Single-vision Lenses

OPHTHALMOLOGY

For patients with an astigmatism who want monovision or single-vision lenses, a new Alcon Toric IOL can correct both vision and astigmatism simultaneously without having to make extra incisions on the eye.

Bob Causland’s vision was diminishing.

“Everything looked somewhat blurry to me,” describes the eighty-five year-old. “It was as though someone was holding a cloudy screen in front of my eyes. It was a concern to me because I’m a very busy person; I enjoy reading, and my eyesight was even beginning to affect my driving vision. I was having a little difficulty distinguishing road signs in the distance so I knew I had better have them checked.”

Bob says he had been wearing eyeglasses for over fifty years. 

“I was seeing a local optometrist,” he recounts. “They had been watching my eyes and advised me I was developing cataracts.”

Many of Bob’s friends and family had had eye surgery: “I don’t recall them complaining about their outcomes, but I do remember them noting a lack of personal attention from their health care providers. It seemed everyone was experiencing more of a revolving-door approach.

“Then I heard about Dr. Mallon.”

William J. Mallon, MD, is a board-certified ophthalmologist and fellowship-trained ophthalmic plastic and reconstructive surgeon at the Center for Advanced Eye Care in Vero Beach.

“Two of his former patients told me about him,” says Bob. “They both stressed how concerned he was with his patients, how well they were treated, and what state-of-the-art techniques Dr. Mallon uses.

“They said the care they received was extraordinary.”

Based on these recommendations, Bob scheduled an appointment with Dr. Mallon in the spring of 2007.

“I couldn’t help but notice what a well-trained staff Dr. Mallon has,” says Bob. “They were all kind, considerate, and very gentle, which I particularly appreciated because the equipment looked pretty touchy.

“I had never before seen the technology they used to test my eyes. They actually scanned my eyeball so that the image looked like a topographical map. I was quite impressed with that. Dr. Mallon pointed out that I had astigmatism in both eyes [see sidebar], and confirmed that I indeed did have cataracts that could be operated on successfully.”

Bob was also pleased to learn that with today’s improved technology, cataract surgery has now moved into the refractive realm. The tiny intraocular lens implant that replaces the clouded natural lens is manufactured with a power that is individualized for each patient. Cataract surgery may, in fact, reduce or eliminate the need for eyeglasses after surgery.

“The thought of not only removing my cataracts but also inserting lenses [intraocular lens (IOL) implant] that could give me sharper vision, potentially without any glasses, sounded very encouraging,” reflects Bob. “I want to stress, though, that Dr. Mallon didn’t promise me I wouldn’t need glasses. He said he didn’t know whether he could get me back to 20/20 vision, but he predicted it would be awfully close.”

Options

Dr. Mallon spoke in depth with Bob about the various options that were available to him: “Patients can have both eyes corrected for distance vision, in which case they will require glasses for near vision, or they may choose to have their eyes corrected for close-up vision, in which case they will require glasses for distance. Some patients may also choose monovision, a technique where the dominant eye is focused for distance vision and the nondominant eye is focused for near-to-intermediate vision. Monovison can help patients be as independent from glasses as possible.”

But that is only the beginning.

“Several types of lens implants are available today,” educates Dr. Mallon. “Along with the monofocal lens, there are multifocal lenses such as the ReZoom and ReSTOR lenses, which provide more than one focal distance. Then there is the Crystalens accommodating intraocular lens, which is designed to move inside the eye, so it simulates more of a natural type of vision. However, neither the multifocal nor the Crystalens correct for astigmatism, which has to be addressed in order to attain an acceptable quality of vision. 

“Until recently, patients with a significant astigmatism really did not have much of a choice in treatment other than having refractive laser eye surgery [Lasik or PRK] performed to reshape their corneas, or limbal-relaxing incisions to relax the steep angle in the cornea.

“However, today for patients with an astigmatism who want monovision or single-vision lenses, the new Alcon Toric IOL can correct both vision and astigmatism simultaneously without having to make extra incisions on the eye.”

Because Bob’s main objective was to have clear vision and he did not mind wearing glasses for reading, he chose the Alcon Toric IOL.

 “The fact that Dr. Mallon was so very specific about what each of the different lenses offered gave me a tremendous feeling of security that the surgery would be great,” notes Bob,” rather than the typical trepidation I expected to have about eye surgery.”

Dr. Mallon and his staff focus much of the practice on educating their patients.

Spectacular vision

“I had my weakest eye, my right eye, done first,” says Bob. “Immediately following the surgery, my sight was almost clear, which absolutely astounded me.”

That, however, was not Bob’s only surprise.

“That evening, Dr. Mallon called me himself to see how I was doing,” remembers Bob, who says his eyesight continued to improve over the next three weeks: “I went back to see Dr. Mallon a number of times during the course of the healing. I just really appreciated the fact that he was so concerned about how I was making out in my own life.”

Dr. Mallon removed Bob’s second cataract approximately three weeks after the first surgery.

“The amazing part is that now I can actually read normal-sized print without glasses,” marvels Bob. “Of course, the clarity in my distance vision is spectacular. Colors are brighter, and road signs are absolutely definitive. I ended up with better vision than I’d had since I got out of the Navy after World War II.

“I am enjoying my new eyesight immensely.

“I did take Dr. Mallon’s advice and got reading glasses for those times when the print is unusually small or I’m going to read for a long period of time, but other than that I’m pretty much glasses free.

“It’s terrific.”


What is astigmatism?

A condition where the cornea (or significantly less often, the lens) is irregularly shaped, affecting light as it enters the eye causing blurry vision, is known as astigmatism.

“Rather than having a symmetrical, circular cornea, patients with astigmatism have a slightly oblong cornea shaped more like a football,” describes Dr. Mallon. “It is steeper at one angle than another. Because light rays entering the eye are bent unequally, there is a distortion of the image on the retina resulting in two focal points. Uncorrected astigmatism causes ghosting or double images.

“During cataract surgery there is an additional procedure we can perform that corrects existing astigmatism. The surgery, known as limbal-relaxing incision, is almost comparable to letting out the seams in a dress. Using precisely measured limbal-relaxing incisions, we relax the steep angle in the cornea, providing our patients with reduced or eliminated astigmatism.”

Dr. Mallon offers his patients various treatment options for astigmatism, including limbal-relaxing incisions, Lasik, PRK, Alcon Toric IOLs, and combinations there of.


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FOR MORE INFORMATION
Center For Advanced Eye Care
William J. Mallon, MD
J. Michael Schnell, MD
Adam M. Katz, MD
3500 US Hwy 1
Vero Beach, FL 32960
(772) 299-1404


www.caec.info