View for cataract patients gets clearer

July 19, 2007
The view for patients undergoing cataract surgery at New Hanover Regional Medical Center is getting a whole lot clearer thanks to a new generation of artificial lens implants. “These lenses go above and beyond simply clearing a person’s vision,” said Byron Stratas, MD, a Wilmington ophthalmologist. “In many instances they can dramatically reduce, or completely eliminate, a person’s dependence on prescription eyeglasses.” In existence for more than five decades, the intraocular lense, or IOL, is used to replace the eye's clouded crystalline lens during cataract surgery.Until a few years ago, all intraocular lenses were monofocal, meaning they provided good vision at one set distance, usually far away. But for objects up close or near-vision activities like reading or knitting, cataract patients still had to wear eyeglasses, which for some meant the burden of extremely thick lenses. “That’s all changed now,” Dr. Stratas said. “New technology has allowed a lot more customization of lenses, so we can very dramatically and safely improve a cataract patient’s vision over a variety of distances, be it near, far or in between … and most patients become eyeglass-free.” Known by brand names such as ReSTOR, ReZoom and Crystalens, these new multifocal lenses made of plastic or acrylic are designed with several different optic zones allowing a person to see close up and at distances without glasses. Specialized IOLs like the Crystalens even work in conjunction with the eyes’ muscles to achieve “accomodation,” or the eye’s natural ability to change focus from distant objects to objects closer. Still another intraocular lens type, the Toric IOL, corrects for astigmatism, a condition where vision is blurred because of an irregularly shaped cornea. “Multifocal lenses have revolutionized cataract lens replacement surgery,” said Alan Brown, MD, a Wilmington eye surgeon. “They make a big, big improvement in a patient’s lifestyle and happiness, allowing them in most cases freedom from glasses.” Insertion of a multifocal lens begins with removal under local anesthesia of the cataract through a very tiny incision on the side of the cornea, the clear, dome-shaped surface covering the front of the eye. Once the clouded lens has been removed, the multifocal lens is inserted through the same incision, where without stitches it remains a permanent part of the eye. In most instances, surgery time for the outpatient procedure lasts between five and 10 minutes. “It’s quite a gift,” said cataract patient Mary Vlahos. “I know a lot of people who had lens replacement surgery for cataracts and still needed glasses after it.” Vlahos, who wore glasses for 54 years, said the difference in her vision before and after receiving multifocal lens implants at NHRMC under Dr. Stratas was dramatic, a difference that today leaves her eyeglass-free. “It’s amazing to me how they corrected my vision so rapidly,” she said. “No pain - nothing. I came out seeing. My vision was 20/400 before surgery. The next day it was 20/30. Within a week, it was 20/15.” “The feedback from patients receiving the new lenses is that their vision is greatly improved,” said Deborah Sholar, RN, NHRMC’s Ambulatroy Surgery Unit coordinator. “They’re just amazed and so excited.” “As people age, they depend more and more on their eyes for enjoyment,” Dr. Brown said. "Cataract surgery with premium lenses is a life-changing investment that makes most patients feel younger and more free. I feel privileged to be a part of this advancement in eye care." With only minor post-operative restictions, patients generally make a fast, painless recovery, Sholar said. “Most patients’ vision is clear the following day, and most patients are resuming normal activities,” she said. “Because of these new lenses, people are seeing life in a whole new way.”For a referral to an ophthalmologist who performs lens replacement surgery, call VitaLine at 815.5188.