Get Rid of Glasses

By Chrys Wu, Correspondent
Article Last Updated: 05/23/2006

Sax player George Shelby sometimes wears sunglasses when he plays indoors. Sure, it's part of his cool look, but lately he's had medical reasons as well. He's recovering from cataract surgery.

The 45-year-old musician had already been thinking about getting LASIK to correct nearsightedness and astigmatism when, nine months ago, the retina in his right eye detached. During his six-week recovery from surgery, he developed a cataract.

He went to see West Hills eye surgeon Jonathan Davidorf, and explained his job required good vision — for near, far and intermediate distances. "I need to be able to focus on the music right in front of me, on the artist 15 feet in front of me, and the audience," says Shelby, who plays with the "American Idol" band and with Barry Manilow's "Music and Passion" show at the Las Vegas Hilton.

Davidorf determined Shelby was a good candidate for presbyopia-correcting intraocular lens (IOL) implants. Like traditional single-power implants used in cataract surgery, these IOLs allow people to see distant objects. But they also correct presbyopia, the declining ability to see things up close.

These presbyopia-correcting IOLs are quickly becoming the new standard in cataract surgery, say local eye surgeons, including Kevin Miller at UCLA's Jules Stein Eye Institute. "I think this is as big for cataract surgery as LASIK was for refractive surgery."

According to a 2004 study published in Archives of Ophthalmology, cataracts are by far the most prevalent eye disease (not counting nearsightedness) among adults age 40 and over in the country.

As many as 20 percent of Americans in their 40s will naturally develop some form of cataract, a clouding of the eye's natural lens, according to the National Eye Institute. By the time people hit their 60s, which the first wave of baby boomers is starting to do, the number jumps to 40 percent. And the likelihood of cataracts increases with age. Without surgery, those affected will go blind.

"Right now in the United States, (surgery) is the only option," says Manuel Datiles, M.D, medical officer at the National Eye Institute-NIH in Bethesda, Md., and a leading cataract and cornea researcher.

He is currently conducting tests for nonsurgical alternatives, but it will be years, if ever, before they receive FDA approval.

Cataract surgery involves a small incision and extraction of the lens by ultrasound, followed by implantation of the replacement lens. For people with healthy eyes, it's a low-risk, no-stitch surgery. Often they return to their normal routines within 24 hours.

Manufacturers and eye surgeons warn that not all patients can have presbyopia-correcting IOLs implanted, and that "spectacle independence" is a best-case scenario. Still, in FDA clinical trials and post-trial market research, many patients have said goodbye to bifocals and reading glasses.

That includes Janice Love, a 53-year-old fitness trainer at Gold's Gym in Woodland Hills. Three years ago, she began to get headaches from fluorescent lights and started seeing halos around headlights at night.

"It got to the point where I couldn't read my appointment book, and that was annoying," Love says. She went to see Davidorf, who diagnosed a cataract. Because Love was in excellent health and only used mild prescription reading glasses, he suggested the new IOL. Her insurance covered a portion of the cost, and she paid another $2,600 out of pocket.

"I remember Dr. Davidorf saying, 'You're not going to believe how clear everything is and the colors you see.' And I'm thinking, 'Yeah, right,' " Love says. "And it is! I'm walking around going, 'Wow!' "

Love's results are fairly typical, says Davidorf, who sees about 500 people per year for cataract surgery. He most often recommends Crystalens because he says it offers a very clear optic with good, crisp vision at intermediate distances, though it's not great for avid readers. Nevertheless, "in our practice, these lenses, they've been phenomenal," he says. After surgery, "the vast majority of patients never wear glasses or rarely wear glasses."

Dr. Alan Berg, an ophthalmologist in private practice at Berg Feinfield Vision Correction, with offices in Burbank, San Marino and Sherman Oaks, uses all three Medicare-approved presbyopia-correcting IOLs in cataract surgery.

About 50% of the implants he puts in are Rezoom lenses — Crystalens and Restor are 25% each. "We've had great results with the Rezoom lens. It gives excellent distance vision and good intermediate and near vision. But they all have their strong points and weak points. (Deciding which implant to use) depends on who the patient is."

Miller favors the multifocal Restor lens.

He implanted Restor IOLs in Elaine Brown of Ventura, and he estimates the out-of-pocket cost was about $1,700 per eye, not including physician fees. Not quite Medicare age, Brown has worn glasses since grade school, but after decades she no longer has to. "The hill I always thought was beautiful — there's more trees and vegetation on it," she says. "Everything's clearer. It's easier to read the freeway signs and street signs. I've even been getting back to doing needlework and small stuff."

As for Shelby, he is so happy with the results of the new lens in his right eye that he plans to have the natural lens in his left eye replaced, too. Like the first surgery, it should be covered in part by insurance, leaving about $1,500 spent out of pocket per eye. Once he has the surgery, it's possible that, after 20 years of wearing contacts, he will never have to again.

"It's really hard to describe how much brighter things are and how much clearer the colors are out of this new lens."