Merry Resolves Polymyalgia Rheumatica Ocular Complications with Monofocal Lens From AGEI Merry Resolves Ocular Complications with Monofocal Lens From AGEI

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Last updated 4/17/2024

 

Merry Hons AGEI patient Cataract Surgery

Merry Hons’ good fortune was certainly in full force when renowned eye surgeon Dr. Kerry Assil was called to replace a lens in her sickened eyes.

 

Until the previous year, Merry had suffered from polymyalgia rheumatica (PMR), an inflammatory disease that causes stiffness and pain in muscles. How does polymyalgia rheumatica affect eyes? 

 

A potential symptom of PMR is blood vessel inflammation that — when it affects the eyes — can cause vision loss from retinal artery occlusion or ischemic optic neuropathy. 

 

“Merry’s circumstances were very unusual; you might see them once a decade,” says Dr. Assil, who has performed more than 70,000 eye surgeries over the past 30 years. “What made it difficult was the long-standing inflammation. This caused her to develop severe scars, completely seal her pupil, and raise pressure in the eye. The scar tissue was extremely tenacious and woven into the eye.”

Polymyalgia rheumatica hits Merry’s eyes 

Merry, 66, was the picture of health until 2016, when she went to sleep feeling fine and woke up semi-paralyzed and choking. Though there is no cure for PMR, patients are often given prednisone for symptom relief. While corticosteroid treatment can decrease inflammation, prolonged use can also cause cataracts and blurry vision.

 

Merry is a high-power realtor building spec houses and selling them to celebrities and athletes — all for between $25 and $80 million.. Before she developed PMR, Merry was used to be nimble and on-the-go.

 

Four years after Merry’s PMR started, it finally subsided. However, the years of inflammation had prevented her from having two cataracts removed and her right eye could no longer process light.

 

She then developed uveitis, a form of eye inflammation that affects the middle layer of tissue in the eye wall (uvea). Symptoms include eye redness, pain, and blurred vision. Uveitis can be severe, leading to permanent vision loss. 

 

In 2024, Merry visited Dr. Assil at the Assil Gaur Eye Institute. The two previous eye surgeons Merry had seen told Dr. Assil that their prognosis for restoring Merry’s eyesight was “guarded.” When a patient has a guarded prognosis, their outlook is questionable and their chances for improvement are small. A doctor may use this term when they are unsure if the patient will be able to recover. 

 

Both of her previous surgeons had recommended that Merry see Dr. Assil.

 

Dr. Assil tackles risky intraocular lens surgery 

Dr. Assil decided to begin Merry’s cataract surgery on the right eye using the Bausch + Lomb enVista monofocal lens. The new monofocal intraocular lens (IOL) has been developed to provide a continuous depth of focus.

 

Because he was the only surgeon willing to approach such a complicated procedure, Dr. Assil had to set some guidelines for himself. 

 

“The main thing with these complex surgeries is not to lose your composure and go slow,” he says, adding that the operation would last two hours instead of a typical 10 minute cataract surgery. “I knew she would never have a normal-looking pupil. Just optimizing her vision would be a complete success.”

 

The immediate problem was reaching Merry’s cataracts through the scar tissue. The eye’s layers typically resemble cellophane and are easy to manipulate. Merry’s eye tissue looked like leather, which made it quite challenging to cut through and needed high levels of laser energy to break down.

 

For 120 minutes, Dr. Assil meticulously unwound the scar tissue using a needle and scissors until he could dislodge the two cataracts. After removing the cataracts, he carefully fitted the monofocal lens into place. Because the iris was scarred over and drawn open, the doctor chose an anti-glare monofocal lens rather than a multifocal lens without glare reduction.

 

What makes a successful IOL exchange? 

Merry is thrilled to have half of her eyesight back. 

 

“When I looked at the ceiling in the surgery suite and saw light, I started crying,” she says.

 

Immediately after the procedure Merry had 20/1000 vision. Two weeks later, her eye pressure was lower, and her vision was 20/30, a 300-fold improvement. “It was the weirdest adventure,” she added.

 

“We are quite pleased,” says Dr. Assil. “There was no corneal swelling.”

 

The doctor is now focused on the left eye, which has diminished sight but slightly less inflammation. Dr. Assil will work on this eye a few weeks after completing the first one to prevent the scarring from becoming more entrenched in the eye.

 

Why trust Assil Gaur Eye Institute with your vision correction?

Dr. Kerry Assil has gained industry-wide respect for his extensive knowledge and contributions to cataract and refractive surgery. His knowledge of Intraocular lenses for cataract surgery and refractive lens exchange is unparalleled.

 

His associate, Dr. Avneet Gaur, is a Board-Certified Fellowship Cataract, Refractive, and Glaucoma Specialist with training and experience developed at nationally renowned ophthalmic institutions.

 

Assil Gaur Eye Institute has assembled a team of top ophthalmologists from around the country who offer their patients the highest quality of specialist eye care in the United States. 

 

With over 40 years of combined experience assisting patients with eye health, Drs. Assil and Gaur are among the most experienced eye surgeons in the United States. Dr. Assil has performed over 70,000 eye surgeries and authored over 100 textbook chapters and articles on refractive and cataract surgery.

 

In keeping with AGEI's founding principles, its eye surgeons keep their clinics comfortable and familiar, much like family-run medical practices used to be.

 

In addition to refractive lens exchange and cataract surgery, the ophthalmology experts at AGEI are nationally recognized for their eye care and treatment options for a full range of conditions, including eye conditions such as hyperopia glaucoma, macular degeneration, retinal detachment (and other diseases of the retina), cornea conditions, contact lens, floaters and flashes, dry eye, presbyopia, astigmatism, farsightedness, myopia, nearsightedness, and ‌other vision correction procedures (refractive surgery) such as LASIK surgery, PRK.

 

Today, AGEI is nationally recognized for its compassionate, patient-centric health care, commitment to pioneering advances in ophthalmology, and dedication to supporting its patients' and the community's health and well-being. Please call (866) 945-2745 or make an appointment online.

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