Drs. Gregory Parkhurst and Arthur Medina Jr. are accustomed to patients crying after they undergo the brief surgical procedure that can transform them from being unable to read a large E projected on the wall to people with 20/20 vision who feel like they’ve re-entered a lost world.
I know. I was one of those patients, overcome with amazement and emotion as the drugs wore off and I awakened to an almost primal awareness of my surroundings and the sudden realization that I could see like a hawk. So I just started crying.
I started wearing eyeglasses in the fifth grade after I tested 20/400 for myopia (nearsightedness) with astigmatism warping vision in both of my eyes. The degradation in my vision came quickly in adolescence. I went from leading my Little League team in hitting and pitching to not being able to track and judge a fly ball.
I’d like to think the three different refractive and laser eye surgical procedures I’ve undergone returned my vision to pre-fifth grade acuity. The truth is, I might see better today than at any other time in my life.
Welcome to the 21st century world of advanced vision correction, where technological and surgical advances seemingly come faster than people can learn about them. Dr. Parkhurst is at the forefront of this rapidly changing world, which is how we first met.
Dr. Medina has been ushering eligible patients in his San Antonio optometry practice for nearly 20 years to refractive surgery specialists. I was one of them, in the summer of 1996 undergoing RK, or radial keratotomy, a now rarely used procedure where the surgeon makes small incisions in the cornea on the surface of the eye, thus relaxing it and restoring it to a more natural curvature. Soon afterwards, PRK, or photorefractive keratectomy, became the more common procedure, where the surgeon accomplishes the same corneal reshaping with a laser.
That was the first time I cried. RK instantly corrected my myopia, something I realized even as the procedure continued and I was still under the influence of pharmaceuticals. But the procedure did nothing to correct my astigmatism. That came a few years later when the FDA approved laser surgery for that purpose. I didn’t cry the second time.
Some years ago, Dr. Medina began taking patients from his practice to Houston where Dr. Parkhurst was rapidly gaining an international reputation and enjoying elite status as one of a select number of eye surgeons approved to perform some of the most advanced FDA approved clinical trials in the country. The more Parkhurst and Medina worked together, the more Parkhurst was drawn to San Antonio where no one was performing the same procedures at the same high level. An example of this occurred Thursday when Parkhurst implanted the first cataract lens implant in San Antonio that corrects astigmatism, on a platform already approved for improving distance vision, while at the same time restoring near vision in the same eye.
“People should choose carefully,” Dr. Medina said. “The quality of eye care you receive and the outcome can depend on who qualifies the patient and who performs the procedure. Like anything else, you can find cheaper alternatives, but that doesn’t mean the end result will be satisfactory. I knew very early on that Greg Parkhurst was a special talent and if we could get him to come to San Antonio, in my opinion, our patients would then have access to one of the best in the country.”
Two years ago Dr. Parkhurst established his own practicein San Antonio, now located at 9725 Datapoint Dr., the same building that now houses the University of Incarnate Word’s Rosenberg School of Optometry.
Meanwhile, after 18 years of good vision, early last year I noticed an acuity fluctuation in my left eye that was both frustrating and difficult to correct with glasses. I was using driving glasses, particular at night to better focus oncoming headlights and my depth perception a common side effect from refractive surgery. When vision in my left eye fluctuated, even the glasses were useless.
Dr. Parkhurst, it so happened, was enrolling more patients in an exclusive FDA clinical trial in August. I wrote a story about the new procedure of corneal inlay surgery: “Wanted: 10 Patients Who Want to Read Without Eyeglasses.” Unfortunately, I wasn’t eligible for the procedure since I had undergone RK. The minute incision scars didn’t affect my vision, but they disqualified me from the trial. Readers who connected with Parkhurst through the article and were accepted into the clinical trial enjoyed a $5,000 procedure at no charge.
“We believe this is going to be the next evolutionary step in vision surgery,” Dr. Parkhurst said last summer. “Right now the (FDA-approved) technology is such that one eye can be corrected for distance focus, and one eye for near focus. We don’t have an approved refractive surgery technology to date that allows each eye to see near and far the way you did when you were 20 years old. This clinical trial is designed to allow people to see both far and near in the same eye, so it restores the near vision while not degrading the far vision. This surgery will get you out of reading glasses.”
Corneal inlays restore the proper curvature of the cornea and thus cure presbyopia, the condition brought on by age that causes the eye to lose its ability to focus on near objects. Patients not only enjoy restored vision, but they don’t need reading glasses like most people 40 and older.
“In the past, surgery gave you the best possible corrected vision,” Dr. Medina said. “With the new surgery, what we are giving you is the best uncorrected vision.”
The American Academy of Ophthalmology estimates there are 60 million Americans who would benefit from corneal inlay surgery.
Last July, while those clinical trials proceeded, I underwent LASIK surgery in my left eye at Parkhurst’s outpatient clinic, Parkhurst-Nuvision. LASIK, short for laser in-situ keratomileusis, is a procedure to reshape underlying corneal tissue so that it can properly focus light into the eye and onto the retina. The surgeon makes a flap in the outer layer of the cornea so that the underlying tissue can be accessed.
The procedure from start to finish took only minutes and was painless. A friend drove me home and pain killers helped me catch up on sleep for a day. After a month or two of fluctuating vision, which is normal, my left eye once again tested at 20/20 and the fluctuation disappeared.
I might not have qualified for the latest, cutting-edge procedure, but that didn’t mean I wasn’t curious. I asked Parkhurst and Medina to connect me to some of their other patients. I was especially interested when Parkhurst told me they were successfully improving the vision of much older patients.
In this new world, technology is closing the gap between aging men and women developing cataracts (which are inevitable, if you live long enough) and people who can shed their eyeglasses and contact lenses and enjoy 20/20 vision or nearly so, sometimes for the first time since early adolescence.
“Two fields, cataract surgery and refractive surgery, are now merging, it’s a very exciting development,” Dr. Parkhurst said. “We are one of the few practices embracing the merging of the two. There aren’t many cataract surgeons who are skilled in refractive surgery, and vice versa.”
The first such patient I spoke with doesn’t need much introduction. Charline McCombs is with her, husband, Red, the matriarch of one of the most philanthropic families in Texas. Locally, her name adorns the Charline McCombs Empire Theater downtown. Even billionaires suffer poor vision, and when they do, they wear eyeglasses just like the rest of us.
“I haven’t had good vision since I was in my 30s, and now I can see as far as you can shoot,” Charline McCombs joked. “I have very good vision in both eyes now, and I wake up every morning and thank the good Lord for my good vision. I don’t wear glasses at all, I’m giving them all away.”
Charline, age 85 at the time of her procedure performed by Parkhurst, said she previously had a cataract removed.
“I now have a lens implant in that eye, and Dr. Parkhurst performed LASIK on my right eye,” she said. “Red’s vision is great. He had cataract surgery way back when we owned the Minnesota Vikings, and Dr. Medina took him to a well-known doctor in San Diego. We are so blessed to have Art Medina and Greg Parkhurst right here in our city.”
Surgery on one member of the family often engenders dinner table discussion among other family members with corrected vision. Charline said one grand-daughter subsequently underwent successful LASIK surgery at Parkhurst-Nuvision, and other family members are talking about who might be next.
Erin Neutzling Scott at age 30 is much younger, but she, too, describes her corneal LASIK surgery as “a great experience. I’ve been wearing glasses for being near-sighted since I was 10 years old at St. Luke’s Catholic School,” she said. “I was getting ready for my wedding in 2012 and I was imagining myself in wedding gown without glasses — even though I always wore funky glasses and liked them. I was feeling vain.
“Dr. Medina has been my eye doctor since I was little and he told me about the new procedure, and I just decided to do it,” Neutzling said. “One week later I was in the procedure. It took like seven minutes. I got up from the table and could read the clock. Dr. Medina once told me it’s one of the most transformative procedures you can have. It changes things so much.”
Her husband, Rodger Scott, also wears glasses and is thinking about following suit.
Before she became a patient, Laura Groninger once worked as an employee in Dr. Medina’s vision care practice.
“I had 20/20 vision back then and never thought of myself as a future patient,” she said. Groninger left her receptionist job after getting married some years ago, and as her 40th birthday approached, she realized she needed reading glasses.
“I was deemed the perfect candidate for the clinical trial,” she said, “and I certainly trust Dr. Medina with my eyes. Dr. Parkhurst is fantastic, too. I had the inlay procedure on my right eye, which is my non-dominant eye, in August. The procedure was quite simple and, more important, painless. It is wonderful not to have to pull out any reading spectacles.”
Millions of Americans have now had some kind of vision correction surgery, and as procedures advance, more and more people will qualify for treatment. Insurance companies and Medicare, however, still do not recognize vision correction surgery as a necessary procedure.
“The policy, in effect, is that the government and the insurance companies will cover partial correction of your vision with eyeglasses, but will not cover total restoration of 20/20 vision without needing eyeglasses and the expense they entail every few years,” Dr. Medina said. “This is not cosmetic surgery. Your ability to see well is essential.”
Interested readers can contact Parkhurst-NuVision at 210-615-9358 or at www.sanantonio-lasik.com.