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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

TORIC IOLs in Philadelphia – Dr. James S. Lewis

Cataract surgery with a TORIC implant can reduce or eliminate your residual astigmatism and make you less dependent on glasses for driving, watching TV, or reading. Astigmatism usually arises from a mild pre-existing variation in the curvature of the cornea. Nearly 50% of patients benefit from this choice of IOL.

Alcon Toric Lens

reset the toric lens model

The cornea and the crystalline lens focus parallel light from a distant clock onto an image projected to the retinal surface. That image is sent to the brain and, if it is perfectly focused across all 12 numbers, we say there is no astigmatism. If the 3 and 9 o’clock are perfectly focused but the 12 and 6 are not, we describe this as astigmatism in the optical system. Simply put, light is bending optimally in one axis (3 to 9) but suboptimally in another axis (12 to 6). That can happen when the cornea is shaped more like a football than a basketball.

Patients with pre-existing astigmatism need glasses or contact lenses to see clearly. These same patients can reduce their dependence on appliances if they have cataract surgery and choose a TORIC intraocular lens.

Astigmatism is actually a more complicated subject involving regularity across all meridians (axes) as well as curvatures measurements for the anterior and posterior surface of the cornea. Choosing the best TORIC implant involves estimates of the effective lens position (ELP), calculation of the ideal IOL orientation, and an offset for surgically induced astigmatism. Nevertheless, TORIC implants are remarkably effect in reducing postoperative astigmatism and improving visual clarity without glasses.

Rarely patients with pre-existing astigmatism do not require TORIC lenses. In these cases the lens (which is now a cataract), is the major cause of the astigmatism. Once it is removed, the astigmatism is essentially gone. Similarly, in some cases, the cataract has astigmatism that counterbalances the underlying corneal astigmatism. Removing the cataract unmasks the latent astigmatism. These patients will be advised of their need for a TORIC implant prior to cataract surgery.

TORIC lenses were approved by the FDA in 1998. The manufacturer, Staar Surgical, provided them without additional cost and our practice used them in nearly half of all cataract surgeries. Second generation TORIC lenses were released in 2006, and while vastly superior to the original design, they require an out-of-pocket payment by the patient because health insurance providers consider TORIC lenses a premium service.

Toric Lenses: Are They for Me?

For those who do not choose a TORIC IOL, glasses and contact lenses still work. Also, patients can have LASIK or a related corneal procedure following cataract surgery to reduce or eliminate astigmatism. Most patients select a TORIC IOL for the rapid rehabilitation and the simplicity of this elegant technique.


STAAR TORIC
Surgical video showing the insertion of the STAAR Toric.
Unique features of this lens are presented.


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(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

Live Cataract, Corneal,
and Glaucoma Surgery

 
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(215) 886-9090

8380 Old York Road
Suite 110A
Elkins Park, PA 19027

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