dynamic.

I believe that the defeatist attitude towards doing anything about the aging process is a direct outgrowth of the notion that our bodies are static systems, like a house or building. I also think that this assumption is the reason why comparatively little of the "biomedical research" done in this country is directed for the specific purpose of understanding the molecular biology that our bodies are based on.

Randall Parker said at May 25, 2006 5:23 PM:


I think treatments for the surface of our bodies will come much quicker than treatments for problems that are deeper. It is easy to apply gene therapies and cell therapies to the surface. I expect balding will be solved with a gene therapy that turns off some genes and turns on others.

I also expect gray hair to become rare for similar reasons. Gene therapy will rejuvenate tired old cells that make hair color. Cell therapies will replace the cells. This will also make permanent hair color change possible. So I expect a huge drop in demand for hair coloring treatments combined with a big rise in the frequency of blonds.

I expect the regulatory mechanisms that cause balding to be elucidated in 10 years. Advances in bio instrumentation makes that likely. Then I figure at most another 10 years to figure out how to intervene to block the process.

Ontogen said at May 25, 2006 5:50 PM:

Given that the hair on the sides of the head are genetically not vulnerable to the hormones that kill off hair on the top, I wonder if baldness would be an early candidate for gene therapy. But the cloning of follicles from the side of the head and implanting on the top (in effect, a cure for baldness) seems likely to be commercially available within 10 years (some researchers claim 5), with a maximum of 15 years.

Kurt said at May 26, 2006 8:32 AM:


Baldness is likely to be treated by a stem-cell therapy, not a gene therapy, that insiders are calling "hair multiplication". This is supposed to be available by the end of this decade. The Japanese (Aderens) is supposedly working on this. A similar treatment is supposed to be available to eliminate grey hair (this is caused by the decay of the stem cells that create the cells that in turn make sebum, which is hair color).

Anything hormonely will be available in the next 10 years, if not sooner.

True artifical tans will be available (Melanotan II).

Comprehensive stem cell therapies will take 20 years to be developed and made available (there's alot of basic science still needed to be done). These will come mainly from Asia. Same for more extensive gene therapies.

I stand by my previous comments about presbyopia and the medical industry, in general. said at May 28, 2010 9:22 PM:

There is quite a remarkable development that has taken place since Kurt (just above) made his prediction last year. melanotan-1 (afamelanotide / Scenesse) has been approved by the Italian Medicines Agency for usage in those suffering from the painful photosensitivity of erythropoietic protoporphyria. The drug allows these folks to develop photoprotective pigmentation which thereby reduces the excruciatingly painful effects of the sunlight on their skin. This LifeScience news article covers this latest development. There are videos and information explaining this here: melanotan-1 Scenesse. It may be that at some point in the near future this drug will become an option for other members of the general public to develop pigmentation in their skin when they otherwise would be unable to.

Melanotan said at February 27, 2013 10:05 PM:

I agree with the fact that presbyopia still exists today is a perfect example of the gay bureaucracy that medicine has become in the last 50 years and why the conventional medical industry is competely worthless. I will add more later, but suffice to say for now that the tools and instruments necessary to determine exactly what causes presbyopia (that is, the molecular biology behind it) have been available for 50 years. The new instruments (AFM and nano-indentation) could answer this question in 1-2 DAYS of experiments. Melanotan 2. The fact that noone has bothered to do this at all in the past 50 years is indicative of the gay bureaucracy medicine has become.

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