Cataract Surgery in Canton, Alliance & Canfield, OH
Types of Cataract Surgery Offered at Roholt Vision
Femtosecond Laser Cataract Surgery (FLACS or LCS)
In 2011, femtosecond laser cataract surgery (FLACS) was introduced and is now promoted in many centers. The doctors at RVI have extensive experience with femtosecond laser cataract surgery, in fact Dr. Roholt was one of the first in the area to use this technology. Femtosecond laser cataract surgery 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. As time passes and the laser technology improves, benefits may become more clear. Because the extra cost is significant, and since Medicare and Insurance do not pay, almost all patients opt for CustomCorrection™ with advanced technology ZeptoTM, or the traditional, gentle ultrasonic PE method.
A new benefit in conjunction with ultrasonic cataract surgery method is the ability to use ZeptoTM. One of the most important steps in cataract surgery or lens replacement surgery is the capsulotomy or capsulorrhexis. The natural human lens, or cataract, is enclosed by a thin, saran-like sac. This “capsular bag” must be entered and peeled away to remove the lens. Currently, there are three ways to accomplish this: 1) the traditional cataract surgery method uses small instruments to peel it open, 2) femtosecond laser cataract surgery capsulotomy, and the latest innovation, 3) ZeptoTM
The ZeptoTM uses an electronic pulse to instantly create a perfectly round capsulotomy, which likely helps in intra-ocular lens centration. The edge of the capsule is congealed for increased strength, which helps in avoiding complications such as tearing of the capsule edge. The ZeptoTM is even stronger than the traditional method, which itself is stronger than a FLACS capsulotomy (created by multiple rapid pulsations which cause an easily torn, serrated edge to the capsular opening). ZeptoTM is also less costly to the patient than FLACS!
Intraocular Lens Implants
The intraocular lens implants used by RVI doctors are high-tech, FDA approved designs. The most common material for intraocular lens implants since 1953 is derived from a hard plastic called polymethylmethacrylate (PMMA). Now foldable PMMA (or acrylic) implants are used. Foldable silicone intraocular lens implants are also used and are safe and effective (this is not the same type of silicone used in breast implants). The doctors will take various factors into consideration when deciding which implant to place in your eye. All the implants are non-reactive with human tissue and hypoallergenic.
Roholt Vision Institute uses the Humphrey-Zeiss IOLMaster®, Lenstar® and the iTrace® eye analyzer, (a first in NE Ohio) and the Pentacam®These technologies enable eye measurements for intraocular lens implants, which are more accurate than those used previously. For more information, visit the Zeiss, Haag-Streit, Tracey, or Oculus website.
Now you must consider your choices for your intraocular 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 Cataract Surgery
This lens uses a single vision intraocular lens, which gives good vision. You will need reading glasses and possibly distance glasses. Medicare and insurance pay for basic intraocular lens implant surgery subject to coinsurance and deductible.
The following services may include the use of Zepto® to produce a stronger, more central lens opening to help in implant centration if Surgeon feels it will help the case:
2. CustomCorrection I™
Advanced techniques such as Zepto®, LASIK, or PRK may be used in this refractive package. This option corrects low degrees of astigmatism and refractive error allowing patients less dependence upon glasses after cataract surgery. Generally, excellent uncorrected distance vision is obtained (requiring only reading glasses), or Blended Monovision (dominant eye distance with non-dominant eye blended for near vision). Superior quality monofocal lenses are implanted, usually chosen for asphericity (corneal curvature) factors.
There is an additional charge that is not covered by Medicare or Insurance with the election of this CustomCorrection I™ package.
3. CustomCorrection II, Multi-focal: Panoptics®, Symfony®, Tecnis® Crystalens®, Restor®
The above intraocular lens implants are multifocal lens implants, which usually 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 many of these advanced lenses even correct for astigmatism. The disadvantage of the multifocal lens is a possible slight decrease of clarity in low contrast, or haloes with night driving, compared to single vision implants. There is an additional charge that is not covered by Medicare or Insurance, for election of one of these packages. For more information on these lenses visit: Acrysof Panoptix®, Tecnis Symfony®, Tecnis Multifocal®, Acrysof Restor®, www.crystalens.com
3. CustomCorrection A™
A special “Toric” or astigmatism-correcting intraocular 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. The PanOptyx® or Symfony® Multifocal lenses also correct astigmatism. Medicare or insurance will not pay for this, only for the basic amount of the surgery.
4. CustomCorrection BlendVision
Patients sometimes prefer a BlendVision, in which the dominant eye is focused for distance, the other eye for near. The ocular system “neuro-adapts” to this in a week or two for most people. This is usually combined with the CustomCorrection A™ or CustomCorrection I™ procedure, since it is less expensive than CustomCorrection II, multifocal lens.
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 occurs even with perfectly performed cataract eye surgery. A YAG laser (Yttrium-Aluminum-Garnet) is used to open the wrinkled or fogged membrane behind the intraocular 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 IITM). With CC-IITM 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.
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 cataract surgery is tailored to the individual.
The cataract surgery / 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.
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 ATM, or through LASIK or other CustomCorrectionTM techniques. As physicians specializing in refractive surgery (correction of focus defects), the doctors at Roholt Vision are uniquely qualified to help you attain the best vision possible.
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 is also reduced compared to the conventional methods of multiple eyedrops.
Refractive Lens Replacement (rLR)
Patients with high degrees of myopia, hyperopia and/or astigmatism may not be candidates for LASIK or other refractive procedure. Additionally, some people may have incipient or minor degree of lens opacity (early cataract) but don’t qualify for insurance coverage. These patients may elect to have an intraocular lens performed as one of the above listed procedures. RLR is a non-covered, self-pay procedure.
Cataract Surgery FAQs
How do I know if I need cataract surgery?
What age do you have to be to have cataract surgery?
Who is a good candidate for cataract surgery?
How do I know which intraocular lens implant is best for me?
What restrictions will I have after cataract surgery?
Will I need new glasses after cataract surgery?
Will I be put to sleep during surgery?
Roholt Vision Institute proudly provides patients from North Canton, Canfield, Alliance OH and surrounding areas with cataract surgery. Contact us today to schedule an appointment!