 Phacoemulsification Cataract/Lensectomy
Dr. Roholt was one of the first in the region to routinely employ the "phacoemulsification" (PE) technique, which is now the standard. PE is the most advanced method currently available. The PE incision is very small and strong and enables the surgeon to perform "No-Stitch" operations. This type of surgery allows for faster healing compared to previous techniques.
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.
Lens Implants
The lens implants used by Dr. Roholt are modern, 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 for no-stitch cataract surgery 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 is pleased to be among the few eye practices using the Humphrey-Zeiss IOLMaster™. This new technology enables us to take eye measurements for lens implant which are ten times more accurate than those used by other eye centers. For more information, visit the Zeiss website.
Now you must consider your choices for lens implants:Focus Defects and Astigmatism
Conventional Implant
This lens is a single vision lens, which gives excellent vision. You will need reading glasses and possibly distance glasses, although if you elect monovision (one eye for distance, one eye for reading) you may be able to do without glasses, assuming no residual focus defects (explained below). Medicare and insurance allow for all testing usually required for a conventional implant subject to coinsurance and deductible.
Custom Implant (Tecnis, B&L AO, Acrysof IQ)
These are a new generation of lens implants, which are wavefront-adjusted to your eye. They generally give sharper, crisper vision and usually better night vision. You would need reading glasses also, unless you elect monovision. If you desire one of these implants, an Orbscan corneal topography is indicated to match the lens to your eye. Roholt Vision Institute is the first center in Ohio to use advanced software for custom lens implant matching. Medicare or insurance will not pay for the additional testing needed for the custom lens implants.
Multifocal Lens Implants (ReStor™, ReZoom™, Crystalens™)
A multifocal lens implant allows a patient to achieve both distant and near vision without eyeglasses. Dr. Roholt was one of the first implant surgeons in the Midwest involved in multifocal lens implant research in the early 90’s. Now the new advanced designs offer opportunities for glasses-free vision. The disadvantage of the multifocal lens is a possible slight decrease of clarity in low contrast, or glare with night driving, compared to conventional or custom 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: www.acrysofrestor.com, www.visioninfocus.com, or www.crystalens.com.
Myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (warped cornea) are all focus defects that can be improved with lens implant surgery. The eyeglass lens power needed for the eye is simply incorporated into the lens implant. Astigmatism is caused by a distorted "spoon shaped" cornea. This visual defect can be reduced or eliminated using toric lens implants, or an incisional technique called LRI (limbal relaxing incision), combined with the QuickVision Cataract surgery. As a physician specializing in refractive surgery (correction of focus defects), Dr. Roholt is uniquely qualified to help you attain the best vision possible. Further surgery such as LASIK is optional to help reduce dependence on eyeglasses after lens implant surgery.
No-Stitch Surgery
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.
Laser Surgery/Secondary Cataracts
Lasers are not used to remove cataracts initially. However, the Yag Laser is used to remove secondary cataracts. A secondary cataract, or cataract re-growth, is a common occurrence after lens implant, lensectomy, or cataract surgery, and usually occurs one to four years after the original operation. This laser procedure takes five minutes and is painless. The cataract then cannot recur. Dr. Roholt's practice was the first in NE Ohio to acquire a YAG laser.
Anesthesia
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.
1. Roholt, PC, "Stability of Lateral vs. Superior Cataract Incision," International Society of Refractive Surgery, June, 1992.
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