From Cataracts To Clarity

The best replacement lens for surgery? Depends on your vision history.

Since her husband passed away 21 years ago, Frances Lotwis has more or less been married to her job. An accountant and building manager for an area law firm, Frances is so attached to her work that, even at age 75, she has no desire to retire.

Frances Lotwis

Since cataract surgery, Frances is less dependent on eyeglasses. That has made doing the job she loves easier.

“I started this job just before my husband died. I really love it and the people I work with,” Frances explains. “They’ve always been very good to me, and the work keeps my brain active.”

Frances has it pretty good where she works. With the exception of tax season, she typically works three days a week. That leaves plenty of time for other activities such as visiting friends and family and being with her grandchildren.

“I especially enjoy going out to dinner with my granddaughter and grandnieces and grandnephews,” Frances notes. “I also watch my boss’s grandchildren whenever that’s needed. I love children as much as I love working. I cherish family time together.”

The middle child in a family of 10, Frances grew up in Long Island, New York, and spent time in New Jersey and North Carolina before moving to Florida. A couple of years ago, she began to experience some problems with her vision.

“The biggest problem was that I had lost some of my peripheral vision,” Frances details. “I first noticed it while I was driving, and I drive a lot. I like to take trips, so that was very concerning for me.

“Driving at night was especially difficult. I was having trouble reading some of the street signs and there was a lot of glare from streetlights and oncoming cars, so I avoided driving to places I didn’t know very well.”

Frances had a pretty good idea what the problem was. A few years earlier, she learned she was developing cataracts, a clouding of the eye’s naturally clear lens that can cause blurred vision, increased sensitivity to light and a reduction in the vibrancy of colors.

She received that news during an annual eye exam conducted at Atlantic Eye Center by Alexandra Kostick, MD, FACS, FRCSC, who is recognized as one of the most accomplished surgeons in the field.

Best in Show

Dr. Kostick told Frances she would eventually need surgery to remove the cataracts. Dr. Kostick explained that cataract surgery is typically performed on one eye at a time in an outpatient setting, with a break of a week or two between each procedure.

During these procedures, the clouded lens is removed and replaced with an artificial intraocular lens, or IOL, that is made of acrylic or silicone and 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 most advanced IOL is a trifocal lens called the PanOptix® that corrects distance, intermediate and near vision. The PanOptix lens is Dr. Kostick’s “IOL of choice” for patients who want a multifocal lens, but not all patients are candidates for the PanOptix.

“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.

Recently approved by the FDA, the Vivity 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 is the first ophthalmologist in her area to implant the PanOptix and Vivity and says the replacement lenses are very similar in terms of how they affect a patient’s vision.

“In terms of how they improve a patient’s vision, the biggest difference between the PanOptix and Vivity is that 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 lens 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.”

Change of Plans

Frances initially planned to be fit with standard IOLs. She altered that plan and opted instead for the Vivity lenses after reading an article about them in Palm Coast Health Care News and hearing
Dr. Kostick’s explanation of their benefits.

“I used to have to wear my glasses all the time,” she says. “I wore glasses so much that the indentations left by the pads on my nose would actually bleed sometimes. When I learned more about the Vivity lenses, I was absolutely thrilled.

“I thought to myself, I’m still working and very active. If I can do everything that I like to and need to do without wearing glasses, that would be fabulous. So I decided to go for it, and I’m so glad I did.”

Frances underwent cataract surgery in the summer of 2021. Since then, her dependence on glasses has all but disappeared, much like those indentations on her nose.

“The only glasses I need now are some cheaters that I wear early in the morning before my eyes have adjusted and when I’m in a dimly-lit restaurant,” Frances says. “Other than that, I don’t need glasses at all, and I’m seeing better than I have in years.

“My peripheral vision is better than it’s ever been. When I’m driving or walking somewhere now, I notice things I couldn’t see before because I had to turn my head to see them. Everything is so much clearer and brighter now. It’s fabulous.”

Frances has been visiting Dr. Kostick for her eye care for several years, and she’s come to appreciate the doctor’s level of knowledge and expertise and the way she treats her patients as if they’re a part of her family.

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

A strong reputation in the community is also something the Atlantic Eye Center staff strives to maintain.

“I think word of mouth is very important for doctors, and we pride ourselves on the referrals we get,” Dr. Kostick adds. “I can honestly say that my staff members go out of their way to ensure that people are cared for to our utmost capability.”

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


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    • Atlantic Eye Center

      Flagler County’s leading female board-certified ophthalmologist, serving the county since 1996, is at Atlantic Eye Center. Benefits the center offers you include: A multi-trained and highly regarded doctor Unparalleled eye care experi... Read More

    • Alexandra Kostick, MD, FACS, FRCSC

      Alexandra Kostick, MD, FACS, FRCSC, is board certified by the American Board of Ophthalmology. After earning her medical degree at the University of Manitoba in Winnipeg, Dr. Kostick served a mixed surgery internship at St. Boniface Hospital at... Read More