Procedures

• Small Incision Cataract Surgery
• YAG Laser Capsulotomy
• Sugical Trabeculectomy for Glaucoma
• Eyelid Procedures
• Botox Cosmetic

Small Incision Cataract Surgery:

All three of our doctors have special interest in cataract surgery, and all use the small incision method of cataract removal. This leads to faster recovery with less risk to our patients.

The cataract is actually the lens of the human eye that has become cloudy due to aging, trauma, or certain disease processes. When visual impairment interferes with one’s job or activities of daily living, it is time to consider cataract removal. Using a special device called a phacoemulsifier, the cataract is fragmented into tiny pieces using ultrasound and aspirated from the eye through a very small incision. It is replaced with a clear intraocular lens implant to allow sharp vision. This technology is available for our patients on an outpatient basis at our own dedicated eye ambulatory surgery center on Northpointe Drive.

One of the many benefits associated with phacoemulsification is that a much smaller incision is required. In many cases, one or no stitches are necessary to close this incision. A specially designed foldable intraocular lens is inserted to allow for a short recovery time and fewer post operative visits to your ophthalmologist.

Many of our patients will find that small incision cataract surgery and intraocular lens implantationwill restore their vision within a matter of days. Frequently, our patients will be ready for theirfinal glasses within 3 weeks of surgery.

After having small incision cataract surgery, patients may resume all activities immediately except for swimming. There are absolutely NO restrictions on bending, lifting, or heavy activities. The vast majority of our patients are candidates for this small incision procedure.

After small incision surgery, a clear lens implant is shown in position replacing the cloudy cataract.This allows sharp focusing for the patient without the need for thick glasses or contact lenses as used in years past. This modern method of cataract removal has a 95-98% success rate.

We are specializing in small incision cataract surgery because we wish to provide the latestsurgical techniques for our patients. If you have any questions about this method of removal, please ask a member of our medically trained staff.

In virtually all of our cataract patients we use a foldable intraocular lens to help maintain the smallest incision size possible. Our lens of choice is the newest Alcon aspheric intraocular lens which can help increase our patients’ post operative quality of vision and contrast sensitivity.

For patients with significant degrees of astigmatism, we also offer the Alcon TORIC intraocular lens. This is made of the same material as the aspheric lens we are using, although it has a "built in" astigmatism correction which is calculated and tailored to each patient’s prescription. This lens can greatly reduce a patient’s post operative need for distance correction. In fact, in the original Alcon study, greater than 95% of those having the TORIC lens implanted in both eyes were able to go without distance glasses.

Our practice also offers the Alcon RESTOR bifocal implant which can help patients focus at both distance and near post operatively. There is a higher risk of induced glare at night from this lens, however. This can occasionally be problematic when driving after dark. In order to achieve the multifocal capability of this lens, the patient must be willing to give up a bit of contrast especially for distant vision. This lens can be quite successful, however, in certain selected individuals. This lens works best when implanted in both eyes.

Our practice would be happy to forward more information to you regarding any of these newest technology lenses.

YAG Laser Capsulotomy:

During modern cataract surgery, an intraocular lens implant is inserted in the eye to replace the cloudy cataract. There is a protective membrane which remains behind the implant called the posterior capsule. In approximately 30-40% of patients, this posterior capsule can become cloudy months or years after the original surgery, causing blurry vision and glare symptoms. This is referred to as a secondary membrane.

Fortunately, the secondary membrane can be treated on an outpatient basis with the YAG laser.

After applying topical anesthetic drops and a special lens to the eye, the patient is seated at the YAG laser which is then used to create an opening in the cloudy posterior capsule as shown. This results in almost immediate improvement in vision. The chance of any complication related to the YAG laser treatment is reported to be less than 1 percent.

Surgical Trabeculectomy for Glaucoma:

Glaucoma is an eye condition where the pressure inside the eye is too high for the optic nerve to tolerate. Most patients can have their glaucoma pressure controlled by using various eyedrops. If eyedrops are not sufficient, an in office laser treatment called Selective Laser Trabeculoplasty can frequently be used to help improve the patient’s pressure status.

In some patients, the intraocular pressure reading is extremely difficult to control. In those patients, a surgical trabeculectomy is recommended. This is an outpatient procedure which actually involves making a new outflow drainage site in the eye. Dr. Ann Melick of our staff has had fellowship training in glaucoma and generally performs most of our trabeculectomy surgery. Such surgery has an 80-90% chance of controlling a patient’s glaucoma without the use of additional eyedrops.

Eyelid Procedures

Common eyelid problems include excessive eyelid skin, droopy eyelids or eyelids that turn inward or outward. These conditions can cause eye discomfort and can limit vision and affect appearance. Fortunately, such eyelid problems can be corrected with surgery. Several of the more common eyelid conditions which we treat include:

PTOTIS: Ptotis is a condition in which the upper eyelid droops due to eyelid muscle weakness. This condition can develop with age or can be apparent at birth. Surgery can restore the upper eyelid to its normal position.

EXCESS EYELID SKIN: Over time, many people develop excess eyelid skin, (dermatochalasis). Since the skin on the eyelid is the thinnest skin of the body, it tends to stretch. In the upper eyelid, this excessive skin may limit your side vision. This same problem may cause “bags” to form in the lower eyelids. The excess skin from the lids can be removed by a Blepharoplasty procedure to improve side vision and other symptoms.

ECTROPIAN: In this condition, stretching of the lower eyelid due to age may cause the eyelid to droop downward and turn outward. Dry eyes, excessive tearing, redness and sensitivity to light and wind can be symptoms. This may be corrected by a brief surgical procedure. More involved cases caused by contraction or scarring of the skin surface may require a skin graft.

ENTROPIAN: This condition also occurs as a result of aging. The eyelid turns inward causing the eyelashes and eyelid skin to rub against the eye. Symptoms can include redness and irritation of the eye, tearing, and sensitivity to light and wind. If this condition remains untreated, it may cause an infection of the cornea.

Eyelid surgery is performed on an outpatient basis using local anesthesia. Prior to the surgery, photographs of your eyelids and side-vision testing may be performed as this is often required by insurance companies. Bruising and swelling of the eyelids are very common side effects following any eyelid procedure.

Botox Cosmetic

Botox Cosmetic is a purified protein. It is a simple, non-surgical, physician administered treatment that can temporarily smooth moderate to severe frown lines between the brows in people from 18 to 65 years of age. During treatment, very low doses of Botox Cosmetic are administered via a few tiny injections directly into the muscles that cause those stubborn lines. The treatment is usually done in about 10 minutes and no recovery time is needed. Within days, you may see an improvement that can last up to four months. Results may vary.

Botox Cosmetic works by blocking the transmission of nerve impulses to the injected muscles. This reduces the activity of the muscles that cause those persistent frown lines or wrinkles to form. Although the results are visible, a treatment with Botox Cosmetic will not radically change your facial appearance or make you look as if you “had surgery.” The muscle activity is simply reduced, so you can still frown or look surprised without the wrinkles and creases between your brows.

If you choose not to continue treatment, the moderate to severe frown lines between your brows will gradually look like they did before you started treatment with Botox Cosmetic.