A cataract is a cloudy area in the normally clear lens in the front of the eye. There is no pain associated with the condition but there are other symptoms, including:
- Blurred/hazy vision
- Spots in front of the eye(s)
- Sensitivity to glare
- A feeling of “film” over the eye(s)
- A temporary improvement in near vision
Risk factors for developing cataracts include being over 55 years old, eye injury or disease, a family history of cataracts, smoking or use of certain medications.
For people who are significantly affected by cataracts, lens replacement surgery may be recommended. During cataract replacement, the most common surgical procedure in the country, the lens is removed and replaced with an artificial one called an intraocular lens or IOL. Our Cataract Procedure
We perform a minimally invasive, small-incision, no-stitch cataract surgery called phacoemulsification (“phaco”) surgery in our state-of-the-art surgical facility.. During this procedure, a tiny incision is made in the eye to make room for a small ultrasonic probe. This probe breaks up, or emulsifies, the cloudy lens into tiny pieces. The pieces are then suctioned out through the probe. Because of its small size, the incision can heal on its own and only requires a topical (eye drop) anesthesia, so there is no injections or stitching in the eye at all.
Once the cloudy lens has been removed, the artificial IOL is implanted in the eye. Advanced foldable IOLs can be inserted through the same small incision that the original lens was removed from. This significantly reduces recovery times while improving safety and reducing the risk of bleeding, scarring, irritation and distortion.
Laser Vision Correction
The cornea works like a camera, focusing light to create an image on the retina. The eyes turn light into images by bending or refracting them. When the shape of the cornea and the eye are not perfect, the image on the retina is blurred or distorted. These imperfections of the cornea are called refractive errors. Myopia, hyperopia and astigmatism are the three primary types of refractive errors. Persons with myopia, or nearsightedness, have more difficulty seeing distant objects as clearly as near objects. Persons with hyperopia, or farsightedness,have more difficulty seeing near objects as clearly as distant objects. Astigmatism is a distortion of the image on the retina caused by irregularities in the cornea or lens of the eye.
It is not unusual to have combinations of myopia and astigmatism or hyperopia and astigmatism. Glasses or contact lenses are worn to compensate for the eye’s imperfections. Now there are more options than just corrective eye wear. Refractive surgery procedures have been developed and are aimed at improving the focusing power of the eye. LASIK (Laser In-Situ Keratomileusis) is one type of refractive surgery that uses precise and controlled removal of corneal tissue to reshape the cornea, changing its focusing power.
Glaucoma – Laser and Surgery
Glaucoma is typically treated with eye drops that decrease eye pressure either by slowing the amount of fluid produced within the eye or by improving the flow through the drainage angle.
Trabeculectomy is a surgical procedure performed by an ophthalmologist used to lower eye pressure. By trying to lower the eye pressure, damage can be halted from further pressure increases, but that damage already done is not reversible.
The trabeculectomy procedure involves the surgeon creating a tiny passage way from the inside to the outside of your eye. This helps fluid drain better from the areas it is presently not draining. A trabeculectomy can lower the pressure in your eye and help prevent more damage to the optic nerve.
Trabeculectomy is more commonly used after other treatment options have not been successful or are simply not stopping the increasing IOP (Intraocular Pressure). Your eye surgeon may consider trabeculectomy if:
- Medicines do not work as planned
- Laser surgery to lower the eye pressure has not worked
A glaucoma shunt is a drainage device, also known as tube shunts. These shunts are implanted into the eye and are intended to assist with drainage. They create a drainage passage for fluid. This procedure is sometimes chosen for individuals at a high risk of failure with the more common traditional glaucoma procedure known as (trabeculectomy). The company Optonol has made some advances in this technology over the past few years (SEE Optonol).
Laser Surgery for Glaucoma
Laser glaucoma surgery treatments may be recommended for certain types of glaucoma. This frontier in glaucoma technology presents significant progress for treating glaucoma in the future. In open-angle glaucoma, a laser can be used to modify the drain to help control eye pressure.
PRK – Photo-Refractive Keratectomy
Photo-Refractive Keratectomy (PRK) brought about renewed excitement to both surgeons and patients. The procedure is performed on an outpatient basis using the excimer laser. In less than a minute, using ultraviolet light from the “cold” or non-thermal laser, the excimer laser reshapes the surface of the cornea to improve nearsightedness, farsightedness, and astigmatism much like LASIK eye surgery. The amount of tissue reshaped depends on the severity of the prescription. In most cases, 5 to 10 percent of the cornea is removed. Once the cornea has flattened, light rays are more easily focused upon the retina. PRK differs from LASIK in that no flap of tissue is created prior to resculpting the cornea with the excimer laser. In LASIK this flap creation does enable a faster recovery period. Results from the relatively young PRK procedure are similar to those of the more mature RK procedure with the vast majority of patients achieving post-operative results of 20/40 (driving vision) or better.
Selective Laser Trabeculoplasty
Selective Laser Trabeculoplasty (SLT) is quickly becoming a widely accepted treatment option in glaucoma treatment. SLT offers a new glimpse of hope for glaucoma patients. By engaging in this NEW laser technology, the ophthalmologists can now lower pressure that can possibly help a patient avoid a more invasive surgery. The surgery might even reduce the dependence on medications or drops.
What does the procedure do?
SLT actually lowers intraocular pressure (IOP) by creating relatively small pulsing, low-energy laser light to target cells in the trabecular mesh system of the eye.
Laser trabeculoplasty utilizing an argon laser (ALT) may be used to treat open angle glaucoma, and provides a significant reduction of intraocular pressure (IOP) in more than 75% of patients on initial treatment. The advantage of this form of treatment is a reduction of IOP which often eliminates the need for pressure-lowering eye drops. Laser energy is applied to the trabecular meshwork, which stimulates opening of the meshwork to allow outflow of aqueous fluid and lowering of IOP. Historically, an argon laser has been used. However, treatment with an argon laser is limited by the temporary nature of the IOP lowering effect and the failure rate of retreatement, which is nearly 90% by 2 years. Only 20% of patients maintain the pressure-lowering effects of an argon laser trabeculoplasty 8 years following the treatment. Recently, a new technology called Selective Laser Trabeculoplasty (SLT) has been used to treat open angle and other forms of glaucoma. This technique has the advantages of less collateral tissue damage as well as efficacy following additional future treatments.
Selective laser trabeculoplasty was introduced worldwide in 1995, and it gained FDA approval for use in March 2001. SLT utilizes an Nd:YAG laser to selectively target melanin within the pigmented trabecular meshwork cells.
Multifocal Intraocular Lenses
Artificial lenses (IOLs) are implanted in the eye to replace natural lenses for patients with cataracts, presbyopia or severe refractive errors. Until recently, IOLs were only available to correct distance vision. These monofocal lenses helped improve distance vision after cataract surgery, but patients still needed glasses or contact lenses for near vision activities like reading and playing cards. Now, advancements in technology have produced multifocal IOLs that allow patients to see clearly at all distances — near, far and many distances in between. Multifocal IOLs such as Tecnis Multifofal and ReStor® Lenspreserve distance vision and correct presbyopia so cataract surgery patients — and patients seeking treatment for presbyopia alone — can enjoy clear sight without relying on glasses.
The procedure to replace a patient’s natural lens with a multifocal IOL is the same as that used in cataract surgery.
Premium Intraocular Lens Implants
Intraocular lenses (IOLs) are synthetic lenses made from inert material that can act as artificial lenses for patients who have either had their natural lenses removed as a result of cataract surgery or patients who have severe astigmatism or presbyopia that is difficult to correct through traditional treatment. IOLs represent a breakthrough in refractive surgery because they allow patients to regain clear and precise vision in cases where it had previously been thought impossible.
Phakic Intraocular Lens Implants
Phakic intraocular lens implant is used to correct moderate to severe myopia (nearsightedness). The lens is placed behind the cornea and in front of the iris of the eye. A Verisyse™ Phakic IOL acts as a secondary focusing lens which precisely focuses images on the retina. The term “phakic” refers to the fact that the existing crystalline lens of the eye remains in the eye at the conclusion of the procedure. Although Verisyse™ IOLs are designed to be permanent replacement lenses, the procedure is reversible because the natural lens of the eye is left intact.