Choosing the right IOL when considering cataract surgery
April 6, 2023
What’s the difference between Diffractive and non-diffractive EDOF IOLs?
Some people adore vitamins and consume them in large quantities, while others totally reject them. However, the reality is, as usual, in the middle.
Рere we consider cases where they were useful and when it is better to rely on more evidence-based methods.
Some people worship vitamins and take them by the handful, while others reject them categorically, seeing them as a shady, billions-of-dollars scam. But the truth, as usual, isn’t at either extreme or even in the middle, but scattered all over the spectrum. After a lot of material came out on the demythologization of vitamins, on one hand, and their revitalization on the other, it’s easy to get confused. And reading all of those articles is impossible, so it’s always better to ask a specialist. Per our tradition, I interviewed Arthur Benjamin on the subject, and also recently read something myself about using vitamins for dry eyes.
The drops you prescribed me for dry eye worked really well, so I’ve forgotten what I read about.
You read about Omega-3s. The results of a serious study on the effectiveness of Omega 3s has been widely talked about in the media. Many believe that they reduce the risk of heart attack, help with cardiac conditions, are effective against hair loss, improve the skin, and also work in the treatment of dry eyes. They say to take these supplements, drink fish oil or flaxseed oil, and life gets better. In this particular study, though, no differences were found between subjects that took the supplements and those who took a placebo – not in the dryness of their eyes or anything else. From this, you could draw the conclusion that vitamins are useless in general. And while it’s clear that they make sense in some parts of Africa with high rates of avitaminosis, it seems that we’re getting enough vitamins in developed countries where people eat a more or less balanced diet.
I feel like there’s a catch.
Yes! BUT there’s also 30 years of data that cannot be denied about AREDS 2 vitamins used for macular degeneration. A powerful study was conducted by the National Eye Institute, paid for by both the taxpayers and Bausch + Lomb. Based on the physiology and pathophysiology of the disease, they developed a theoretical formula using retinoids (a group of fat-soluble vitamins), flavonoids (derived from dark, leafy greens), vitamins A and E, and zinc that was supposed to protect the retina from degeneration. The formula was then released into the market and used on patients with AMD. As a result, the progression of wet macular degeneration in those who took the formula slowed down significantly, as opposed to those who did not take the vitamins. In short, their sight was better.
Remind us of what’s involved with AMD.
Age-related macular degeneration or macular degeneration (AMD) is the most common cause of loss of vision among the elderly. It starts as the gradual destruction of the central field of vision, making it difficult for someone to read, drive, or recognize faces.
And this complex vitamin can help with that?
Yes, but there’s still a catch. Smokers are four times more likely than non-smokers to have AMD, but taking this formula is contraindicated in this case, because the beta-carotene increases a smoker’s chance for lung cancer. Therefore, for smokers, another formula is recommended that replaces the beta-carotene with lutein.
I have friends that are smokers and I care about them, so I gotta have more details. So smokers shouldn’t eat carrots, for example? Or how exactly is beta-carotene bad for smokers?
Despite the fact that the word “carotene” comes from the Latin word for carrots, “carota”, they are not a threat. The study took place in Finland, which has an excellent health care system, and all subjects were supervised and registered. They wanted to somehow lower the risk of lung cancer among smokers, so they studied the physiology of the disease and had the idea that they could neutralize the free radicals in smokers by using beta-carotene. It became clear, though, that that vitamin has the opposite effect in some circumstances. Thus, the risk for cancer increased, rather than decreased.
Maybe this is particular only to Finns, or perhaps the sample is too small? Is it the same in other countries?
This study can be trusted, because it was constructed in the scientific canon. However, hear this – everyone who has macular degeneration, and those who’ve read about the uselessness of vitamins for dry eyes, shouldn’t discount their benefits for the retina. And in addition to the study I’ve already mentioned, other research was carried out on this subject 25 years ago where the formula was slightly different, and it worked. So it isn’t a question of faith, but of knowledge.
What do you mean “it worked”? It improved their condition?
Macular degeneration can’t be cured, so we’re talking about preventing future deterioration. But unfortunately these wonderful vitamins are often the size of horse pills, so older people run the risk of choking, especially when they have to take multiple pills a day. What’s interesting, though, is now a company has put them in powder form. Simply dissolve it in water and drink, and the taste is almost like orange juice, so the whole process is rather pleasant.
I can’t stand huge pills. You can’t just shatter them with a hammer? It turns into powder.
(to be continued)
What’s the difference between Diffractive and non-diffractive EDOF IOLs?
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Medicine.
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Researchers observed a sizable population for 15 years, which demonstrated that the probability of developing macular degeneration was 60% lower in orange lovers than in orange haters. Flavonoids, according to the study's author, are most likely what cause this impact. Numerous authors adore the word "flavonoids" because it is so lovely. However, what are they?
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Genentech has created a new delivery method for medications needed to prevent age related macular degeneration (AMD) called Port Delivery System. It resembles a small grain of rice that goes directly into your eye and time-releases medication. Genius!
