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Cataract Surgery

With a success rate better than 95%, modern cataract surgery is one of medicine’s brightest successes. No other surgery brings so much joy to so many people. The way to that joy is amazingly simple and with a minimum of discomfort. Through proper examination and treatment, a good visual result is usually obtained, but like all surgery there is never a guarantee on how one will be able to see.

Before surgery, we will measure and test your eye using modern equipment of determine the appropriate lens implant for your eye.

On the day of surgery you will be given eye drops and a mild sedative to help you relax. You will be awake but you should not experience any discomfort. The cataract is gently removed using an operating microscope and specialized instruments. Complications are rare; when they do occur, they are usually minor and easily treated. Modern cataract surgery does not require a long stay in a hospital or a long recovery period. It takes only 15 to 30 minutes and is performed on an outpatient basis. More than a million Americans a year have cataract surgery.

The removal of your cataract (the cloudy natural lens) requires a new way for your eye to focus light. A tiny man-made lens, smaller than a dime, is put inside your eye during surgery and replaces your cloudy natural lens. The new lens is permanent and restores to you the most natural vision possible.

Recovery from cataract surgery is brief, simple, and with virtually no discomfort. Following surgery you will be given specific instructions for the care of your eye. You will find this care quite easy. You will be given medicine for your eye and a protective shield to wear while sleeping.

You may return to most normal activities almost immediately. You may watch TV, read, and sew. Your vision will improve as your eye heals. You may be able to see quite well almost immediately, or you may need a few weeks for healing. You will heal at your own rate. Once your eye has recovered, you may need glasses to fine-tune your vision.

 

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Glaucoma Surgery

Treatment of Open Angle Glaucoma

OAG treatment concentrates on lowering the pressure inside the eye to prevent damage to the optic nerve. The most common treatments for glaucoma have been the use of medications in the form of eye drops, pills, and laser treatments. Laser treatments and some medications allow for faster drainage, while other medications reduce the production of aqueous humor. If these methods fail to decrease fluid pressure, conventional surgery may be required to create a new drainage channel.

Traditional Laser Treatment

Since medications and eye drops can cause undesirable effects or simply fail to control glaucoma, and because patients frequently fail to take their medications, laser surgery may be a better alternative.

With traditional argon laser trabeculoplasty (ALT), tiny, evenly spaced burns are made in the trabecular meshwork with an argon laser. These laser burns stimulate the drainage of aqueous humor. However, scarring of the trabecular meshwork occurs as a result of ALT burns, and may limit its success and the ability to retreat the eye should the procedure need to be repeated in the future.

Selective Laser Trabeculoplasty

Selective Laser Trabeculoplasty (SLT) is an advanced type of laser surgery and approach to managing patients with an open-angle glaucoma. Instead of generally burning tissue as in ALT, SLT selectively targets pigmented cells in the trabecular meshwork. Both SLT and ALT produce equivalent drops in IOP, however the more sophisticated SLT procedure does not have the associated damage to other tissues and adverse scarring effects. For this reason, where ALT is limited, SLT may potentially be repeated many times. SLT has also been found to be effective when ALT and other forms of treatment have failed.

Benefits of SLT


• SLT results in a biological response that increases aqueous drainage, and reduces IOP.
• No adverse reactions from medications
• No adverse scarring of trabecular meshwork
• May reduce the need for lifelong use of expensive eye drops and other medications
• May reduce or eliminate the trouble of always having to take glaucoma medications

How is SLT performed?

SLT is usually performed in the office and only takes about 15-20 minutes. Prior to the procedure, eye drops will be given for anesthesia and to prepare the eye for treatment. The laser applications are made through a slit lamp microscope, similar to the one used for eye examinations. About one hour of office time should be planned so the IOP can be checked after the eye is treated.

What should be expected after SLT treatment?

The IOP should drop significantly within a day of having the SLT performed. The doctor may treat the eye with anti-inflammatory eye drops that will be continued for four to seven days after the procedure. Most patients will have to return for follow-up visits to recheck the treated eye.

Unlike some glaucoma medications, there are no incidences of allergy or systemic side effects with SLT. Complications are minimal but may include inflammation, transitory IOP spike, conjunctivitis, or eye pain. For more information about SLT and its benefits and possible adverse effects ask the doctor.

Prevention is the best medicine

Vision loss from glaucoma is permanent but can usually be prevented with early detection and treatment. Glaucoma management is usually a lifelong process that requires frequent monitoring and constant treatment. Since there is no way to determine if glaucoma is under control based on how a person feels or their vision, a person with glaucoma generally should be examined every three to four months for the rest of their lives.

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