Cataract surgery will be needed in space, surgeon predicts

All six flight LALs shared an unresolved surface morphology. Dr. Morgan Micheletti from the Berkeley Eye Center, Houston, Texas, U.S., predicted that cataract surgery will be needed in space. He sent IOLs made of different materials into space as part of the Joint Assessment Of Material Exposure In Space (JAMES) project. The study found that some lenses showed cracks and localized surface roughening consistent with early atomic oxygen erosion. The analysis included 61 of those lenses and 20 of the 45 controls stored on Earth. The results showed that some lenses exposed to space conditions showed changes, but the mechanism remains unknown. The findings suggest that lens material and exposure location may influence the changes observed. Packaging, shielding and storage were not compared in this experiment and are the next protective strategies we need to test. The engineering challenge will be providing enough protection without adding unnecessary mass because every kilogram sent into space carries a cost.

• "The JAMES project tested 135 IOLs in three different locations on the ISS, exposing them to high atomic oxygen, substantial ultraviolet (UV) and partial shielding."
• "Of the 61 lenses analyzed, 42 showed no notable exposure-associated findings, while 19 showed three principal patterns: eight lenses in the Ram tray showed cracks and localized surface roughening, and one lens was silicone with yellow discoloration."
• "The study did not compare different makes or types of lenses, and the sample sizes were small and uneven, with some positions in the carriers having only one lens of a given model."

The findings should not be used to rank manufacturers or lens models and do not imply a safety concern for routine cataract surgery on Earth. Micheletti hopes to investigate how a phacoemulsification system, the ultrasound and fluidics system used in cataract surgery, performs during the brief periods of microgravity produced by parabolic flights. If that work is successful, the longer-term path could include sustained microgravity testing and, eventually, an in-orbit surgical experiment. The progression has to be deliberate: first the materials, then the equipment, then the procedure and, ultimately, the surgery. His long-term hope is to help make the first eye surgery beyond Earth possible.

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