‘Super HD’ Eyesight After Cataract Surgery

Retiree enjoys sharp distance vision without glasses following laser procedure.

Paul riding a bike

Paul LaRosa

After working for 42 years as an assistant supervisor for the water department of Sea Isle City, New Jersey, Paul LaRosa finally retired in 2014. That same year, he bought a home in sun-drenched Clearwater, where he takes full advantage of the balmy Florida climate.

An active outdoorsy type, Paul enjoys bike riding, going to the beach and playing horseshoes. In recent years, however, Paul’s ability to engage in those activities became increasingly difficult as an issue with his eyesight progressed.

“My vision became increasingly blurry. I was seeing halos and glare around lights at night, and during the day, it was like the sun was too bright,” says Paul, 68. “I avoided driving at night because of the halos and glare, but I couldn’t see the TV very well, either. I couldn’t read anything on the TV screen.

“I visited my regular eye doctor and asked him to check my eyes for cataracts. He confirmed that I had cataracts and referred me to The Eye Institute of West Florida.”

When Paul arrived at The Eye Institute of West Florida, which has offices in Largo, Clearwater, St. Petersburg and Tampa, he met with Robert J. Weinstock, MD, director of cataract and refractive surgery.

“Mr. LaRosa came to me for a cataract evaluation complaining of blurry vision and other vision difficulties,” Dr. Weinstock recalls. “On examination, I discovered that he had significant cataracts in both eyes. We talked about cataract surgery and discussed all the options for improving his vision.”

A cataract is a clouding of the lens caused by a buildup of protein deposits. Cataract surgery is typically performed on one eye at a time, with a break of a week or two in between. Each procedure takes just minutes and starts with the breakup and removal of the clouded lens. Then, a clear replacement lens is implanted, permanently correcting the vision.

Known as intraocular lenses, or IOLs, replacement lenses are typically made of 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.

“Once we determined that Mr. LaRosa was a good candidate for cataract surgery, the discussion then turned to, How are we going to correct his eyes when we’re done?

Dr. Weinstock observes. “Cataract surgery has evolved and become more than a procedure to remove cataracts and then give patients new glasses. With the advanced technologies we use, it has become a procedure in which we customize patients’ vision and give them freedom from glasses following surgery.”

Custom Package

Among those advanced technologies are lasers to correct astigmatism, an imperfection in the curvature of the eye that causes blurry vision. A specialty IOL called a toric lens can correct the problem in people with higher degrees of astigmatism. There are many other types of IOLs that perform different functions.

“The original IOLs corrected a patient’s vision primarily for one zone such as distance, meaning the patient still needed to wear glasses for reading,” Dr. Weinstock describes. “Some patients can get around this by having one eye fixed for distance vision while the other is corrected for reading, a process called monovision.

“Overall, my vision is very much improved. Everything is bright and clear.” – Paul

“But today, there are IOLs that in addition to providing distance vision, have parts built in that correct for near vision as well. Some of these bifocal lenses are geared toward intermediate, or computer vision, and some are geared toward near, or reading vision. The choice depends on the patient’s goals.

“And if the patient wants to be free of glasses, we can implant a higher performance lens, a trifocal lens that has distance, intermediate and near vision built into the lens.”

Adaptive Intelligence

Another tool is the ALLY  Adaptive Cataract Treatment System by LENSAR®. Approved for use by the FDA in mid-June, this system is the latest femtosecond laser technology that combines world-class imaging with an advanced dual-pulse laser.

“The ALLY is the second-generation laser for cataract surgery. It is a faster and more precise laser,” Dr. Weinstock asserts. “It will help surgeons perform the procedure in even less time and with greater safety.”

The ALLY is the first cataract surgery platform to provide Adaptive Intelligence. This process automatically determines cataract density and optimizes fragmentation patterns and energy settings. The goal is to minimize overall energy delivered to complete the cataract procedure more efficiently and help contribute to a quicker visual recovery, resulting in better patient outcomes.

According to Dr. Weinstock, The Eye Institute of West Florida will be among the first practices in the US to use this technology.

“Like Super HD”

Paul LaRosa sitting at his kitchen table

Now, Paul is essentially glasses-free. He just needs “cheaters” for close-up vision.

The ALLY system wasn’t available when Dr. Weinstock performed Paul’s cataract surgeries in the spring, but Paul still had an exceptional outcome.

“Mr. LaRosa had very healthy eyes, so he had pretty much an open book for how we corrected his vision,” Dr. Weinstock explains. “He decided he would be happy with sharp distance vision and was OK with wearing readers and computer glasses, so we scheduled him for our custom vision package.”

As part of the package, Dr. Weinstock performed a thorough astigmatism evaluation. During surgery, the doctor used a laser to correct Paul’s astigmatism. Once he removed the cataracts, Dr. Weinstock took a measurement with a device called an intraoperative aberrometer to determine the strength of Paul’s replacement lenses.

“In the end, Mr. LaRosa achieved excellent distance vision and did not need glasses for driving and watching TV,” Dr. Weinstock reports. “He just needs a pair of over-the-counter readers from the drug store for clear up-close vision.”

Paul is extremely pleased with the outcome.

“Overall, my vision is very much improved,” he enthuses. “Everything is bright and clear. I feel confident driving at night again, and I can read road signs as I drive. The glare and halos are pretty much gone.

“The TV looks crystal clear to me now, and I can see it without glasses. Before, if a little sunlight came through the window, it blurred out the entire TV. Now, everything is like it’s in super HD, which is good because I watch a lot of sports.”

Paul had worn glasses for 20 years. In recent years, he turned to wearing bifocals, but since his cataract surgeries, he essentially has become glasses-free.

“I still need glasses to read,” Paul reveals. “I can usually make out what I’m reading, but I need a little help with the very small stuff. So far, I’ve been getting away with store-bought cheater glasses.”
Paul is as pleased with the work of Dr. Weinstock as he is the outcome of his surgeries.

“Dr. Weinstock is a good doctor. He has a good manner with patients before, during and following the procedure,” Paul raves. “He’s very knowledgeable and competent. I definitely recommend him and The Eye Institute of West Florida.”

© FHCN article by Patti DiPanfilo. Photos courtesy of Paul LaRosa. mkb
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    • The Eye Institute of West Florida

      The Eye Institute of West Florida was founded by Stephen Weinstock, MD, in 1974. For more than forty years, the practice has provided excellence in eye care in a warm, personal environment combined with a tradition of service and devotion to th... Read More

    • Stephen M. Weinstock, MD, FACS

      Stephen M. Weinstock, MD, FACS, is a board-certified, fellowship-trained ophthalmologist specializing in refractive cataract surgery. He founded The Eye Institute of West Florida in 1974, pioneering subspecialty eye care in Pinellas County. As ... Read More

    • Robert J. Weinstock, MD

      Robert J. Weinstock, MD, is a board-certified, fellowship-trained ophthalmologist specializing in cataract, LASIK and refractive surgery. Dr. Weinstock joined the practice in 2001. He is the director of cataract and refractive surgery at The E... Read More

    • Neel R. Desai, MD

      Neel R. Desai, MD, is a board-certified, fellowship-trained ophthalmologist specializing in corneal disease, LASIK and refractive surgery. Dr. Desai completed his fellowship in corneal, cataract and refractive surgery at the Wilmer Eye I... Read More