Seth A. Biser, M.D., P.C.

Cataracts and Modern Lens Implants

 What is a Cataract?  A cataract is a clouding or darkening of a natural part of the eye called the lens. The lens is a truly remarkable living tissue which sits in the center of the eye and actively keeps vision in focus. More accurate than the lens of any auto-focus camera, the natural lens of the eye
changes shape and position instantly in relation to your visual needs.  During early cataract formation, this natural lens stiffens and becomes less responsive to our need to focus. This happens in most people at around age 40, and it is why most people at this age start needing reading glasses. As the cataract develops further, it becomes cloudy and more difficult to see through. In general, the risks for cataract development include advancing age, family history, smoking, sun exposure, diabetes, steroid use, and other conditions. Poor vision from cataracts can affect lifestyle (such as driving and reading), but can also create health problems ranging from depression to injuries from falls and auto accidents. Cataracts can also lead to higher eye pressure, especially in patients with farsightedness. Increasingly, ophthalmologists have recognized that removing such cataracts early can lower the eye pressure to safer levels.

Symptoms.  Early cataracts just cause a change in the glasses prescription, typically making patients more nearsighted or farsighted. More advanced cataracts blur vision in a way that cannot be cleared
up, even with new glasses. The vision gradually dims, colors are less distinct, and glare or haloes occur with bright lights.

Prevention and Treatment. Ensuring adequate nutrition, and wearing UV-blocking sunglasses to lower the eye’s UV exposure, can help to slow cataract development. Using an antireflective coating on driving glasses can help with nighttime headlights; eventually, avoiding nighttime driving may be necessary. Using brighter lights while reading, using sunglasses for daytime glare, and avoiding night driving can also help. While there are a few studies on cataract prevention using eye drops such as n-acetyl-carnosine, the effectiveness of these drops is questionable. To date, no drops of any kind have ever passed the requirements of the FDA to prove safety and effectiveness in slowing cataract formation in human beings. Once all other options have been exhausted, and when the quality of life is significantly affected, cataract surgery may be the best option.

Cataract Microsurgery. Cataract microsurgery using ultrasound energy is a painless and quick outpatient procedure that usually lasts around 15 minutes and requires no needles or stitches. (This method is called phacoemulsification and was pioneered by Charles Kelman, M.D., who came up with the idea during a visit to his dentist!) Once the cataract is removed, a clear lens implant is placed in the eye in order to focus light on the retina, allowing the eye to see. The lens implant is permanent and stays safely inside the eye, so the patient never feels it, and it never needs changing. As with any surgical procedure, there are some risks associated with cataract surgery, including eye infection. Precautions must be followed in all cases, including eye drops before and (especially) after surgery.

Advanced-Technology Lens Implants. Despite decades of development, our intraocular lens implants are nowhere near as miraculous as the natural lenses that we were born with! Remember that the natural lens of the eye changes both position and shape in order to help us focus at any distance. For decades, lens implants have only given us vision at one single distance, making it necessary for most patients to use glasses postoperatively in order to improve their range of vision. However, some recent advances to lens implants have helped get us closer to our goal of restoring fully natural vision. These lens implants range from astigmatism-correcting lenses such as the Acrysof Toric (which in nearly all patients eliminates the need for distance glasses), to lenses that offer both near and distance vision, such as the Crystalens (pictured at left) and the Restor (at right)--now including the Restor +3 IQ. These presbyopia-correcting lenses substantially reduce the need for both distance glasses and reading glasses.

Not everyone is a candidate for such advanced-technology implants; patients must be carefully screened and counseled in preparation for surgery. For those patients who are good candidates, it should be noted that health insurance will not pay for the “upgrade” to an advanced-technology lens implant. However, many patients find the cost of these implants extremely cost-effective when compared to the cost of prescription glasses, and are usually extremely pleased with their results.

Results. After cataract surgery, the eye usually heals very quickly, with minimal discomfort. Most patients return to their normal routines on the day of surgery, and the vision clears over hours to days, depending on the patient. To ensure safety, the postop regimen of eye drops and ointments must be followed closely, even after full visual recovery. Most patients note improvements in all
aspects of vision, including color intensity, clarity of vision, and brightness of light. While cataracts never grow back, a film may grow over back of the lens implant in some cases (this is called “posterior capsule opacification”). A medical laser, called a YAG laser, may be used to clear away this film and improve vision, typically months after surgery. (This laser is not a vision-correcting laser, and this simple procedure is covered by health insurance.)

Surgery Locations.  Dr. Biser performs work as a cataract surgeon in Westchester NY. Most of his Westchester cataract surgery is performed at Lawrence Hospital (Bronxville, NY) and at the Eye Surgery Center of Westchester (New Rochelle, NY). Dr. Biser performs all cataract surgery himself, and personally examines each patient both before surgery and after surgery. He has taught and lectured on cataract surgery to other eye surgeons at N.Y.U. and Manhattan Eye, Ear and Throat Hospital, where he won Attending Surgeon of the Year for his surgical teaching skills.

Insurance Coverage/Payment.  Medicare and all major health plans will cover the basic costs of cataract surgery, including the cost of a standard lens implant. Many HMOs and PPOs require that patients make a coinsurance payment to the facility; this amount varies with the plan. As stated above, the cost of an upgrade to an advanced-technology implant is optional, and is left up to the patient.

Selected Testimonials

“My recent experience with cataract surgery was outstanding…I have to thank Dr. Biser for his kind and attentive care.” – E.H.D.

“Two weeks ago I could not see the big E on the eye chart or balance my checkbook. After Dr. Biser performed two relatively quick operations, I can now see better than I ever have in my life.” – J.C.J.

“It’s a delight to be able to to see objects and people so clearly. I thank Dr. Biser for his skill, dedication, and devotion to eye surgery.” – A.R.

If you are looking for the best Restor surgeon in Westchester to suit your individual needs, please consider Dr. Biser.  Dr. Biser has been performing Restor surgery in Westchester NY since 2004. Currently, the Restor +3 IQ is one of Dr. Biser’s top choices for lens implants in cataract patients. If you are also looking for an Acrysof Toric surgeon in Westchester NY, Dr. Biser has extensive experience with numerous Acrysof Toric IOL patients, including excellent repair of difficult high-astigmatism cases by combining limbal relaxing incisions with Toric IOL implantation.

If you still have questions, please contact us anytime! We look forward to hearing from you.