Cataract Risk, Diet and Nutrition

Eating meat and animal products may increase your risk of developing Cataracts according to a study published in the American Journal of Clinical Nutrition (March 23, 2011). Findings from the European Prospective Investigation in Cancer and Nutrition Study (EPIC) demonstrated that eating meat was positively associated with the risk of Cataracts. Participants in the study were divided into six diet groups: highest meat consumption, mid-range meat consumption, least meat consumption, fish-eaters, vegetarians, and vegans. Compared with those who ate the most meat, the risks for developing cataracts after adjusting for multiple confounders including age and smoking were as follows: mid-range meat consumption participants decreased their Cataract risk by 4 percent, least meat consumption group decreased their Cataract risk by 15 percent, fish-eaters decreased their Cataract risk by 21 percent, vegetarians decreased their Cataract risk by 30 percent, and those who followed a vegan diet decreased their Cataract risk by 40 percent.

Diabetic Complication Protection

Researchers have reported that some people with Type 1 Diabetes seem to avoid complications from Diabetes such as eye, kidney and heart disease, as they seem to have an inherent protection against them. The study published in the April issue of Diabetes Care confirmed that while it has been well known that control of blood sugar in Diabetics is an important factor in avoiding the complications of Diabetes such as Diabetic Retinopathy there seems to be a group of people who avoided serious diabetic related disease to a much greater extent.

In a group of people who'd had Type 1 Diabetes for more than 50 years, nearly 43 percent remained free of serious eye disease, while about 87 percent never developed kidney disease, nearly 40 percent were free of nerve damage and more than 50 percent were free of cardiovascular disease, according to the study. Overall about 35 percent did not develop and serious problems related to their Diabetes.

The exact protective mechanism is not yet understood and it may be somewhat different for microvascular complications such as Diabetic Retinopathy as compared to macrovascular complications such as heart disease. One potential thought is that “protective mechanism’ is related to the combination of substances called advanced glycation end products (AGEs), which the study found were 7.2 times more common in people with complications. AGEs develop in the body after long-term exposure to high blood sugar levels.

This particular combination of AGEs (high plasma carboxyethyl-lysine and pentosidine) was linked to complications, but other AGE molecules appeared to have a protective effect -- an exciting finding the researchers said may lead to new biomarkers for protection against complications of Diabetes.

INTRAOCULAR LENS IMPLANTS IOLs

Cataract Surgery Questions & Answers:

Question: What are lens implants?

Answer: Intraocular lenses, or IOLs as they are more commonly known, are artificial lenses that are used to replace natural lenses that have become clouded with cataracts. They can also be used as a solution for people who suffer from presbyopia, a condition in which the lens becomes less flexible, thus losing its ability to focus on near objects.  Before the U.S. Food and Drug Administration approved the use of intraocular lenses in 1981, patients who had cataract surgery were forced to wear thick eyeglasses or contact lenses to improve their vision. Early monofocal IOLs were generally used to correct problems with distance vision, leaving patients to rely on glasses or contacts for near vision.

Monofocal vs. Multifocal IOLs

Traditional, or monofocal IOLs, can only offer patients improvement at one distance (intermediate, far, or near). Many Cataract Surgeons happily offer multifocal implants to help our presbyopia and cataract surgery patients see more clearly at a range of distances. This technology allows eye surgeons replace the eye’s natural lens with a new, artificial lens that can help restore visual clarity to near, intermediate and distance vision.

Cataracts, Astigmatism Toric IOLs

If you have astigmatism, you may still experience blurred and distorted vision after traditional cataract surgery because a monofocal IOL cannot correct astigmatism. To achieve quality distance vision with a traditional IOL, you may still require glasses, contact lens or further surgery. If freedom from glasses for distance vision is important to you, you now have a better option.  The unique design of a toric IOL makes it possible to reduce or eliminate astigmatism and significantly improve uncorrected distance vision.  Toric IOLs provide significantly improved distance vision and may reduce the need for corrective lenses compared to a traditional monofocal IOL.

Spherical Aberration and Cataracts

It's a little-known fact that, in spite of all the advances in eye care technology today, even healthy eyes still contain some imperfections called higher order aberrations. One type of higher order aberration common to cataract patients are spherical aberrations, which can lead to a gradual reduction in vision acuity and function. An aberration is an irregularity in the shape of the eye's refractive surface that can distort vision. As you get older, your eyes’ lenses get thicker and rounder, causing image quality to deteriorate. Spherical aberrations are generally associated with:

• Blurriness
• Halos
• Loss of contrast
• Poor night vision

Cataract surgeons can implant a lens designed to reduce spherical aberrations, increase contrast sensitivity, and improve functional vision. Aspheric implants offer these advantages over traditional spherical lens implants: enhanced clarity, improved image quality, and filtered blue light for rich vibrant color.

Cataract Lens Implants and Glaucoma

It was suggested at the American Glaucoma Society Meeting that patients with Cataracts who are considering Cataract Surgery with multifocal lens implants (IOL)s and who also have Glaucoma need to have a careful and thoughtful discussion with their Cataract Surgeon. Glaucoma damages the retinal nerve fiber layer and the optic nerve and in doing so can negatively affect contrast sensitivity. Depending on the type of multifocal lens used, it is possible to create an additive effect of contrast loss for the patient. Further, there is little understanding of the performance of these IOLs in patients with Glaucoma who have a visual field loss. Thus, selection of a multifocal lens for vision correction after cataract Surgery in patients with Glaucoma requires a careful evaluation by the cataract Surgeon and a detailed discussion with the patient.

HOW TO CHOOSE A CATARACT SURGEON Part 8

Most people don’t buy a car without test-driving a couple or more. Don’t limit your eye surgeon selection to a choice your insurance has made for you. If there is any discomfort, doubt, uncertainty or insecurity PLEASE get another opinion. The choice of an eye surgeon for Cataract Surgery is the most important step in the entire process. The best Cataract surgeons do not mind that you have or are going to get a second opinion. In fact, one quick test of your eye surgeon’s comfort with his or her own ability is to let him or her know that you would like a second opinion. If the surgeon becomes defensive about this then you know the second opinion was a good idea, after all.Last, But Not Least….. Get a Second Opinion.

RECOVERY AFTER CATARACT SURGERY

Cataract Surgery Question: My mother and father both had cataracts in their early 60’s. They both did pretty well and I remember them driving and golfing and really being able to do pretty much everything after their cataract surgery. I am 54 years old been told that I have cataracts. I am a salesman for a roofing company and I drive all over my territory. I am noticing that I am having more and more problem seeing the signs and at night I can’t really take the glare from headlights. I have to work but I think I might need to have the cataracts removed soon and I am worried about how long I will be out of work and not able to drive. How long is the recovery and what else might I not be able to do after the surgery and for how long?

Cataract surgery today is really very advanced and quite “patient friendly”. First, if you are in generally good health it is most likely that your cataract operation will be performed in an ambulatory surgery center. These eye surgery facilities are comfortable and efficient and your entire cataract surgery procedure should take only 2-3 hours from the time you check in until the time you check out. Second, advanced cataract surgery is most often performed with “topical eye drop anesthesia”-that is, for most patients the only anesthesia required are some eye drops along with a tablet to help you relax. Thus, there is really minimal if any “recovery” from the anesthesia used. You are usually feeling “back to normal” by the end of the day of your surgery or certainly by the next morning. Third, with the advanced cataract surgery technique of “small incision phacoemulsification” there is only a need to create a tiny incision-often just a few millimeters-through which the cataract is removed and the intraocular lens is implanted. This tiny incision is so small so as not to require any “stitches” or sutures in many cases. Thus the wound healing is very quick. Finally, depending on the type of lens implant that is used it is highly likely that your distance vision will be dramatically improved within 24 hours. In fact many patients actually are comfortable driving the next day after their cataract operation. If you have a multifocal or accommodating lens implant to correct both your distance and near vision, it might take a bit longer to appreciate the full clarity of the near vision correction. So, it is pretty likely that you will be back to work in a few days and depending on your cataract surgeon’s instructions, you should be able to resume all of your normal activities with a couple of days.

CATARACTS AND BIFOCAL GLASSES

Cataract Surgery Questions & Answers

Question: My eyes are bothering me enough that I finally told my eye surgeon that I was ready to have Cataract Surgery. At my examination he had me meet with a woman in his office to talk about the kind of lens implant I wanted to have. She said that because I wear bifocal glasses I should have a “premium” lens so I don’t have to wear bifocals after my Cataract operation. I don’t know what this is and she wasn’t very helpful. Can you give me any information about this?

Answer: For many years the choice of the type of intraocular lens implant (IOL) to use in Cataract Surgery was left entirely to the Cataract Surgeon. This was because until 2005 there was really was only a “technical” choice to be made regarding the “style” and power of lens implant. Today, there are a number of types of lens implants used for vision correction after Cataract Surgery that can help patients become much less dependent and sometimes completely free of the need for eyeglasses after Cataract Surgery. Selecting the best type of lens implant for each patient really depends on their individual vision correction goals and lifestyle. If there are tasks in your daily routine that you would not like to have to wear eyeglasses for, it is possible to select a lens implant that might correct your vision in way that helps you achieve that. For example, let’s say it’s important for you to be able to go to church and read the Bible and see the minister, and go back and forth without having to wear to remove glasses. This can possibly be accomplished by implanting an intraocular lens that corrects both far and near vision-this type of lens can be a multifocal lens implant or an accommodating lens implant. This type of lens can help you comfortably see the dashboard on your car and street signs without eyeglasses after Cataract Surgery. Maybe you want to be able to watch television and read the newspaper-without relying on eyeglasses. Again this might be possible with a multifocal lens implant or an accommodating lens implant. These types of intraocular lens implants (IOL) that correct both distance and near vision-and sometimes arms length vision too-are called “premium lenses” because most insurance companies and Medicare only pay for the implantation of a “basic lens implant”-one the only corrects distance vision-and ask the Cataract Surgeon or the Cataract Surgery center to bill the incremental cost of these IOLs directly to the patient. If this is something that might be meaningful to you, you should ask your eye doctor’s staff member or your eye surgeon to fully explain all of the risks, benefits and costs of advanced technology premium lenses and answer all of your questions. If they are unwilling or unable to do so, then seek a second opinion with a Cataract Surgeon who will do so.

HOW TO CHOOSE A CATARACT SURGEON Part 7

The above research can give you an idea if a particular Cataract Surgeon is someone you should strongly consider to select as your eye surgeon. However, you cannot know if this is the person you want performing eye surgery for you until you get a chance to meet them. Personal comfort, demonstrating empathy and building trust are characteristics you can only experience face to face. It is important to hear, directly from the surgeon, what your situation presents to them in terms of challenges and how their experience translates into helping you get the best possible results.Schedule a Consultation & Meet the Surgeon.

GLAUCOMA EYE DROP USE COMPLIANCE

The successful treatment of glaucoma requires patients to understand the need to use their eye drop prescriptions and to follow through consistently in using their glaucoma eye drop medication. At the Wills Eye Institute Alumni Conference there was a presentation of the results of the Glaucoma Adherence and Persistency Study in which 90% of patients reported taking eye drops daily and 10% admitted to not using drops as directed. Reasons glaucoma patients reported for not being consistent with the their glaucoma medications included simply forgetting to use their eye drops, concerns about side effects, running out of drops, not having the eye drops with them when traveling and difficulty in using the eye drops when away from home.

The study concluded that ophthalmologists can improve patient adherence by doing a better job is speaking to patients. A study showed that physicians spend an average of 6 minutes speaking with patients and 18% asked their patients open-ended questions about disease and treatment. After the physicians were themselves taught better communication skills 82% of physicians asked open-ended questions and had educational discussions with their patients. Further, before physicians were trained in better communication skills only 25% even identified that their patients were not compliant whereas after the physician communication skill training 78% detected non adherence.

Eye Exams for Macular Degeneration

According to a recent survey conducted by the Opinion Research Corporation although more than two thirds of Americans 55 years of age or older have had an eye exam to maintain eye health and vision, 80% of those do not know that Age Related Macular Degeneration (AMD) is a leading cause of vision loss of people older than 60. Further, even among those who had eye examinations, only 46% could identify the risk factors for AMD and only about 50% could state any one symptom. What is more disturbing is that of the 24 % who claimed to be familiar with Macular Degeneration only about 1/3 were even aware that there were treatment options available for the most severe type-“wet macular degeneration”-if it were diagnosed early enough. Almost all cases of AMD begin as “dry macular degeneration”, but some 10-15% of cases progress to the more sight devastating “wet macular degeneration”. Early detection, diagnosis and treatment depend on regular eye examinations and being aware of symptoms of AMD that may occur and how AMD may occur with Cataracts.
In its early stages, AMD may not cause any noticeable symptoms. As the disease advances, symptoms may occur in one eye or both, and can include blurred vision, difficulty reading or recognizing faces, blind spots developing in the middle of the field of vision, colors becoming hard to distinguish and distortion causing edges or lines to appear wavy. If a person develops any of these symptoms, an eye exam is crucial and early diagnosis and treatment is essential to help avoid severe vision loss.
People who have certain risk factors should absolutely schedule routine eye examinations and monitor symptoms. The single greatest risk factor for AMD is age although it is more likely to affect women, Caucasians and those with a family history of AMD.

US Diabetic Retinopathy Prevalence

It is well documented that the prevalence of diabetes in the United States has increased. People with diabetes are at risk for diabetic retinopathy and until recently no recent national population-based estimate of the prevalence and severity of diabetic retinopathy existed. By using an analysis of a cross-sectional, nationally representative sample of the National Health and Nutrition Examination Survey (NHANES) researchers were able to describe the prevalence and risk factors of diabetic retinopathy among US adults with diabetes aged 40 years and older.

They found that the estimated prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy was 28.5% and 4.4% among US adults with diabetes, respectively. Diabetic retinopathy was slightly more prevalent among men than women with diabetes. Non-Hispanic black individuals had a higher crude prevalence than non-Hispanic white individuals of diabetic retinopathy. Male sex was independently associated with the presence of diabetic retinopathy as well as higher hemoglobin A_1C level, longer duration of diabetes, insulin use, and higher systolic blood pressure.

The authors concluded that in a nationally representative sample of US adults with diabetes aged 40 years and older, the prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy was high, especially among Non-Hispanic black individuals.

Early diagnosis and treatment of diabetic retinopathy can help preserve eye health and vision. Diabetics should have regular eye examinations as they have greater risk for developing a cataract as well as for developing glaucoma.

CATARACTS AND ASTHMA

Cataract Surgery Questions & Answers

Question: My daughter has had asthma since she was 7 years old. She is now away at college and is 21 years old. She went to an eye doctor near her college to get new contact lenses and he told her she didn’t need new contacts and that her vision was blurry because she had a Cataract. He said the medication she was taking for her asthma all this time may have caused her to get the Cataracts. How can someone her age have Cataracts? Is he right?

Answer: Sometimes bronchial asthma is treated with oral, injectable or nasal steroids. If your daughter was in fact on steroids, and for any length of time, and perhaps in significant doses, it is possible that the medication could have caused a Cataract to form, even at her young age. Cataracts are a known side effect of the use of certain steroids. The best course of action is for you daughter to schedule an examination and consultation with a top Cataract Surgeon in your area when she returns home from college. You will want to be with her as she is unlikely to remember her entire medical history from childhood.  An experienced Cataract Surgeon will be able to do the necessary testing to confirm the diagnosis and possibly confirm that steroids were the cause. Then he or she will be able to help your daughter determine the extent of the visual compromise, the stability of the condition and the treatment options. As always, choose an experienced Cataract Surgeon with sound reputation who will takes the time necessary to evaluate your daughter properly and guide you through the right diagnosis and treatment options.

Cataract & Prostate Cancer Treatment

Cataract risk may be higher in patients being treated for prostate cancer with Androgen Deprivation Therapy (ADT). The side effects of ADT such as weight gain, insulin resistance and blood lipid level problems have been linked to Cataract formation. Although further prospective study is necessary to truly understand the findings, researchers from Karmanos Cancer Institute in Detroit used the Surveillance, Epidemiology and End Results Medicare database to analyze cataract formation in prostate cancer patients.

HOW TO CHOOSE A CATARACT SURGEON Part 6

Visit Your Cataract Surgeon’s Web Site

Physician practice web sites really serve two goals-patient information and education and marketing. While it is not likely that a practice web site will ever tell you that a Cataract Surgeon has poor skills, the attention to detail and quality of the information provided is an indication of how this eye surgeon presents him or herself. A practice web site cannot overcome poor surgical skills but it can tell you how seriously they take their role in patient education. It also will give you some insight into the practice philosophy and approach to eye surgery care.

Lucentis for Diabetic Eye Disease

Genentech reported positive results from its two-year clinical study of the anti- vascular endothelial growth factor (VEGF) drug Lucentis when used to treat Diabetic Macular Edema (DME) a cause of significant vision loss in patients with diabetes. Patients with Diabetic Retinopathy in the form of DME who received the drug experienced rapid and sustained improvement in vision compared to those who received a placebo injection.

Diabetic Macular Edema or DME is the swelling of retina in people with diabetic eye disease called diabetic retinopathy, which causes damage to the blood vessels of retina. The DME patients suffers fluid leak from the damaged blood vessel to the central portion of retina, causing it to swell leading to blurred vision, severe vision loss and blindness.

Of the 26 million U.S. people with diabetes, a portion of up to 10 percent tends to develop DME during their lifetime, and up to 75,000 new cases of DME are estimated to develop each year. Currently, DME patients are treated with laser surgery that helps seal the leaky blood vessels to slow the leakage of fluid and reduce the amount of fluid in the retina.

Lucentis is approved for use by the U.S. Food & Drug Administration (FDA) for the treatment of “Wet” Age-Related Macular Degeneration (AMD) and for Macular Edema following Retinal Vein Occlusion. In 2011, Lucentis was approved for treatment of visual impairment due to DME in Europe.

CAN A CATARACT COME BACK & REGROW

Cataract Surgery Questions & Answers

Question: I had my cataract removed and a lens implant put in about 6 months ago. The vision was really good until 2 weeks ago when I started having the night driving glare all over again. I think my cataract came back but I didn’t think this could happen. Can cataracts come back?

Answer: Once a Cataract is removed, no, it can not come back. What you may be describing is possibly a condition called “posterior capsular opacification”. The crystalline lens of the eye is where a Cataract forms. While it might sound a little funny, the crystalline lens is structured like an M&M candy. The crystalline lens has a soft protein center and is surrounded by a capsule-kind of like the structure of an M&M candy. A Cataract forms because the protein becomes cloudy. During Cataract Surgery your Cataract Surgeon uses microscopic instruments to break up and remove the cloudy material as this is what blurs your vision. However, the eye surgeon leaves the “capsule” in place. In fact the surgeon will actually place the intraocular lens implant (IOL) to correct vision inside the capsule to help correct your vision. In some patients the capsule become “opacified” some time after surgery leaving the patient’s vision cloudy and often with glare sensitivity, much like the symptoms they had from the Cataract. Fortunately, using a YAG Laser, the Cataract Surgeon is able to quickly, safely and effectively create an opening in the capsule along the visual axis which restores the vision almost instantly. This procedure called a “YAG Capsulotomy” takes only a few minutes and is often performed right in the comfort of the eye doctor’s office using simple eye drop anesthesia without discomfort. So, the simple answer to the question “Can a Cataract come back? is no. However a condition called “posterior capsular opacification” can make it seem like the Cataract has returned. As always, choose a reputable Cataract Surgeon with experience in performing YAG Capsulotomies who will takes the time necessary to evaluate you properly and guide you through the right diagnosis and treatment options.

HOW TO CHOOSE A CATARACT SURGEON Part 5

Review Their Licensure History

All eye surgeons must be licensed to practice medicine in the state that they practice in. By going to your state web site you can confirm their license status as well as review any history of disciplinary or legal action against your choice of Cataract Surgeon.

Surgery for Cataracts in Children

Children with Cataracts require early treatment in order to have the best vision. Early treatment with Cataract Surgery is critical to visual acuity of children with congenital Cataracts. In children treated for bilateral dense congenital Cataracts, surgery before 3 months of age is important to decrease the risk of visual acuity loss, according to a Swedish study published in January in Acta Ophthalmologica. The single most important predictive factor for long term visual acuity in children with congenital Cataracts is how quickly they have Cataract Surgery the study reported.

Laser Cataract Surgery Approval

Laser Cataract Surgery offers the promise of assisting Cataract Surgeons in providing even greater safety, effectiveness and reproducibility with Cataract operations and Lens Implants (IOL). The LensAR™ Laser System has now received FDA Clearance for Lens Fragmentation and Anterior Capsulotomy in Cataract Surgery which are two of the technically difficult steps in Cataract removal that are now performed manually. By using a Cataract Surgeon directed and controlled femtosecond laser to perform the challenging manual steps of Cataract Surgery and Lens Implantation it is hoped that this common eye surgery will provide further improvements in outcomes beyond their current excellent levels.

MACULAR DEGENERATION AND STROKE RISK

Older adults with late-stage, Age-Related Macular Degeneration (AMD) may have a significantly higher risk for hemorrhagic stroke than do individuals without the eye disease, a prospective, population-based study suggests. 

There may be a common underlying process contributing to both Age-Related Macular Degeneration (AMD) and bleeding strokes, but more research will be needed to determine if that’s the case, Dr. Renske G. Wieberdink of the Rotterdam Study at the International Stroke Conference. 

Researchers found that the risk for any stroke was 56% higher in participants with late-stage AMD than in individuals without AMD after they controlled for the effects of age, sex, diabetes, blood pressure, use of antihypertensives, smoking, cholesterol levels, carotid artery plaques, body mass index, alcohol intake, and C-reactive protein levels. 

Participants with late-stage AMD (either the wet or dry forms) had sixfold higher risk for intracerebral hemorrhage than did participants without AMD.

ASTIGMATISM CATARACT SURGERY COST

Cataract Surgery Questions & Answers

Question: For as long as I can remember my eyeglasses have had a prescription to correct for astigmatism. Now I have a Cataract and my eye surgeon says I should I have a lens implant that corrects the astigmatism instead of having to wear the eyeglasses to see distance after my Cataract operation. The thing is, they want to charge me more and I will have to pay it out of pocket for the astigmatism lens implant. Is this correct?

Answer: If you have had astigmatism correction in your eye glasses for many years, you have what is called “pre-existing astigmatism”. That is, that it was there before your Cataract even formed and before your Cataract Surgery. Since you have always had corrected in the past, you will need to have it corrected as part of your Cataract Surgery or else will have to wear eyeglasses that correct the astigmatism after your Cataract surgery. One way or another, the astigmatism has to be corrected for you to have the best possible vision after Cataract Surgery. One way to correct astigmatism as part of a cataract operation is to perform a secondary procedure called Limbal Relaxing Incisions (LRI). For some patients with certain types and degree of astigmatism this may be an option. Keep in mind that it is a secondary surgical procedure and thus has incremental cost associated with it that your insurance and Medicare does not cover. You are actually very fortunate. Today, your Cataract can be removed and the crystalline lens replaced with an intraocular lens implant (IOL) that corrects your entire prescription-including the astigmatism. The type of intraocular lens implant (IOL) that corrects astigmatism is called a “toric lens implant”. Many insurance plans, as well as Medicare, only pay for the insertion of “basic” monofocal lens implants that do not correct astigmatism. They ask the Cataract surgeon or Cataract surgery center to bill the patient separately for the toric lens implant. The typical cost of the toric lens implant can range from $1,000 to $2,000 per eye depending on the type of lens and geographic location.

So, the simple answer to the question “Can I have a lens implant to correct astigmatism with Cataract surgery and does it cost more?”, is yes. As always, choose a reputable Cataract Surgeon with experience in performing Cataract Surgery with toric lens implants for astigmatism correction who takes the time necessary to evaluate you properly and guide you through the right decisions.

HOW TO CHOOSE A CATARACT SURGEON Part 4

Determine the Cataract Surgeon’s Experience Level & Commitment

Once you have identified some possible eye surgeons it is appropriate to call their office and speak with a counselor or surgery coordinator. Determine how often they do Cataract Surgery-they should do Cataract Surgery at least 2 days per month to maintain their skills. Determine how many total Cataract Operations they have done-it should generally be at least 500 to build proficiency. Determine whether they do their surgery in a hospital or outpatient ambulatory surgery center-you will be more comfortable and have a better overall experience at an ambulatory surgery center. Determine whether they use advanced technology intraocular lens implants such as lens implants for astigmatism and near vision correcting lens implants-they should, in order to offer you the best vision correction options in case you are a good candidate for one.

When investigating the background of Cataract Surgeons it is easy to get “over impressed” by their residency or fellowship training. While attending solid training programs may contribute to the “learning curve” it does not really indicate how well an eye surgeon can perform the Cataract Surgery procedure. Sometimes in the “best” training programs surgeons actually get very little surgical experience because the “superstar” faculty does all the surgery and they just assist. Visa versa, sometimes less well known training programs expose residents to a great deal of surgical experience-it’s about their experience not where they went.

Glaucoma, Antidepressants & The Elderly

Researchers from the Division of Geriatric Psychiatry at Queen's University in Kingston, Ontario reported on a study at the American Association for Geriatric Psychiatry (AAGP) 2011 Annual Meeting in which the results indicated that elderly patients over 66 taking antidepressants were at significantly greater risk of developing Acute Angle Closure Glaucoma (AACG). Depending on the class of antidepressant the risk was as much as 2-fold higher. Many people taking antidepressants complain of visual problems after taking antidepressants and usually it is thought to be related to dry eyes. These findings should make clinicians a bit more aware that ocular complaints might be more serious than that. Although the study was on a large group, it was agreed that it was necessary to be replicated in a randomized, controlled design to be unquestionable.

GLASSES AFTER CATARACT SURGERY

Cataract Surgery Questions & Answers

Question: Will I need to wear eyeglasses after cataract surgery?

Answer:There are two primary goals of Cataract Surgery. The first goal is to remove the cloudy crystalline lens. The crystalline lens is actually an optical component of the eye that provides focusing power. The second goal of Cataract Surgery is to replace the optical and focusing power that was provided by crystalline lens. This is accomplished by implanting an intraocular lens (IOL) to provide the correct amount of focusing power to allow you to see clearly.

If you wore glasses because you were nearsighted, farsighted or had astigmatism before you developed a Cataract, it is possible for the Cataract Surgeon to use a carefully calculated IOL power or special IOL that can correct astigmatism so that you may not need to wear eyeglasses to see at distance after your surgery. Today, it is even possible for Cataract Surgeons to select IOLs that can correct both distance and near vision so that you can decrease, or even eliminate, your dependence on bifocals and reading glasses after Cataract Surgery.

If you think you have a Cataract or have been told you have a Cataract and would like to be less dependent on glasses it is worthwhile to find a Cataract Surgeon who has experience with advanced technology intraocular lens implants so that they can guide you as you learn about your possibilities and options for vision correction after Cataract Surgery.

HOW TO CHOOSE A CATARACT SURGEON Part 3

Search the Internet for Possibilities

While it is not possible to determine everything about an eye surgeon on the internet it is a good place to begin to develop a list of possibilities. Search “cataract surgeons in (insert your town/city/state)” or “best cataract surgeon in (insert your town/city/state)”. Compile a list of possibilities and compare it to you insurance list and your personal Cataract Surgeon referral list.

CATARACT SURGERY & DIABETIC RETINOPATHY

Cataract Surgery Questions & Answers
Question: I am 68 years old and have been a diabetic for over 20 years. During that time I have tried to stay healthy but my vision has varied. I needed laser treatment 5 years ago and the vision was pretty good until about 6 months ago. My retina doctor told me I now have Cataracts in both eyes and it is decreasing my vision-especially at night. Can I have Cataract Surgery since I already had the laser treatment for my diabetic retinopathy? Are there any risks or more complications beyond what my friends who have had Cataract Surgery experienced?

Answer: The answer is that you absolutely can have Cataract Surgery if you have diabetic retinopathy , even after laser treatment. The fact that your retinal specialist is in the loop is important. One of the retinal problems created by diabetic retinopathy is diabetic macular edema. As part of your examination and consultation, your Cataract Surgeon may wish to perform a test called ocular coherence tomography (OCT) in order to carefully observe and review the status of the macula, specifically to look for macular edema. It is possible that they will prescribe and ask you to use a type of eye drop called an NSAID (non-steroidal anti-inflammatory agent) for some time before your Cataract Surgery and for as long as three months after your surgery. Also, in certain instances your eye surgeon may recommend that either he or she at the time of Cataract Surgery, or your retinal specialist after the surgery, place an injection of an anti-vascular endothelial growth factor (Anti-VEGF) agent such as Avastin™ in order to retard the possible growth of new blood vessels in the retina. These are several steps that a Cataract Surgeon my take to minimize the risks and complications of cataract surgery if you have diabetic retinopathy.

Regarding the actual cataract surgery operation procedure, if your Cataract Surgeon is using the most modern small incision phacoemulsification technique, they are not likely to make any modifications in their procedure.

So, the simple answer to the question “Can I have Cataract Surgery if I have diabetic retinopathy?” is yes. As always, choose a reputable Cataract Surgeon with experience in performing Cataract Surgery for diabetics and who takes the time necessary to evaluate you properly and guide you through the right decisions.

HOW TO CHOOSE A CATARACT SURGEON Part 2

Do Not Limit Yourself to the Insurance List
Just because a Cataract Surgeon is listed by your insurance company as “in-network” does not mean that they are the best Cataract Surgeon for you. Nor does it mean that other very well regarded Cataract Surgeons who are “out of network” do not take your insurance. Sure, there may be a slightly higher co-pay or deductible but this is about eye surgery and a small added expense to get the best Cataract Surgeon in your area may very well be worthwhile.

Cataract Eye Surgery Information & Cataract Surgeon Directory Website Receives Reaccreditation by Health On the Net (HON) Foundation

North Andover, Massachusetts, (3/16/11) The cataract eye surgery information & cataract surgeon directory website www.aboutcataractsurgery.com has been notified that it has received its annual reaccreditation by the Health On the Net (HON) Foundation.

“Accreditation by the HON Foundation means that http://www.aboutcataractsurgery.com/ is in full compliance with the HON principles (http://www.hon.ch/HONcode/Conduct.html) which serves as the basis for its initiative to improve and maintain the quality and integrity of health and medical information on the World Wide Web,” said Katherine Carlisle, a Managing Partner of Medical Management Services Group, L.L.C.

http://www.aboutcataractsurgery.com/ is structured to provide potential eye surgery patients with useful and reliable information about cataract symptoms, how eye cataracts affect vision, surgery for cataracts to correct astigmatism, night vision and cataracts, near vision and cataract surgery, laser cataract surgery, the cataract surgery procedure, recovery from cataract surgery and cataract surgery complications.

In addition www.aboutcataractsurgery.com contains detailed information regarding the different types of intraocular lens implants (IOL) that can be used to correct vision after cataract surgery such as aspheric lens implants, astigmatism correcting toric lens implants and near vision presbyopia correcting lens implants.

“When trying to decide about cataract surgery and intraocular lens implantation patients should seek current information about the various procedures to be certain that they understand the available options for vision correction. The final decision should be made between an informed patient and their eye surgeon. The choice of a cataract surgeon is the most important decision they can make. Thus we have included a “Find a Cataract Surgeon” feature to assist users in locating the best cataract surgeons in their geographic area,” said Ms. Carlisle.

In order to provide eye care consumers with the most unbiased information, unlike many websites offering information about cataract, cataract surgery, cataract surgeons or intraocular lens implants (IOL), www.aboutcataractsurgery.com does not accept funding, support or advertising from pharmaceutical, medical device, laser or lens implant companies.

CONTACT: Katie Carlisle, The Medical Management Services Group, L.L.C.
978.470.8217, or email, katie@aboutcataractsurgery.com

SOURCE: Medical Management Services Group, L.L.C.

PALM BEACH CATARACT SURGEON LAWRENCE KATZEN, M.D. JOINS CATARACT SURGERY PATIENT INFORMATION DIRECTORY

NORTH ANDOVER, Massachusetts, (3/15/2011) Medical Management Services Group, L.L.C., managers of the patient information web site for cataracts, cataract surgery and lens implants www.aboutcataractsurgery.com announced today that Palm Beach Cataract Surgeon Lawrence Katzen, M.D. of Katzen Eye Care & Laser Center in West Palm Beach and Boynton Beach, Florida has become a member of it's network of top cataract surgeons offering access to the useful patient friendly web information resource.

"Katzen Eye Care has worked diligently for over 30 years in the Palm Beaches to bring world class eye care to our community. We have been in the forefront of the many advances in the management of cataracts and the technology of cataract surgery and lens implants (IOL). I personally believe that having well educated and well informed cataract patients helps us get the best possible results for each and every cataract surgery patient,” stated Lawrence Katzen, M.D.

http://www.aboutcataractsurgery.com/ is structured to provide eye care consumers with useful and reliable information about symptoms of cataracts, the cataract surgery operation and procedure, how cataracts affect vision, cataracts and astigmatism, near vision & presbyopia, recovery from cataract surgery and complications of cataract surgery. In addition the site contains specialized information regarding diabetes and cataract surgery and what patients taking prostate medication should know about cataract surgery. To help cataract patients understand their options after cataract surgery there is detailed information regarding the different types of intraocular lens implants (IOL) that can be used to correct vision after cataract surgery such as aspheric lens implants, astigmatism correcting toric lens implants and near vision correcting presbyopic lens implants.

“We are committed to helping patients learn as much as possible about cataracts and cataract surgery so that they understand the available options. This education helps us to help the patient make the best decisions regarding their cataract surgery and care. A well informed patient makes a helpful partner for the cataract surgeon," said Dr. Katzen.

In order to provide eye care consumers with the most unbiased information, unlike many websites offering information about cataracts, cataract surgery, cataract surgeons or intraocular lens implants (IOL), www.aboutcataractsurgery.com does not accept funding, support or advertising from pharmaceutical, medical device, laser or lens implant companies.

CONTACT: Katie Carlisle, Medical Management Services Group, L.L.C. 978.470.8217, or email, katie@aboutcataractsurgery.com

PRACTICE CONTACT: Sondra Stateman, Katzen Eye Care & Laser Center, 877.736.2020, http://www.katzeneyecare.com/, sondra@katzeneyecare.com