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Cataract Philadelphia

Cataract Surgery Philadelphia

  • Cataracts
  • Complex
    • Cataracts and Astigmatism
    • Cataracts and Glaucoma
      • Hydrus Microstent
      • Ahmed M4
    • Cataracts and Cornea
    • Cataracts and Dry Eye
    • Cataracts after LASIK
    • After Retinal Surgery
    • Cataracts After Glaucoma Surgery
    • Cataracts in Monocular Patients
    • Cataracts after Trauma
    • Cataracts in Special Populations
    • Cataract Instrumentation
    • Cataract Failures
  • Implants
    • RxSight Light Adjustable Lens
    • PanOptix Trifocal
    • Toric IOLs
  • Co-Management
  • Risks
  • Yag

Hydrus Microstent – Micro-Invasive Glaucoma Surgery – Dr. Lewis
Serving Northeast Philadelphia, the Main Line, King of Prussia, Conshohocken, Philadelphia, Phoenixville, Willow Grove, Abington, and surrounding areas.

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Hydrus Microstent Implant

Hydrus® Microstent Fact Sheet

Facts about Hydrus:

– Roughly the size of an eyelash, the Hydrus® Microstent is a revolutionary new minimally invasive glaucoma surgery (MIGS) device designed to reduce eye pressure by reestablishing the patient’s natural outflow pathway (known as Schlemm’s canal) through which fluid (called aqueous humor) exits the eye .

– The Hydrus Microstent is placed in the eye by a surgeon using a small incision in a minimally invasive procedure. This less invasive approach may allow for fewer complications and faster healing times than traditional incisional glaucoma surgery.

– The unique design of the Hydrus Microstent provides a Tri-Modal mechanism of action to treat glaucoma:

  •  The device opens a bypass through the trabecular meshwork, a common site of aqueous blockage in the eye;
  •  It then dilates and scaffolds (keeps open) an important part of the eye called Schlemm’s canal to enhance flow; and
  •  The device spans a full 90 degrees within the canal. This coverage is designed to ensure that fluid reaches the eye’s drainage system, which carries fluid from Schlemm’s Canal in to the body’s circulatory system and allows pressure in the eye to be lowered
– The Hydrus Microstent is one of the most studied glaucoma devices to date, with more than 4,000 cases treated globally in patients with a wide range of disease severities.

– The FDA approval is based on the landmark HORIZON Trial, the largest MIGS clinical study ever conducted.  The study included 556 adult patients with open-angle glaucoma and was conducted at 38 centers in nine countries. The study demonstrated the safety and effectiveness of the Hydrus Microstent with cataract surgery to lower intraocular pressure (IOP) compared to the control which was cataract surgery alone. 1

  • In this pivotal study more than 78 percent of Hydrus Microstent patients remained medication-free compared to 48 percent in the control group, a 30 percent difference and the largest improvement versus control of any MIGS pivotal trial to date.
  • Additionally Hydrus Microstent patients had a 43% lower intraocular pressure at 2 years compared to the control group

Facts about Glaucoma:

– Glaucoma is a leading cause of blindness and affects more than 70 million people worldwide; it is estimated that over 4 million patients have glaucoma in the United States.2  There is no cure for glaucoma, but its long term effects may be prevented with early detection, medication use and other treatments, including surgery.


– Glaucoma is a group of eye diseases that occur due to increased pressure in the eye caused by a buildup of excess fluid.  Treatment is aimed at lowering pressure to prevent further loss of vision.

About Ivantis:

–
Ivantis, Inc. is a privately held company established in 2007 to design, develop and commercialize new technologies to treat eye disease.

FAQs:

–
Q: Who are candidates for this procedure?
–
A: The Hydrus Microstent is indicated for use in conjunction with cataract surgery to treat adult patients who have mild to moderate primary open angle glaucoma.  Your doctor can provide you with additional information to determine if you may be a candidate.
–
Q: What can patients expect during and after the procedure?
–
A: The Hydrus Microstent is an outpatient procedure designed to be quick and minimally
invasive for the patient. Typically performed using topical anesthesia, the Hydrus Microstent is implanted in conjunction with cataract surgery. Patients will be able to go home the same day, following the procedure. Patients will not be able to see or feel the tiny device in
the eye.
–
Q: What are the alternative treatment options for glaucoma?
–
A: Current therapies include prescription eye drops, laser therapy, and surgery. The advent of minimally invasive glaucoma devices, such as the Hydrus Microstent, offer a new solution
designed to safely and effectively reduce eye pressure and reliance on medical eye drops.
–
Q: When does the procedure start to work for patients after surgery?
–
A: Although patients will not be able to feel the Hydrus Microstent once its implanted, patients will know soon how well the device is working. In the weeks following the procedure, your doctor will test your IOP to determine if the pressure in your eye has been adequately lowered.

Hydrus® Microstent Important Safety Information

CAUTION: Federal law restricts this device to sale by or on the order of a physician.

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INDICATIONS FOR USE:

The Hydrus Microstent is indicated for use in conjunction with cataract surgery for the reduction of intraocular pressure (IOP) in adult patients with mild to moderate primary open angle glaucoma (POAG).

CONTRAINDICATIONS:

The Hydrus Microstent is contraindicated under the following circumstances or conditions: (1) In eyes with angle closure glaucoma; and (2) In eyes with traumatic, malignant, uveitic, or neovascular glaucoma or discernible congenital anomalies of the anterior chamber (AC) angle.

WARNINGS

Clear media for adequate visualization is required. Conditions such as corneal haze, corneal opacity or other conditions may inhibit gonioscopic view of the intended implant location. Gonioscopy should be performed prior to surgery to exclude congenital anomalies of the angle, peripheralanterior synechiae (PAS), angle closure, rubeosis and any other angle abnormalities that could lead to improper placement of the stent and pose a hazard.

PRECAUTIONS

The surgeon should monitor the patient postoperatively for proper maintenance of intraocular pressure.  The safety and effectiveness of the Hydrus Microstent has not been established as an alternative to the primary treatment of glaucoma with medications, in patients 21 years or younger, eyes with significant prior trauma, eyes with abnormal anterior segment, eyes with chronic inflammation, eyes with glaucoma associated with vascular disorders, eyes with preexisting pseudophakia, eyes with uveitic glaucoma, eyes with pseudoexfoliative or pigmentary glaucoma, eyes with other secondary open angle glaucomas, eyes that have undergone prior incisional glaucoma surgery or cilioablative procedures, eyes that have undergone argon laser trabeculoplasty (ALT), eyes with unmedicated IOP < 22 mmHg or > 34mmHg, eyes with medicated IOP > 31 mmHg, eyes requiring > 4 ocular hypotensive medications prior to surgery, in the setting of complicated cataract surgery with iatrogenic injury to the anterior or posterior segment and when implantation is without concomitant cataract surgery with IOL implantation. The safety and effectiveness of use of more than a single Hydrus Microstent has not been established.

ADVERSE EVENTS

Common post operative adverse events reported in the randomized pivotal trial included partial or complete device obstruction (7.3%); worsening in visual field MD by > 2.5 dB compared with preoperative (4.3% vs. 5.3% for cataract surgery alone); device malposition (1.4%); and BCVA loss of ≥ 2 ETDRS lines ≥ 3 months (1.4% vs. 1.6% for cataract surgery alone). For additional adverse event information, please refer to the Instructions for Use.

MRI INFORMATION

The Hydrus Microstent is MR-Conditional meaning that the device is safe for use in a specified MR environment under specified condition, please see the Instructions for Use and Patient Information Card for details.

Please refer to the Instructions for Use for complete product information.

1. A Schlemm Canal Microstent for Intraocular Pressure Reduction in Primary Open-Angle Glaucoma and Cataract: The HORIZON Study. Ophthalmology. In press, corrected proof. Available online June 23, 2018. Thomas W. Samuelson, David F. Chang, Robert Marquis, Brian Flowers, et al; HORIZON Investigators.
2. 2017 Glaucoma Surgical Device Report: A global Market Analysis for 2016 to 2020, Market Scope, LLC.
©2018 Ivantis, Inc. Ivantis® and Hydrus® are registered trademarks of Ivantis, Inc.
All rights reserved. IM-0013 Rev A
www.IvantisInc.co
Hydrus Microstent illustration
CALL FOR AN APPOINTMENT

(215) 886-9090

RxSight Light Adjustable Lens

Select uncompromised clarity with an IOL that matches your visual requirements.
RxSight's FDA-approved implant is customized to your eye's post-operative needs. Monovision patients can test drive their vision and achieve their desired focus. LASIK patients achieve the WOW-factor they remember. Patients can permanently and completely eliminate their astigmatism. Perfectionists can obtain the clearest vision without glasses...
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PanOptix Lens

PanOptix Trifocal dominates Cataract Philadelphia

Enjoy a glasses-free life, with the most advanced multifocal IOL.
Alcon’s PanOptix implant, a second generation trifocal, provides continuous focus without glasses for tasks like driving, reading, and computer use. PanOptix has been available outside the US for a half dozen years and it is driving the premium intraocular lens markets in Canada, Australia, and Europe. Our practice uses advanced intraocular lens power calculation methods to select the ideal PanOptix or PanOptix Toric implant for appropriate
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Dropless and Less Drops Cataract Surgery

Choose safer surgery and save $100 to $300 per eye.
Intraocular antibiotics administered at the time of eye surgery reduces risk. We have employed this technique on every appropriate procedure since 2014. By instilling antibiotics and steroids in the operating suite we reduce the need for postoperative drops saving patients $100 to $300 per eye.
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Hydrus: Cataracts and Glaucoma

Stop your glaucoma drops with Hydrus MicroStent.
Hydrus MicroStent has emerged as the best surgical option for patients with cataracts and mild to moderate glaucoma. Unlike alternative MIGS procedures, Hydrus has been shown to reduce the risk of aggressive glaucoma progression. Nearly 80% of patients using a single drop each night can stop their glaucoma medication ...
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Lewis LASIK

In the Pennsylvania cataract surgery offices of Dr. James S. Lewis, patients can expect the highest quality treatments and impeccable care. Dr. Lewis and his talented team use the latest surgical technologies and techniques to deliver the best possible results. A wide range of services including premium IOLs, refractive procedures, corneal care(Cross Linking), and MIGS (micro-invasive glaucoma surgery), including Hydrus® Microstent, TORIC Intraocular Lens, Alcon's new PanOptix and now the new Light Adjustable Lens are offered by our practice.

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Related Sites

  • Phoenixville Eye Associates
  • LewisLASIK
  • Dry Eye Philadelphia
  • Laser Dry Eye
  • LASIK TV

FOLLOW US

Our practice will start seeing patients again on M Our practice will start seeing patients again on Monday, May 11th in full compliance with all local, state, and federal guidelines. This includes masks, social distancing, and the disinfection of all common surfaces. Elective surgeries are also being rescheduled. Care will be taken to avoid office congestion and minimize exposure to COVID-19.

We require: ➡️ You do not have fever, chills, shaking, muscle pain, headache, sore throat, or a loss of taste or smell ➡️ You have not had exposure to anyone with a flu-like illness within the past two weeks ➡️ You wear a mask or equivalent facial covering over both your nose and mouth ➡️ You agree to maintain social distancing ➡️ You avoid touching your eyes, nose, mouth, and face ➡️ You enter the office alone if possible

Expect to hear from our staff shortly. You may contact us at your convenience from links at jameslewismd.com
Chorioretinal folds are a known finding following Chorioretinal folds are a known finding following penetrating glaucoma surgery, as in these two cases who underwent Ahmed valve tube shunt placement. Prevalence is estimated between 10-50% of incisional glaucoma surgeries.

Pic 1.) several linear chorioretinal folds throughout the posterior pole. Intraocular pressure was 4mmHg at the time of this photo. The fundus and visual acuity returned to baseline within a week as IOP leveled at 10mmHg.
Pic 2.) Small choroidal folds can be seen distributed temporal to the macula. This image also demonstrates a large hemorrhage consistent with ocular decompression retinopathy.
Pic 3.) shows complete resolution of the choroidal folds and hemorrhage after 4 weeks in patient 2.

#ophthalmology #ophthalmologist #ophthalmictech #ophthalmologyresident #ophthalmicphotography #ophthalmicsurgery #cornea #corneasurgery #eyesurgeon #eyesurgery #eye #oculardisease #optometry  #optometrystudent #optom #sunyoptometry #osuopt #salusuniversity #glaucoma #glaucomasurgery #retina #chorioretinalfolds
Inflammation of the anterior chamber can create fi Inflammation of the anterior chamber can create fibrin plaques that are readily seen within the pupil. The second and third images demonstrate an almost completely occluded pupil with synechia formation. The fourth image demonstrates an ultrasound biomicroscopy image of a patient in angle closure following complete pupil occlusion from fibrin (blue arrow). Aggressive corticosteroid therapy can ‘melt’ the fibrin and cycloplegics can mechanically disrupt it. Nd:YAG laser can also instantly disrupt total occlusion.

#ophthalmology #ophthalmologist #ophthalmictech #ophthalmologyresident #ophthalmicphotography #ophthalmicsurgery #cornea #corneasurgery #eyesurgeon #eyesurgery #eye #oculardisease #optometry #ocularinflammation #optometrystudent #optom #sunyoptometry #osuopt #salusuniversity
Descemet stripping endothelial keratoplasty (DSEK) Descemet stripping endothelial keratoplasty (DSEK) is a corneal transplant procedure that replaces only the innermost cells of the cornea. It is readily combined with cataract surgery to improve refractive outcomes. This is a one day post operative visit of a DSEK showing faint edema and remaining air bubble. The air bubble will typically dissolve over the first 48-72 hours.

#ophthalmology #ophthalmologist #ophthalmictech #ophthalmologyresident #ophthalmicphotography #ophthalmicsurgery #cornea #corneasurgery #eyesurgeon #eyesurgery #corneatransplant #dsek #fuchsdystrophy #endothelium #eye #oculardisease #optometry #optometrystudent #optom #sunyoptometry #osuopt #salusuniversity
Ocular surface disease is a complex state that rep Ocular surface disease is a complex state that represents a poorly performing pre-corneal tear film. It can frustrate many patients and can be challenging for clinicians. No two cases are alike.

In this case, a young patient without evidence of desiccation or inflammation had persistent physical symptoms. Biomicroscopy revealed clear lid margins, no conjunctival injection, and no corneal epitheliopathy. Meibography (imaging the meibomian glands) provides insight into the cause. A previous course of oral medication that acts on sebaceous glands has likely impacted his meibomian glands as well. The gland dropout is easily seen as truncation and atrophy. The final video demonstrates a noninvasive tear-breakup time where the red squares are regions with early loss of tear film stability.

#ophthalmology #ophthalmologist #ophthalmictech #ophthalmologyresident #ophthalmicphotography #ophthalmicsurgery #cornea #corneasurgery #eyesurgeon #eyesurgery #dryeye #ocularsurfacedisease #OSD #eye #oculardisease #optometry #optometrystudent #optom #sunyoptometry #osuopt #salusuniversity
Iris cysts are benign. If suspected, they should b Iris cysts are benign. If suspected, they should be imaged with ultrasound biomicroscopy (UBM) to confirm the diagnosis and rule out other causes of iris elevation.
#ophthalmology #ophthalmologist #ophthalmictech #ophthalmologyresident #ophthalmicphotography #ophthalmicsurgery #cornea #corneasurgery #eyesurgeon #eyesurgery #ubm #eye #oculardisease #optometry #optometrystudent #optom #sunyoptometry #osuopt #salusuniversity
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