Multifocal IOL Options For Cataract Patients

Latest intraocular lenses can make you glasses-free – even if you’ve undergone LASIK or PRK.

In the first 10 months of 2022, the Flagler Humane Society returned 465 pets to their rightful owners and found homes for more than 1,500 other lost or abandoned animals.

Amy Carotenuto can’t help but be proud of those numbers.

Now in her 38th year in animal welfare, Amy is the executive director of the local nonprofit, which provides shelter, care and protection for more than 6,000 animals a year.

“I started out by volunteering one day a week, but I always felt like I could and wanted to do more,” Amy shares. “It’s a challenging job, but it’s a job I absolutely love.”

One of the challenges Amy faced in recent years was brought on by her vision. The need for reading glasses, or “cheaters,” presented some difficulties.

“I had readers on my head, readers in my purse, readers everywhere,” Amy laments. “I had so many pairs of readers that I couldn’t keep track of them all.

“There were also times when I would forget I had readers on my forehead and would start looking around for another pair because I needed them for everything.

“I also didn’t like the fact that if I just wore my readers down low on my nose all the time it made me look older than I really am. I’m only 59, so I’m not that old.”

Reading, or near vision, fades naturally as part of the aging process, but that wasn’t Amy’s only eye issue brought on by aging.

Through her ophthalmologist, Alexandra Kostick, MD, FACS, FRCSC, of Atlantic Eye Center, Amy learned a few years ago she was also developing cataracts.

Gradual Changes

Cataracts are a clouding of the lens that forms because of a breakdown of lens fibers or a 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. That was certainly the case with Amy, who experienced a minor uptick in blurred distance vision but little else.

“But I knew this problem wasn’t going to go away and would only get worse,” Amy recounts. “So, when Dr. Kostick told me last spring that my cataracts had developed to a stage where they could be taken out, I decided to go ahead and get that done.”

Cataracts are removed surgically through an outpatient procedure, typically one eye at a time with a week or two in between.

During this procedure, the clouded natural 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 varieties correct distance and near vision in much the same way as bifocal glasses or contact lenses.

“My vision is so good now, I don’t need readers for anything. I don’t even carry them around anymore.” – Amy

The most advanced IOL is a trifocal lens called the PanOptix®, which 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 anyone who had refractive surgery such as LASIK or PRK are not candidates for the PanOptix lens,” 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 readers.”

Back in Focus

Due to her frustration with reading glasses, Amy chose to be fit with PanOptix lenses. She was soon informed, however, she could not be fit with a PanOptix in her left eye because of an old injury. As a result, she chose the Vivity for that eye.

Despite two types of lenses, Amy says the results have been life-changing.

“I had the right eye — the one where I received the PanOptix lens — done first, and wow, what a difference that made,” Amy enthuses. “I was amazed at how fast my overall vision improved just from having the surgery done on one eye.

“It was so cool because the day after the surgery I could see everything without having to wear readers. The only time I needed the readers was if I was working late at night and my eyes were tired or if there was very little light.

“Other than that, the one surgery made a world of difference. I even noticed that my distance vision was better and colors were brighter. Then, after I had the second surgery, my vision got even better. Everything had more clarity.

“My vision is so good now that I don’t need readers for anything. I don’t even carry them around anymore. And I can’t tell you how convenient that is. It’s just one less thing I have to worry about, so I could not be happier with the outcome.”

Like Family

She is equally pleased with Dr. Kostick, who has cared for Amy’s eyes for nearly a decade.

“I first met Dr. Kostick eight or nine years ago because she donates to the Flagler Humane Society,” Amy recalls. “After that, I started seeing her for my eye care, and immediately I noticed that the walls of her office are just lined with awards.”

One of the most accomplished surgeons in the field, Dr. Kostick was the first ophthalmologist in the area to implant the PanOptix and Vivity lenses in patients, but the knowledge and expertise she offers are just two parts of her practice’s foundation.

“We also 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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