Vision of the future / Lancaster eye doctor offers state-of-the-art cataract treatment

Dr. Thomas Krulewski is the only doctor to offer high-tech ocular implants. (Blaine Shahan)

Cataracts blurred Dorothy Mentzer's vision so badly, she stopped driving at night.

The harsh glare of headlights made her feel unsafe.

Mentzer, 75, turned to Dr. Thomas Krulewski, of Eye Physicians of Lancaster, for an innovative cataract treatment.

Krulewski is one of several area doctors to offer high-tech new ocular implants that correct cataracts and virtually eliminate the need for glasses.

"I have so much fun telling people I don't need glasses anymore," says Mentzer, of Lancaster.

Cataracts - the most common cause of age-related vision loss - cloud the eye's natural lens, making tasks like reading or nighttime driving difficult without glasses.

To treat cataracts, doctors remove the natural lens and implant an artificial one that allows light to again pass through the eye unobstructed.

Traditional implants correct vision in only one plane, usually distance. Patients must wear glasses to see near and middle distances.

The new implants allow most patients to see well at all distances, usually without glasses.

"(Older implants) offered good distance vision but no close-up, and the middle was a struggle," Krulewski says.

"With these, the struggle goes away."

Krulewski has offered the three new implants for about nine months. ReZoom is made by Advanced Medical Optics, the AcrySoft ReSTOR is made by Alcon and crystalens is made by eyeonics.

Other local doctors who offer ReSTOR include Dr. Justin Cappiello, Lancaster; Dr. Raymond De Maio, Elizabethtown; Drs. Barton Halpern and Ted Jones, Eye Doctors of Lancaster; and Drs. Catherine Rommel and Francis Manning, Manning & Rommel Associates, Lancaster.

Krulewski most often inserts the tiny, plastic artificial lenses into the eye after cataract removal. The entire outpatient procedure takes about 10 minutes.

Medicare or private insurance partially covers the surgery. The implants last for life.

Krulewski estimates that 90 percent of his post-surgery patients don't need glasses for nighttime driving or reading menus or price tags.

"To not need glasses when you're over 40 - that's exceptional," he says.


According to the Eye Surgery Education Council, cataracts affect 60 percent of people over age 60 and 70 percent of those over 75.

"If you live long enough, you'll get cataracts. So our goal is to get (them)," Krulewski says, smiling.

Doctors have treated cataracts with conventional implants for about 50 years.

According to the ESEC, cataract removal is the most common surgery in the world, with more than 14.2 million procedures annually - 2.7 million in the United States.

Cataract surgeries have a high success rate and a low number of complications, Krulewski says.

The U.S. Food and Drug Administration approved the new implants last year. They can also treat presbyopia, or age-related farsightedness.

Krulewski performs about 500 cataract surgeries a year, with 20 percent of patients choosing the new implants.

Medicare - and many private insurance companies - cover the costs associated with traditional cataract treatment, Krulewski says.

But patients must pay the additional costs related to the high-tech lenses - about $2,000 per eye, he says.

Mentzer admits the price tag initially gave her pause. But she was thankful she could afford the implants.

"It's my eyes," she says. "So I figured, What was I saving the money for?"


Traditional and newer implants require essentially the same surgical procedure.

ReZoom, ReStor and Crystal Lens have slight differences. Which implant is best depends on a patient's job, hobbies and lifestyle, Krulewski says.

The new implants are made of clear, high-quality plastic about the size of a pencil eraser.

The cataract removal and implantation surgery takes about six to 10 minutes, Krulewski says. (Patients who get implants in both eyes require two separate surgeries.)

Most patients are under local anesthesia, fully awake but comfortable, he says.

"Cataract extraction is one of the most pleasant surgeries you can have," says Krulewski, who compares it favorably to having a cavity filled.

After applying numbing eye drops, Krulewski makes a tiny incision in the eye. He breaks apart and removes the cataract and affected lens with a special probe, then inserts the implant.

Despite some initial anxiety, Mentzer says her surgery and recovery were pain-free.

"I knew what was going on, but it didn't (hurt)," she says of the surgery. "All of the sudden he said, 'You're done.' "

The tiny incision heals quickly, with little or no discomfort, Krulewski says. Patients can go home after 10 to 15 minutes of observation.

Many patients see well by the next day, but vision may continue to improve for up to a week, he says.

Since she got high-tech implants last fall, Doris Shaud, of Elizabethtown, doesn't need glasses to work on the computer or read her favorite Christian novels.

"I can see close, I can see far, I can see in-between," says Shaud, 71. "It's like a miracle."

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