Dr. Douglas Liva is an superb cataract surgeon who utilizes the latest techniques and technology available. Dr. Liva performs most of his cataract surgery at his outpatient surgical facility Saddle River Valley Surgical Center. It is conveniently located in Bergen Medical Center in Paramus centrally located in Bergen County.
Cataracts, the leading cause of treatable blindness, create vision cloudiness and develop for a variety of reasons, but most commonly result as part of the aging process. However, they can also be caused by long-term ultraviolet (UV) light exposure, trauma to the eye and as secondary effects of diseases such as diabetes. Cataracts typically require surgical removal and replacement of the eye’s lens.
Cataract surgery is a highly effective way to restore vision impaired by cataracts. Both the removal of the clouded natural lens and the implantation of the replacement IOL are accomplished through microscopic incisions from 2.4 millimeters in length. Incisions this small usually avoid the need for stitches and induce minimal amounts of astigmatism. Foldable lens technology has led to the development of microincisional surgery.
To calculate the lens power for for intraocular lens insertion Optical biometers, such as the Carl Zeiss Meditec IOLMaster, perform a new method of preoperative A-scan biometry where infrared light is used to calculate axial length, keratometry and anterior chamber depth. This precise, rapid method reduces technical variance and eliminates physical contact with the cornea. However, optical biometry may not perform consistently with patients who have dense cataracts. So in those cases where the cataract is so dense that even a laser can’t penetrate. Dr. Liva uses an excellent alternative, immersion ultrasound. This procedure involves doing ulrasonic measurements through a shell filled with water to avoid having error produced by compression artifact of the ultrsound probe indenting the cornea.
Standard Monofocal IOL
With 25 million implants worldwide, ACRYSOF® lenses are the most frequently implanted in the world, as physicians appreciate the long-term clinical results and unmatched stability of the lens. Recent advances to this line of lenses also address other visual disturbances while correcting for cataracts. For patients with cataracts and spherical aberration there is the ACRYSOF® IQ lens, which corrects both conditions simultaneously. The spherical aberration of a patient’s cornea can be measured with the Atlas Corneal Topographer and the the choice of an intraocular lenscan be made which reduces the spherical aberration the optimal amount.
Filtering Blue Light Like the Natural Lens
All AcrySof® IQ IOLs are available with a lens technology which is designed to have light-filtering abilities that approximate the light transmission of the human lens.
The human lens has the natural ability to filter UV and blue light. Unlike other UV-absorbing IOLs, this lens is designed to filter light similar to the human lens.
The AcrySof® IQ ReSTOR® IOL is available with the blue light-filtering chromophore.¹ This unique chromophore filters blue light in a manner that approximates the natural crystalline lens, in the 400-475 nm wavelength range. The blue light-filtering chromophore filters blue light without impacting color vision or the quality of vision.²*
For patients who have small amounts of astigmatism and don’t find reading glasses inconvenient or can’t afford to upgrade to a premium lens, this lens is an ideal choice.
For correction of astigmatism or presbyopia
In May of 2005, the Centers for Medicare and Medicaid Services (CMS) clarified its payment rules to present Medicare beneficiaries with the choice to receive presbyopia-correcting intraocular lenses (IOLs) that provide restoration of distance, near and intermediate vision with less dependency on eyeglasses or contact lenses following cataract surgery.
Prior to the CMS ruling, limitations on Medicare payment prevented beneficiaries from choosing to purchase these lenses. Under the new policy, Medicare will continue existing reimbursement amounts for cataract surgery, and patients may elect to pay additional charges for advanced technology lenses such as the AcrySof® IQ ReSTOR® IOL.
Private insurances also consider premium lenses a “luxury” and require that patiens pay for the additional expenses involved with their implantation.
AcrySof® IQ ReSTOR® Intraocular Lens (IOL)
The ReSTOR® active focus lens is a forth generation multifocal lens. This multifocal design focuses light from several different distances onto the retina at the same time allowing the patient to see distance and near without glasses. For most patients, the ReSTOR® IQ IOL will eliminate the need for glasses in most situations when implanted in both eyes. Some patients may still need glasses for fine print, but will be pleased to find that their reading vision is adequate for most tasks. If glasses are needed for distance the prescription is typically mild. The latest design has reduced the incidence of side affects of earlier multifocal lenses such as glare, haloes and waxy vision. In addition, the lens is now available in a toric design to correct corneal astigmatism. In the past patients who had significant corneal astigmatism were disqualified from having multifocal lens implantation. The lens is also available in an increased range of powers so are now suitable for patients with higher amounts of astigmatism.
AcrySof® IQ Toric IOL
In cataract patients with corneal astigmatism, Dr. Liva may suggest implantation of a toric implant . Corneal astigmatism is a condition where the cornea is shaped like a football rather than a basketball. The two different curvatures results in having two focal points causing blurred vision . The toric intraocular lens neutralizes corneal astigmatism. The lens is aligned with the steep axis of the cornea at the time of implantation during cataract surgery. Correction of preexisting corneal astigmatism enables these patients the best opportunity for quality distance vision without glasses.