Rudy Hanzsek says he had worn corrective lenses since he
was nine years old.
“I had forty-plus years of it, beginning back when lenses
were made of actual glass and were easily broken by active children,” reflects
the supply chain manager, “so I experienced all the heartbreak that went with
glasses.
“Next, I went through the old, hard, plastic contact
lenses, followed by soft lenses that, because of my astigmatism, were weighted
such that, if I lay down to watch television, they went out of focus. I had to
sit at attention.
“Then, as I aged, my eyes became drier and I began having
trouble tolerating contact lenses of any kind.”
Rudy admits that, by that point, he had had enough: “I
decided to find out if I was a candidate for LASIK.”
His optometrist referred him to Robert J. Weinstock, MD,
known as “Dr. Rob” by his patients. Dr. Weinstock is board certified by the
American Board of Ophthalmology and fellowship trained in cataract and
refractive surgery. He was the first eye surgeon to successfully remove a
cataract through a 1.2 millimeter incision (1/16th of an inch) and has been
invited to lecture and teach other surgeons from around the world on this
safer, less invasive technique for removing cataracts.
“LASIK is a procedure used to reshape the inner corneal
tissue of the eye,” explains Dr. Weinstock. “Patients who can benefit from
LASIK have a cornea
(the front surface of the eye) that is shaped either too steeply or too flat.
When the cornea is not shaped to match the length of the eye, light rays do not
focus properly and it causes either nearsightedness or farsightedness.
“During
LASIK surgery, I use a laser to remove tiny bits of tissue from the cornea. For
those like Rudy who are nearsighted, I flatten the cornea; for farsighted
patients, a steeper cornea is created.”
Rudy
remembers his first appointment with Dr. Weinstock.
“The
first thing I noticed was that the doctor was a lot younger than I was,” notes
Rudy, who was 55 years old at the time, with a laugh. “But I didn’t think that
was a downside. In the field of eye surgery, where technology is often moving
at the speed of light, I saw his age as a positive because he wasn’t encumbered
by the old rules and techniques. He knew what could be done and was looking
into the future; that was really important to me. Even as such a young man, he
had a great record and he was moving forward all the time.”
After
a thorough consultation and careful examination to determine the type of
correction Rudy required, Dr. Weinstock performed LASIK surgery on both of
Rudy’s eyes.
“It
went wonderfully,” observes Rudy. “I could see perfectly even coming out of the
operating room. There was minimal discomfort and it gave me 20/20 vision.”
Refractive cataract surgery
“Many patients come in to see me because their vision is
getting worse for distance or near and they think they need LASIK,” observes
Dr. Weinstock. Often, however, the real issue is an early cataract that is
causing their vision loss.
“In our youth, our natural lenses are soft and flexible,
but for most people as they enter their early forties, their lenses become less
pliable. People often turn to reading glasses in order to see close-up. This is
typically the earliest sign of a cataract.”
A cataract is an opacity, or clouding, of the natural lens
in the eye, which lies behind the iris and the pupil. In a healthy eye, light
passes unobstructed through the clear lens, allowing images to be sharply
focused on the retina. However, as people age and the lens becomes clouded,
light is blocked and a blurred image forms on the retina, which passes this
poor image along the optic nerve. As a cataract develops, it offers less clear
lens area for the passage of light.
“A cataract grows like an onion does, adding layer upon
layer,” educates Dr. Weinstock. “Eventually, the cataract becomes very hard and
dense, which is when the vision becomes cloudy, resulting in an indistinct
image and making it more difficult to see. It is what we refer to as lens dysfunction.”
Rudy observes that, even with the excellent vision that
comes with LASIK, his eyes continued to age: “After several years, I began
noticing that my vision was deteriorating…particularly my night vision, and more in
my left than my right eye.
“Because it’s hard to mess with success, I consulted Dr.
Rob about it.”
“Traditionally, for patients like Rudy with both
astigmatism and cataracts, few ophthalmologists have corrected astigmatism at
the time of cataract surgery, but that is beginning to change,” observes Dr. Weinstock.
“When a patient has an astigmatism as well as a cataract,
replacing the cataract with either a standard lens implant or a Crystalens®
Lifestyle intraocular lens (IOL) will not correct the astigmatism. The patient
will still require glasses.
“However, during cataract surgery there is an additional
procedure we can perform that corrects the astigmatism. The surgery, known as a
limbal relaxing incision, or LRI, is comparable to letting out the seams in a
dress. Using precisely measured limbal relaxing incisions, we relax the steep
angle in the cornea, which reduces or eliminates the astigmatism. For many of
these patients, more advanced implants can then be used to reduce the need for
reading glasses.”
Another option for patients who qualify is a lens
replacement implant known as a toric IOL, adds Dr. Weinstock: “It can correct
both vision and astigmatism simultaneously without having to make extra
incisions on the eye.
“Because everyone’s eyes are different, the best results
for some patients may be a combination of the two: a toric lens with additional
LRIs.”
Two and a half years ago, Rudy chose to have the premium
IOL Crystalens with the LRI for his left eye. In May 2010, Dr. Weinstock
performed the same treatment on Rudy’s right eye.
“The challenge with any form of astigmatic correction is
to be accurate and predictable in order to provide the desired results for our
patients,” emphasizes Dr. Weinstock. “The new ORange™ Intraoperative Wavefront
Aberrometer by WaveTec Vision Systems can help, and presently there are only
four facilities in Florida offering this technology.”
The device is designed to provide a real-time analysis of
the changes during surgery. With this new technology, the eye can be measured before
and after the LRI so Dr. Weinstock can determine more precisely whether the
astigmatism has been corrected or whether the incisions need to be a little bit
deeper or longer, or if an additional incision is required right then and there
to ensure the patient gets the best possible result. Dr. Weinstock was the first refractive specialist in
Pinellas County to use this technology, and Dr. Rob Weinstock, Dr. Stephen
Weinstock, and Dr. Neel Desai all use WaveTec at The Eye Institute of West
Florida.
Excellent results
“Once again, my results were absolutely wonderful,”
assures Rudy. “Dr. Rob performed the surgery over lunch. I went home at two. By
the next day, when my pupil had reverted back to its normal state, my vision
was perfect.
“I’m sixty-five years old and I can read the newspaper
classified ads without glasses*, yet I can see a road sign two blocks down the
street, also without glasses. I spend long hours at work, a lot of computer
time, and I’m just happy.
“I like the organization at The Eye Institute of West
Florida; it is very efficient and the people are all very nice.
“I’m confident in Dr. Rob, and he is confident in himself,
which I like very much.” FHCN – Kris Kline
*Not all Crystalens patients are free
of the need for glasses.