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Crystalens: crystal clear vision after cataracts

By Megan Workman

CHARLESTON, W.Va. -- Carol Hannah knew she had cataracts.

But the 73-year-old didn't know the clouding in her eyes would cause her to accidentally drive out of an alley and in front of an oncoming car.

"There was a car coming from my left and I couldn't see it at first. That's when I knew the cataracts were impeding my vision," Hannah said. "I could tell driving that I was not having full vision in my left eye; that's when I decided to get Crystalens."

Hannah's eye doctor, Dr. Lawrence Minardi, has performed Crystalens implants since March 2005.

Crystalens is an artificial lens implant that can treat both a person's cataracts and presbyopia, the loss of near and intermediate vision.

Introduced in 2003, it is the first and only accommodating intraocular lens approved by the Federal Drug Administration, Bausch & Lomb, developers of the Crystalens, wrote in an email.

Nearly 4,000 physicians in the U.S. have implanted several hundreds of thousands of Crystalens, Bausch & Lomb wrote.

Minardi said when he performs cataract surgery he typically replaces the eye's natural lens with a standard IOL. But the Crystalens actually mimics what the natural lens of an eye does, he said.

"The standard conventional lens implant can only focus for far away because it doesn't have the ability to accommodate like the natural lens," Minardi explained. "There's no perfect lens implant. Nothing we have manmade is quite as good as the natural lens the good Lord gave us, but the Crystalens is made in such a way that it's closer to the natural lens than the conventional replacement."

For Hannah, who wore glasses since her 50s, not having to put another pair of bifocals on again was the biggest bonus of her surgery.

"The regular lens implant doesn't give you the full vision -- you still have to wear glasses," Hannah said. "To me, Crystalens were worth it because I can read a newspaper without glasses. I can watch TV without glasses."

Former First Lady Gayle Manchin, 65, put on her first pair of glasses at the age of 12. She started wearing contacts as a young adult to help her see at a distance and even tried bifocals as an adult.

When she and husband Sen. Joe Manchin, D-W.Va., moved to Washington in 2010, Manchin said she started seeing halos of light around cars' headlights and blurry street signs.

"For me, there was a safety issue involved. I didn't feel comfortable driving. I felt my lack of really good eyesight was preventing me from driving as well as I should be," Gayle Manchin said.

After her mother referred her to Minardi, Manchin and Minardi agreed that Crystalens was the best option for her.

"I was probably the only person in the world who prayed for cataracts because if they were there then there was a surgery Dr. Minardi could do and I wanted the Crystalens," Manchin said. "I have been very, very pleased with the surgery and the Crystalens and him as my doctor."

The Crystalens implant goes in the eye a little differently than the standard lens implant. But for an ophthalmologist who has performed more than 27,000 cataract operations -- at least 500 of them Crystalens surgeries -- it's not that big of a deal, he said. His office has been honored as a National Crystalens Center of Excellence for four years.

The artificial implant is not one-size-fits-all, Minardi said.

Minardi does not recommend Crystalens to younger people, those who have astigmatism or an advanced disease in the eye, he said.

For those who do opt for the special lens, preparation for surgery isn't too daunting. The patient uses dilating, antibiotic and anti-inflammatory eye drops the day before the surgery.

After they lie down in the outpatient surgeon center -- next door to Minardi's Donnally Street office -- an anesthesiologist, a couple of nurses and Minardi surround the patient.

"They're given the sedation and that's all the patient knows," Minardi said.

Cameras mounted on Minardi's microscope help him see as he probes a hole smaller than the tip of a ballpoint pen and it dissolves the cataract. He then inserts the new lens by "roll[ing] it up and inject[ing] the lens through the incision in the eye," he said.

The patient comes back the following morning for a check-up and then visits Minardi one week later to have the second eye fixed.

Patients usually see an improvement in their eyes the day after surgery but some people take up to four months to recover completely, Minardi said.

Rollin Webb, 71, of Charleston, said he could see clearer the next day but after one week he could see better than he had in years.

"I wish I would have known sooner because I would have gotten them before now," Webb said. "It's the God's truth, I feel like somebody that's 30 years old, and I can't hardly get any better. It's the best thing a person can do for their vision."

Hannah couldn't agree more. The $2,000-per-eye cost was worth every penny, she said. Medicare typically covers the cost of cataract surgery but not for Crystalens.

"What's more important than your eyes? We go out and buy a car and don't think about it, so why not finance your own eyes? You afford your car don't you? Why don't you finance your eyes?" Hannah said.Reach Megan Workman at megan.workman@wvgazette.com or 304-348-5113.


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