Cataract Surgery Restored Teen’s Eyesight

Categories: Medical Center News, Partners in Caring
Removing the cataract during cataract surgery
A screen image of the cataract and the cutting tip of the tool being used to scrape it away. This sort of procedure is delicate work, and having the latest equipment makes an enormous difference.

Fatima Briley is only 15 years old, but when she came to Connecticut Children’s, she had a condition usually associated with the elderly: cataracts. In fact, her cataracts were so dense, she was functionally blind. Connecticut Children’s was able to help her, thanks to Paul Rychwalski, MD, his ophthalmic surgical team and a state-of-the-art machine. Fatima became the first pediatric patient to have cataract surgery, to remove and replace her lenses, at Connecticut Children’s.

It started in March 2019. Fatima’s eyesight became a little hazy. “At first it wasn’t too bad,” she says. “It was pretty good at the beginning of March, but then within two weeks I couldn’t see.” The cause, it turned out, was a type of corticosteroid that had been prescribed for another medical condition. One of the extremely rare side effects of that medication is cataracts.

“It was really bad,” Fatima says. “I had to use my mom for support. She had to tell me, ‘Oh, there’s a step or something in the way.’ What happened to me came out of nowhere; I didn’t even think it was possible. I tried to entertain myself by listening to music or listening to a movie on Netflix.”

Dr. Rychwalski poses with Fatima Briley after the cataract surgery.
Dr. Rychwalski poses with Fatima Briley after the surgery. At this exam, Fatima’s eyesight was 20/25.

Cataract Surgery a Delicate Procedure

Fortunately for Fatima, she came to Connecticut Children’s. The Division of Ophthalmology is headed by Paul Rychwalski, MD, who has decades of experience with this sort of surgery. Connecticut Children’s recent acquisition of a state-of-the-art microsurgical system makes it much easier to perform the delicate surgery that she needed. The new surgery system offers much finer control of the tools and a much higher speed for the cutting blades that are used to carefully aspirate the cataract.

“When I first saw Fatima,” says Dr. Rychwalski, “she was being guided in. When you see a previously healthy child that age being guided, one of the possible causes is psychosomatic. It’s something called functional or non-organic vision loss. Then I took one look at her eyes and said, ‘Oh, my! This is not psychosomatic; she has completely opaque, white lenses.’”

Dr. Rychwalski performing cataract surgery.
Dr. Paul Rychwalski uses a microscope to see his work on an extremely fine level.

A Whole New World

The surgery was done one eye at a time, letting the first eye heal a bit before beginning the second one. It involved irrigating and aspirating the milky white lens followed by injecting a tiny, foldable acrylic artificial lens. All this is done under an operating microscope and through two incisions between 1/8 and 1/16 of an inch wide “When she first had the bandages off,” Dr. Rychwalski says, I asked her, ‘Well, how do you think I look?’ I asked because she had never seen me, only heard me. And she said, “Well, pretty good.”

“I thought he had dark brown hair, and he looked really 3D,” said Fatima—Dr. Rychwalski is, in fact, sandy blond.

The results of the cataract surgery were both quick and impressive. “Within a couple of hours, her eyesight was 20/20,” Dr. Rychwalski says. That’s not to say it was all back to normal from Fatima’s point of view.

“A day after the surgery, everything looked like virtual reality,” she says. “My dog looked weird, my brother looked weird. But then it got better. I was looking outside at the leaves on the tree and thought, ‘I’m never going to take this for granted again, and now I want to help people.’”

Dr. Rychwalski examines Fatima’s eyes after cataract surgery.
Dr. Rychwalski examines Fatima’s eyes a few weeks after the surgery.

Bringing the Light

“A lot of times,” Dr. Rychwalski says, “something like this stimulates people to serve others. When someone does something good for you, you want to pass it along and that’s when the world becomes a really good place. Ninety-nine percent of people are good and can bring light into our world. I really believe that. That’s what I try to do: bring light.”