Cataracts After LASIK? Here’s Your IOL

Vivity replacement lenses provide clear vision at all distances for refractive patients.

Among the billion or so people who were forced to either cancel or postpone plans to travel internationally because of the COVID-19 pandemic was Steven Kravitz, who missed a trip to Ireland and Scotland.

Steven and Dr. Kostick

“My wife is Irish, and she and I had been toying with the idea of taking a trip to Ireland for many years,” Steven relates. “Then, just as we decided to go ahead with it, the coronavirus came along and dug its claws into our plans.”

Steven and his wife eventually took that trip in May of 2022. In a change from their original plans, they knocked Scotland off the itinerary and spent the entire time soaking up all that Ireland has to offer.

It was worth waiting for because, before leaving, Steven took care of a vision issue that had worsened significantly since he first learned about it four years ago.

“During a regular visit with my optometrist I was diagnosed with cataracts,” Steven explains. “Then, about two years later, my optometrist said to me, Wow, these cataracts are developing rather quickly. You need to see someone about them.

Steven followed that advice, but the pandemic prevented him from doing anything to correct the problem. He then moved to Florida, where his issue with cataracts was pushed to the back burner — until the symptoms began to greatly impair his vision.

Cataracts are a clouding of the lens that form because of a breakdown of lens fibers or a clumping of proteins. They typically result in blurred vision, increased sensitivity to light and/or a reduction in the vibrancy of colors.

“I definitely noticed a marked decrease in visual acuity as well as a number of other issues,” Steven says. “While driving at night, for example, the headlights of the cars coming in the other direction had these big halos around them.

“And reading became increasingly difficult. I had LASIK surgery many years ago, but now I needed reading glasses to read. In fact, reading eventually became so difficult that, at its worst, I sometimes needed a jeweler’s loop to read fine print.”

It was at that point that Steven renewed his quest for a physician to do something about his cataracts. His search led him to Atlantic Eye Center, the practice of Alexandra Kostick, MD, FACS, FRCSC, who is among the most accomplished surgeons in the field.

Remove and Replace

Following a thorough examination, Dr. Kostick told Steven he needed surgery to remove the cataracts and explained that the procedure is typically performed in an outpatient setting on one eye at a time, with a week or two in between.

During those procedures, the clouded lens is removed and replaced with an artificial intraocular lens, or IOL, that is made of either acrylic or silicone and is coated with a special material to protect the eyes from the sun’s ultraviolet rays.

Like contact lenses, IOLs are available in various focusing powers. Standard IOLs typically correct distance vision, while multifocal IOLs can correct distance and near vision in much the same way that bifocal glasses or contact lenses do.

“The difference in how I see now compared to before is remarkable.” – Steven

The most advanced IOL is a trifocal lens called the PanOptix® that corrects distance, intermediate and near vision. The PanOptix is Dr. Kostick’s “IOL of choice” for patients who want a multifocal lens, but not all patients are candidates for it.

“People who have macular degeneration or retina problems or had refractive surgery such as LASIK or PRK are not candidates for the PanOptix,” Dr. Kostick confirms. “For those patients, I now recommend the Alcon AcrySof® IQ Vivity® IOL.

The Vivity lens is designed to provide crisp, clear distance and intermediate vision as well as functional up-close or reading vision in patients who are not candidates for the PanOptix. Dr. Kostick says the PanOptix and Vivity lenses have similar effects on eyesight.

“The biggest difference is the Vivity does not provide the same sharp near or reading vision that the PanOptix does,” Dr. Kostick notes. “But it does offer some up-close vision.

“Patients receiving the Vivity may still want to wear some weak plus-1 cheaters for reading, but they will gain some ability to see up close, whereas before they were getting none with standard lenses or some of the other multifocal lenses.”

“Remarkable” Results

Because Steven had previously undergone LASIK, Dr. Kostick recommended the Vivity for him. Steven agreed and, to ensure the best outcome, Dr. Kostick made use of a special machine called the ORA during surgery.

ORA, or Optiwave Refractive Analysis, is a tool used “to fine tune the power of the replacement lens” any time cataract surgery is performed on a patient who previously had refractive surgery, Dr. Kostick explains. It had the optimum effect on Steven.

“I don’t want to be overly dramatic and say the surgery gave me a new lease on life, but the difference in how I see now compared to before is remarkable,” Steven enthuses. “I’m happier with the outcome than I ever thought I would be.

“For two years I had a real hard time seeing, and reading was very difficult. Now, I can go into a restaurant and not worry about taking reading glasses with me to read the menu because I can see clearly at all three distance levels. It’s amazing.”

Dr. Kostick measures Steven’s vision at 20/20 at each distance. That’s one reason Steven highly recommends Dr. Kostick, especially for patients who have had refractive surgeries. Dr. Kostick greatly appreciates the endorsement.

“As doctors, we pride ourselves on the referrals we get,” Dr. Kostick notes. “I can honestly say that my staff members go out of their way to ensure that every one of our patients is cared for to our utmost capability.

“We strive to make our patients part of our extended family. We want to make them comfortable by creating a very caring environment and make sure they know they are going to be treated with a personal touch whenever they come here.”

© FHCN article by Roy Cummings. Photo courtesy of Atlantic Eye Center. mkb
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