WEDNESDAY MAY 15, 2013 CONTACT US KIM COOL FEATURES EDITOR 941-207-1000
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FIGHTING MACULAR DEGENERATION
Tiny telescope helps treat Venice woman By KIM COOL
Features editor Caution paved the way for a Venice woman to become the first Florida patient blinded by end-stage macular degeneration to receive a tiny telescope prosthesis implant that was expected to help improve her vision. The woman, Leslie Vlontis, 81, was treated for a detached retina 20 years ago by a doctor at the Kantor Eye Institute. “Dr. Menendez said not to let anyone remove my cataracts,” she said. That decision made it possible for her to have eye surgery this year that was not available 20 years ago. “End-stage age-related macular degeneration is the leading cause of blindness,” according to a release from Sarasota Memorial Hospital. “Patients have a blind
spot in the center of their field of vision. As the disease progresses, the blind spot increases in size.” Vlontis was a good candidate for the implant surgery performed in mid-February by Dr. Marc Levy, a board-certified neuro ophthalmologist at Sarasota Retina Institute and an associate of Sarasota Memorial Hospital, Doctors Hospital, Venice Regional Medical Center and Fawcett Memorial. When followed by vision rehabilitation training given by a low-vision specialist, the patient receiving the implant should be able to once again recognize faces and even words on a page, Levy said.
Clinical trials Levy was one of the surgeons involved in
SUN PHOTO BY KIM COOL
Leslie Vlontis of Venice looks at a telescope such as the one implanted in her right eye just 10 days earlier because of agerelated macular degeneration whch had left her nearly blind in the right eye and also was affecting the vision in her left eye. She is holding a device which contains an identical implant encased in glass. Photo taken in an examining room at the Sarasota Retina Institute.
the original trials of the telescope implant device that is part of the treatment program developed by VisionCare Ophthalmic Technologies CentraSight treatment program. It is considered to be the only treatment for patients who can no longer respond to medication. During the clinical trials in Sarasota, the miniature telescopes were implanted in five patients, including Glenridge at Palmer Ranch-resident Eloise Hedstrom, whom Levy has monitored for 10 years. The five patients in the trials were selected from 217 candidates. Three of the initial patients have since died. Eloise and the other surviving patient continue to have better vision than they had before the surgery. “I’ve gone gray and nearly bald waiting for this day,” Levy said after Vlontis’ mid-February surgery at the Cape Surgery Center at Sarasota Memorial Hospital. “Our team was the Florida test site for this device 11 years ago, and we recognized the benefits to patients early on, both visually and psychologically. Although it’s not a cure, it is effective in restoring enough vision for people to enjoy many of the simple acts we all take for granted — pouring a cup of coffee, crossing the street safely, seeing a smile on their grandbaby’s face.” Comparable in size to a pea or a small hearing aid battery, the device magnifies objects two to three times and projects the image to the healthy part of the retina. “It is a tube with optics,” he said of the device. “It is 4 mm high and 13 mm wide. It is a
PHOTO COURTESY OF SARASOTA RETINA INSTITUTE
Dr. Marc Levy performs eye surgery at Cape Surgery Center at Sarasota Memorial Hospital. virtual prosthetic device that renders a magnified image with a relatively wide field. “Sutures are thinner than human hair.”
Candidate selection is key to success Candidates for the surgery are selected by age, vision and cornea health according to standards of the Food and Drug Administration (FDA). Patients with macular degeneration either have wet (10 percent) or dry (90 percent) eyes. “I learned that it is only for those with dry eyes,” Hedstrom said. Laser surgery has been found to slow or stop the leaking blood vessels that cause wet eyes to slow the advancement of macular degeneration. It PHOTO COURTESY OF SARASOTA RETINA INSTITUTE is not considered a cure, according to information This is a simulation of what a patient with macular degeneration might see. in a pamphlet on macular degeneration from the American Academy of and some 500,000 are is more likely to occur in Ophthalmology. legally blind in both eyes. those over the age of 50. Levy said 15 million Vlontis said her Other risk factors include Americans have some form father also had macular smoking and abnormal of macular degeneration. degeneration. Studies cholesterol levels. Two million have an adhave shown a “genetic MACULAR | 5 vanced form of the disease predisposition.” It also
Cornel Dolana swam the Danube to escape Communist Romania By DON MOORE
sun Correspondent Cornel Dolana is a survivor. As a child he survived the German occupation of his country on his parents’ family farm outside Plosti, Romania, during World War II. He survived the Communist takeover of his country as a teenager. He escaped Communism and fled to Yugoslavia, Italy, France and finally, in the early 1960s, the U.S. In the beginning of the Second World War, Romania sided with the Axis Powers. Almost immediately Romanian oil from refineries in Plosti was used to keep the German war machine going. “I started paying attention to the war when the
Americans bombed the Plosti refineries 100 miles from our farm,” said the 75-year-old Englewoodarea resident. “I remember hundreds of bombers flying over our farm on the way to Plosti.” The most important raid by American B-24 “Liberator” bombers on Plosti took place Aug. 3, 1943. Called “Operation Tidal Wave,” 177 heavy bombers destroyed 40 percent of the refinery’s production, but the Germans rebuilt the damaged factories within weeks. American losses during that raid were heavy because they struck the Romanian refineries at 10,000 feet, less than half their normal altitude. A total of 54 of the 177 bombers were shot down
SUN PHOTO BY DON MOORE
Cornel Dolana today at 75, at his apartment near Englewood. by 700, 88 mm anti-aircraft guns protecting the refineries. The Butcher’s Bill for this single raid totaled 440 American airmen killed, and 120 became POWs. The next thing Dolana remembers about WWII is “… when the German
Army came through our area on its way to the Russian Front. By the time I was a teenager, the Communists had taken over after the Germans lost the war. “After the Russians arrived, we lost everything. During the war we had plenty of food, but when the Communists turned our farm into a collective operation, food was scarce and we were issued ration books,” he explained. “At this point I knew we were going to have a real problem with the Communists. My father wasn’t a Communist, he wouldn’t join the Communist Party, so I PHOTO PROVIDED wasn’t supposed to be able to go to high school. This was Cornel Dolana in his best outfit about the time he “Because my father was arrived in Italy after escaping Communist Romania in the early
1960s. He eventually made it to America thanks to a Baptist
DOLANA | 5 minister he met in Paris.
WEDNESDAY, MAY 15, 2013
MACULAR FROM PAGE 1 CentraSight’s program specifies “a multi-specialty provider team approach for diagnosis, surgical evaluation and post-operative care.” The Sarasota Retina Institute team dealing with Vlontis included, in addition to Levy, Retina and Vitreous Boardcertified doctors Melvin Chen and Waldemar Torres plus low-vision specialist Lissa V. Rivero, a doctor of optometry.
Only 28 certified centers for the procedure in the US There are 28 certified centers in the U.S. The one in Sarasota is the only one in Florida, although one is expected to receive approval soon in Miami. Even after the extensive trial period, Levy said, the device is only available to doctors involved in the original trials. The first surgery took 1 hour and 17 minutes, Levy said. “It is an outpatient procedure.” “The device actually sticks out of the eye a bit,” Levy said following Vlontis’ surgery. “It is larger than the cataract. “The eye can tolerate this.” During the surgery both the lens and cataract are removed. The miniature telescope replaces the lens and is aimed at a portion of the macula not affected by degeneration. Levy said that during World War II, when soldiers ended up with glass in their eyes from
DOLANA FROM PAGE 1 friends with the director of the high school, he not only got me into the school, but I went to live with the director’s family for my first two years. After that I moved to another city where my uncle lived and taught school. He helped me complete my last two years of high school,” Dolana said. After high school he got a job as an office worker in a huge factory that produced locomotives and railroad cars only because his father met the head of the factory while in jail. Dolana’s dad was jailed for anti-Communist activities. He had no idea what crime the future factory director committed. After three years working as an expeditor in the locomotive factory, Dolana happened to see a movie made in India called “The Vagabond.” It showed cities in America and other parts of the world were booming while conditions in Romania under the Communists were harsh and unappealing. “After seeing ‘The Vagabond,’ we realized the Communists had been lying to us and feeding us propaganda about the rest of the world,” he said. “It was about this time I found an old radio in my uncle’s basement and got it working. I started listening to ‘Radio Free Europe’ and ‘Voice of America.’ “I decided to leave the
explosions, doctors learned that the eye can tolerate certain types of glass. The glass for this device is made in Israel. It is held in place with plastic loops. FDA approval was finally granted in 2010. After the surgery, patients apply eye drops for four to six weeks, undergo rehabilitation therapy with a low-vision specialist and visit the Retina Institute once or twice a week. Those requirements are why patients must also have a caregiver or friend who will be responsible for taking them to appointments before and after the surgery.
Therapy is the final determinator for success Therapy begins when the last stitches are out, but Vlontis was prepared for that because of the team approach. “You have to have follow-up,” Vlontis said May 9. “Some people have been refused the surgery because of that. I had no fear because I knew what to expect. I am seeing Dr. Rivero today and Dr. Levy afterwards. He (Levy) gets everyone involved. There may be a problem but it can be fixed.” Vlontis was seen by several people at the Sarasota Retina Institute, including Yolanda Cates, an occupational therapist, and Levy before the surgery. Cates came to her home to make sure that environment was all right for the postoperative therapy. “Yolanda will make home visits the first few weeks,” Rivero said. “We country with the help of my cousin, who lived in a town closer to the Romanian-Yugoslavian border. In order to go from town to town in Romania, under the Communists, you had to go to the local police station and obtain permission. “I got a couple of bottles of moonshine and gave them to the police chief. He gave me a two-week pass to go see my cousin,” Dolana said. “I concocted a plan to swim the Danube River, separating Romania and Yugoslavia, near my cousin’s home.” During the 15 days his pass was good, they made several attempts to cross the river without success. “We ran out of time and money. We had to do something,” Dolana said. “We decided to climb the fence along the riverbank where a boat taking people up and down the river was docked.” Dolana dived into the Danube wearing nothing but his underwear and started swimming underwater, away from the docked boat. His cousin got caught and ended up in jail for a long time. “When I came up for air there were lights on the water everywhere. I went back underwater and kept swimming. Halfway across the river I was caught in a whirlpool and was dragged to the bottom. When I surfaced I was completely disoriented. I didn’t know what direction to swim, but I kept swimming,” he said. “It was starting to get
SUN NEWSPAPERS 5B don’t want patients falling the first three or four weeks.” Post-operative therapy includes work with eye charts. The patient tries to read smaller and smaller letters. “It was good that her (Vlontis’) retina doctor had the knowledge and sense to tell her to wait it out and not have cataract surgery.” If everything goes as planned, the patient who could just barely read the big E on the eye chart should be able to read the next two lines. Sixty-seven percent will be able to read three lines and 26 percent will be able to read five lines on the chart, Levy said. That would be considered 21-80 vision. Glasses can be worn with the device. Glasses were the only expense for Vlontis, who was contacted May 9, nearly three months after her mid-February surgery.
PROTO COURTESY OF SARASOTA MEMORIAL HOSPITAL
Leslie Vlontis of Venice immediately before she received a surgically implanted telescope in her right eye which was nearly blind because of are-related macular degeneration.
How much? “It didn’t cost me anything,” Vlontis said. “They (Sarasota Retina Institute) had it all lined up with Medicare. Medicare approved the surgery. All it cost me is my glasses. I have several pair.” Because the telescope is preset at a fixed focal length, she needs different lenses for that eye depending on whether she needs to see close up or at a distance. The lens was put in the bad eye. “You can’t adjust the telescope,” she said. “I was lucky I saw Yolanda before the surgery,” Vlontis said. “That helped. I knew what I would be doing. A woman has even
PHOTO PROVIDED
A new treatment for macular degeneration features the implanting of a miniature telescope comparable in size to a pea. The FDA-approved prosthesis employs wide-angle micro-optics in a Galilean telescope design to enlarge images in front of the eye up to 2.7 times their normal size, to reduce the effect of the “blind spot” associated with macular degeneration. come twice from the company in California that makes the telescope.” There was no cost for that either, she said. Medicare covered the entire procedure, including the post-operative therapy, which continues to include regular visits from Cates. Therapy is vital because
PHOTOS PROVIDED
Dolana was a skinny young man when he arrived in the U.S. He was about 25 when this photo was taken. “I was taken to the light again when I reached the riverbank. As I climbed police department in Belgrade. They interup the rocky bank, I rogated me for a month, looked up and three but still didn’t believe I had soldiers were pointing escaped from Romania. their rifles at me,” Dolana Eventually I wound up in a said. “They were speaking jail in a remote mountain Yugoslavian so I knew I area of Yugoslavia that I had made it across the escaped from in the dead Danube.” Although Yugoslavia was of winter. “I spotted a cabin in the a Communist country like Romania, the Yugoslavians mountains with a light from a fire. Its owner alhad no love for the Soviet lowed me to come in and Union. So the soldiers warm up while he took his didn’t turn him back over horse and went to town to the Romanian border to get food. I wasn’t sure police.
the patient must literally train his brain to use the telescopic prosthesis in a sort of partnership with the remaining vision of the other eye. “The other eye will continue to get worse,” she said. “You have to train your brain to take over. Yolanda has me
playing puzzles. It can only get better. They are learning from me. “I’m happy I had it done.” ••• For more information, call the Sarasota Retina Institute at 941-921-5335 or visit VisionCareInc.net or CentraSight.com
about his intentions, so I left before he returned,” Dolana said. He spent the next couple of days in the freezing cold. Along the way, he got directions to the Italian border and made the crossing without incident. “I reached a highway and tried to get a car to stop and take me to a hospital, but no one would stop. I found out where the local police station was and told police I was a Romanian escapee. They said that wasn’t possible, but I pulled out a Romanian train ticket I had kept. “The ticket changed their minds. They gave me food, a hot shower and took me to the hospital,” he said. “After I got out of the hospital I was interrogated by the police and eventually let go. “I made contact with the American Embassy in Rome. I filled out a form to become an American citizen and they gave me a little money. I was told it would take at least a year and I needed a sponsor to gain entrance to the U.S. I couldn’t wait. “At that point I took the train to Paris without a passport or any financial support. I met a Baptist minister in Paris who wrote a letter to a Baptist Church in Branford, Conn., that decided to
sponsor me. I received a U.S. passport and the church provided me with sufficient money to make the trip from Europe to Connecticut,” he said. “I was taken in by two high school teachers in Branford. It was 1963 and I began by doing odd jobs for members of the church. Then I got a job in an electronics factory for $1.50 an hour. I was so happy. I stayed there nine years working in quality control for the company,” Dolana said. Eventually he married, had two children and built a home in Branford. Later, he got another job working for a big electronics firm that made CAT scanners and MRI equipment. “In 1980 I decided to go into the electronic business for myself. I founded Doltronics, and eventually we had 40 employees. Twenty years later I retired as the head of Doltronics. My wife, Elilia, and I moved to Florida and built a house in Port Charlotte. Later we moved to an apartment south of Englewood.” If you have a war story or a friend or neighbor has one, email Don Moore at
[email protected] or call him at 941-4262120. For more war stories, visit donmooreswartales. com.
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