Not A Cloud In The Sky

New lens implant provides clear vision without glasses after cataract surgery.

Cornwall is a little town in upstate New York. It is the next town north of West Point, home of the United States Military Academy, on the western shore of the Hudson River. 

It was also the childhood home of Edward Kearney.

Edward now has clear reading, distance and intermediate vision, perfect for working on his computer.

Edward now has clear reading, distance and intermediate vision, perfect for working on his computer.

“My father was a doctor and my family lived in that area since the early 1950s,” Edward shares. “I was raised in Cornwall along with my brother and two sisters.”

After graduating from college in 1966, Edward joined the Navy and served 3½ years as a diver and explosives ordnance disposal officer. His stint included a tour in Vietnam.

“When I left the service, I moved to Denver and became a stockbroker with Merrill Lynch,” Edward recounts. “At that time, there was a lot of money to be made in the oil and gas industry, and I was fortunate enough to form a small oil and gas exploration company, which we took public in 1979.

“But oil eventually went from $35 a barrel to $10 a barrel, and that’s when little oil companies like mine disappeared. I then worked for a company called Integrated Resources, which sold investments in commercial oil and gas companies. That business disappeared as well when the government changed the tax laws.”

From there, Edward went into real estate development, concentrating on convenience stores and other retail spaces around Denver. The effort was profitable for a while, but when the business environment in Colorado took a serious downturn, Edward moved to Florida. 

“I moved to Florida in 1989 and earned a real estate license,” Edward relates. “I’m now 76, and I still have a commercial real estate office where I keep my toe in the water and ocassionally work on deals. It gives me someplace to go when I feel like getting out of the house.”

When he’s not working, semi-retired Edward can often be found playing golf. Last year, during the height of COVID-19, Edward began to struggle to see his ball after he’d hit it. Not long after, he suddenly realized he also had another vision issue.

“If I closed my right eye, everything I looked at with my left eye had a brownish tint,” Edward reveals. “The bigger issue, though, was that I was losing my distance vision. I didn’t have any trouble driving, but playing golf was becoming difficult because it’s annoying when you’re constantly asking people, Where did my ball go? That gets on the nerves of your playing partners.”

Edward didn’t seek treatment for his vision right away because of COVID-19. By the time he did seek help, his eye doctor had retired and referred him to Helayna Brown, MD, a board-certified, fellowship-trained ophthalmologist at The Dry Eye Spa & V.I.P. Laser Eye Center in Palm Beach Gardens.

During an initial examination of Edward, Dr. Brown discovered that the problem in Edward’s left eye was a cataract, a natural clouding of the eye’s normally clear lens. 

It wasn’t the first time Edward had received such a report.

About eight years ago, Edward learned he had a cataract in his right eye. To correct the problem, he underwent cataract surgery, a brief procedure during which the natural lens is broken up, removed and replaced with a synthetic intraocular lens, or IOL.

Dr. Brown specializes in cataract and refractive surgery, and based on Edward’s symptoms, she recommended surgery to restore the fading vision in his left eye.

“Edward was experiencing some of the typical symptoms associated with cataracts, including trouble reading and seeing street signs,” Dr. Brown reports. “Often, people with cataracts also experience halos and glare that make driving at night difficult.”

Diffractive Technology 

During the evaluation, Dr. Brown learned of the previous cataract surgery on Edward’s right eye. She also learned Edward previously sustained a detached retina in his right eye and underwent a corrective procedure.

“Although he now has good vision out of his right eye, it wasn’t his dominant eye since it has undergone multiple surgeries, including cataract surgery and a retinal detachment repair,” the doctor observes. “For his left eye, which was now symptomatic, I recommended cataract surgery. We then discussed the different replacement lens options available.”

Replacement lenses are typically made of a flexible plastic such as acrylic or silicone. They are also coated with a special material to help protect the eyes from the sun’s ultraviolet rays. IOLs come in different focusing powers, which correct a variety of vision issues.

“The standard monofocal lens would give Mr. Kearney clear vision in only one plane, such as distance or reading vision,” Dr. Brown explains. “He would still require glasses to see clearly in the other planes of vision.

“Most multifocal IOLs provide clear vision in two planes. Typically, they provide good distance and near vision, but intermediate, or computer vision, is blurry. Patients require glasses for that.

“Mr. Kearney was interested in having a full range of vision without needing to wear glasses, so I recommended a new IOL by Johnson & Johnson called the TECNIS Synergy™. This lens provides the largest depth of focus of any lens on the market. It delivers clear, continuous distance, intermediate and near vision without glasses.”

The Synergy uses diffractive technology. Rather than splitting light entering the eye into three planes, like most trifocal IOLs, the Synergy bends and extends the light rays, allowing them to properly focus on the retina. The retina turns the light into nerve signals, which are sent to the brain to interpret as visual images. 

“This technology works best when used on both eyes,” Dr. Brown discloses. “But Mr. Kearney already had cataract surgery in his right eye. It is also important that the eyes be healthy outside of the cataracts, which was true in Mr. Kearney’s case, so he was a good candidate for the Synergy lens.”

“My Vision Is Great”

Dr. Brown performed cataract surgery on Edward’s left eye on August 11. According to Dr. Brown, Edward now has 20/20 distance vision and 20/15 near vision in his left eye.

“In addition to being able to read fine print without glasses, he also has functional computer vision,” Dr. Brown asserts. “So, just as we planned, he can now see everything he needs to see without glasses.”

Edward is thrilled with the outcome of the procedure and effectiveness of the Synergy IOL.

“My vision is great, and with the upgraded lens I don’t need glasses,” he raves. “I have no problems seeing distance and no problems reading. Seeing my golf ball is much easier now as well. I don’t like where the ball goes, but that’s a different matter altogether. Overall, it’s a pretty miraculous result from a 10-minute operation.”

Edward is also pleased with his experience at The Dry Eye Spa & V.I.P. Laser Eye Center as well.

“Dr. Brown is very knowledgeable and has a great sense of humor,” he enthuses. “She’s very straightforward and professional, and was very sympathetic and warm about the entire situation. It wasn’t like she was just counting how many patients she could see in one day. Rather, she spent as much time as necessary with me so that I was comfortable.

“The staff at The Dry Eye Spa & V.I.P. Laser Eye Center were very helpful. They were all very conscientious about making my experience easy and pleasant. Typically, I only waited five or 10 minutes when I had an appointment. They run a pretty efficient operation. I absolutely recommend them.”

Dry Eye Determination

The tale of Pamela McGregor’s career begins when she left her native Chicago at age 21 to be a flight attendant. Pamela was initially based in San Juan, Puerto Rico, but was transferred to Miami in 1980. Not long after, the airline went out of business.

Pamela loves to cook. It’s one of her passions in life.

Pamela loves to cook. It’s one of her passions in life.

“At that time, I met my first husband, got married and had babies pretty quickly,” Pamela shares. “When my children were around kindergarten age, I decided to go back to work. That’s when I started my career in real estate. It gave me the opportunity to both work and take care of my kids.”

After earning her real estate license, Pamela established a goal of becoming a broker. She achieved that in 1998. Now 62, Pamela still dabbles in real estate but, like Edward, considers herself semi-retired.

A year ago, while making the transition to semi-retirement, Pamela developed a painful stye, a small bump that forms when the tiny glands lining the eyelids become infected. At that time, the COVID-19 pandemic had forced most physicians to close their offices to all but the most emergent cases, but Pamela’s ophthalmologist agreed to see her. 

The doctor prescribed antibiotics and anti-inflammatory eyedrops to combat the stye. The doctor also noticed Pamela was showing early signs of dry eye disease. He recommended Pamela use over-the-counter artificial tears to keep her eyes moistened. Those medications worked for a while.

“My dry eye symptoms really flared up after the infection cleared,” Pamela discloses. “There was a gritty feeling in my eyes, and there was burning, itching, watering and general irritation. It felt like an eyelash was in my eye when, in fact, nothing was there.

“My eye doctor wasn’t an expert on dry eye disease, so I started searching the internet for someone who was. That’s how I found Dr. Salinger.”

Clifford L. Salinger, MD, is a cornea specialist and the founder of The Dry Eye Spa & V.I.P. Laser Eye Center. Upon first seeing Pamela, Dr. Salinger evaluated her eyes using a digital imaging device called the LipiView™ interferometer.

“The LipiView provides an image of the structure of the Meibomian glands, the tiny oil glands located in the eyelid margins, as well as an assessment of their function,” Dr. Salinger educates. “It measures the output of oil into the eye’s tear layer. The LipiView of Ms. McGregor’s oil glands revealed their structure and function were significantly compromised.”

Gland Expression 

After identifying Pamela’s issues, Dr. Salinger prescribed several treatments. These included hot compresses, lid cleaning, vitamin supplements containing omega 3 and omega-6, tear supplements, steroid eyedrops to reduce inflammation and an antibiotic drop to help improve the flow of the oil glands.

“We also prescribed an eyedrop called CEQUA, which is a new and improved form of RESTASIS®,” Dr. Salinger details. “The chemical ingredient in both is cyclosporine, which decreases inflammation in the eyes and increases tear production.

“After following this treatment regimen for several weeks, Ms. McGregor showed some improvement, but only a little.”

Dr. Salinger then recommended the LipiFlow ®Thermal Pulsation System from TearScience®. Pamela agreed, and the procedure was done June 5.

The LipiFlow system combines the controlled application of therapeutic heat with a gentle, pulsating massage. These functions work to liquefy, then remove clogging debris from the eyelid glands, enabling them to function efficiently. At the Dry Eye Spa & V.I.P. Laser Eye Center, LipiFlow is a three-step process.

“We begin with a thorough deep cleaning of the eyelids and follow that with the LipiFlow treatment itself,” Dr. Salinger describes. “After that, we perform a manual expression of the Meibomian glands to remove any remaining clogging material. This makes room for healthier oil material to populate the glands and flow normally so the tear layer is more stable and uniform, which improves the dryness.

“We maintain the patient on the previous treatment regimen, which helps to amplify and extend the benefits of the LipiFlow. We believe that continuing with the other treatments encourages the oil glands to continue producing healthier oil material that flows more smoothly. Our goal is to find the least amount of treatment that can maintain the benefits patients realize with the LipiFlow.”

“Zero Symptoms”

“The LipiFlow treatment doesn’t take very long, and it doesn’t hurt,” Pamela maintains. “It was actually quite comfortable.” 

Some people notice a difference in their dry eye symptoms right away following their LipiFlow treatment. For others, it takes several weeks or even months to experience a change. Pamela was one of those people.

“It took a few months, but then I really started feeling relief,” Pamela enthuses. “I noticed I wasn’t reaching for eyedrops all the time. That was happening less and less often, which I found amazing. Right now, I have zero dry eye symptoms, and my eyes feel great. I’m very happy with how my treatment turned out.” 

© FHCN article by Patti DiPanfilo. Photos by Jordan Pysz. mkb
Print This Article