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The Fog is Lifted

The Fog is Lifted

Edward St. John knew it was time for cataract surgery when driving at night became dangerous.

“It was like looking through thick glass,” St. John says of his vision at the time. The halo effect of the oncoming headlights had become so pronounced that he had to stop driving after dark. “I knew I had to have the cataracts removed.”

When that day arrived, St. John thought of going only to once place, the Wilmer Eye Institute, where he’d had LASIK surgery years before. There, after some research, he came to Ashley Behrens, M.D., the KKESH/Wilmer Professor of International Ophthalmology and chief of the Comprehensive Eye Care Division, one of the most experienced cataract surgeons in the country.

“He had an outstanding reputation and came highly recommended by others,” St. John says.

Behrens explained to St. John that cataracts were pretty much unavoidable but entirely correctible with surgery. “If you live long enough, you’re going to get cataracts,” Behrens assured St. John. In fact, more than half of all Americans age 80 or older either have cataracts or have undergone surgery to get rid of them.

The surgery involves replacing the eye’s aging lens with an artificial one. The surgery is delicate, but new technologies make it almost routine. With a laser or, more often, an ultrasonic cutting tool, the surgeon makes a small incision. “Just one-tenth of an inch,” Behrens says. If the patient needs both eyes done, the surgeries are done two weeks apart, for safety’s sake.

The old, murky lens is dissolved and sucked out of its protective sheath. The surgeon then injects a replacement lens, typically made of acrylic. “It’s very, very flexible and about the size of an M&M,” he says.

Cataract surgery removes the cloudiness that most associate with the condition, and patients often report that colors become more vivid. Many patients can put away their eyeglasses for the first time in years.

Behrens says that St. John’s case was particularly challenging. Behrens had to do a number of specialized calculations to estimate the exact power of the new lens. Too strong or too weak, and St. John might need to wear glasses after the surgery, something he was loath to do. Behrens calculated correctly, and St. John now enjoys crystal-clear vision.

“He has perfect vision, both distance and near, with each eye,” Behrens says with delight. In fact, St. John’s vision is so good, both near and far, that it’s “optically impossible,” Behrens says. St. John now finds himself the object of study to figure out exactly how his vision can be so good.

St. John couldn’t be more pleased: “There was no pain. The team was extremely efficient. The process was seamless. And Dr. Behrens gave me my ‘youthful’ sight back. What more could you ask?”

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