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For Cataract Patients, Seeing is Believing

Posted on: Sunday, 21 August 2005, 18:00 CDT

Aug. 21--Lois Fischman kept ignoring the cataract developing in her left eye.

After all, the one in her right eye wasn't as bad and she could rely on it to see. Then, the Oxnard resident went in for her annual eye exam.

"When they put the chart and stuff out, and covered my right eye and said, 'Read the chart,' I said, 'Did you turn it off?' I didn't see it at all," she said.

For Fischman, it was time to look into cataract surgery. It would require having her eye's inner lens replaced with an artificial one.

In March, the U.S. Food and Drug Administration approved two new multifocal lenses that allows the wearer to see near, far and distances in between. Earlier intraocular lenses only allowed a patient to see clearly at one distance -- meaning they usually had to wear reading glasses after surgery.

Fischman had surgery on her left eye in May and her right eye in July. She was Dr. John Davidson's first patient to receive the new AcrySof ReSTOR lens. Davidson is with Miramar Eye Specialists Medical Group, a Ventura firm that already has performed 40 ReSTOR implants, reportedly the most in Southern California.

Davidson expects even more people will be seeking the new lenses.

"It's basically what we've been waiting for as ophthalmologists and cataract surgery patients," he said. "The main complaint after cataract surgery these days is the blurred vision (up close)." The implants are more expensive for patients because insurance companies and Medicare won't cover them, Davidson said. That means there's a premium of about $2,000 per eye for people who opt for the lenses.

Fischman said she was willing to pay the price to avoid glasses or having one near and one far lens implanted into her eyes.

"I just figured if I could have both my eyes working like normal eyes, it was better," she said.

For Jay Bjorndahl of Ventura, being able to see without glasses was something he hadn't experienced since he got his first pair in the second grade.

When he needed cataract surgery on his left eye, he compared the lenses on the market and chose the AcrySof ReSTOR lenses. A former university assistant professor, he used his research background to make his decision.

He liked that the lens was made by Alcon Inc., which has been making intraocular lenses for years. The company was started by two pharmacists in Texas in 1945, and it is a former subsidiary of Nestle SA.

The company reported global sales of $1.17 billion for the second quarter, a 12.8 percent increase from a year earlier.

Surgery and recovery time are much faster these days than when cataract surgery was introduced.

Fischman remembers her grandfather staying in the hospital for 14 days with sandbags on either side of his head so he wouldn't move while he healed.

On the day of her first surgery, Fischman went in at 6 a.m., was at breakfast by 7:30 a.m., home by 8:30 a.m. and out seeing the movie "Monster In Law" at 2 p.m.

Bjorndahl had noticed about a year ago that he was having problems seeing at night. When he would pull up to a stoplight, it would look as if it were foggy around the light, but it wasn't foggy outside.

He got the implant in June. The time in the prep room took longer than the surgery.

Since then, "I'm having fun," he said.

"It's hard to remember a time you could actually wake up and see things clearly," he said. He mentions that he didn't have to slip his glasses back on after his most recent haircut to see how it had turned out.

Bjorndahl still wears glasses to correct the vision in his right eye and a slight correction in the left eye with the new implant. But he sometimes doesn't wear his glasses at home.

He no longer has to pull glasses on and off to read the computer or to help a customer in the Santa Barbara hardware store he co-owns. These are things people with perfect vision take for granted, he said.

"The opportunity to have both corrected -- near and far, without glasses -- it was worth the price to do that," he said.

There are potential downsides to the new lenses.

Both Bjorndahl and Fischman mention seeing halos around lights at night. Davidson said there is a higher risk of seeing the halos with the new lenses compared with the old lenses, though there is still a risk of a glare or halo with the old monofocal lenses.

"We recommend that people who do a lot of nighttime driving seriously consider if they are willing to tolerate the risk of glare and halo around lights," he said. "Most people have decided the trade-off was worthwhile to have clear near vision all day long." Bjorndahl said the rings, often seen around car headlights, don't bother him, but they might bother others.

Fischman returned to Davidson's office recently to have an implant polished to see if that would help with the halos.

Davidson said the implants last a lifetime, whether the person receiving them is 2 or 82.

The implants have been used solely for patients with cataracts, but Davidson said they will be offered in the near future as an alternative for patients who are not good candidates for laser vision correction. An implant that corrects near and distance vision can make a real difference to patients who need both, he said.

In FDA clinical trials, about 20 percent of patients needed to wear glasses, the remaining 80 percent didn't.

Fischman, a bookkeeper and office manager for Rubicon Theater, said she likes that she doesn't have to dig out glasses to read the labels in the grocery store. If she had had the surgery any earlier with the monofocal lenses, that wouldn't be the case.

"It was the right time to do it when I did it," she said.

ON THE NET

http://www.allaboutvision.com

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ACL, NSRGY, NESN,

Source: Ventura County Star

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