Monday, March 30, 2009

What Is SLT And Am I A Candidate For Glaucoma Laser Surgery?

SLT or Selective Laser Trabeculoplasty is a laser procedure that can help control intraocular pressures of patients with open angle glaucoma. This laser procedure can be used as the first treatment in those diagnosed with glaucoma. It can be used in patients presently on medication whose pressures are inadequately controlled by medications.
Patients, who are on multiple medications for glaucoma with good control, can have this procedure performed by their ophthalmologist. These patients may benefit by being able to reduce the number of medications they use in order to control their glaucoma.

SLT works by increasing the number of areas that can drain fluid from the eye. By doing so, the intraocular pressure is decreased. Usually the ophthalmologist will treat a 90 degree area at a time. This is an office procedure which takes only a few minutes with minimal if any discomfort. Patients are able to drive home safely after the procedure. The treating physician will recheck the patient in 2 to 4 weeks and know if there is a decrease at this time. In order to get better control, often the ophthalmologist will treat each eye up to four times. Other than mild discomfort in brightly lit areas for the next few days after treatment, the patients don't usually experience any other side effects.

Five year studies have shown that the effects of SLT can last at least five years. Some patients do not get as much benefit as others from this treatment. However, in general, this new laser has really changed how we can help our patients with open angle glaucoma attain better intraocular pressures.

The diagram above shows the area of the eye that is responsible for producing the fluid that circulates to the front of the eye, the ciliary body. If you look carefully, you will see an area labeled trabecular meshwork. That is the area that is treated with a laser to make more openings in order to bring the intraoculare pressure down by providing more areas of fluid outflow.

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Tuesday, March 10, 2009

Are You A Good Candidate For Premium Intraocular Lenses For Cataract Surgery?

A thorough eye examination and expectations are essential in helping to decide whether you are a good candidate for multifocal intraocular lenses. These lenses are implanted at the time of cataract surgery and allow the patient to see near and far. Corneal health is very important to obtain good vision post-operatively. Equally important, is the health of the patients fovea, the center of sight in the retina. Patients who are considering having multifocal lenses implanted at the time of cataract surgery should discuss their eye health with their ophthalmologist in order to select the appropriate intraocular lens that will give them the results they would like to achieve.

Patients with moderate amounts of corneal astigmatism would likely have more satisfying results receiving a Toric intraocular lens, rather than a multifocal lens, for the simple reason these patients would still need glasses to correct their astigmatism.

There are many factors to consider when choosing the best intraocular lens for each patient. It is important to keep in mind that not every point seen will be in perfect focus. The technology is good but not perfect. With a monofocal intraocular lens, (one that only focuses at distance), there is a 2% chance of a patient experiencing glare or halos. There is up to a 5% incidence of experiencing glare or halos with multifocal lenses. Your ophthalmologist and you need to decide together when considering the lens that will provide the best results for you.

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Tuesday, March 3, 2009

What Are Premium Intraocular Lenses For Cataract Surgery?

As a patient facing cataract surgery, there are some wonderful options now available to you. Ophthalmic surgeons have been replacing the cataract with intraocular lenses for over twenty-five years. These monofocal lenses have provided excellent distance vision. They do not allow for near vision and patients require prescriptive lenses to see clearly at near.

Today we have many more options. A patient who has a lot of astigmatism and needs his/her cataract removed, has the choice of receiving at the time of surgery, a Toric lens that will correct the astigmatism and will provide excellent distance vision. A prescriptive lens will be needed for near with these intraocular lenses.

Also available over the past few years are intraocular lenses, such as the ReStor lens, the Crystalens, and the new Tecnis multifocal lens, that can provide the patient with both distance and near vision at the same time. It is important to have the same type of lens put in both eyes. In addition, the patient needs to understand that sometimes, there will still be a need for a prescriptive lens to attain the best vision possible.

These premium lenses are not covered by Medicare or other insurances at this time and will be an out of pocket expense for the patient. It is important to discuss your visual needs with your ophthalmologist so the best choice can be made together in regard to your results and expectations.

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