Come see at any of our Ohio locations: Canton, Canfield, or Alliance
Femtosecond Laser Cataract Surgery (FLACS or LCS)
Years ago, Dr. Roholt was one of the first in the region to routinely employ ultrasonic phacoemulsification (PE), for cataract removal, which is now the standard. This incision is very small and strong and enables the surgeon to perform “No-Stitch” operations. In 2011, femtosecond Laser Cataract Surgery (FLACS) was introduced and is now promoted in many centers. The doctors at RVI have extensive experience with FLACS, and will perform the surgery upon patient request. FLACS is performed with a laser such as the LenSx™, Catalyse™ or others, which are used to make the incisions, open and soften the cataract, but has not been shown to improve the result of cataract surgery (Also click here). As time passes and the laser technology improve, benefits may become more clear. Because the extra cost is significant, and since Medicare and Insurance do not pay, almost all patients opt for the traditional, gentle ultrasonic PE method.
QuickVision™ Cataract Surgery
Dr. Roholt was one of the first in the country to advocate the lateral or “temporal” incision. He found that a temporal incision markedly reduced astigmatism allowing many more patients to see well without glasses after cataract surgery (1). This side approach gradually evolved to the “clear corneal” incision in use today.
The lens implants used by RVI doctors are high-tech, FDA approved designs. The most common material for lens implants since 1953 is derived from a hard plastic called polymethylmethacrylate (PMMA). Now a foldable PMMA (or acrylic) implant is used. Foldable silicone lens implants are also used and are safe and effective. This is not the same type of silicone that was used in breast implants. Dr. Roholt will take various factors into consideration when deciding which implant to place in your eye. Roholt Vision Institute uses the Humphrey-Zeiss IOLMaster™ and Lenstar™. These technologies enable eye measurements for lens implant which are ten times more accurate than those used previously. For more information, visit the Zeiss or Haag-Streit website.
Now you must consider your choices for lens implants – to help in your decision, ask yourself:
“Do I want to be less dependent upon glasses or is wearing glasses ok?”
1. Basic Implant
This lens is a single vision lens, which gives excellent vision. You will need reading glasses and possibly distance glasses. Medicare and insurance pay for basic implant surgery subject to coinsurance and deductible.
2. CustomCorrection I™
This is for patients who prefer to be less dependent on glasses. More extensive testing is used to maximize crisp, glasses-free vision. The implants used are a new generation of lens implants, and a distortion measurement, called spherical aberration, is taken into consideration, thus often giving sharper, crisper vision and usually better night vision. (Click Here) You would need reading glasses, unless you elect monovision (one eye for distance, one for near). Sometimes a secondary treatment (LASIK, PRK, CK or others) is required to reduce the eyeglass dependency, included in CustomCorrection I™. Roholt Vision Institute is the first center in Ohio to use advanced software for custom lens implant matching for spherical aberration. Medicare or insurance will not pay for CustomCorrection I™.
3. CustomCorrection II™
Symfony™, Tecnis™ Multifocal, Crystalens™, Restor™
The above lens implants are multifocal lens implants which allow patients to achieve both distant and near vision without eyeglasses. Each type has unique characteristics, and the doctors at RVI are skilled at implanting all. Dr. Roholt was one of the first implant surgeons in the Midwest involved in multifocal lens implant research in the early 90’s as an investigator in the Storz TruVista™. Now the new advanced designs offer opportunities for glasses-free vision, and the Symfony™ Toric and Crystalens Trulign™ even correct for astigmatism. The disadvantage of the multifocal lens is a possible slight decrease of clarity in low contrast, or glare with night driving, compared to single vision implants. There is an additional charge that is not covered by Medicare or Insurance with the election of one of these lenses. For more information on these lenses visit: Tecnis Symfony™, Tecnis Multifocal™, Acrysof Restor™, or www.crystalens.com.
4. CustomCorrection A™
A special “Toric” lens implant (Acrysof™, Tecnis™, or Crystalens Trulign™) is used to achieve the same results as in CustomCorrection I™ for individuals who have moderate to severe astigmatism. Medicare or insurance will not pay for this.
YAG Laser and Secondary Cataract (After-Cataract)
A secondary cataract, or cataract re-growth, is a frequent occurrence after lens implant, lensectomy, or cataract surgery, and can occur within weeks after the original operation. This can occur even with a perfectly performed eye surgery. A YAG laser (Yttrium-Aluminum-Garnet) is used to open the wrinkled or fogged membrane behind the lens implant. This laser procedure takes five minutes and is painless. The secondary cataract will usually not recur. Performance of a YAG laser is more common with Multifocal implants (CustomCorrection-II). With CC-II the YAG may be performed prior to a focusing procedure such as LASIK, PRK, or CK. Dr. Roholt’s practice was the first in NE Ohio to use the YAG laser. This treatment is NOT included in the cost of CustomCorrection™ and is billed separately to insurance or Medicare.
Focus Defects and CustomCorrection™
Myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (warped cornea) are all focus defects that can be improved by lens implant surgery with CustomCorrection™. The eyeglass lens power needed for the eye is incorporated into the lens implant. Astigmatism is caused by a distorted “spoon shaped” cornea. This visual defect can be reduced or eliminated using a toric lens implants as in CustomCorrection A, or through LASIK or other CustomCorrection techniques. As a physician specializing in refractive surgery (correction of focus defects), Drs. Roholt and Celmer are uniquely qualified to help you attain the best vision possible.
The incision into the eye is generally very small and is self-sealing, creating a “No-Stitch” incision. However, sometimes for safety’s sake, one or more sutures are placed to close the incision and, therefore, the “One-Stitch” procedure is used. In general, the surgery is tailored to the individual.
The cataract/lensectomy surgery is performed using anesthetic placed around the eye area and/or adjacent eyelids, or strong eyedrop “topical” anesthesia which causes complete loss of pain sensation. A short-acting sedative is also used to eliminate anxiety or discomfort.
Roholt Vision is one of the first centers in Ohio to offer the EZ-Drop™ method of antibiotic/steroid prophylaxis after cataract surgery. This greatly reduces the number of drops that need to be instilled. The risk of infection may also be reduced compared to the conventional methods.
1. Roholt, PC, “Stability of Lateral vs. Superior Cataract Incision,” International Society of Refractive Surgery, June, 1992.