LASIK Los Angeles, Cataract, Presbyopic Implants, ICL, Pterygium Specialist
Sharing is Seeing

Category Archives for Cataracts

ReSTOR+2.5 D VS ReSTOR+3.0 D

Comparing and contrasting Presbyopia implants ReSTOR+2.5 D VS ReSTOR+3.0 D

ReSTOR®+2.5 D IOL

ReSTOR ® +2.5 D IOL with ACTIVEFOCUSTM optical layout for the patients with energetic lifestyles, such as those who

  • Participate in activities requiring more intermediate (53 cm/21 in) and distance (4 m/13 ft.) vision
  • Are not willing to compromise distance vision for a full range of vision
  • Desire more opportunity for a range of vision versus mono-focal
  • Might prefer an alternative to mono-vision
  • Desire increased spectacle independence

The ACTIVEFOCUS optical layout is crafted to take those patients’ distance vision a step further while offering the well balanced near as well as intermediate efficiency with the objective of reducing spectacle dependency for tasks like:

  • Driving and dashboard viewing while driving
  • Playing or watching live sports
  • Attending theater or performance events live

* Active-lifestyle individuals join activities that need intermediate as well as distance vision such as golf, tennis, home cleaning and also driving.

ACTIVEFOCUSTM Optical Design

Using sharp distance vision plus well balanced efficiency at near as well as intermediate focal points, the AcrySof® IQ ReSTOR®+2.5 D IOL features:

  • 7 diffractive steps
  • 3.4 mm diameter diffractive region (8.4 mm2 total diffractive area)
  • Large peripheral zone that allocates more light to distance as pupil size increases
  • 0.94 mm-diameter central refractive zone dedicated fully (100%) to distance vision
  • -0.2 μm negative asphericity

The result?

  • ReSTOR ® +2.5 D IOL designates a lot more light to the distance focal point at every pupil size, however particularly in mesopic problems.

Light distribution at a 3.0 mm pupil aperture:

  • Distance: 69.4%
  • Near: 18.0%
  • Total: 87.4%

ReSTOR®+3.0 D Multifocal IOL

Ophthalmologists should recommend IQ ReSTOR ® +3.0 D IOL with a pupil-adaptive layout for their appropriate patients who desire:

  • A broad range of vision from 16 inches (40 cm) to distance
    • The greatest opportunity for spectacle independence
    • To engage in a variety of activities requiring near, intermediate and distant focal points

Developed to minimize spectacle dependency in all distances for the broadest array of vision, this sophisticated IOL can aid your patients refocus on the activities they love:

  • Reading
    • Cooking
    • Playing cards
    • Watching TV

Pupil-Adaptive Optic Design

Providing exceptional performance at whatsoever distances, the AcrySof ® IQ ReSTOR ® +3.0 D IOL includes a pupil-adaptive optical layout crafted to maximize efficiency in all lighting conditions with the following features:

  • 9 diffractive steps spaced closer together
  • A larger diffractive region (3.6 mm diameter, 10.2 mm2 area)
  • A 0.86 mm-diameter central diffractive zone dedicated 60% to the near focal point (40% to distance)
  • Negative asphericity of -0.1 μm

The result?

ReSTOR ® +3.0 D IOL disperses light much more uniformly in between the near and distance focal points in photopic problems, preferring distance much more as the pupil broadens in mesopic problems.

Light distribution at a 3.0 mm pupil aperture:

  • Distance: 59.0%
  • Near: 25.5%
  • Total: 84.5%

We would like to summarize that both ReSTOR+2.5 D VS ReSTOR+3.0 D are PIE manufactured by Alcon. Dr. Khanna has experience with both the styles.

MIGS- minimally invasive glaucoma surgery

INTRODUCTION

MIGS is a solution for Open Angle Glaucoma, a disease of increased pressure in eye.

Open angle glaucoma (OAG) is an illness impacting an estimated 2.8 million people in the USA. It represents an approximate cost of $1.5 billion annually.  Preliminary therapy for OAG usually consists of drops that can assist in lowering aqueous humor production or boosting aqueous humor discharge uveoscleral pathway. Furthermore, laser trabeculoplasty is an additional alternative for the therapy of very early, mild, open angle glaucoma. Long-term efficiency has actually been discovered to be comparable to clinical management with drops. Commonly, pharmacologic and also laser therapy have actually been the mainstays of treatment up until the condition advances to a phase that calls for the need for trabeculectomy. This treatment is commonly reserved for those with moderate to advanced cases of glaucoma as a result of the invasiveness of the treatment and also possible complications.  While surgical alternatives had been reserved for individuals with moderate to severe glaucoma, creating micro invasive glaucoma surgical treatments (MIGS treatments) are creating brand-new alternatives for those that do not fulfill the requirements for trabeculectomy. These treatments have a greater safety profile with fewer complications and also a much more quick recovery time than various other intrusive methods. They have actually been revealed to be reliable in lowering IOP along with a patient’s need for medications, which is necessary provided a commonly reduced conformity rate for medication adherence.

Indications

Patients that are prospects for micro-invasive glaucoma surgery are:

Patients with mild-moderate glaucoma.

Primary open-angle glaucoma, pseudo-exfoliation glaucoma, or pigmentary dispersion glaucoma.

Glaucoma is uncontrolled with optimum pharmacologic treatment or there are obstacles preventing sufficient medication dosing.

Age more than 18.

Those Patients who have clinically significant cataract, their surgery may be performed simultaneously.

All patients should have a pre-operative extensive eye examination including gonioscopy and a thorough case history.

Contraindications

Contraindications for this treatment may include angle-closure glaucoma, secondary glaucoma moderate-advanced glaucoma, previous glaucoma surgical treatment, or significantly unrestrained IOP. Various other factors to consider include patients with previous refractive procedures along with monocular patients.

Minimally invasive glaucoma surgical treatment work by increasing trabecular outflow.

  • Trabectome.
  • iStent.
  • Hydrus stent.
  • Gonioscopy aided transluminal trabeculotomy.
  • Excimer laser trabeculotomy.
  • Suprachoroidal shunts.
  • Cypass micro-stent.
  • Reducing aqueous production.
  • Endo-cyclophotocoagulation.
  • Sub-conjunctival filtration.
  • XEN gel stent.

Trabectome

Trabectome is a surgical treatment established by NeoMedix (Tustin, CA). It was introduced in 2004 that allows a trabeculotomy to be executed through an interior technique. The system works by eliminating a strip of trabecular meshwork and also the internal wall surface of Schlemm’s canal in order to produce a course for the drainage of aqueous humor. The device itself consists of a one-use, disposable hand piece that is utilized for electro-cautery, irrigation, and aspiration. It is connected to a generator with a frequency of 550 kHz that enables adjustments in 0.1 watt increments as well as is managed through a 3-stage Foot Pedal Control that initiates irrigation, aspiration, as well as electro-cautery in sequence. Constant irrigation as well as aspiration allows for removal of debris as well as regulation of temperature. Furthermore, the suggestion of the Trabectome is curved at a 90 ° angle to develop a protective triangular footplate and also enable less complicated insertion right into Schlemm’s canal as well as coated to allow smoother movement within the canal. Ablation of 60 ° -120 ° enables re-establishment of the water drainage pathway. Maeda et al reviewed the end result of surgical procedures making use of Trabectome in 80 eyes of 69 patients. A mean preoperative IOP of 26.6 ± 8.1 mmHg was found to reduce to a mean postoperative IOP of 17.4 ± 3.4 mmHg within 6 months after the surgical treatment. Average number of medicines likewise lowered from 4.0 ± 1.4 to 2.3 ± 1.2 at 6 months. The research study reported no major complications, including chorodial effusion, chorodial hemorrhage, or infection.

iStent

The device is a heparin-coated, non-ferromagnetic titanium stent with a snorkel shape to assist in implantation. The device is placed using a single-use, sterilized inserter through a 1.5 mm corneal incision. The applicator is inserted right into the anterior chamber and across the nasal angle. The pointed tip allows penetration of the trabecular meshwork and insertion into Schlemm’s canal as well as 3 retention arches ensure that the device will certainly be held in place. The iStent itself is the smallest FDA approved device, measuring at 0.3 mm in height and 1mm in length. In a prospective randomized clinical trial, the effectiveness of phacoemulsification as well as stent placement compared to cataract surgery alone was assessed in 239 patients, with 116 patients receiving the stent. Patients associated with the research were those with mild-moderate glaucoma who had an un-medicated IOP in between 22 and 36 mmHg.

CyPass Micro-Stent

The device itself is a polymide, supraciliary device for ab-interno implantation. The objective of the device is to create a regulated cyclodialysis with stented outflow to the supraciliary space. The stent is 6.35 mm long with an outer diameter of 0.51 mm. throughout surgery, the implant is loaded onto a retracting overview wire, inserted through the preliminary phacoemulsification incision, and also advanced towards the sclera spur. The overview wire is utilized to execute blunt dissection of the ciliary body in order to permit passage into the supraciliary space where the stent can be placed. In the CyCLE study, 238 patients received the CyPass Micro-Stent in addition to cataract surgery treatment. In general, the device has actually shown in initial trials that there can be a considerable decrease in number of medicines used in addition to a considerable reduction in uncontrolled IOP or maintenance of a controlled IOP. This device has been recalled due to corneal problems.

XEN Glaucoma Implant

The XEN Glaucoma Implant (AqueSys Implant) was created by AqueSys Inc and is an investigational device that is presently going through medical trials. The implant itself is constructed out of a soft, collagen-derived, gelatin that is known to be non-inflammatory. The goal of implantation is to create an aqueous humor outflow path from the anterior chamber to the sub-conjunctival space. The implant is infused through a small corneal incision with using an inserter similar to those used for IOLs. Similar to various other implants, it can be done along with cataract surgical treatment. While minimal, there is company offered data readily available from worldwide trials. In general there have actually been 118 topics that have actually received the implants. The mean preoperative IOP was 23 mmHg with approximately 3 medicines. At the 12 and 18 month postoperative follow ups, the mean IOP had actually decreased to 15.4 ± 4.5 mmHg and after that 14.5 ± 3.1 mmHg, respectively. At 24 months, it was 14.3 ± 5.1 mmHg. At all-time points, the typical variety of medicines was one and 33% of patients were using no medications at 24 months.

Hydrus Microstent

It is a device which is implantable, flexible, a metal nitinol (Nickel Titanium) tube with windows (open-back stent) pre-loaded onto a hand-held delivery system which is used to implant the stent. The Hydrus ® Microstent is meant to decrease eye pressure (intraocular pressure, or IOP) in grown-up individuals with moderate to modest primary open angle glaucoma (POAG) by functioning as a support structure in one part of the natural drainage path of the eye (Schlemm’s canal). POAG is a kind of glaucoma where there is associated eye disease causing increased eye pressure and also where the eye pressure normally increases gradually. This progressive increase in eye pressure can be related to damages to the optic nerve which will impair vision significantly.

Gonioscopy Assisted Transluminal Trabeculotomy (GATT)

GATT is a kind of ab interno trabeculotomy which was defined by Grover et al in 2014. Under the guidance of a gonioscopy lens, a goniotomy is made in the nasal trabecular meshwork which functions as the entry point for the iTrack micro-catheter (iScience Interventional Corp, Menlo Park, CA), which has a 250 micron diameter. A customized method has actually likewise been explained using 4-0 nylon suture rather than the micro-catheter. Microsurgical forceps are used to advance the micro-catheter into Schlemm canal circumferentially 360 degrees, tracking its development with its illuminated distal suggestion. Once it has actually been gone through the entire canal, the catheter is externalized to create a 360-degree trabeculotomy. In their original evaluation, Grover et al reported on the 6 as well as yearend results of 85 patients; 57 patients with primary open angle glaucoma showed an average IOP decrease of 11.1 ± 6.1 mm Hg as well as fewer medications. For the 28 patients with secondary glaucoma, IOP reduced approximately 19.9 ± 10.2 mm Hg and 1.9 fewer medications. One of the most usual problem was a short-term hyphema reported in 30% of patients which resolved by one month. Considering that the original publication, Grover and colleagues have actually reported the effective use of the GATT technique in primary congenital glaucoma, juvenile open angle glaucoma, and also even eyes with prior incisional glaucoma surgical treatment. These very early results an appealing, conjunctival sparing method that can be utilized in conjunction with, or independent of cataract surgical procedure.

Conclusion

In patients with mild-moderate glaucoma with an IOP that has actually been unable to be controlled by medicines or who have poor medication compliance, micro invasive glaucoma surgery appears to be a feasible option. Clinical trials have actually revealed there to be a substantial decrease in IOP over periods of up to 24 months along with a significant reduction medication usage. The procedure has maintained a high safety and security profile with minimal adverse impacts. While the Trabectome as well as iStent are presently the only FDA authorized devices, there are several brand-new devices pending. Micro invasive glaucoma surgery can provide a technique of treatment for glaucoma patients that reduces dependence on medicines without the risks of more invasive procedures.

RESTOR 2.5 VS SYMFONY.

AN APPROACH TO CHOOSING PRESBYOPIA CORRECTING IMPLANTS IN THE CONTEXT OF               RESTOR 2.5 VS SYMFONY.

With reference to Presbyopia Correcting Implants, it is an accepted fact amongst ophthalmologists that  extended depth of focus lenses have actually increased interest in presbyopia-correcting lenses for surgeons as well as patients. As this topic relates, these implants provide an extended focal range rather than 2 unique focal points as in a multifocal lens. Although optically the Tecnis Symfony uses a unique system, functionally the Tecnis Symfony works likewise to a low add multifocal in offering patients distance as well as intermediate vision.

However like any type of lens that prolongs beyond a single focal point, the EDOF Symfony does have its constraints. Despite an ideal emmetropic result, a couple of patients complained about “spiderweb” glare, specifically while driving at night. These complaints become much more common when there is residual refractive error. These implants are certainly much more flexible of residual refractive error than conventional high add multi-focals, however, Doctors have actually learned to avoid doing mini-monovision with them due to these undesirable visual phenomena.

Around 60% of cataract patients choose presbyopia-correcting lenses, and here’s an approach the eye surgeons actually found to be extremely rational based on data from several research studies they have actually performed on patient satisfaction.

Initially, we’ll just talk about patients who are good prospects for a multifocal or EDOF lens. They have healthy and balanced maculas, controllable completely dry eye as well as fairly aberration-free corneas.

If a patient has astigmatism more than 0.5 D and also desires distance and intermediate vision, the Symfony toric is a an option.

For patients who prefer distance, intermediate as well as near, I do not recommend targeting a mini-mono-vision with an EDOF Symfony lens. A lot of these patients do not tolerate the spider-webs in the non-dominant, near eye. With low astigmatism, it likewise makes sense to do this with a Tecnis multifocal 2.5/3.25 also.

Now lets look at Restor active focus. It is yellow in color. It also provides ability to correct astigmatism.Again we do not recommend monovision with these. We have tried mini monovision in patients who were aleready employing that strategy with contact lenses. Those pateints did well. A better option, these patients will certainly do well with a ReSTOR ActiveFocus 2.5 in the leading as well as a +3.0 ReSTOR in the non-dominant eye. Therefore, we can achieve goal of reducing spectacle dependence for activities like Driving and Dashboard viewing, Playing or watching live sports & attending theatre or performance events. While Tecnis SYMFONY IOL lessens the effects of presbyopia and enable the patients to see clearly.

COMPARISON :-

  SYMFONY   Tecnis Symfony is an extended depth of field lens. It works  a low add multifocal in offering patients distance as well as intermediate vision.   Patient’s complaints about “spiderweb” around lights, specifically while driving at night.         Tecnis Symfony is certainly much more flexible of residual refractive error than conventional high add multifocals for patients who prefer distance and also intermediate (but not near) vision and if they have low astigmatism.   Appropriate for patients who prefer distance, intermediate as well as some near vision.   It has high refractive accuracy but can rotate.   ReSTOR ActiveFocus 2.5   While ReStOR works on those patients who have astigmatism more than 0.5 D     With ReSTOR, patients have complaints of glare and also halos. They do not face “spiderweb” glare problems. They do well with a ReSTOR ActiveFocus 2.5 in the leading as well as a +3.0 ReSTOR in the non-dominant eye.   ReSTOR one may have desire more opportunity for a range of vision versus monofocal.         For patients who are not willing to compromise distance vision for a full range, ReSTOR is an appropriate answer. ResTOR is having more rotational stability for both eyes, again targeting emmetropia. This is important with toric lenses        

CONCLUSION:-

In the present scenario, multifocal intraocular lenses (MF IOLs) are the most stable,reliable and dependable method for the surgical correction of presbyopia.  While looking at the facts, residual astigmatism is one of the leading causes of dissatisfaction after the implantation of a MF IOL.  

These IOLs require emmetropia for the attainment of the best visual results, and small amounts of astigmatism that may limit visual performance significantly.  Thus, astigmatism has to be completely corrected in order to obtain the maximum efficiency of a MF IOL. Hence, we like to correct astigmatism by various methods. If it is astigmatism with spherical equivalent of zero, we perform limbal relaxing incisions at the time of cataract surgery or during follow-up period. When there is associated myopia or hyperopia we deploy advanced wavefront idesign laser vision correction achieve emmetropia.

symphony toric presbyopic implant

Symfony or Tecnis Multifocal lens for Presbyopia Treatment

Today our topic of discussion will be Symfony or Tecnis Multifocal lens for Presbyopia Treatment.

Hi. I am Doctor Khanna, here with some models of intraocular lens implants when we do cataract surgery or we want to get rid of glasses and you are not a candidate for Lasik surgery. For example, if you are 56 years old and you want to be able to see far, middle and near, then you are up for presbyopic implants. There are different types of presbyopic implants. Today, we are going to talk about the differences between ‘Tecnis’ and ‘symfony’, which are both from Johnson and Johnson.

This is how the lenses look like. This is a clear lens and this is ‘Tecnis’ and ‘symfony’. ‘Symfony’ has less rings than ‘Tecnis’ and it is considered an EDOF (extended depth of field) lens. Whereas, ‘Tecnis’ has certain ridges, which splits the incoming light into distant and near. You can see distant and near and the bimodal curve, lets you see middle. ‘Symfony’ acts like a pin hole camera where you can see middle, distance and somewhat near.

How are you going to choose between the two? If you have long hands, then choose ‘Symfony’ but if you want to real closely then choose ‘Tecnis’. If you have had previous surgery like radial keratotomy then ‘symfony’ might be a better choice. In terms of side effects, ‘Tecnis’ has glare initially which faded away and ‘Symfony’ you can see a spider web. The best option is to discuss these various choices with your surgeon and to make sure that the surgeon is comfortable with the choices.

If you have more questions about Symfony or Tecnis Multifocal lens for Presbyopia Treatment call (310) 482 1240.  You can always read my book on amazon ‘The Miracle of PI in Eye’.

Have a wonderful day.

see far and near

New Technology Allows You to See Near and Far Without Glasses

Los Angeles Lasik, Cataract, Presbyopic Implants, ICL, Pterygium Specialist
See Near and Far and everything in between. Without the need of any visual aids

 

Say Bye Bye Trifocals, Bifocals and goodbye Readers too.

While  bidding adeu you may say Good riddance to contact lenses too.

Imagine getting up in the morning and looking at the alarm clock with your naked eyes. You then grab your smart phone to check on your email and the latest from your friends on face book.  While eating breakfast you skim through the newspaper. Continuing the trend, you drive with no glasses to work and then go on to play golf.  After playing the best golf of your life, you get a quick swim in which is a pleasure without glasses or contact. On way home you pick up groceries without squinting. Then you cut some organic veggies for a nice dinner. Catching up on bedtime reading, you wonder why you did not get this unbelievable rejuvenating therapy before.

 

see far and near and everything inbetween

Man playing golf, stuck in bunker needs to see far and near.

No more glasses ever?

How is that possible? But first why not talk about why you even need glasses for reading. or I think I may have presbyopia. 

Presbyopia is medical jargon for ageing eyes.

What causes presbyopia?

There is increasing stiffening of natural lens and decreasing strength of eye muscles. The zoom mechanism of the natural lens undergoes deterioration.

  • Is it something only older people get?

Old is difficult to define. This condition is present in mid forties. It may appear a little earlier in farsighted people. People with smaller pupils may display a delay in onset of presbyopia.

  • NOW THAT WE HAVE DETERMINED PRESBYOPIA IS A PAIN IN THE ….., WHAT SHOULD I DO?

    Or How can I see near and far ?

 

We have a few choices to overcome this natural malady.

  • Glasses – Cheaters, readers, bifocals, trifocals, progressives.
  • Monovision
  • Multifocal Contact lenses

And the new technology _ PIE

Pie is the creme de le creme of methods to rejuvenate ageing eyes. Let us explore how it is superior to other methods which combat effects of taking too many revolutions around the sun.

PIE is more advantageous than Glasses

Heck yeah. You agree with this or you would not be reading this page.

  • Glasses can fog  in the rain
  • Not possible to swim with glasses
  • Scuba diving is no fun
  • Always forgetting where you kept them.
  • Dont let your pet bit them
  • or your grand kids scratch them
  • You can add your own problems with glasses here _____

It’s safe to say PIE overcomes all these nuisances.

Pie gives binoucularity which is better than Monovision
This is a process of setting the focus of one eye on close-up objects and the focus for your other eye on far-away objects. In doing this, your brain combines the two images to create a clear picture. This is a relic from the twentieth century. Primary disadvantage is one looses binocular vision.

PIE allows you to preserve binocular depth of field vision.

Brain prefers PIE to multifocal contact lenses

Multifocal contacts move with every blink. The image presented to the brain fluctuates confusing it. That is why many people are not able to adapt to multifocal contact lenses.

PIE are stable and do not move. Brain neuroadapts improving vision.

Contact can lead to sight threatening cornea infections for as long as you wear them.

PIE is not exposed to the elements or bugs.

Types of PIE

Multifocal PIE let you see far and near
These include the ReZoom, ReSTOR, Symfony and Tecnis lenses. Multifocal IOLs are lenses that have concentric rings of varying focal power, like a bullseye. Some rings provide focus for near objects, others for mid-range objects, and some for seeing objects at a distance.

The Tecnis Multifocal Foldable IOL also has concentric rings for different distances. It received FDA approval in January, 2009 for use in cataract surgery, where the natural lens is replaced. In the clinical trials most participants achieved 20/25 distance vision or better and 20/32 or better for near vision. It is designed using Wavefront data – the same precise level of information that is gathered when you are having Wavefront LASIK.

Accommodating PIE implants mimic natural lens

These lenses are designed to change focus. An accommodating IOL allows you to see distant objects, and then is can change focus and allow you to see objects that are close up. The only accommodating IOL approved in the United States is the Crystalens. This was true in 2005 and is still true in 2014. We even have toric crystalens called trulign.

Wherever you live you will want to enjoy good vision. If you want to see near and far , please contact our

Beverly Hills, Los Angeles, CA

office today. Los Angeles ophthalmologist Dr. Khanna and his staff can help you find the new technology PIE that is best for your lifestyle and needs. Please call today to schedule your free vision screening so that you can see far and near and your computer too.

By Rajesh Khanna MD



lasik doctor nearby

symphony toric presbyopic implant

SYMFONY TORIC TO TREAT PRESBYOPIA

Symfony toric is a new premium intraocular lens to correct astigmatism. It is manufactured by Johnson and Johnson, the same company which also makes Band Aids.

actual sizeThere are about 4 million cataracts surgeries that are performed every year and more than half of Americans have undergone cataracts surgery by the time that they are 80 years old. It is not only a condition that treats older people, but it can occur in the eyes of any human being. Similar surgeries are done in people who suffer from presbyopia, astigmatism, and other problems people may experience with their vision. These surgeries are not necessarily painful, but they do cause some discomfort. However, there is a new way in which patients can look forward to crisp vision after the surgery.

Symfony Toric is FDA approved

The Symfony Toric contact lens has been approved by the FDA recently and shows that it can help with any of the above problems. Doctors have recommended it to their patients following their cataract surgery in order to help them enhance their recovery and vision. It is especially helpful for those who suffer from presbyopia. The lens returns the sense of freedom and independence to the patients and allows them to continue with an active lifestyle without having to wear glasses.

During a cataract or presbyopia surgery, the lens of the eye is removed and an artificial lens, or IOL, is inserted into the eye. The IOL is usually a monofocal lens which only allows patients to see objects at a distance. The result is then that objects that are closer are out of focus. The Symfony lens is developed in such a way that both the objects at a far distance and those at a closer distance can be seen perfectly. It improves the range as well as the quality of vision in patients. Those who have had the Symfony implanted in their eyes have proven to have more successful results than those who have the IOL implanted in their eyes.

Lens Implant

The Symfony lens has been approved by over 50 different countries worldwide and is also available in the United States of America. It has been clinically tested on over 2,000 eyes and these are the results that have been returned:

  • Provides seamless, day to day vision: the patients with the Symfony lens showed that their vision has improved and that they could see objects that were far away, objects that were at intermediate distances, and objects that were close to them. They could also see different points in between and they reported clearer and sharper vision.
  • Symfony Toric provides high-quality vision: in contrast with the IOL’s, the Symfony does not leave the patient with an inability to focus. The reason for this is because the Symfony is specifically engineered to capture the wavelengths of light at the right spots as it hits the lens. It also moulds to the shape of the cornea for improved vision.
  • Symfony Toric has a resistance against halo and glare: the Symfony has reduced the chances of bright glows around bright lights, enabling the patient to see better without disturbances. This allows the patient to drive and see better at night time.

symphony toric relieves glasses

Would you like tolerant more about symfony toric or presbyopic implants. You should read this informative book on Presbyopic Implants.

Signs and Symptoms of Presbyopia

As you grow older, you may find that is more difficult to read, use the computer and focus on near objects. The reason is presbyopia. This is a medical condition where people begin to lose the ability for their eyes to focus.

The earliest warning signs can be seen between the ages of 40 and 50, though some experience symptoms years before.

Difficulty reading and blurred near vision are two of the most common signs of presbyopia. Some individuals may also experience headaches and eye fatigue as well.That is when the need for readers and cheaters starts. Gradually the dependence increases.

The most common symptoms of Presbyopia include:

  • Hyperopia, or farsightedness. Objects at a distance are clear, but objects close up are blurry
  • Farsightedness increasing with age
  • Difficulty focusing on nearby objects
  • Difficulty reading
  • Experience eyestrain or headaches from prolonged reading or close work
  • Holding books or magazines at a distance to read clearly

If you or a loved one is exhibiting the early signs of presbyopia, it is important that you contact our Ventura or Los Angeles County Office as soon as possible so that your condition does not worsen. We offer free vision screenings for all new patients. Please schedule your appointment with Dr. Khanna today.

lasik nearby | lasik nearby usa | lasik surgeon nearby | lasik specialist nearby

Above 65 Years Old

7 Myths Cataract Surgery

Hi folks. This is doctor Khanna, your laser eye man. Coming to you with some new information. Today, I am going to talk to you about the 7 myths of cataract eye surgery. Cataract surgery has been there for many ages. You have probably heard about it but what is interesting is that your grandparents have probably heard about it. Even their grandparents knew about cataract surgery. Over the years, cataract surgery has advanced so much. The surgical finesse has become so much better that the modern day cataract surgery is way ahead the cataract surgery that was performed 60-70 years ago.
The problem is all the new information and knowledge has not circulated to the masses. Most of the information from decades old technology is still circulating amongst our friends and relatives. Today, I want to destroy all these myths, which are still existing.

MYTH 1 Cataract Surgery You have to wait for cataract to get ripe before they can have surgery.

This might have been true around 60 years ago when we did not have microscopes, surgical lubes and stitches. We did not have modern technology to pulverize the lens and take it out through small openings. At that time, the only to take it out was when you could see that the cataract is white, red or black. Freeze it and then pull it out in mass. Over the years, we have developed surgical loops, microscopes to binocular microscopes and we can see the smallest things in there. We can make minute openings, go in there and remove lens, which might not have been visible to the naked eye. That is the first myth that we have to destroy totally. In fact, the opposite is true. You should never wait for the cataract to get ripe because as the cataract matures, it gets hard and requires more energy to be taken out. Why is so much energy bad? It is because we are in a closes space in the eye and the energy is going to hit the iris (the colored part of the eye), the cornea (the clear front part of the eye) and damage the cells. We want to avoid that. The first myth has been dismissed.

Myth 2 The doctor has to decide when you need cataract surgery. 

This is news from a by-era when the doctor has to see the cataract and he was comfortable with the surgery. Today, it is all about you. Even Medi-care, medical insurance and everybody says that. The best time to do cataract surgery is when you feel that the cataract are bothering you and interfering with your active lifestyle. For different people it might be different. If you are 52-years old, and you have cataract that cause a lot of glaring driving, it might be troublesome for you and you might an early intervention. If you are a librarian or a stay-at -home person who does not drive a lot, then those minor cataract might not cause a lot of difficulty to you. You get to decide not the doctor or the insurance.

Myths Cataract Surgery  #3 You cannot go blind with cataracts.

It is important because many people are fearful of cataract surgery. They feel that the surgery will harm them and that cataracts are not going to cause any problem in the long run. That is wrong because the cataract is hardening and changing the lens and it gradually keeps cutting off the light until there is no light. You would be surprised to know that cataract is the most common preventable cause of blindness in the world. When the cataract hardens, it can lead to increased pressure and inflammation leading to blindness. The third myth that cataracts cannot make you go blind has been busted. You should do everything at all cost to avoid it.

Myths Cataract Surgery #4 The cataract has to be removed entirely.

This was the in the 70’s when the cataract had to be taken out in mass. That is not true and in fact, the opposite is true. We do not want to take out the entire cataract. We take out the cataract bag, clean out the contents and put in a new synthetic lens using the old lens as a support of the new lens. If you do not do that, the new lens would fall down and you do not want that. It is like taking your car for an engine oil change, out comes the old and in comes the new. You do not change the whole cask of the engine itself.

Cataract surgery is painful. Myths Cataract Surgery #5

This myth is close to everybody. Today, it is not true. Today, cataract surgery is one of the simplest and easiest procedure to perform. We keep it pain free both by topical drops and specially formulated drops that are instilled inside your eye. We make sure that your eye is numb and is pain free. We do not have to numb your whole body.

Myth #6 You have to be put out during cataract surgery.

If we are operating on your eye, we do not have to numb the whole body. We can take care of the pain.

#7 Myth Cataract Surgery
Recovery is long and painful. That is not true. Why? It is because it is a simple surgery performed in a short period of time for about 7-10 minutes. You are pain free and not totally asleep. Many people can go and work or even drive the same day if we do not give them enough medications. That is not what we are recommending. It is not like before when it was six weeks, in a day or two, you can go back to your activities of daily living.
I hope this information is useful and we have destroyed these 7 myths for now and forever. Thank you and have a wonderful day.

Fear afraid eye surgery

Afraid of eye surgery

Hi. Welcome. This is doctor Khanna. I want to talk to you about fear of eye surgery. This lesson is divided into three parts. Today’s lesson is on why we are so afraid of eye surgery. In the forth coming lesson, we will discuss how to overcome the fear. Why are we so afraid of eye surgery, we have to delve back into evolution, our upbringing and find some answers there. People are always afraid of the dark. Remember when you were a kid; you thought that there might be a monster in the closet or under the bed. People are afraid to go to the graveyard but today it is so much better. There are streetlights everywhere and we have a phone with flashlight on it.
Imagine Sherlock Holmes going out in the night when there is fog and mist around. There is an inherent fear in us coming from the times we lived in the forest. In the night, predators would come out and that fear has continued. Another thing you might have heard of is insomnia, when people are unable to sleep. It is very interesting why some people find it difficult to fall asleep and the simple answer might surprise you. The answer could be that they are afraid that they may not be able to get up if they go to sleep. They are afraid to lose their consciousness and go into a semi-conscious state. It is inculcated in every culture. Each civilization that is present on earth celebrate the festival of light in the dark days. That is their hope to overcome the darkness.
Another fear the people have is for the white coat. It is funny that people can check their blood pressure at home and it is okay and then they come to the hospital and see the white coat and the blood pressure shoots up. These are all evolutionary mechanisms that are built in for safety to preserve us and they all stack against us. There is one more called the menace reflex; when something comes near the eyes or when we sneeze, they instantly close. That is encoded in our DNA.
Corneas and eyes are every important. In fact, some evolutionary biologists feel that this reflex may have pre-dated the existence of eyes. Small microorganism who do not have eyes have had light shun on them and they immediately move away. All those things combined in the subconscious and conscious mind are all playing to develop fear about eye surgery. Do not feel fearful.
In the next lesson, we are going to come up with methods that are time tested and true to see, how we can overcome the fears regarding eye surgery. Thank you

Myths-Laser-Cataract-Surgery

Hi. How are you? This is doctor Khanna, laser man here once again, bringing you up to speed with the latest in eye technology. Today, we are going to talk about a very exciting and new topic; laser cataract surgery. There are a lot of myths about laser cataract surgery and we are going to bust them all. We are going to talk about 7 myths of laser cataract surgery, which has been found not to be true and we are going to go over it one-by-one.
Laser cataract surgery is safer the manual cataract surgery. Even doctors believe that but reports came out of a study that showed that it was not the case. Laser surgery is at best as good as manual cataract surgery but not safer. That is one myth, which has been busted not by me but by published and reviewed journal studies of Europe.
Laser cataract surgery is going to be free and covered by insurance. That is not true. Medical insurance has determined that if someone wants to upgrade to laser cataract surgery, they will have to pay extra.
Laser can perform all the steps of cataract surgery. I think that is one of the biggest myths out there, thinking that it is going to be a robotic surgery and robots are going to come and do everything. That is not true. Lasers do certain steps pf the procedure, mainly opening in the lens and sometimes cutting the lens. They cannot do all the steps. In fact, some steps are done better by hand.
Cataract wounds made by lasers are better than those made by diamond knives. The reverse is true, diamond knives can make better and more precise wounds than the current generation of lasers used in cataract surgery. It is very logical why this happens, because the laser will need to see where they have to act. They are seen by using ‘ocular coherence topography’. The wounds have to made at the junction between the clear part and the hazy part which is the cornea and sclera. It is sometimes not discreet for the machines and that is why human eyes can detect them better and make better wounds.
If we do laser cataract surgery, we would not have to wear glasses after the procedure. That is not true. Only ‘presbyopic implants in eye’, can free you from the bondage of contact lens and glasses after cataract surgery and not laser.
After cataract surgery, drops will not be needed. Again, that does not hold the light of day. You will need drops. Drop less surgeries is a different concept. After the laser cataract surgery, you might need more drops.
Laser cataract surgery might be less painful and faster by cataract surgery done by hand. I feel sorry but, we have to bust that one too. When we do laser cataract surgery, we have to apply something that would hold your eye while the laser moves around making the openings and cutting the lens up. That is held by negative suction pressure, which is painful and we have to give you medication for that. For that, we have to add another step, we have to do the part of the surgery done with laser first and then in the operative room, we have to do the rest of the surgery by hand. It increases the time that you would be in the operating theater.
I hope you have seen the truth about laser cataracts surgery. It is a good procedure but it is not recommended for all based on knowledge and published studies that we have. Thank you for listening to me. Have a wonderful day. Keep sending your questions here.

1 2 3