Electromechanical Reshaping Offers Safer Eye Surgery

Summary

A new, promising technique has the potential to replace laser surgeries in ophthalmologists’ offices in the future, for a fraction of the cost. Called electromechanical reshaping (EMR), the technique offers a gentler approach to correcting the cornea than Laser-Assisted in Situ Keratomileusis (LASIK), today’s gold standard for treating vision issues including nearsightedness, farsightedness, and astigmatism.The eye develops these and other conditions when the cornea’s curvature is off—too steep, too flat, or too uneven. To solve the problem, surgeons generally use laser techniques such as LASIK to “sculpt” the eye surface by cutting away small parts of corneal tissue. The results can be life-changing, but the procedure has its risks, as LASIK permanently reduces corneal strength, raising the risk of new vision problems.Alternative nonsurgical methods such as specially designed contact lenses can temporarily mold the cornea, but these require nightly wear and can cause infection. Now, engineers and eye doctors are trying to find a way to permanently reshape collagen-rich tissues like the cornea without cutting, burning, or removing material.Brian Wong, a surgeon-engineer at the University of California, Irvine, stumbled upon a possible solution about a decade ago. He had long worked with thermal techniques for reshaping cartilage tissues—which include the cornea—but found a puzzling “Goldilocks problem” during his research: The heating needed to change shapes often killed too many tissue cells. Then a “happy accident” opened a different perspective, he says. “My postdoctoral fellow connected a pair of electrodes and a Coke can to a power supply…and out of spite, fried a piece of cartilage,” Wong recalls. The cartilage began to bubble, which the postdoc thought was from heat. “But it wasn’t hot. We touched it and thought, this is getting a shape change. This must be electrolysis,” he says. That surprise pointed to electrochemistry rather than heat as the mechanism. To...