Advances in Lens Implant Technology: Making You Less Dependent on Glasses
Over the past few years, new ‘premium’ lens implants have been introduced that are capable of correcting astigmatism and presbyopia, two common problems that were previously impossible to correct with standard cataract surgery.
About 1 in 4 patients has visually significant astigmatism. Astigmatism is an abnormality in the shape of the front surface of the eye, the cornea, which results in visual blurring and makes patients dependent upon glasses. Small amounts of astigmatism (less than 1 diopter) can be corrected during standard cataract surgery using a ‘Limbal Relaxing Incision’. However, higher amounts of astigmatism can not be reliably corrected with this technique. If you have moderate or high astigmatism, the Alcon Acrysof Toric intraocular lens is an excellent, reliable, and safe option to eliminate the need for distance glasses after surgery. Typically, there is an extra fee for the lens (which is not fully covered by insurance). However, it is important to remember that this lens will be in your eye forever, and that over time most patients end up saving money because they no longer need to purchase expensive, astigmatism-correcting glasses.
Presbyopia refers to the inability to ‘accomodate’ or to see up close as one gets older. Standard lens implants are monofocal, meaning that they only give sharp vision at a single distance (either far away or up close). Therefore, most patients after standard lens surgery see great at distance, but are dependent on reading glasses for near. The new presbyopia-correcting lenses are mutlifocal oraccomodating and offer patients improved near vision in addition to excellent distance vision. In our practice, we use three different types of presbyopia-correcting lenses: Crystalens®, ReSTOR®, andTecnis Multifocal. Each lens has its own particular features and strengths, and if you are interested in these lenses we will discuss them with you in detail during your visit.
This is an exciting time in cataract surgery, with new lenses that will allow you to be less dependent on glasses after surgery. Be sure to ask us if you are a candidate for these new implants.
We’d like to officially welcome Dr. Brad Feldman to Philadelphia Eye Associates. Dr. Feldman joins us after completing a fellowship in Corneal and Refractive Surgery at the prestigious Duke University Eye Center. He brings state of the art corneal surgery including corneal transplants, lamellar grafts, DSEK and a wealth of knowledge of external eye disease. Partial thickness corneal transplants (DSEK/DALK) have revolutionized the treatment of many blinding corneal conditions with safer, quicker surgery and faster, better visual recovery. In addition many of these surgeries can now be performed with greater precision and safety using the Intralase laser instead of blades. Dr. Feldman is also experienced in performing Intralase Intacs for the treatment of keratoconus.
In addition, Dr. Feldman will be available for routine eye care and cutting edge cataract surgery including the use of presyopia correcting implants such as the Crystalens, Restor and Technis multifocal lenses. This will allow many of our cataract surgery patients to enjoy excellent vision without any glasses. And lets not forget astigmatism, which can be cured with toric intraocular lens implants or limbal relaxing incisions (LRI’s) at the time of cataract surgery. Be sure to ask us if these implants are right for you.
And if that doesnt keep him busy, he will also join Dr. Blecher in providing the finest in laser refractive surgery using the Intralase Customvue technologies. Our results have never been better with over 95% achieving 20/20 or better vision and an enhancement rate under 1%.
Dr. Feldman will be seeing patients at both the South Philadelphia office and the Wills Eye Institute location. Be sure to check out his bio on our website.
Its been a while since I’ve written. Mostly because in the world of refractive surgery, and most specifically LASIK things have been puttering along. Medically that is. We have been fortunate enough to be at a point with our surgical technology that not a lot new has come along, and what we have has been excellent. Custom LASIK and Intralase blade free flaps have provided us with a very dependable and amazingly accurate set of tools for the carefully selected patient. Its the only type of LASIK i will agree to perform from a safety and precision standpoint.
From an economic perspective, these have been difficult times for many people. State of the art LASIK is not cheap, not if its done right. And refractive surgery is elective surgery. Understandably patients are carefully considering all elective expenses. LASIK however is an investment that does not lose it’s value. It’s the best kind of investment: an investment in yourself. And since you are only going to do it once, it makes great sense, and great economic sense, to do it right.
Also, despite what you may have heard or thought, we are having great success in getting financing for our patients. So if you have been thinking about LASIK, now is a great time to see if you are a candidate. And be sure to ask us if the laser center is running any special promotions, they occasionally do.
On another note, I wanted to announce that Philadelphia Eye Associates will be taking on a new associate. We would like to welcome Dr. Brad Feldman to the practice. He will be starting to see patients September 1, which isnt really all that far off. Dr. Feldman is currently finishing specialized fellowship training in cornea and refractive surgery which will allow us to treat even a wider range of refractive errors and corneal problems. I’ll post more about him as we get closer to September. Feel free to call us to find out if he could help you.
Patients ask me which refractive surgery procedure they should have. Should they have standard or custom LASIK, should they have bladeless LASIK or choose the microkeratome? The newer technologies are a bit more money so its a good question to ask. When they first came out it wasnt immediately clear that the difference was significant. Now that we have had Custom LASIK and Intralase bladeless LASIK for a while I can categorically answer with a resounding YES they are definitely worth it.
Custom LASIK utilizing the VISX S4 excimer laser works by scanning your eye and creating a customized treatment that not only corrects your nearsightedness, farsightedness and astigmatism but also treats a larger area of the cornea and in a way that maintains its optimal curvature. In addition the CustomVue IR laser can in most cases scan your eye and adjust the treatment exactly to your eye position under laser. All this results in significantly better results, with less chance of halos, blur and a much lower retreatment rate. We now have many studies which support this.
The Intralase laser creates the flap needed for LASIK using a high speed laser which is more reliable, accurate, safer and less painful than the microkeratome which uses an oscillating metal blade to cut the flap. In addition, Intralase flaps are more stable, heal faster and better and also result in better visual outcomes. Again we now have a lot of experience with this technology and great studies that show better results for patients.
Its clear at this point that we now have a more reliable and safer procedure than we have ever had for refractive surgery providing better vision for more patients. Our retreatment rate has dropped to below 5% and over 95% of patients are 20/25 or better. So now is an excellent time to consider refractive surgery, especially if you have a flex spending account. You want to be sure to utilize those dollars before the end of the year, or come in for an evaluation to see if you are a candidate so you can set aside dollars for next year.
I realize these are challenging times, but there is no better investment than in yourself. Financing is still available for those interested.
Today the FDA will hold hearings on consumer satisfaction and outcomes of LASIK surgery. While there have been good large studies that document the safety and efficacy of LASIK, specifically quantifying patient satisfaction has not been addressed. Patients, both happy and unhappy, as well as surgeons and other eye care professionals will testify.
I have been performing LASIK for over a decade now with well over 8000 surgeries under my belt. I think that I can provide some insight into my refractive patients. LASIK is not for everyone. Not every person is medically a candidate (prescription too high, cornea too thin, eyes too dry, etc). And not everyone is psychologically a candidate for surgery (unrealistic expectations, poor surgical cooperation, not appreciating the risks of surgery). One of the most important things I do is to help patients figure out if they are good candidates. In order to get good results, you need good candidates. And a good surgeon of course. I tell prospective patients ‘no’ all the time if I think LASIK isnt a good choice for them.
The risk of complications is below 1%, and going lower. The surgery I perform today is a superior and safer surgery than in the past as the technology and our knowledge has improved. While there will always be a small risk with LASIK surgery, and some few patients may not always be happy, the vast majority of bad LASIK outcomes are in those patients who have had surgery with old technology and old techniques.
I look forward to the report from the study that the FDA is commissioning on LASIK as I know that it will support what has been the overwhelming experience of my refractive practice: good candidates operated on by a good surgeon, in a great laser center with superior technology will produce great results and happy patients. I am always happy to discuss this and any issue, so dont hesitate to email me. I want all of my patients to completely understand the procedure, its risks and benefits and how it may or may not be right for them. Mark H. Blecher, M.D.
I’d like to wish everyone a happy and healthy 2008 and welcome you to our new website and blog. I will use this blog to provide timely updates on eye care with an emphasis on new technologies and in particular refractive surgery. 2007 was a great year for Philadelphia Eye Associates, our employees and our patients. We brought new technologies to the offices such as OCT (Ocular Coherence Tomography) for the evaluation of the retina and optic nerve, the IOL Master for measuring the axial length of the eye, new visual field machines to help in the management of glaucoma, and some major changes in refractive surgery. Last year TLC laser center of Mt Laurel, where I perform all my LASIK surgery, merged with Kremer Laser of Cherry Hill and combined their operations at the Cherry Hill location. After a lot of work, the end result is nothing short of amazing. The facility is great, and as a result of the merger we were able to bring in two of the newest technologies in refractive surgery: Intralase and Pentacam. In addition the center has two full time Optometric refractive specialists, three surgical technicians, two ophthalmic technicians and a great front office staff. NO laser center provides better technology or personnel and for you the patient, no one provides a better laser vision experience. As you can tell I’m quite pleased with the result.If you have any questions about Philadelphia Eye Associates or any of the vision care services we offer, don’t hesitate to email me through the website. Mark H. Blecher, M.D.
Ophthalmologists Dr. Carolyn S. Repke, Dr. Joseph Markoff, Dr. Marc D. Garden, Dr. Mark H. Blecher,
Dr. Robert D. Behar, Dr. Stacey L. Ackerman, and Dr. Brad Feldman, serving New Jersey (NJ), Philadelphia, and all surrounding areas.