Douglas Liva is an superb cataract surgeon who utilizes the latest techniques and
technology available. Dr. Liva performs most of his
surgery at his outpatient surgical facility Saddle River Valley Surgical Center conveniently
located in Bergen Medical Center in Paramus centrally located in Bergen County.
Cataracts, the leading cause of treatable blindness, create vision cloudiness and develop for a variety of reasons, but most commonly result as part of the aging process. However, they can also be caused by long-term ultraviolet (UV) light exposure, trauma to the eye and as secondary effects of diseases such as diabetes. Cataracts typically require surgical removal and replacement of the eye's lens.
is a highly effective way to restore vision impaired
by cataracts. Both the removal of the clouded natural lens and the
implantation of the replacement IOL are accomplished
through microscopic incisions from 2.4 millimeters
in length. Incisions this small usually avoid
the need for stitches and induce minimal amounts of astigmatism. Foldable lens technology has led to the development of microincisional surgery.
To calculate the lens power for for intraocular lens insertion Optical biometers, such as the Carl Zeiss Meditec IOLMaster, perform a new method of preoperative A-scan biometry where infrared light is used to calculate axial length, keratometry and anterior chamber depth. This precise, rapid method reduces technical variance and eliminates physical contact with the cornea. However, optical biometry may not perform consistently with patients who have dense cataracts. So in those cases where the cataract is so dense that even a laser can't penetrate. Dr. Liva uses an excellent alternative, immersion ultrasound. This procedure involves doing ulrasonic measurements through a shell filled with water to avoid having error produced by compression artifact of the ultrsound probe indenting the cornea.
With 25 million implants worldwide, ACRYSOF® lenses are the most frequently implanted in the world, as physicians appreciate the long-term clinical results and unmatched stability of the lens. Recent advances to this line of lenses also address other visual disturbances while correcting for cataracts. For patients with cataracts and spherical aberration there is the ACRYSOF® IQ lens, which corrects both conditions simultaneously. The spherical aberration of a patient's cornea can be measured with the Atlas Corneal Topographer and the the choice of an intraocular lenscan be made which reduces the spherical aberration the optimal amount.
Filtering Blue Light Like the Natural Lens
All AcrySof® IQ IOLs are available with a lens technology which is designed to have light-filtering abilities that approximate the light transmission of the human lens.
The human lens has the natural ability to filter UV and blue light. Unlike other UV-absorbing IOLs, this lens is designed to filter light similar to the human lens.
The AcrySof® IQ ReSTOR® IOL is available with the blue light-filtering chromophore.¹ This unique chromophore filters blue light in a manner that approximates the natural crystalline lens, in the 400-475 nm wavelength range. The blue light-filtering chromophore filters blue light without impacting color vision or the quality of vision.²*
For patients who have small amounts of astigmatism and don't find reading glasses inconvenient or can't afford to upgrade to a premium lens, this lens is an ideal choice.
For correction of astigmatism or presbyopia
In May of 2005, the Centers for Medicare and Medicaid Services (CMS) clarified its payment rules to present Medicare beneficiaries with the choice to receive presbyopia-correcting intraocular lenses (IOLs) that provide restoration of distance, near and intermediate vision with less dependency on eyeglasses or contact lenses following cataract surgery.
Prior to the CMS ruling, limitations on Medicare payment prevented beneficiaries from choosing to purchase these lenses. Under the new policy, Medicare will continue existing reimbursement amounts for cataract surgery, and patients may elect to pay additional charges for advanced technology lenses such as the AcrySof® IQ ReSTOR® IOL.
Private insurances also consider premium lenses a "luxury" and require that patiens pay for the additional expenses involved with their implantation.
recently, cataract surgery patients were given IOLs that provided good
distance vision, but they continued to require glasses for near
vision. Crystalens is an accommodating intraocular lens that,
unlike a standard IOL, can treat both a person's cataracts and
presbyopia—loss of near and intermediate vision. You probably noticed
in your forties that you started to lose some of your up-close vision
and had to start wearing reading glasses. Crystalens not only treats
your cataracts (a clouding or hardening of your lens), but can also
reduce or eliminate your dependence on glasses.
a stepped surface, from thin at the outer edge for the
most distant vision, to thick in the center for the
nearest vision. This design focuses light from several
different distances onto the retina at the same time.
For most patients, the ReSTOR® IQ IOL will eliminate
the need for glasses in most situations. Some patients
may still need glasses, but will be pleased to find
that, in most cases, the prescription is very mild.
patients with astigmatism, Dr. Liva may suggest implantation of a toric
implant . The new IQ toric lens implant offers an enhanced aspheric
optic that improves image quality and increases contrast sensitivity in
cataract surgery patients with astigmatism. The innovative lens design
offers these patients the best opportunity for quality distance vision
The advances in cataract surgery have led to refractive lens exchange,
the replacement of lenses that have not yet developed cataracts but
suffer from moderate to high refractive error. Just as with cataract
replacement surgery, refractive lens exchange with standard IOLs
provides excellent distance vision, but patients will still require
glasses for near vision. The benefits include stable adjusted vision
that exceeds preoperative vision, the elimination of the eventual need
for cataract surgery, and the preservation of the central cornea for
those patients for whom LASIK surgery is not appropriate.
As with cataract surgery, refractive lens exchange with the ReSTOR® IQ IOL or the Crystalens AO
improves the outcome, eliminating or significantly reducing
the need for glasses.
Contact the office of Dr. Douglas
Liva today to learn more about cataract surgery with premium lenses.