Crystal Clear Vision After Cataract Removal

The latest intraocular lens replacement can make you glasses-free.

During the 30-odd years that they were together, the Quarternotes played their brand of adult dance music at weddings, parties and just about every fraternal hall on Florida’s Upper East Coast with an animal skin hanging on a wall.

Mike Wilson

“That was the running joke among the boys in the band,” bassist Mike Wilson says. “We also played car shows and festivals, that sort of thing. If we were asked to come back and play again, we took it as a good sign.”

That three-decade tenure suggests the Quarternotes were often asked to come back and play again. Like most bands, though, the group eventually fractured and broke up five years ago. Since then, the members have gone their separate ways.

For Mike, 73, that meant devoting more time to what he’s been doing since he “retired” several years ago, which is work part time as a medical scribe at Atlantic Eye Center, the practice of Alexandra Kostick, MD, FACS, FRCSC.

Mike is highly qualified for the job.

“I’ve been in ophthalmology since I was 19,” Mike says. “I was an optician for 31½ years and a technician for 14. Just as I was starting to think about retiring, Dr. Kostick asked me if I’d like to help her instead. It’s worked out really well.

“It works well with my schedule because it’s only a couple of days a week, and at the end of the day, I can go home and say I did something good for someone that day. I like that feeling, and I really like working for Dr. Kostick. She’s an amazing doctor.”

Mike found out firsthand just how amazing Dr. Kostick is earlier this year after the doctor informed him that the cataracts she had diagnosed him with a few years ago had matured to the point where they should be removed.

Gradual Changes

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

Those changes tend to happen gradually, sometimes over the course of a few years. As a result, they often go unnoticed. In Mike’s case, the only vision change he noticed was the steady increase of cloudy halos around lights at night.

“I knew the cataracts were maturing, though, because Dr. Kostick had been monitoring them for a while and because of where they ranked on the scale that she has for measuring the severity of cataracts,” Mike relates.

“That scale runs from one to four, with four being the worst. My cataracts were between two and three, but l know from working with Dr. Kostick that the surgery to remove the cataracts gets more difficult when you get past three.

“I probably could have waited to have mine taken out, but I said, Let’s take them out now while it’s not a lot of trouble. And, of course, I asked Dr. Kostick to do the surgery. There was never a question about that.

“I’ve been in this business for years, and I see every day the incredible work that she and her staff do. These people are highly skilled, very intuitive, and they really care about their patients. You walk into their offices and feel the warmth. It’s like family.”

Dr. Kostick, the matriarch of that family, is among the most accomplished surgeons in her field, and despite their working relationship, she was “very honored” that Mike chose her to perform his cataract surgery.

“To me that was a huge compliment because he’s seen firsthand my surgical outcomes,” Dr. Kostick adds. “Based on that, he was able to make an informed decision.”

As it was with Mike, that surgery is typically performed in an outpatient setting on one eye at a time, with a week or two in between. During each procedure, the clouded lens is removed and replaced with a synthetic intraocular lens, or IOL.

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 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 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 only real difference is that the Vivity doesn’t provide the same sharp near or reading vision that the PanOptix does,” Dr. Kostick notes. “It provides some up-close vision, but patients receiving the Vivity may need to use some weak plus-1 cheaters for reading.”

“A Real Boon”

Mike, who has been wearing glasses for more than 40 years, wanted to be as close to glasses-free as possible following his cataract surgery. As a result, he hoped to be fit with the PanOptix. But a couple of other issues precluded that.

One was the presence of dry macular degeneration, an early yet mostly controllable deterioration of the retina. The other is epiretinal membrane (or macular pucker), which is scar tissue on the macula, the light-sensitive tissue at the center of the retina.

In addition, Mike’s eye pressure had been on the rise prior to the surgery, so much so that Dr. Kostick recently prescribed eyedrops to ward off glaucoma, a disease in which a backup of fluid in the eye puts damaging pressure on the optic nerve.

As a result, Mike was fit with Vivity lenses, and he’s thrilled with the outcome.

He now has 20/20 vision in the right eye and 20/30 in the left. That has allowed him to discard all but a weak pair of reading glasses, which he only needs for fine print.

“It’s really nice to wake up in the morning and not have to reach for a pair of glasses to see everything,” Mike enthuses. “And I love the fact that I can sit at a computer and see clearly without glasses. That’s a real boon for me.”

Another boon is that Mike’s eye pressure has gone down. Dr. Kostick made that possible by performing an OMNI® canaloplasty/trabeculotomy, during which she reestablished the eye’s natural outflow drainage system.

“It’s really nice to not need to take those drops anymore, and I have Dr. Kostick to thank for that,” Mike concludes. “She’s an amazing doctor who works harder than anyone I’ve ever known in this business, and I recommend her to anyone.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb
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