Sight Adjustment

Revolutionary replacement lens brings world into greater focus.

An incredibly positive turn of events has occurred for patients with cataracts. For the first time, there is a cataract lens implant that can be adjusted after surgery to give patients the perfect vision they’ve always wanted. As Mary Arana-Anderson and Lee Stillwell learned, this revolutionary light-adjustable lens, or LAL, can easily give patients freedom from glasses for good.

Mary’s photos courtesy of Mary Arana-Anderson.

A raccoon that she’s nursing back to health is one the many critters running around Mary’s home.

Mary has a little lamb. She also has a goat, two hedgehogs and a raccoon that she’s been nursing back to health ever since it wandered back onto her property in a wounded state a few months back.

With all those animals running around, some might find it difficult to determine the difference between Mary’s Inverness home and the wild. That’s how this former nurse likes it, though.

“We actually provided food for the local zoo, and when we delivered produce there, we almost always wound up bringing home a monkey or something. Ever since then, I’ve loved being around different kinds of animals.”

When she’s not looking after her animals, Mary, 68, works as an accountant at a friend’s firm. During a recent two-year span, however, her ability to do that job and many others was greatly compromised by problems with her vision.

“I wear reading glasses for work and a lot of other things, and during those two years I went from wearing plus-1.00 readers to wearing plus-3.50 readers. I still couldn’t read well even after using a magnifying glass,” she laments.

“After a while, it got to a point where everything was blurry. Eventually, I had trouble watching TV, putting on makeup, everything. I literally stopped putting on makeup and had makeup tattooed on my face because I couldn’t do it anymore.”

Mary’s worsening vision problems eventually prompted a trip to a couple of eye doctors, who diagnosed her with advanced cataracts and suggested she have surgery to remove them.

Cataract surgery is one of the most common medical procedures, with more than 4 million performed in the United States each year. Despite that and the fact she had LASIK surgery 30 years earlier, Mary was hesitant. She was, at least, until she followed up on the advice of a couple of friends and made the trek from Citrus County to Largo to visit Robert J. Weinstock, MD, at The Eye Institute of West Florida.

“I don’t know why, but while talking to the other doctors, the idea of having cataract surgery seemed scary to me,” Mary says. “But Dr. Weinstock made me feel so comfortable and confident about it that I decided to go ahead with it.”

Groundbreaking Option

During his initial visit with Mary, Dr. Weinstock learned that during her LASIK surgery she had one eye corrected for distance and the other for reading, an option known as monovision.

Before the cataracts developed, Mary enjoyed exceptional results from the monovision procedure, so Dr. Weinstock recommended the same correction for her cataract surgery. He also recommended implanting the revolutionary light-adjustable lens.

Mary’s photos courtesy of Mary Arana-Anderson.

Mary Arana-Anderson

“This new LAL is the best lens yet for monovision patients,” Dr. Weinstock exclaims. “It’s also great for people who have had LASIK, PRK (photorefractive keratectomy) or radial keratotomy surgeries because those procedures throw a curveball at us when measuring the eye and picking the right lens.

“That’s why I recommended it for Mary. It’s really state-of-the-art, and it’s implanted just like any other intraocular lens. The difference is that this lens can actually be adjusted for better vision following the surgery.”

Those adjustments are made about a month after the surgery during a relatively routine appointment. During the visit, the lens power can be customized and locked into place by shining an ultraviolet light onto the exterior of the lens.

“This lens has been in development for almost 10 years, and it allows us to do a better job of reaching the goal of modern-day cataract surgery, which is to get the patient completely out of glasses,” Dr. Weinstock educates.

“Typically, when picking a replacement lens for a patient and later implanting that lens, there are some inherent inaccuracies and healing factors that we can’t control. These factors can result in the patient’s post-op vision being close but not quite perfect.

“It’s never far off, but sometimes we need to either give the patient glasses, which we hate to do, or do another procedure afterward that is not super invasive, but still, it’s another procedure, which requires healing.

“With this light-adjustable lens, you take the best numbers and measurements before and during surgery. Then, you put the lens in the eye. You let the eye heal and review the results at the patient’s follow-up appointment.”

“If the patient’s vision is not perfect, you can adjust the lens inside the eye. To do that, all you need to do is dilate the patient’s eyes and have them look at this blue light. The new prescription is then programmed into a laser, which makes the adjustment. When the vision is where the patient wants it, the final lens power is locked in.

“The adjustment is made in about 30 seconds to a minute, and you can do it up to two or three times over the course of the first couple months after surgery. It’s a much more customizable approach than we’ve ever been able to do before.”

Dr. Weinstock says the only drawback to being fit with light-adjustable lenses is that, prior to receiving the final adjustment, the patient must wear special glasses to protect the eyes from ultraviolet light.

“That’s done to keep the lenses in the stage where it is still adjustable,” Dr. Weinstock notes. “So, yes, you’re wearing those glasses for a month or two. But do you want to wear glasses for a month or forever? Most people will say they’ll wear them for a month.”

Perfect Fit

Not every patient is a candidate for the light-adjustable lens, according to Dr. Weinstock, but Mary was. Since being fit with LALs and having them adjusted, Mary’s vision is better than 20/20.

“We’re measuring her at 20/15 for distance vision and 20/15 for near or reading vision,” Dr. Weinstock confirms. “And that is typical of the results we’re getting with many of the patients we’re fitting with these new lenses.

“I’ve got to tell you, of all the replacement lenses that have come along over the years, I’ve never seen a lens that can deliver this level of precision and allow someone to read so far down the chart – better than 20/20 – as this one does.”

Like Dr. Weinstock, Mary can’t help but marvel at the results of her cataract surgery. She says the outcome has so greatly improved her life that she wonders why she waited so long to have the surgery.

“I see perfectly now,” she enthuses. “I can see far away, and I can see up close. It’s like I have the vision I had when I was a child. Even colors are brighter. It’s great.

“The only hard part has been getting used to actually being able to see so well. I know that sounds funny, but after so many years of not being able to see everything so clearly, it’s an adjustment. This experience truly has been life-changing for me.”

New World View

From journalist to press secretary to lobbyist for the American Medical Association, Lee experienced firsthand the world of national politics from just about every angle during his long and distinguished career.

Lee’s photo courtesy of Lee Stillwell.

Lee Stillwell

“I started out as a journalist in the Air Force, and after I got out, I slowly worked my way up to the national staff covering politics for the Scripps Howard News Service,” Lee says. “I then went over to the dark side and got into politics myself as a press secretary.

“I worked both sides of the House, first for Abe Ribicoff, a Democratic senator from Connecticut, and later for Bill Armstrong, a Republican from Colorado. From there, I got recruited by the American Medical Association.

“I was the AMA’s senior vice president for advocacy and had staff in Washington, DC, and Chicago and spent a lot of time traveling back and forth between the two. As my wife put it, I was an influence peddler for doctors and patients.”

Now retired and living on the beach in Clearwater, Lee and his wife spend as much time as they can traveling. Lee says “the entire world” is on their bucket list, and they plan to scratch the Seychelles and South Africa off that list in 2020.

“There’s always something new to see,” says Lee, who will be seeing those new destinations better than he’s seen any before, thanks to the expert work recently performed by Dr. Weinstock.

Lee sought out Dr. Weinstock last summer after he noticed a discernible change in his vision. Thinking the decreased sharpness was the result of cataracts, Lee first visited an optometrist who confirmed his suspicion.

“He said the cataracts needed to come out, and because I wanted to get this done before our next big excursion, I immediately started looking for a specialist to do the surgery,” Lee says. “That’s how I found Dr. Weinstock.

“While reading about Dr. Weinstock, I learned that he does a lot of research and is tied with the FDA. That is important to me. After reading about him, it was just a matter of meeting him and deciding what kind of replacement lens I was going to get.

“I’m a guy who likes to get the latest and the best, and when I mentioned that to Dr. Weinstock, he suggested that I might want to go with this new lens called the LAL that he and his technicians were all talking about.

“So, I went back and read up on LALs, looked at all the data and studies, and realized the FDA had just approved them, and The Eye Institute of West Florida was going to be the first in the Southeast to use them. I liked what I read and decided that’s what I wanted to do.”

Lock in Perfect Sight

The LAL is one of several intraocular lens (IOL) options at The Eye Institute of West Florida. Others include standard IOLs that correct primarily for distance and multifocal vision.

For years, the best multifocal IOLs could be fit to improve a person’s distance vision and either their reading or intermediate vision. A new multifocal lens called the PanOptix® lens now allows for correction of distance, near and intermediate vision.

“The PanOptix is one of several great lens options that can provide a patient with freedom from glasses, so it’s definitely not a one-size-fits-all type of environment these days,” Dr. Weinstock explains.

“That’s why it’s important to find a surgeon who knows how to use all these technologies and help each patient make the right decision based on individual needs and history, which is precisely what we did with Lee.

“He wanted to be sure that his distance vision was 20/20 or 20/15, so we gave him LALs, and what we did was make one eye outrageously sharp in the distance. The other, we set for intermediate use, such as looking at a computer.

“Now, when he’s using both eyes, he has almost a full range of vision. That’s because we set the second eye in such a way that he would be able to read most anything without glasses, so he is pretty much glasses-free.”

“They do great work… So if you need eye surgery of any kind, go to The Eye Institute of West Florida. They’re great.”- Mary

Lee, who had his cataract surgery in early October 2019 and the LAL adjustments about a month later, confirms he no longer needs glasses. He says the freedom the lenses give him is nothing short of a miracle.

“I can sit at the breakfast table in my home and read texts on my iPhone and read my iPad, which is right in front of me, and also look out at the TV in the other room and see it all clearly, without glasses,” Lee exudes.

“I see everything perfectly. I can even read menus in restaurants without glasses. This is perfect for my lifestyle, and I thank Dr. Weinstock for recommending it and for guiding me through it.

“As you might suspect, I’ve been around a lot of doctors, and his background really impressed me. Then I got around him, and I found him to be very personable. He’s a very engaging guy, and he stays on top of things.

“I’ve already recommended him to others because his recommendations have sure worked out for me. I am more than satisfied and happy, and I can’t wait to see all those wild animals up close in Africa.”

“This lens… allows us to do a better job of reaching the goal of modern-day cataract surgery, which is to get the patient completely out of glasses.” – Dr. Weinstock

Mary doesn’t have to travel to Africa to see wild animals. She has plenty of them in her own backyard, and she’s seeing them more clearly than ever thanks to
Dr. Weinstock and the staff at The Eye Institute of West Florida.

“It was like surgical precision in the operating room there,” she raves. “Being a former nurse, I know how an operating room works and how people move around there, and everyone knew what their job was and how to do it, and they did it perfectly.

“Everyone there is so friendly and kind. It was almost like going to Disney World. That’s how friendly and sweet everybody is. Everybody’s smiling there all the time, and that makes you feel good when you go there.

“But that’s just one of the reasons I recommend them. The most important is that they do great work. The fact that I can see better than I have in years is proof of that, so if you need eye surgery of any kind, go to The Eye Institute of West Florida. They’re great.”

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    • The Eye Institute of West Florida

      The Eye Institute of West Florida was founded by Stephen Weinstock, MD, in 1974. For more than forty years, the practice has provided excellence in eye care in a warm, personal environment combined with a tradition of service and devotion to th... Read More

    • Stephen M. Weinstock, MD, FACS

      Stephen M. Weinstock, MD, FACS, is a cataract specialist. He founded The Eye Institute of West Florida in 1974, pioneering sub-specialty eye care in Pinellas County. Today, as President and Medical Director, Dr. Weinstock is recognized as a worl... Read More

    • Robert J. Weinstock, MD

      Robert J. Weinstock, MD, is a board-certified ophthalmologist and is fellowship trained in cataract and refractive surgery. Dr. Weinstock joined the practice in 2001 after completing his residency at the St. Louis University School of Me... Read More

    • Neel R. Desai, MD

      Neel R. Desai, MD, is a fellowship-trained ophthalmologist specializing in LASIK, cataract, and corneal diseases. Dr. Desai is a top graduate of the Pennsylvania State University College of Medicine and completed his fellowship in cornea, ... Read More