Cataract Evaluations-What to Expect

If you are considering cataract surgery at Alabama Eye and Cataract Center, you will undergo a series of special testing to evaluate your eyes. Patients scheduled for a cataract evaluation can expect a multitude of tests to determine exactly which intraocular lens will best suit their needs. Today’s more advanced intraocular lens technology gives the patient the option to choose between the correction of astigmatism and/or presbyopia allowing patients to see both distance and near without the aid of glasses or contact lens. Careful screening of patients is necessary to determine the best choice of lens.

It is important for Dr. Michelson to understand the patient’s personal goals for vision correction; just exactly what do they expect after the cataract surgery? People have different visual demands for their jobs, retirement, or leisure. While many are encumbered with long hours of computer work and extensive reading, others enjoy fine craftwork, reading the newspaper, or competing in sports. All require different levels of sight. Designing your vision following cataract surgery and choosing the right implant for your needs requires thorough evaluation and analysis to assist you with your desired goals.

Cataract testing will include:

1. Visual acuity testing distance and near
2. Refraction
3. Contrast/Glare sensitivity
4. Keratometry
5. Topography analysis
6. Pentacam analysis
7. Lenstar optical biometry or immersion biometry (A-scan)
8. Slit lamp exam
9. Dilated fundus exam

Once your eye exam is completed by the doctor, he or she will discuss your options. Together, you will plan the next steps to achieve your goal for your best vision.

Cataract Surgery-Do I Still Need Glasses?

“When I perform Cataract Surgery for patients I have 2 main goals. The first is to remove the cloudy crystalline lens which is actually an optical component of the eye that provides focusing power. The second goal is to replace the optical and focusing power by implanting an intraocular lens (IOL) to provide the correct amount of focusing power to allow you to see clearly,” commented Marc Michelson, M.D. of Alabama Eye & Cataract Center.

If you wore glasses because you were nearsighted, farsighted or had astigmatism before you developed a Cataract it is possible for Dr. Michelson to use a carefully calculated IOL power or even special IOL that can correct astigmatism so that you may not need to wear eyeglasses to see at distance after your surgery. Today, it is even possible for Dr. Michelson to select IOLs that can correct both distance and near vision so that you can decrease, or even eliminate, your dependence on bifocals and reading glasses after Cataract Surgery.

If you think you have a Cataract or have been told you have a Cataract and would like to be less dependent on glasses it is worthwhile to schedule a consultation at Alabama Eye & Cataract Center to learn more about Cataracts, Cataract Surgery and Lens Implants by calling 205.930.0930.

Blade Free All Laser LASIK Advantages

The evolution of LASIK has since FDA approval in 1999 has been nothing short of remarkable. The first LASIK procedures were performed by creating a thin superficial corneal “flap or cap” with an instrument known as a microkeratome or “blade”. The microkeratome is a sophisticated device with a mechanical blade that oscillates at a high rate of speed creating a thin flap of corneal tissue about 150 microns thick. The flap would then be elevated exposing the inner cornea. Next, the excimer laser treatment would be directed to the exposed surface of the cornea to reshape the eye. The flap would then be repositioned and allowed to heal. The advantage of LASIK was the fast healing time of the flap allowing rapid return of vision within hours of the procedure. Despite the good outcomes, many complications of LASIK surgery were related to the flap created by a mechanical microkeratome.

Since approval of LASIK in 1999 by the FDA, newer and more sophisticated methods hare now employed to create of the corneal flap that are much safer, more precise, reproducible than flaps created by the microkeratome. ALL LASER “Blade Free” LASIK has evolved and is now incorporated in all LASIK procedures at Michelson Laser Vision. The femtosecond laser fires at speed of 10-15 seconds to create corneal flaps as thin as 90 microns with incredible precision and reproducibility. The femtosecond laser reduces variability and results in better outcomes. Dr. Michelson prides himself on having the latest state-of-the-art technology and equipment and remains a leader in the field of LASIK and refractive surgery.

For the ultimate in blade free procedures, Dr. Michelson currently uses the Femtosecond Laser known as Ziemer, to create “blade free” corneal flaps. The Ziemer alleviates the need to use blades for LASIK.

The femtosecond laser produces millions of tiny submicroscopic closely spaced gas bubbles inside the cornea to aid the surgeon in lifting of the “cap or flap”. An additional advantage of the femtosecond laser is the capability of allowing more patients who might not have been a good candidate for LASIK with a microkeratome to become good candidates for LASIK with the femtosecond laser. People who previously were told that they were not viable candidates for LASIK because their corneas were too thin should be re-evaluated. Since the flaps generated by the femtosecond laser are only 90 microns thick, patients who were told their corneas were too thin may now experience the joy of not depending on eyeglasses or contacts for their vision. If you or someone you know were previously not a viable candidate for LASIK, consider having a free consultation to determine if this technology will enable you to join others in breaking free from the dependency of contacts and eyeglasses by contacting Michelson Laser Vision at 205-969-8100.

Good LASIK Candidates-Who Are They?

“Many many patients from Birmingham and throughout Alabama come see us wanting LASIK. Our first responsibility is to make sure that they are good candidates for LASIK or any type of Laser Eye Surgery for vision correction”, said Marc Michelson, M.D., Corneal Specialist, LASIK Surgeon and Medical Director of Michelson Laser Vision.

The desire or the need to be free of the hassle of eyeglasses or contact lenses for seeing at distance motivates millions of people-just like you-to consider LASIK. Thoughts of being able wake up and see the alarm clock clearly-and just get up and go, have great appeal for anyone who depends on glasses or contacts. But, LASIK is not for everyone. Here are some things to think about to help you determine if you might be a potential candidate for LASIK.

 The great majority of patients who are nearsighted, farsighted or have astigmatism are potential candidates for LASIK.

 Good LASIK candidates are at least 18 years of age or older and have stable vision. This means that their eyeglass or contact lens prescription has not changed much in the last year or so. Many people do not have "stable" vision until 21 years of age, however so each person is a bit different.

 Good LASIK candidates have healthy eyes that are free from retinal problems, corneal scars, and any other eye diseases. They have normal corneal shapes and thickness as well as healthy tears.

 The best LASIK candidates are those with a lifestyle, activities or occupation in which they are dissatisfied with their contact lenses or glasses.

The best way for you or someone you know to find out if they are a good candidate for LASIK is to have an evaluation, examination, and consultation at Michelson Laser Vision. Please feel free to schedule an appointment by calling us at 205-969-8100.

Intraocular Lens Implants

Intraocular Lens Implants, Intraocular Lenses, or IOLs as they are more commonly known are artificial lenses that are used to replace natural lenses during Cataract Surgery that have become clouded with Cataracts. They can also be used as a solution for people without Cataracts who suffer from Presbyopia a condition in which the crystalline lens of the eye becomes less flexible, thus losing its ability to focus on near objects. There are many types of Lens Implants that we use at Michelson Laser Vision and Alabama Eye & Cataract Center.

Monofocal vs. Multifocal Lens Implants
Traditional Lens Implants or Monofocal IOLs are able to improve vision at one distance (intermediate, far, or near) only. Dr. Michelson uses Multifocal Lens Implants to help presbyopic patients who are having problems with their near vision see more clearly at a range of distance. This advanced IOL technology allows Dr. Michelson to replace the eye’s natural lens with a new, artificial lens that can help restore visual clarity to near, intermediate and distance vision.

Astigmatism Correcting Toric Lens Implants
People with astigmatism before their Cataract Surgery will have to wear eyeglasses or have additional surgery after the Cataract is removed in order to fully correct their vision unless they elect to have an astigmatism correcting toric lens implanted as part of their Cataract Surgery. “If freedom from glasses for distance vision is important to you, you now have a better option. The unique design of a toric IOL makes it possible to reduce or eliminate astigmatism and significantly improve your uncorrected distance vision after cataract Surgery,” said Dr. Michelson.

Spherical Aberration and Cataracts
A type of visual distortion that is common to patients with Cataracts is called spherical aberration. Spherical aberrations are generally associated with:

• Blurriness
• Halos
• Loss of contrast
• Poor night vision

Dr. Michelson uses Aspheric Lens Implants rather than traditional spherical lens implants for his patients as they provide enhanced clarity, improved image quality and better contrast sensitivity that is especially noticeable in dim illumination or at dusk.

Please feel free to schedule an appointment and contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Alabama Eye & Cataract Center at 205-930-0930.

LASIK or PRK-Which is Best for Me?

“Both LASIK and PRK are excellent Laser Eye Surgery procedures for vision correction when they are used to treat appropriate patients with healthy eyes who want to decrease their dependency or even eliminate eyeglasses or contacts for seeing at a distance”, said Birmingham LASIK Surgeon and Corneal Specialist Marc Michelson, M.D. “While the long term visual results of both PRK and LASIK are pretty much identical, there are some differences that we always discuss with our patients”.

Patients who have LASIK may have very slightly reduced contrast sensitivity in dim illumination. If one uses extremely sensitive clinical measuring methods they can sometimes find a slight reduction in “low contrast” vision. Often it is so slight that the patient does not notice it except in the testing conditions or in very extreme instances of reduced contrast situations such as driving at dusk in the rain. Thus it is a limited problem for most patients.

The real differences between PRK and LASIK are based on the fact that PRK is a “surface laser treatment” and LASIK is a “lamellar laser treatment.” PRK is performed on the surface of the cornea whereas LASIK is performed between the layers of the cornea. “To do a LASIK surgery I use a 3-step procedure. First I use a laser to create the “flap”. Then I will gently fold the flap back and apply the laser and then finally I will replace the flap in its original position”, said Dr. Michelson. To perform a PRK is a single step procedure, just applying the laser. “Any procedure with multiple steps has a greater risk of complications. “Fortunately the risks, side effects and complications of LASIK are relatively few and minor so that if we tell you that you are a good candidate the risks are minor.” So, PRK does offer a safer risk profile because it is a single step procedure. However one of the not so subtle differences is that because it is a lamellar procedure, LASIK does not disturb the surface of the cornea during treatment. This provides patients with a much faster visual recovery and significantly less discomfort than PRK. This is why from a consumer perspective patients have tended to want LASIK eye surgery more than PRK. They can get back to pretty much normal activities within a couple of days without any real pain-just some mild discomfort-and with good vision. Most LASIK patients are able to pass a drivers test with 24-48 hours of their laser treatment. PRK patients often experience moderate discomfort that can last a few days and depending on the degree of their prescription can take a week or so to achieve good functional comfortable vision.

The best way for you or someone you know to find out if they are a good candidate for LASIK, PRK or any type of Laser Eye Surgery is to have an evaluation, examination and consultation at Michelson Laser Vision. Please feel free to schedule an appointment by calling us at 205-969-8100.

Alabama Eye & Cataract Center Cataract Awareness Month

Alabama Eye & Cataract Center wishes to announce that Prevent Blindness America has designated June as National Cataract Awareness Month. Cataracts are the leading cause of blindness worldwide. About 20.5 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80.
Many patients do not actually know that a cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. They need to understand that cataracts are not a growth or a film over the eye. For many patients cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision. The most common symptoms that bother patients with cataracts include:

• blurring of vision
• sensitivity to light and glare
• double vision in one eye
• poor night vision
• fading or yellowing of colors
• frequent changes in glasses or contact lens prescriptions.

 When cataracts do begin to interfere with daily activities or with patient comfort and safety they can be treated surgically. Cataract Surgery is one of the safest and most frequently performed surgeries in the United States. Today at Alabama Eye & Cataract Center Dr. Michelson uses the full range of Intraocular Lens Implants (IOL) available that allow us to correct near vision as well as distance vision without requiring bifocals or reading glasses for the vast majority of patients as well as correct astigmatism. Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by Alabama Eye & Cataract Center at 205-930-0930.