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Advancing Cataract Care in Hagerstown and Frederick

The good news for people who have been diagnosed with a cataract is that cataract surgery today is safer, more precise and more predictable than at any other time in medical history. In fact, cataract surgery today is among the safest, most common procedures performed in all of medicine.

Here at Maryland Vision Institute, our surgeons have been setting the standard in cataract care for years. This includes performing the first LenSx laser cataract procedure in the region and the first to implant the new multifocal cataract lenses and the new Toric cataract lenses for treating your Astigmatism. 

Dr. Gus Stern and Dr. Sidney Chang are helping pioneer new laser and lens implant technology that will always keep Maryland Vision Institute on the leading edge of cataract care. This includes performing our cataract procedures in the comfort and safety of our Medicare-approved outpatient surgery center in Hagerstown. Our method of cataract surgery is not only the safest and most advanced method of cataract care…it’s also the most affordable. Our efforts are helping save patients money as well as helping preserve the Medicare and health insurance system by reducing costs.

What Is A Cataract and When Do They Develop?

Cataracts are simply a natural part of the aging process of the eye. In fact, more than 90% of people living in the United States will eventually undergo cataract surgery. Research shows that over 50% of people over the age of 60 suffer from cataracts. Many people don’t realize it, but cataracts are actually one of the leading causes of blindness worldwide. 

In addition to to the natural aging factor, there are other factors that can also cause cataracts. These include exposure to ultraviolet light, trauma, diabetes and even lifestyles such as diet, alcohol consumption and smoking can all lead to the development of cataracts.

A special note of interest is that cataracts are more common in women than in men and affect more than 22 million Americans. A cataract forms at different rates and it could affect one or both eyes. A cataract is the progressive clouding of the eye’s natural lens. Eventually, this clouding of the eye’s natural lens interferes with light passing through the eye to the retina. Aging and other factors cause proteins in the eye’s lens to clump together forming these cloudy areas. Over time cataracts typically result in blurred or fuzzy vision and sensitivity to light, which makes activities like night driving and reading more difficult.

Some of the causes for cataracts include:

  • Age
  • Eye trauma
  • Heredity
  • Diabetes
  • Ultraviolet radiation
  • Smoking
  • Glaucoma

Helping Our Cataract Patients Make a More Informed Decision at Maryland Vision Institute  

Our goal for our cataract patients in the greater Hagerstown, Frederick and surrounding Maryland areas is to help each and every one of you enjoy a lifetime of the best possible vision. Today, that includes helping you make a more informed decision on all of the cataract options available to you. Your lifestyle and the role your eyes play in the activities you enjoy most will help us ‘customize’ a cataract surgery plan that is tailor made to fit your needs. Please be sure to ask one of our surgeons or a staff member about your cataract options. 

Understanding Your Cataract Surgery Options in Hagerstown, Frederick and Surrounding Maryland 

Once a cataract has progressed, the only way to gain your full clear vision is to undergo cataract removal and lens implantation surgery. In cataract surgery, your natural lens where the cloudiness occurs will be removed and replaced with a new intraocular lens (IOL). Today, there are several different options when it comes to the technology used in cataract surgery. We will help you decide what technology and intraocular lens will be the best fit for restoring your vision to its full potential. In the 1960s, cataract surgery was considered somewhat risky, and it usually required a longer hospital stay. However, with advances in laser & lens implant technology, cataract surgery only takes a few minutes and it is an outpatient procedure. It is now one of the most common and successful medical procedures performed. Many patients even have better/clearer vision than before they had surgery.

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What To Expect On The Day of Your Cataract Surgery Procedure

The day of surgery, you will arrive at Maryland Visions surgery center an hour prior to your procedure. Once you have been checked in by a member of our staff, you may be offered a sedative to help you relax. Then, you will be prepared for surgery. We will clean the area around your eyes, and a sterile drape may be applied around your eye. Eye drops or a local anesthetic will be used to numb your eyes. Once your eye is completely numb, an eyelid holder will be placed between your eyelids. Then, a small incision will be made on the cornea of your eye and the cataract will be broken up into microscopic particles and we will suction out microscopic particles. Next, a folded intraocular lens (IOL) will be inserted through the micro-incision, unfolded, and carefully placed into position. The cornea is a “self-sealing” part of your body and usually requires no stitches. Naturally, it remains tightly closed by the outward pressure within the eye. The small incision heals quickly and provides a much more comfortable recuperation. Following the surgery, you will go home and rest for the day. Everyone heals differently, but many patients notice improvement in their vision within hours. Most patients return to their normal activities within a couple days, with some limited restrictions for 1-2 weeks.

How We’re Making Cataract Surgery Safer, More Precise & Accurate

Technology drives innovation, which has never been more evident than today with the evolution of Laser Cataract Surgery. Traditional cataract surgery produces excellent outcomes. However, until recently the major steps of cataract surgery were done using manual techniques. Today, we are able to offer our patients a laser method of cataract surgery, which is setting a new standard for safety and precision in cataract surgery.

Our LenSx laser is the first of its kind in central Maryland and is used for cataract surgery patients who choose astigmatism-correcting cataract surgery or surgery with a premium lens (such as the Symfony, Crystalens, ReSTOR or Tecnis Multifocal lens) A bladeless, computer-controlled laser surgery is planned and performed to exacting individualized specification not attainable with other traditional surgical methods. Laser cataract surgery is designed to improve the precision, safety and accuracy of your cataract surgery.

Our LenSx Laser Automates the Most Challenges Steps of Surgery

The LenSx laser used at our practice provides our patients with computer-controlled precision for their cataract surgery. It automates some of the most challenging steps of refractive cataract surgery. This femtosecond laser replaces the traditional hand-held blade to optimize all incisions for enhanced, reproducible surgical results.

In traditional non-laser basic cataract surgery, the surgeon makes incisions and removes the cataract using surgical instruments and blades. However, during laser cataract surgery, several of the most critical steps of the surgical process are performed using an image-guided femtosecond laser. 

Maryland Vision Institute is pleased to be among the first practices in central Maryland to offer patients the benefits of laser cataract surgery. We believe in providing our patients with the latest technology for vision correction and are now using the latest evolution of femtosecond laser technology in cataract surgery.

Laser Cataract Surgery Shortens Patients’ Healing Time

Laser cataract surgery is a state-of-the-art technology that improves the precision and shortens the healing time for a patient undergoing cataract surgery.  Traditionally, cataract surgery involves using blades to create the corneal incisions; using a needle and small forceps to create the opening to the cataract; and using only ultrasound energy to break up the cataract into smaller pieces for safe removal.  In contrast, femtosecond-assisted cataract surgery uses laser energy to create all of the corneal incisions; laser energy to create a perfect circular opening to the cataract; and laser energy to break up the cataract into even smaller pieces.

We feel that this laser technology is superior to “standard” cataract surgery because no human can match the precision of a laser!  Laser-assisted cataract surgery is also much gentler on the corneal endothelium (i.e. the “water pumps” of the cornea) which translates into faster patient recovery times.  Lastly, astigmatism reduction is more precise using the laser compared to traditional methods using blades.

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Wait a second, I thought all surgeons used a laser for cataract surgery?

Contrary to popular belief, most cataract surgeons do not have access or experience with laser-assisted cataract surgery. We were the very first surgeons to perform laser-assisted cataract surgery in the area including Hagerstown, Chambersburg, Frederick, and Cumberland. Because of our dedication to this disruptive technology, we are also the most experienced laser cataract surgeons in the area and are in the top 5th percentile laser cataract surgeons in the nation in volume. We brought this technology to the area because of our ongoing dedication of providing the most advanced technology of any practice in the nation.

Advancing The Art of Cataract Surgery With Breakthrough Technology

We utilize Alcon’s LenSx femtosecond laser which is the industry leader for this technology.  This amazing machine allows us to create very specific corneal incisions, limbal-relaxing incisions for astigmatism reduction, perfect circular openings to the cataract, and divides the cataract into many little pieces for atraumatic removal.

We also use Alcon’s Centurion Vision System as our phacoemulsification platform.  This is the latest generation phacoemulsification technology that optimizes the fluidics during the removal stage of cataract surgery.  Better fluidics equals safer cataract surgery!  In addition, ultrasound times are minimized compared to older phacoemulsification machines.  Using the Centurion with the LenSx femtosecond laser means you are getting the best that today’s technology has to offer for cataract surgery.

We also use Alcon’s ORA System with VerifEye+. This device is an example of an intraoperative aberrometer. The purpose of this device is to calculate the exact intraocular lens power that your eye needs during the time of the surgery! This device is superior to other methods of intraocular lens power calculation which are based more on theoretical or regression formulas. The ORA system with VerfiEye+ is even more useful for patients receiving multifocal and toric intraocular lenses. These premium lenses require the most precision in terms of lens power determination, and the ORA helps you achieve that goal!

We also use Alcon’s Verion Image Guided System. This device provides a real-time heads up display over the actual eye during surgery. This technology helps guide the surgeon during key parts of the surgery and also increases the precision of toric intraocular lens alignment.  This heads-up display is similar to the technology that fighter pilots use to control their intricate jets!

Custom Lens Implants

Most patients that over the age of 45 who are nearsighted or farsighted are most likely presbyopic. Presbyopia is a condition that prevents the eye’s natural lens from changing shape. When this is prevented, it will hinder your ability to see clearly for both distance and near vision. Some signs of presbyopia are the need to use reading glasses or feel like their arms are not long enough to the newspaper.

Refractive Lensectomy

Thanks to advances in technology, patients may now have their presbyopia corrected at the same time as their cataract surgery, reducing or eliminating their need for reading glasses. Some patients have Refractive Lensectomy before developing cataracts, in order to correct their presbyopia and reduce or eliminate their need for reading glasses. An important thing to point out is that you can have this procedure before being diagnosed with a cataract. Refractive Lensectomy surgery is actually very similar to cataract surgery.

During cataract surgery or a Refractive Lensectomy, your natural clear lens inside your eye is actually removed and replaced with an intraocular lens (IOL). Until recently, patients undergoing cataract or lens implant surgery received a monofocal, or a single focus lens. Monofocal IOLs implanted in both eyes generally provide excellent distance vision. Following surgery, patients often need spectacle correction for near and intermediate vision, or to correct astigmatism.

Options for Lens Implant Surgery?

At Maryland Vision Institute, we want our patients to have the best options on the market when it comes to their lens implant surgery. With some recent FDA approvals, there are now several different intraocular lens (IOL) implants available that can dramatically reduce your dependence on glasses following your lens implant procedure. Our doctors and staff will discuss which IOL and which surgical techniques may be best suited for your particular vision, lifestyle and activities.

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AcrySof® ReSTOR

The AcrySof® ReSTOR® IOL is one of the most revolutionary lens technology in the market today. The unique design allows patients to see clearly at all distances without bifocals or reading glasses.

In the clinical study, 80% of patients receiving the AcrySof® ReSTOR® IOL reported that they never wear glasses for any activities. With the AcrySof® ReSTOR® IOL they can read a book, work on the computer, and drive a car – day or night – and play golf or tennis with an increased freedom from glasses. In fact, 94% of patients said they would have the AcrySof® ReSTOR® IOL implanted again because they were so satisfied with the results.

Cataract surgery is performed on an outpatient basis and usually takes just a few hours from start to finish. Your eye will be treated with anesthetic prior to the procedure so you’ll feel little, if any, discomfort. Once the cataract is removed, the AcrySof® ReSTOR® IOL will be inserted through the same tiny incision and set into its permanent position.

After the procedure you’ll rest for a short while before you go home. Your doctor will typically examine your eye within 24 hours. You’ll need to use prescription eye drops to guard against infection and help your eye heal. Once both eyes have been treated, you will fully appreciate the AcrySof® ReSTOR® IOL and realize that your cataract was one thing you could definitely live without.

AcrySof® IQ Toric

More than 50% of the population has an astigmatism in one or both eyes. The majority of patients undergoing cataract surgery have some form of astigmatism. Corneal astigmatism is simply a condition that causes blurred or double vision due to the cornea of the eye being irregularly shaped. In patients who don’t have an astigmatism, their cornea is regular and round as in the shape of a doorknob or hemisphere. In patients who have astigmatism, their corneas are more oval-shaped like the back surface of a spoon where there is a difference in the steepness in each direction. The irregular shape of the cornea causes light rays to not properly focus on the retina (back portion of the eye). Because these light rays are skewed, people with astigmatism need prescription glasses or special contact lenses to correct this condition.

AcrySof® IQ PanOptix

Maryland Vision Institute’s PanOptix Technology

Patients undergoing cataract surgery at Maryland Vision Institute now have access to a breakthrough ‘trifocal’ lens implant called the AcrySof® IQ PanOptix® Trifocal Intraocular Lens (IOL), that recently received approval by the Food & Drug Administration for implantation in the United States. During investigational clinical trials, PanOptix patients were able to enjoy uninterrupted vision at near, intermediate and distance. The results also showed high patient satisfaction with more than ninety-nine percent of PanOptix patients saying they would choose the same lens again.

The PanOptix lens is the first trifocal IOL of its kind capable of delivering a unique combination of near, intermediate and distance vision to patients while significantly reducing your need for glasses after cataract surgery. This trifocal lens implant is designed for patients with active lifestyles who require good vision at all ranges.

This would include everything from viewing mobile devices & computer screens to intermediate and high-quality distance vision in a range of lighting conditions. The PanOptix lens uses ENLIGHTEN®Optical Technology, a proprietary design that optimizes intermediate vision without compromising near and distance vision.

This multifocal IOL is used to focus images clearly onto the back of your eye to allow clear vision after cataract removal. In addition, the center of this unique Trifocal IOL allows for better near (reading) vision and intermediate (computer work) vision versus what a monofocal – or single vision – lens would provide.

Medicare now allows patients to upgrade their vision using advanced lens implant technology like the PanOptix lens. This lens is fully approved by Medicare, but the PanOptix IOL is not covered by insurance. So patients are responsible for the out-of-pocket costs associated with Premium IOL technology like the PanOptix.

Click here to learn more about the PanOptix lens or watch the following videos:

The New Tecnis Symfony® Lens (IOL)

Leading cataract specialists, Gus Stern MD and Sidney Chang MD, are proud to be among the first ophthalmic surgeons in the region to offer patients the benefits of an exciting new multi-purpose cataract lens implant that can not only help you see clearly at all ranges of vision…but can also correct your Astigmatism at the same time.

It is called the Tecnis Symfony® Intraocular Lens (IOL) implant, the first and only FDA-approved cataract lens of its kind in the U.S. designed to give you a full range of continuous high-quality vision. The breakthrough Symfony® IOL is also the only extended depth of field IOL designed to correct presbyopia by helping you focus on near objects. Dr. Stern and Dr. Chang combine the added benefits of the Symfony® IOL with the safety and precision of our Femtosecond laser technology, which we feel gives patients the optimal cataract experience.

Correcting Presbyopia 

As part of our body’s normal aging process, our eyes begin to lose the ability to focus on near objects, which eventually causes almost all of us to need reading glasses. This is known as presbyopia and usually sets in during our 40’s, when we start noticing a difficulty reading small print. This loss of near focus progresses to the point that nearly all “up-close” vision will require the use of reading glasses.

Correcting Astigmatism 

The FDA’s approval of the Symfony® IOL also includes a Toric version of the lens – the Tecnis Symfony® Toric IOL – for patients with astigmatism. Astigmatism is a common condition that causes the light to enter the eye and focus in more than one point on the retina (back of the eye). This creates a “double vision” effect and can also leave your vision blurry. The added benefit of the Symfony® Toric IOL is that it can correct both presbyopia and astigmatism at the same time.

Cataract Lens Improves Range and Quality of Vision

In studies conducted by the manufacturer of the Symfony® Lens (Abbott Medical Optics), cataract patients in the Symfony® IOL group achieved greater improvements in intermediate and near vision while maintaining similar distance vision when compared to a standard single focus IOL. Symfony® patients were also less likely to wear prescription eyewear and achieved high overall visual performance in any lighting condition.

However, because not all patients are ideal candidates for this lens implant, patient selection and patient expectations are key to the overall success with the Symfony® lens.

Customizing Your Cataract Outcomes 

The key to our success with lenses like the Symfony® IOL lies in our ability to match your lifestyle, your expectations and your general ocular health with the appropriate lens. No manufactured cataract lens implant is perfect in all of its capabilities, but the Symfony® is a significant improvement in our ability to offer seamless, high quality vision that patients enjoyed in their younger years.

If you enjoy a good book, playing golf, knitting, scanning the internet, or other activities that require vision at various distances, the Symfony® IOL will enable you to live the lifestyle you want.

Fortunately, our surgeons employ the same, safe and proven surgical techniques with the Symfony® IOL that has made cataract surgery the most common and successful surgical procedure performed today. Each year, more than 15 million people just like you have their vision restored through modern-day cataract surgery.

Despite this, every surgical procedure has risks and side effects. Some patients may experience an adjustment period to their new lenses in which they encounter a glare or halos around bright light. This usually goes away over a period of weeks or months.

Insurance Coverage

Although IOLs used in cataract surgery are approved by Medicare and the insurance industry, the additional features of the Symfony® lens that provide a longer range of vision or correct astigmatism are not covered by insurance. So, similar to our other Toric and multifocal IOLs, cataract patients will experience an out-of-pocket expense to use the Symfony® lens over a conventional monofocal IOL.

LenSx® Laser System

The FDA-approved LenSx® Laser System is one of the newest advancements in cataract surgery. This ground breaking technology is based on the same femtosecond technology used in a bladeless LASIK procedure. The LenSx® laser substitutes the need for any hand-held blades during cataract surgery. When using a laser, there will be improved accuracy, a quicker healing process and a better outcome. This laser gives the surgeon image-guided control and the ability customize every procedure. Everyone’s eye is unique so it is important that your surgeon can tailor it to fit you. The LenSx® also has the unique ability to correct an astigmatism with greater accuracy and predictability than ever before.

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