Cataract surgery on Mars?
A research collaboration between the John A. Moran Eye Center’s Intermountain Ocular Research Center (IORC) and surgeon Morgan Micheletti, MD, with Texas-based Berkeley Eye Center, aims to answer key questions that could make it possible one day.
In a first-of-its-kind project, Micheletti partnered with a NASA and Space Center Houston materials testing program to send 135 types of artificial intraocular lenses (IOLs) to the International Space Station (ISS). The lenses spent six months mounted outside the ISS in special capsules, directly exposed to real space conditions like high UV radiation, extreme temperature fluctuations, and elevated atomic oxygen levels.
If humans one day begin growing old in space, they will almost certainly need cataract surgery. A cataract—caused mainly by aging—is a gradual thickening and hardening of the naturally transparent lens in the eye, which makes it increasingly difficult to see. Surgeons remove the cloudy lens and replace it with an IOL to restore clear vision.
“One of my goals is to perform the first surgery in space,” said Micheletti, who has performed over 10,000 cataract and other surgeries as part of his practice with Berkeley Eye Center in Houston, where he also serves as a partner and director of research and fellowship training. “Cataract surgery is the most common operation on Earth. As space exploration advances, we believe it will one day become routine off Earth as well.”
However, there are significant questions to answer first. How will different types of IOLs, made of a variety of surgical biomaterials, hold up in space? What are the safest and most efficient ways to transport and store sterile medical
implants beyond Earth?
Enter Lilliana Werner, MD, PhD, co-director of the IORC, a nonprofit laboratory that researches IOL design, materials, and complications for companies and physicians worldwide.
“I’ve gotten lenses from everywhere in the world to analyze, and I thought I had seen it all,” said Werner. “But I’ve never gotten lenses from space—it’s super cool!”
Micheletti is equally excited to work with Werner on the next step of his Joint Assessment of Intraocular Lens Exposure in Space (JAMES) project, which has received funding support from several leading makers of IOLs.
“She’s not only a world-renowned expert in IOL materials,” said Micheletti, “but also brings decades of experience in understanding how these lenses perform in every imaginable condition, making her the perfect person to tackle this unique project.”
EARLY OBSERVATIONS
Cobblestones, bubble wrap, burn scars. These are a few of the damages to the once-clear and smooth-surfaced lenses from space that Werner noted from analysis in her lab and the Nanofab Electron Microscopy and Surface Analysis Lab at the University of Utah.
“These are damages I’ve never seen before,” said Werner. “This damage does not happen on Earth.”
Not all the lenses showed signs of damage, probably a result of their exact position on the ISS and how they were stored, Werner said.
She and Micheletti will be working to publish the results of the JAMES project as they continue their exploration into this new world of cataract surgery.
“The whole purpose of this is to determine how these materials act in space,” Micheletti said. “In my lifetime, someone will have cataract surgery off of this planet, and we need to figure out how to send lenses there.”
