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There are sportswear firms offering bespoke trainers and funeral companies that sell personalised coffins, but this latest extension of Savile Row principles may shock even the staunchest devotees of mass customisation.
Laser eye surgeons are now offering tailor-made corneas. Two decades after the first laser eye treatment in Britain, in November 1989, the quest for perfect vision has been replaced, in many cases, by eyesight tailored to an individual’s life and career.
Would sir like night vision? Does he require the eyes of a hawk? Or one eye customised to see into the distance, the other for reading? Such questions are now the stuff of client consultations in leading eye clinics.
Now one of the three most common surgical treatments in Britain, an estimated 100,000 people undergo the procedure each year, about 20 million have had it worldwide, and an increasing number have their corneas tailored to meet specific demands.
Julian Stevens, of Moorfields Eye Hospital, is an expert on laser refractive surgery. He has, in the past, offered tailored treatment for members of the special forces. “They require 1,000-metre vision at night,” he said. “It is the same for fighter pilots.”
Increasingly, though, he offers to reshape corneas to cope with the more mundane work/life demands of office workers and lorry drivers.
The refractive power of a lens is measured in diopters. “Vision changes by about 0.3 diopters at night,” he said. “If you are a sniper that’s critical. It is also important for long-distance lorry drivers, who need excellent night-time distance vision.”
Professor Stephen Trokel, who was the first to demonstrate the application of the excimer laser (then used for carving microchips) to the field of eye surgery in 1983, recently operated on a leading soprano in his New York clinic. She requested that her eyesight be corrected so that she could see the front row of the orchestra and read the music.“I also had a catcher for the New York Yankees whose vision was terrible and who needed to be able to see a ball coming out of the light at night,” he said.
Laser refractive surgery alters the shape of the cornea to correct myopia (short-sightedness) or hyperopia (longsightedness), but technological advances have now made more specific alterations possible. Wavefront technology, originally developed by Nasa to aid the focus of the Hubble Space Telescope on distant stars, measures up to 250 spots in the pupil to provide a precise map of the cornea and iris. This offers the potential to correct problems not addressed by glasses, such as halos around lights at night or glare.
If it seems peculiar that many patients do not simply require 20:20 vision, Professor Trokel’s explanation is that perfect vision is defined by the person’s needs and age. The eye’s ability to focus on close objects declines with age, and older patients given laser eye surgery to correct myopia, for example, may soon find that they require reading glasses and have simply swapped one set of glasses for another.
To compensate, it may become common practice for office workers over 40 seeking eye correction in the future to be made mildly short-sighted.
Another group of middle-aged professionals favours a stranger alteration called “monovision”: one eye designed for distance vision, the other for reading. Professor Marguerite McDonald, who performed the world’s first excimer laser treatment in New Orleans in 1987, said she had received several requests from US presidential candidates: “They never wanted to look helpless on the campaign trail because they couldn’t read their notes. They wanted to send a message that they were young.”
In this brave new world of customised corneas, a radical change of lifestyle or career may soon precipitate a decision to have one’s eyeballs resculpted. Mr Stevens offers an example. “One of my patients led an active life and had high-quality distance vision. When he became paralysed from the neck down, his world became smaller — reading and television. Spectacles on your nose become painful if you can’t shift them.” The solution? Mr Stevens made him slightly short-sighted.
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