Wednesday, May 18, 2016

Clear Lens Extraction

Clear Lens Extraction

Some patients may not be good candidates for Laser Vision Correction to reduce their need for glasses and contact lenses.  It could be that the cornea isn’t the correct shape or thickness or the attempted correction is too great to do with laser on the cornea.  Some people have early cataracts in the 50’s and 60’s and in that case, it makes more sense to go ahead and do the cataract removal with intraocular (IOL) lens implantation. 

The IOL outcomes of cataract surgery in recent years have become so accurate, that we can offer our patients who may not be candidates for LASIK a procedure whereby the “premature” cataract lens is removed and an IOL is implanted to improve vision and reduce the need for glasses and contact lenses.  

 "Outcomes of cataract surgery in recent years have become so accurate, that we can offer our patients who may not be candidates for LASIK a procedure whereby the “premature” cataract lens is removed and an lens is implanted to improve vision and reduce the need for glasses and contact lenses."
- R. Scott Hoffman, MD

We call this "Clear Lens Extraction".  It is a surgical procedure equivalent to cataract surgery in which the natural crystalline lens is removed and replaced with an intraocular (IOL) synthetic lens. When cataract surgery is performed the IOL usually corrects for distance vision, often requiring reading glasses to improve near vision for close work.

The difference is that Clear Lens Extraction, sometimes referred to as Refractive Lens Exchange (RLE) or Presbyopic Lens Exchange (PRELEX) , is done before cataracts (clouding of the natural lens) have developed. The goal is to reduce or eliminate the need for glasses and contacts for daily activities.  

Just as in cataract surgery, different types of IOL options are available to replace the natural lens, depending on the specific vision needs and the health of the patient's eyes. They are:

Monofocal IOL:  This type of lens has one focal point so the aim is usually to put the focus at distance, minimizing the need for distance glasses.  For normal print, though, one would need reading correction.  People often use reading glasses, like many experience in the 40’s and 50’s with natural loss of their near vision (presbyopia).

Mono-vision Correction:  This option uses a traditional monofocal lens in each eye. One eye is corrected for distance and the non dominant eye is corrected to be nearsighted to be able to read at near.  This makes the distance vision in that eye somewhat blurry, but many people tolerate this very well.  Patients who have mono vision correction in contact lenses and love it are particularly good candidates for this strategy.

Multi-Focal Lenses: These specialty intraocular lenses have two distinct focal points.  Multifocal implants create a focal point at distance and another at near.  This way, one can see at distance and for reading with a minimal or no need for glasses.  There can be some glare at distance, since part of the lens is out of focus in order to allow for reading.  

Toric (astigmatism correction) IOL:  Often there is significant astigmatism of the cornea, that is, the shape of the cornea is not spherical, as would be a perfect camera lens.  Astigmatic corneas are rather ellipse shaped, like the side of an egg.  The vision correction then must involve correcting the astigmatism.  This can be done with Toric IOL’s and corneal shape-changing incisions.   
After examining your eyes and reviewing measurements,  your eye surgeon will discuss your visual needs and expectations in order to recommend an IOL that is most suitable for your individual needs.

·         The recovery is fast and there is excellent predictability of outcome.
·         This procedure is an alternative for patients who are not eligible for laser surgery.
·         Quality of vision is excellent.
·         This can correct high myopia (nearsightedness) and hyperopia  (farsightedness) that is out of the range of either laser surgery or phakic IOLs.
·         May be better than LASIK for some people over 40 years old.
·         Although this is an elective procedure, the patient will no longer develop a cataract later on because the lens has been removed and replaced by a clear implant.
·         There will be minimal postoperative discomfort.

·         Patient might lose the ability to accommodate or may need glasses for near vision.
·         This procedure is more invasive than laser refractive surgery. It is done in the operating room with topical anesthesia and mild sedation
·         Each eye is done on different days, usually a week or two apart, to make sure that healing occurs as expected and there are no signs of serious rare complications.
·         As with all surgery there are some risks with these procedures.  Fortunately, serious sight-damaging risks such as infection, bleeding, retinal detachment, glaucoma and loss of vision are very rare.

- R. Scott Hoffman, MD

Thursday, April 21, 2016

How often should I get an eye exam?

This is a question we get asked a lot, especially by folks who have no idea if they should wait until they have a problem before having their vision checked. It is also a question that is asked by people who have come in occasionally over the years for solutions to specific vision problems. Many people think that as long as they don't have a problem, they don't need to see an eye doctor.
The American Optometric Association recommends that healthy adults ages 18 to 60 get eye exams every other year if they do not wear contact lenses and have no factors for health and vision problems. In addition, current guidelines from the American Academy of Ophthalmology call for a baseline comprehensive dilated examination at age 40 in most healthy adults. Kids should have eye exams at least every 2 years and in some cases every year.  
The only sure way to know if you have an undetected problem or an eye disease such as glaucoma, macular degeneration or cataracts, is to have a comprehensive eye examination. Some eye diseases have no noticeable symptoms until damage has already occurred. Early diagnosis and treatment are the keys to preventing loss of vision, particularly in glaucoma, where the pressure in the eye builds up and, if left untreated, damages the optic nerve. A comprehensive eye exam, including dilation and perhaps other diagnostic tests, can help us determine if you have any eye disease.
Patients with a family history of any eye disease are strongly urged to see an eye doctor to discuss this situation and have a baseline exam with regular follow-up exams. Eye diseases that can be hereditary include glaucoma, macular degeneration, retinitis pigmentosis and diabetic retinopathy.

80% of outside stimuli is through the visual system. If it has been a while since you last saw your eye doctor, you should call Koby Karp Doctors Eye Institute to schedule an appointment today. Call (502) 897-1604 or 1-800-777-4393

Wednesday, April 13, 2016

Hey Doc, when should I get my cataracts removed?

It is time to consider surgery for cataracts when your daily visual needs require it. Your decision should be based on whether or not you can see to do your job, drive safely and engage in such activities as reading and watching TV in comfort. Can you see well enough to perform daily tasks such as cooking, shopping or taking medications without difficulty?
Cataracts do not need to be removed just because they are present and It is not true that cataracts need to be "ripe" before they can be removed. You and your doctor should decide together when surgery is appropriate based on your symptoms.
Now, when it does come time to remove cataracts,  we understand that patients are anxious to get results quickly and painlessly, so we'll answer some "how long" questions here.
How long does it take for cataracts to develop?
The rate of development can vary among individuals and may also be different between the two eyes. Most age-related cataracts can progress gradually over a period of years. It is not possible to predict exactly how fast cataracts will develop in any given person. Some cataract development, especially in younger people and people with diabetes, may progress rapidly over a short time. A comprehensive eye examination can reveal early signs of cataract development.
How long does cataract removal take? Removing cataracts is regarded as outpatient surgery and generally takes between 15 and 30 minutes to perform depending on the severity of the cataracts. You should not feel any pain during the procedure as local anesthesia is given. Afterwards, little if any pain is experienced.
It is wise to plan to be at the surgery center for approximately 2-3 hours in order to accommodate the pre-op preparation and post-op recovery period. You will need to arrange to have someone drive you home after the procedure.
How long does cataract surgery recovery take?
The good news is that smaller incisions for cataract surgery means shorter healing time and more rapid vision recovery for most patients. In some cases patients see well the day after cataract surgery. Other patients see well a few days after surgery, and still others may need a full month or several weeks before reaching maximum vision improvement.

The new Multi-focal lens implants and the most advanced intraocular lenses (IOL's), allow patients who are good candidates the opportunity to enjoy good distance and reading vision with minimal or no need for glasses following the cataract procedure.
For more info give Koby Karp Doctors Eye Institute a call at 502-897-1604 or 1-800-777-4393.

Friday, March 25, 2016

Welcome To Our Family

Welcome to our family.   
Family attitude,  family values.

Some families do it a lot better than others do. They welcome new members in a way that makes them glad to be included. Then they continue to make the outsiders feel even more like insiders as time passes. Very nice.

We believe our family of doctors and staff does exactly that, too. And that they do it really well. That's why we think you will enjoy our family of care at Koby Karp Doctors Eye Institute.

Even though the members of the Koby Karp family of eye care professionals aren't related by birth, we have adopted a family culture that is uniquely special. You see, many of our staff and doctors have been with our practice for twenty and even thirty years or more. While some of our "youngsters" have only been around for ten years or less.    

But what does that mean to you? Our long-time as well as prospective new patients?

For one thing, it means a smooth transition of care. Over the years we have developed a mutual sense of patient expectation. So, it makes no difference who serves you in any area our practice, the service mindset is the same  - you're treated with kindness, consideration, and respect conveyed with a gentle touch. After all, that's what we would expect as patients of our own practice!    

At Koby Karp we also stay abreast of the latest technology, treatment and services so we can remain at the forefront of eye care to deliver the most advanced solutions for your best outcome. So, we're a family of eye care for you

Yes, many of us have been together for such long time that some of us can even finish one others' sentences. And that's a good thing for you. Our ease of communication means you receive exceptional care in a seamless transference of our services.

We want to be your eye care family.

Call us to set an appointment and meet our friendly family. Call (502) 897-1604.  We think you'll feel very welcome in the Koby Karp eye care family.