Lifelong good vision? It’s possible with this surgical option to glasses, contacts, LASI

After graduating from Texas A&M University some 40 years ago, Deborah Hrab took a position at NASA. Her father had worked for the space agency, so it was an easy choice for her. Ultimately, she left NASA to work for a defense contractor. She stayed within that field and thrived with several employers for whom she created proposals to attract new business. 

“Currently, I work for a defense contractor in Reston, Virginia,” Deborah discloses. “My job is to take care of all the business development work for some of our upcoming contracts. But I live in Gulfport. I’m fortunate to be able to work from home.” 

Even after four decades, Deborah, 62, finds her work stimulating. 

“My job is very interesting and challenging,” she elaborates. “It’s also given me all kinds of opportunities. I think the beauty of it is I’m constantly learning, so there’s a big mental challenge. I’m definitely not ready to retire yet.”

Living in Florida, Deborah devotes most of her free time to outdoor activities such as kayaking and going to the beach. She also enjoys attending various festivals in St. Petersburg. 

“I also like to do yoga,” Deborah expounds. “And I’m a big foodie. I love going out to eat and am always ready to try something new. I also have another home in Rehoboth Beach, Delaware, and I go back and forth between the houses. I’m very fortunate.” 

Deborah was also fortunate to have good vision for most of her life. She didn’t require glasses until she was almost 50. But she didn’t like how she looked in glasses, so she tried contact lenses. That didn’t go so well, either. 

“When I wore the contacts, they would pop out constantly, and I couldn’t find them half the time,” Deborah laments. “I just didn’t like wearing contacts. When COVID happened, I quit wearing contacts altogether, so I was always wearing my glasses. But being outside a lot, I didn’t like wearing the glasses. I had no choice, though, because my eyes were getting worse. 

“Then I thought about getting LASIK, so I went to The Eye Institute of West Florida to talk about it.” 

LASIK, or laser in-situ keratomileusis, is a refractive surgery that uses a laser to change the shape of the cornea, the clear window on the front of the eye. This surgery is done to correct vision problems caused by refractive errors such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism, which is an irregular curvature of the cornea or lens that causes blurred vision. 

“When I first went to The Eye Institute of West Florida, we started talking about my options for getting rid of my glasses, but the ophthalmologist I met with said I had the beginnings of cataracts,” Deborah recalls. 

Cataracts are a clouding of the lens caused by a buildup of protein deposits. The only treatment is surgery to remove the affected lens. 

Typically, the doctor operates on one eye at a time, with a break of a week or two in between. Each procedure takes only a few minutes and starts with the breakup and removal of the lens. Then, a synthetic replacement known as an intraocular lens, or IOL, is implanted. IOLs come in various focusing powers to correct a variety of vision issues. 

IOLs are typically made of a flexible plastic such as acrylic or silicone and are coated with a special material to help protect the eyes from the sun’s ultraviolet rays. 

“I have a family history of cataracts, so the ophthalmologist said I would probably end up needing cataract surgery within the next five years,” Deborah adds. “As such, the results of LASIK surgery wouldn’t last long, so I opted to have another type of surgery.” 

The Aging Eye 

Following her initial appointment at The Eye Institute of West Florida, Deborah met with the practice’s director of cataract and refractive surgery, Robert J. Weinstock, MD. 

“Ms. Hrab is a 62-year-old healthy woman who began having vision problems in her late 40s and needed glasses to correct her hyperopia,” Dr. Weinstock reports. “Hyperopia and presbyopia are conditions that commonly develop in people who have had good vision most of their life, like Ms. Hrab. 

Presbyopia is the natural, gradual loss of the eyes’ ability to focus on nearby objects. 

“There are people who did not need glasses as kids, but when they are about 40 to 45, they start to have trouble with near vision and need reading glasses from the store. That change in vision is presbyopia. 

“Then, as these people get into their 50s and 60s, the lens starts to become larger and layers develop like layers on an onion. This condition is actually the earliest formation of a cataract. That’s why people in this age group begin to rely more on glasses for clear up-close vision. 

“But some people do not want to wear glasses, so they get fit with contact lenses. If the person is having trouble seeing up close, we may correct them with what is known as monovision.

 “With monovision, we put a contact in one eye only and purposely create nearsightedness so the person can read without glasses. Many people’s brains can tolerate and adjust to having one eye seeing better at a distance while the other eye reads. That is monovision. 

“When Ms. Hrab started wearing contact lenses, one contact was for distance and the other was for near vision, so when she woke up in the morning she could put in the contacts and run around all day without having to wear glasses all the time. 

“But when COVID hit and for a variety of other reasons, she decided she was tired of wearing contacts. She did not want to have to put them in and take them out every day, and she did not like wearing glasses. 

“So, she asked if there was a surgery that would make it so she could wake up every day with good vision and not have to deal with glasses or contacts. There is. It’s called a clear lens replacement.” 

Light-Adjustable Lens 

A clear lens replacement is generally performed on people older than 40 who don’t have symptomatic cataracts but want to get out of glasses or contacts. The procedure involves removal of the clear natural lenses and replacing them with artificial lenses. 

“The procedure is the same we use for cataracts. We are simply performing it on people a little younger.” Dr. Weinstock informs. “Then, the person never develops cataracts, and the new lenses will last the rest of their lifetime. 

“In Ms. Hrab’s case, because she had monovision with her contact lenses and her brain was used to it, I recommended a very special IOL that is the best lens for monovision correction. It’s called the light-adjustable lens.” 

The light-adjustable lens can be adjusted postoperatively to ensure the best possible vision outcomes. About a month after surgery during a relatively routine appointment, the lens power is customized using ultraviolet light. 

“We take the best numbers and visual measurements before and during surgery,” Dr. Weinstock explains. “Then, we put the lens in the eye, we let the eye heal and we review the results at the follow-up visit. 

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

“The adjustment is made in about 30 seconds to a minute, and we can do it up to three times over the course of the first few months after surgery. The adjustments can be done on each eye, so it is a much more customizable approach than we have ever had before.” 

Dr. Weinstock encourages people ages 40 to 70 with poor vision to consider clear lens replacement. 

“People who are wearing glasses all the time do not have to wait until their vision becomes so bad that they require cataract surgery,” he asserts. “With the technology we have, these people can pursue the same surgery as they would get down the road for cataracts. They just do it sooner so they can enjoy more years of good vision without glasses.” 

“Awesome” Vision 

Deborah’s clear lens replacement surgery was scheduled for early January. 

“I went to The Eye Institute of West Florida and had one eye done on a Tuesday. The next day, on Wednesday, I had the other eye done,” she remembers. “There were no problems. It was a very easy surgery. I think for me, the worst part was getting the IV. 

“Nothing about the procedure was uncomfortable. I had no side effects and felt no pain. I followed Dr. Weinstock’s directions to a ‘T.’ I followed the full protocol, and I think that’s why everything worked out so well.” 

Deborah is thrilled with the outcome of her surgeries. 

“My vision is awesome now,” Deborah enthuses. “It’s perfect, better than when I wore glasses. I don’t have to wear readers or anything. I’m glasses-free now. On a scale of one to 10, I would rate my happiness with my outcome a 12. 

“My eyesight is 20/20 in one eye, and the other eye is even better. Right after surgery, I saw clearly. I had no vision problems; nothing was blurry. Since then, I’ve had three adjustments on the lenses and never felt anything during those adjustments. 

“Immediately after each adjustment, my eyes were very sensitive to light for about the first hour, but I was fine after that.” 

Deborah is also impressed by the surgeon who performed the procedures as well as his team. 

“Dr. Weinstock is incredible,” she raves. “He’s very professional. He laid out everything that would happen, and it was exactly as he described. He’s great to work with. He explains things and breaks them down so that I can understand. His staff is awesome as well. 

“I would tell anybody to get this procedure done. I would say, Don’t wait until you’re 65 and have cataracts. If you have problems with your eyes and you want to get rid of your glasses, I strongly recommend Dr. Weinstock and this procedure. 

“I’m going to The Eye Institute of West Florida for all my follow-ups now and my yearly eye appointments, too. I think that much of the staff.” ■

 BY PATTI DIPANFILO
Florida Health Care News
patti.dipanfilo@ifoundmydoctor.com