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Address cataracts and glaucoma through the same minimally invasive incision

Jordan Pysz / ifoundmydoctor.com
One procedure for each eye alleviated Terry’s glaucoma and greatly improved her vision.

When Terry Coker and her husband decided to leave Savannah, Georgia, for “someplace new” a year ago, they didn’t realize that by retiring in Palm Coast they were actually moving to one of the newer communities in the country. 

Located 25 miles south of St. Augustine (the nation’s oldest continuously occupied city), Palm Coast was nothing but swamp and pine forest until a land developer started a housing community there in 1970. 

“We wanted to be on the water somewhere and saw that Palm Coast had a canal district,” explains Terry, 66. “We were very intrigued by that and wound up finding a house on one of the canals.” 

Since relocating this past fall, Terry and her husband have devoted the bulk of their time to turning their new house into a home. They also visit the beach once or twice a week and occasionally take a road trip out of town. 

“We’re doing all the things that retired people like to do,” Terry offers. “And that includes doing nothing on those days when we wake up and decide to do nothing that day. So, we’re enjoying our retirement very much.” 

Of course, Terry would be enjoying this time even more were it not for the visual struggles of cataracts, which are a clouding of the eye’s lens caused by a buildup of protein deposits. As with Terry, cataracts can cause a variety of symptoms, including blurred vision. 

“The first thing I noticed was that I was having trouble reading street signs because they were too blurry,” Terry confirms. “The worst thing for me, though, were the halos and starbursts I was seeing around headlights and streetlights at night while driving. 

“In some weird way, it was sort of beautiful because it was like seeing starbursts and snowflakes. But seeing a car coming toward me and seeing that instead of seeing distinct headlights was very distracting.” 

Shortly after experiencing those symptoms, Terry underwent a vitrectomy and an epiretinal membrane peel, two procedures designed to correct issues with the macula, which is the portion of the retina responsible for detailed close-up vision. 

“My eye doctor told me that my cataracts may accelerate in growth following those procedures, and he was right,” Terry adds. “Six months later, everything I looked at looked like I was looking at it through a soft filter.” 

“Ripe” for Removal 

Long before the cataracts developed, Terry was diagnosed with low-tension glaucoma, a disease in which an imbalance of the fluid flowing inside and out of the eye causes an increase in eye pressure that can damage the optic nerve. 

If left untreated, glaucoma can lead to severe vision loss, so one of the first things Terry did after moving to Palm Coast was look for a new ophthalmologist to treat her glaucoma. She chose Alexandra Kostick, MD, FACS, FRSCC, of Atlantic Eye Center. 

One of the most accomplished surgeons in the field, Dr. Kostick began her care by reviewing Terry’s medical history and conducting a thorough examination, which confirmed the diagnosis of glaucoma and the presence of cataracts in both eyes. 

“Of the cataracts, Dr. Kostick said, These look pretty ripe, meaning it was time to take them out,” Terry recalls. “So, when I left her office that day, I already had an appointment for surgery to remove the cataracts. Dr. Kostick moved quickly on that, which was great.” 

Surgery is the only treatment for cataracts, which are typically removed one eye at a time during separate outpatient procedures a few weeks apart. During the procedure, the affected 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 that bifocal eye glasses or contact lenses correct vision. 

Another option is monovision, where one eye is fixed for distance vision and the other for reading vision. Terry has long seen images from a distance better out of her left eye and closer images out of her right, so she chose monovision. 

Before removing the cataracts, however, Dr. Kostick offered to perform a second procedure at the same time to alleviate Terry’s glaucoma: Minimally Invasive Glaucoma Surgery, or MIGS. 

“MIGS is a surgical procedure that can be done safely during cataract surgery through the same incision,” Dr. Kostick educates. “There are several kinds of MIGS procedures. In Terry’s case, I performed a goniotomy.” 

During a goniotomy, the surgeon creates a new channel that allows for better flow of fluid out of the eye. The improved flow naturally lowers the eye pressure, which reduces or eliminates the need to treat the glaucoma with eyedrop medication. 

“MIGS procedures are effective options for patients with glaucoma. This procedure is very convenient for the patient since it is done at the time of their cataract surgery,” Dr. Kostick explains. “They also require no additional downtime for recovery.” 

“Amazing” Results 

Terry underwent the dual surgeries on her left eye in October and on her right eye in December. The results, she says, have been phenomenal. 

“First of all, my vision is great,” Terry raves. “I started wearing glasses after my retina surgery, but now I don’t need glasses for anything except fine print. Even then, I just need some weak readers. 

“The vision correction is amazing. The other thing is, I no longer need to take any drops for my glaucoma. So, I could not be happier with the outcome from these procedures. And I could not be happier with Dr. Kostick. 

“She’s fabulous and she really knows her stuff. I totally trust her because she’s very professional, and she and her staff take their time with you and really listen to you. They’re all great. Even the surgery center they use is top notch, so I highly recommend them.” 

Dr. Kostick greatly appreciates the recommendation. A strong reputation in the community is something the Atlantic Eye Center staff strives to maintain. 

“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.”  

Alexandra Kostick, MD, FACS, FRCSC

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