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Seeing life through a clearer lens

By Scott Scanlon

Refresh Editor

Pardon Dr. Ephraim Atwal for feeling good about life these days.

He still owns a house on St. Charles Avenue on the Mardi Gras parade route in New Orleans, where he did his ophthalmology training and residency at Louisiana State University-affiliated hospitals.

In May, he married longtime girlfriend Jennifer Gabryszak – daughter of state Assemblyman Dennis Gabryszak from Cheektowaga, where the couple grew up – and the Atwals are expecting their first child in November.

The 36-year-old doctor also recently got a new piece of very expensive equipment, the Catalys, which is making cataract surgery at Atwal Eye Care more rewarding for doctors and patients.

“I was surprised the first time I did it. I didn’t expect much of difference, but I was blown away,” Atwal said last week from the company headquarters and surgical hub on Harlem Road in Cheektowaga.

Atwal joined the family practice about two years ago. It was started by his father, Dr. Awal Atwal, in 1990. The two have performed more than 40,000 cataract procedures and have a staff of more than 70 medical professionals at sites in Williamsville, Kenmore, West Seneca, Hamburg and Cheektowaga.

What is a cataract?

A lens in your eye that’s gone bad. If you live long enough, you’re going to get a cataract.

What’s the difference between conventional and laser cataract surgery?

Cataract surgery has been around since 600 to 800 B.C., so there’s been a lot of variations around throughout the years. The bad lens is removed and it’s replaced with an artificial lens. That artificial lens acts just like a lens on a camera. It focuses light so that you can see clearly.

I always tell my patients the cataract is a lot like a peanut M&M. You’ve got to make a little hole in the candy shell, then you’ve got to suck out the chocolate and the peanut, then you put a (foldable artificial) lens into the candy shell remnant. That little hole that’s in that little shell is very specific. If you screw up that step, the whole surgery can go south from there. What the laser does is it has the ability to make that little circle perfect every single time.

The surgical form that the majority of the ophthalmologists currently are using has been around since the mid-1960s. It uses ultrasound technology similar to that used to scale teeth in a dental office. It breaks up the cataract in the eye and then it has a small bore needle attached to that same device that removes the cataract from the eye at the same time …

The laser is a two-step process. First we use a laser without ever entering into the eye, without using any blades. The laser breaks down the lens externally. It turns a rock-type lens into something really nice and soft, like a frozen bar of butter into soft warm butter that’s been out for days. That allows us to just go in and suck it up.

We use the incisions the laser made and remove the lens, (then install an artificial lens). So it’s longer, but when I say longer, a normal cataract surgery takes five or less minutes to do. Cataract surgery with a laser, total operating time, is about eight to nine minutes …

When you can soften the lens, you can reduce the amount of energy that impacts the eye. That’s a tremendous advance in the surgery. It also has the ability to get rid of astigmatism, to change the way light enters the eye. It can do all the things that were surgeon dependent … with incredible accuracy.

What is the recovery like?

Because the laser is performing all of the breakdown techniques, the patient can expect a swifter and more predictable visual recovery after the surgery. Depending on how bad the cataract was initially, I have patients who say they see better when they’re sitting up after the surgery. Most patients see much better the following day. Typically, full recovery takes about two weeks.

How much does one of these Catalys machines cost?

It’s over a half-million dollars.

How does corrective laser eye surgery using LASIK technology work?

While cataract surgery is intraocular – we have to go inside of the eye – LASIK operates on the surface of the eye. In that thin little layer in front of the eye, the cornea, we make a thin, little flap using our laser to perform the LASIK. It’s the same type of laser we use for our cataract surgery. The cataract surgery just took a lot more time to become sophisticated enough to work down into the eye. With LASIK, we can fix nearsightedness, farsightedness and astigmatism.

What is the cost range for LASIK and Catalys procedures? Is any of the cost covered by insurance?

LASIK is $2,300 per eye. Some insurance plans offer special programs to their subscribers. Catalys will range anywhere from $1,495 to $3,195 additional, depending on the lens options, such as multifocal lenses. Insurance picks up the basic cost of the surgery. The cost out of pocket is due to the technology and laser equipment costs, and the lens costs.