Cataract surgery, the most commonly performed ophthalmic surgery, is a specialty at Nevyas Eye Associates. We have been pioneers in developing and adapting new technologies of cataract surgery. We were one of the first practices in the Delaware Valley to perform Phacoemulsification (1974) and were among the first practices to implant modern intraocular lenses (1975). The surgeons at Nevyas Eye Associates have pioneered new cataract surgical techniques, developing new instruments and inventing several intraocular lenses. Nevyas Eye Associates has the most experience in cataract surgery in the Philadelphia/ Delaware Valley region.
What Can I Expect?
Today, most of our cataract surgery is performed by phacoemulsification (ultrasonic cataract removal through a small incision), and we usually utilize a the self-sealing clear corneal incision with topical anesthesia, which means that we usually do not use needles, stitches, or eye patches after surgery.
What is a Cataract?
A cataract is the clouding of the natural lens of the eye. Cataracts are often associated with with aging, a familial tendency to have them, or diabetes. Usually we cannot pinpoint any one cause for cataract formation. Cataracts can usually be cured completely by removal of the cataract and substitution with a clear synthetic intraocular lens implant. We can usually choose a power of lens implant to make each patient relatively independent of glasses after surgery. There are now a variety of intraocular lenses that can be used, each with its own advantages and disadvantages. There is not one specific lens which works best for everyone, but after a thorough eye exam, your surgeon will work with you to select the proper lens. We offer two different advanced lens technologies for your cataract surgery. Each of our lenses can provide a different type of visual outcome. The overall health of your eye and your personal goals and expectations will help to determine which of our options will best suit your needs. Once your surgeon has examined your eyes and also understands your visual requirements, he or she will make a lens implant recommendation to you
With the new accommodating Crystalens®, the patient can usually focus comfortably from far to near with both eyes, as a young person would do naturally. With new aspheric lens technology, we can give our patients sharper vision than ever. Some of the newly available technologies may not be covered fully by all insurance policies and, if chosen, may require out-of-pocket expense.
Is Cataract Surgery Painful?
Cataract surgery, performed by Drs. Herbert Nevyas, Anita Nevyas-Wallace and Vipin Goyal, is usually painless, and is done in our own outpatient surgical center (Delaware Valley Laser Surgery Institute) adjacent to our Bala Cynwyd offices. We have a complete modern state-approved, Medicare-approved and AAAHC-approved surgery center in which most patients will spend just a few hours from arrival to departure. Actual operating time is usually about 20 to 30 minutes for each eye. Patients are awake for the surgery, but are kept relaxed by gentle intravenous sedation by our physician anesthesiologists.
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The Crystalens Accommodating Lens
The Crystalens Accommodating lensis used when good vision at all distances is desired without having to use glasses or contact lenses. Nearly all cataract patients are over the age of 40, and require glasses or contacts to see well at both distance and near. This is because, in addition to being nearsighted or farsighted, they also have presbyopia, which is the cause of the loss of near vision due to age.
The Crystalens implant works with the muscles of the eye to allow you to focus on objects at different distances, delivering a smooth, continuous range of vision for far, intermediate and near. It focuses by moving back and forth as the muscles in the eye contract and relax, much as the natural lens did before losing its focusing ability from presbyopia. After Crystalens surgery, most patients see well enough to pass the drivers test as well as read a newspaper without glasses. Crystalens is the only lens that actually restores focusing.
The Crystalens Accommodating lens does require some out of pocket cost to you, beyond what your insurance plan will cover, and financing is available.
Another option in lens implants is “aspheric” lenses, which give you sharper or higher contrast distance vision, especially in low light situations — like driving at night. They include the first FDA approved lenses that have actually been proven to help you attain sharper vision than before you developed cataracts. This is achieved by advanced testing of your eye’s corneal aberrations, or distortions, so that an aspheric lens may be implanted which will neutralize those aberrations.
In order to get the full benefits of either the aspheric lens or the Crystalens, your surgeon will need to correct any astigmatism you may have. This correction can be performed during or after your lens replacement surgery, to give you the best possible vision without glasses after surgery.
Even with an aspheric lens, you may need glasses under some circumstances, such as reading. Although Precision Vision gives you sharper vision, it does not restore focusing, so reading glasses would still be necessary in most, if not all near vision activities. One option to further reduce your dependency on glasses for near is monovision. Monovision occurs when a lens is chosen to give the best possible far distance vision in one eye and give some help for near vision in the other eye (by leaving the near eye slightly nearsighted). You may discuss with your surgeon which focal distance will best suit your needs. The Precision Vision package also requires some out of pocket cost to you, beyond what your insurance plan will cover, and financing is available.
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