Adjustable replacement lens gives retiree 20/20 vision following cataract surgery

Michigan native Randy Goers moved to Florida in 1986 seeking career opportunities and a respite from the chilly Midwest winters. Almost immediately, Randy secured a job as a city planner for the city of Tampa, a position he held for nearly 36 years. He retired as director of city planning at the end of 2021. 

“My role was to look at the city in terms of how it was going to grow and then develop policies, regulations and actions to accommodate that growth,” Randy describes. “My office identified the need for new roads and buildings and determined what the impacts of the growth would be. We determined how to work with residents and businesses in planning for the future.” 

Randy, 66, has always kept active with many hobbies. About three years ago, however, issues with his vision began interfering with his dynamic lifestyle. His eye doctor discovered he was developing cataracts, a clouding of the lens that develops through a buildup of proteins. 

This accumulation prevents light from passing through the lens, obscuring eyesight and possibly causing an array of symptoms, including blurriness, a sensitivity to light, a reduction in the vibrancy of colors and double vision. 

“I experienced typical cataract symptoms,” Randy notes. “There was glare from the sunlight; I had difficulty seeing in the dark; and my vision wasn’t clear. Those symptoms were exacerbated by radial keratotomy surgery, which I had 30 years ago.” 

Radial keratotomy, or RK, was a refractive surgery during which small cuts were made on the cornea, the clear outer layer at the front of the eye, to correct nearsightedness and sharpen vision. However, it was replaced by another refractive procedure, laser in sutu keratomileusis, or LASIK, around 1997. 

“My eye doctor told me that I’d eventually be a candidate for cataract surgery, so he monitored my cataracts for a few years.” Randy relates. “Last year, the cataracts got to the point where my vision was consistently 20/40 or worse, and it was difficult to see in certain situations. So, we scheduled surgery.” 

Challenge Addressed 

Randy’s eye doctor, Craig E. Berger, MD, of Bay Area Eye Institute in Tampa, is a board-certified, fellowship-trained ophthalmic surgeon who also spent 15 years as an adjunct assistant professor of ophthalmology at the University of South Florida Eye Institute. 

Dr. Berger has extensive skill and experience in performing cataract surgery, which is the only treatment for cataracts, a condition that develops as part of the natural aging process. 

“Typically, cataracts become a problem later in life, but they actually begin forming around age 40 and progress at different rates in different people,” Dr. Berger educates. 

More than half of all Americans will develop cataracts by age 80, studies show. Other factors such as diabetes, sun exposure, smoking and family history can cause the condition to develop at a younger age. 

Treatment involves the surgical removal of the lens, which is replaced with a synthetic intraocular lens, or IOL. Cataract surgery is generally performed on an outpatient basis on one eye at a time, with a break of a week or two between procedures. 

Like contact lenses, IOLs are available in various focusing powers. Standard IOLs correct vision primarily for distance, but patients can have one eye corrected for distance and the other for reading, an option called monovision. 

Another option, multifocal IOLs, typically call for the patient to be implanted with an intraocular lens that corrects distance, reading and intermediate vision. 

Before recommending a replacement IOL, Dr. Berger describes for patients all the advantages and disadvantages of every option. The doctor also reviews the patients’ lifestyles to find the best match. 

“I always consider the patients’ activities, hobbies, the type of work they do and their visual requirements,” Dr. Berger asserts. “Then I perform a complete eye exam looking at the tear film, retina and optic nerve. I also look for astigmatism, an imperfection in the cornea that leads to blurry vision. 

“I recommend IOLs based on all of that information, and I encourage patients to take time to gain a clear understanding of the benefits of each of the intraocular lenses before making a choice. No one lens is ideal for everyone. Lenses come in many sizes, with a variety of features and benefits.” 

With patients who’ve had previous RK or LASIK, such as Randy, choosing the proper IOL lens power is a challenge due to eye changes from the previous refractive surgery. Fortunately, a newer technology IOL is available that addresses this issue: the RxSight® Light Adjustable Lens™. Dr. Berger recommended this lens for Randy. 

“The unique feature of the RxSight lens is that its shape and focusing characteristics can be adjusted after implantation using an office-based ultraviolet light source,” Dr. Berger explains. “The resulting changes create a highly predictable alteration in the curvature of the lens. The new shape matches the patient’s eye after the eye has healed from the cataract surgery. 

“The RxSight lens can be adjusted up to three times to fine-tune the patient’s distance, intermediate and reading vision. In most cases, patients who receive the RxSight lens become glasses-free after cataract surgery and the adjustments that follow.” 

“The Glare is Gone” 

Dr. Berger performed Randy’s cataract surgeries in June and July 2022. After healing for several weeks, Randy visited Bay Area Eye Institute once a week for three weeks for a UV light adjustment to his RxSight lenses. 

“First, Dr. Berger performed an exam to determine what my vision was,” Randy reports. “Then, I sat in front of a machine that focused a burst of UV light in my eyes anywhere from 30 seconds to 2 minutes depending on the results of the exam. After the first adjustment, it was pretty routine. And it was painless. 

“When the adjustments were done, my vision was nearly 20/20. I don’t have to use reading glasses unless my eyes are tired, but generally I can see without them. I also gained some distance vision I didn’t have before. The glare is gone, and I don’t have any trouble seeing in the dark or driving at night.” 

Prior to locking in the final prescription, the RxSight lens can be affected by the sun’s UV rays, so patients selecting it are typically asked to wear sunglasses outside during the day for a few weeks after surgery. Randy says the payoff of the RxSight lens far outweighed that minor inconvenience. 

The patient has high praise for the ophthalmologist. 

“Dr. Berger is great. I’ve been with him for 10 years,” Randy raves. “He’s very knowledgeable. His ability to explain my options and how things were going to lay out was very good. His aftercare was also very good. 

“I trusted his surgical skill because I have a lot of scarring from my RK surgery. Because of that, Dr. Berger had to use a modified approach to implant the new lenses, and he’s got a lot of experience doing that. 

“The facilities at Bay Area Eye Institute are very professional. The staff does a great job, and they’re very friendly. I highly recommend them.” ■ 

© FHCN staff article 

Photo by Jordan Pysz