Laser Cataract Surgery

A revolution in Cataract Surgery from one of Pittsburgh's most trusted laser surgery centers.

 

AIO is the first eye surgical practice in Western Pennsylvania to offer Laser-Assisted Cataract Surgery. In 2012, we acquired the newest FDA-approved technology for treating cataracts – the Alcon® LenSx® Laser. 

In the early days of cataract surgery, patients endured a long and somewhat painful recovery time, with unpredictable visual results. Over the past 20 years, AIO’s cataract surgeons have been at the forefront of further developed surgical technique and technology. These improvements have allowed us to utilize outpatient surgery to perform topical, sutureless cataract surgery with an operating time of 5-10 minutes, resulting in enhanced visual outcomes. 

Now at AIO, we have implemented the most advanced cataract removal system currently available. Our surgeons perform blade-free laser cataract surgery. This is the same laser technology we have been using for more than a decade in bladeless LASIK surgery to achieve excellent outcomes. 

The femtosecond technology of the LenSx® Laser allows surgeons to make an opening into the lens, create corneal incisions, correct astigmatism, and perform lens fragmentation by using a laser instead of a blade, all before entering the eye to remove the cataract. 

Ask your eye doctor if cataract surgery with the LenSx® Laser is right for you.

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AIO offers new technology to optimize cataract surgery outcomes

AIO is proud to announce yet another FDA approved technology aimed at improving visual outcomes with cataract surgery. The newest addition to our cataract surgery technology is called ORA™ (Optiwave Refractive Analysis) System. It is currently the most advanced intraoperative diagnostic tool for cataract surgery available with over 200,000 procedures performed and 500 units placed to date globally.

The ORA™ System, Now Featuring VerifEye+™ provides precise, real-time measurements during surgery that are not possible with conventional measurements and instruments. It works by directing an invisible beam of low intensity light into the eye during cataract surgery. This light then reflects back from the eye and sensors within the ORA device analyze the eye’s unique optical characteristics. This information is utilized by our surgeons to select the most accurate intraocular lens implant and more accurately place intraocular lenses improve the visual outcomes after surgery.

“We continuously seek new ways to address the needs of our cataract patients, particularly those who live with astigmatism and presbyopia,” said Dr. Cibik. “The ORA System provides intraoperative measurements and is designed to help improve patient outcomes through optimal IOL selection and placement during surgery.”

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Introducing "GoDropless" Cataract Surgery!

We are pleased to announce that our practice is now offering "Dropless" Cataract Surgery as part of our premium services to all LenSx Laser, Toric and Lifestyle IOL patients. As you know, the traditionally prescribed pre- and post-operative drops are often the most cumbersome challenge associated with the cataract surgery experience.

This revolutionary new treatment option will provide convenience and cost-savings for our patients while reducing patient’s post-operative treatment regimen. During "Dropless" Cataract Surgery, medication is placed in the eye to help reduce the risk of inflammation and infection, and is a critical part of ensuring successful outcomes. “Go Dropless” Cataract Surgery has been used in the United States for almost 2 years, and has been used in over 100,000 cases with no reported infections.

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What is a Cataract?

A cataract is a clouding of the natural lens inside your eye. This lens, located behind the iris (colored part of the eye), works like the lens of a camera – focusing light images on the retina, which sends images to the brain. When a cataract forms, this lens can become so clouded it prevents light and images from reaching the retina. Cataracts cannot be prevented and eventually affect 100% of the population. 

Symptoms: 

  • Blurred or cloudy vision
  • Colors appear faded or dull
  • Headlights or streetlights have glare or halos
  • Poor night vision
  • Sunlight or fluorescent lights may appear to be too bright
  • Double or multiple vision in one eye
  • Frequent prescription changes in your eyeglasses or contact lenses
  • Difficulty reading

Presbyopia (progressively diminished near vision that usually begins in middle age) with nearsightedness, farsightedness, or astigmatism, requires the use of bifocal or “progressive” lenses to see clearly both near and far. The important thing to remember is that now, cataract surgery can often correct refractive errors AND presbyopia. This means that it may be possible for you to gain clear vision with little dependence on glasses or contact lenses.

Cataract removal is one of the safest and most effective surgical procedures performed in the US today. In fact, more than 3 million cataract surgeries are performed each year in the U.S. alone. A tiny incision is made, and an ultrasonic instrument, about the size of a pen tip, is inserted to break up and remove the cloudy lens. Once the cataract is removed, an artificial replacement lens – or intraocular lens (IOL) – is inserted through the same tiny incision and set into its permanent position.
While all human eyes share the same basic anatomical structure, every eye is just a bit different in terms of size, depth, curvature of the cornea, and other key features. This is why every eye must be carefully measured and mapped prior to cataract surgery. While these measurements have been routinely performed prior to surgery, the LenSx® laser uses a range of highly advanced technologies, including coherence tomography (OCT), to capture incredibly precise, high-resolution images of your eyes. These images – and the data they provide – are then used to plan and perform a surgery to exacting specifications not attainable with traditional surgery.
In non-laser cataract surgery, the surgeon makes incisions and removes the old lens using traditional surgical instruments and blades. The LenSx® laser performs several of the most critical steps of the surgical process with an image-guided femtosecond laser. Ask your eye doctor if cataract surgery with the LenSx® laser is right for you.
The LenSx® laser provides patients with computer-controlled precision as it automates some of the most challenging steps of refractive cataract surgery. The laser replaces the traditional hand-held blade to optimize all incisions for enhanced, reproducible surgical performance. This breakthrough technology provides the surgeon with real-time, three-dimensional visualization for true customization of your lens replacement procedure.

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Lens Selection

An intraocular lens (IOL) is an artificial lens that is implanted during cataract surgery. The good news is that you have developed cataracts at a really significant time, when intraocular lens technology has progressed greatly. Recent advances have been so significant that new-generation lenses could allow you to see well at multiple distances with greatly reduced dependence on glasses. 

No single lens works best for everyone. During your eye exam, your surgeon and our lens specialists can help determine the best option for you. The information you are given will help you make an informed decision. For many patients, choosing a lifestyle lens over a standard monofocal lens allows for an increased quality of vision and decreased dependency on glasses. For example, passengers may become drivers again; golfers may be able to keep their eye on the ball, enjoy the surrounding scenery, and even mark the scorecard. 

Lens Options 

Several lens options are available to our patients. Please discuss the following lens types with your doctor to determine which one best fits your lifestyle and vision needs.

The proven performance of AcrySof® IQ Toric IOLs provides cataract treatment and astigmatism correction in a single procedure. Featuring exceptional rotational stability and a wide range of correction, AcrySof® IQ Toric IOLs can reduce dependence on glasses and provide crisp, clear distance vision.
  • Intended to only give clear vision at one distance, usually far
  • Will still need glasses for all near and intermediate, and distance activities to be perfectly corrected to full potential)
  • Insurance will typically cover at least 80% of surgery, including this standard lens
  • Hinged to work within the eye, allows lens to move forward as the eye focuses on near objects and backward to focus on distant objects
  • Good intermediate and distance vision
  • Will most likely need weak readers (+1.25 to +1.50) for small print or lengthy reading
  • 24-month, no-interest financing available
Introducing the Restor Multifocal Toric IOL; see the big picture without missing the details

Director of Cataract Services, Lisa Cibik, MD, FACS was the first surgeon in Western PA to implant the AcrySof® IQ ReSTOR® Multifocal Toric IOL, a revolutionary astigmatic correcting lens that improves vision in a range of distances — from near to far.

Why choose the AcrySof® IQ Multifocal lenses?

The ReSTOR® Toric lens is a breakthrough lens for cataract surgery that lets patients see from near to far, usually without glasses. An innovative optical technology called “apodization” makes the lens uniquely effective, especially when placed in both eyes. A similar technology has been used for years in microscopes and telescopes to improve image quality and has now been patented for use in intraocular lenses by Alcon. Most patients find that they can read a book, work on the computer, drive a car — day or night — and play golf or tennis with an increased freedom from glasses. Four out of five lens recipients reported never wearing glasses after having the lens placed in both eyes.

  • The goal of a multifocal IOL is to provide functional vision at a range of distances to minimize the use of glasses
  • Some patients may prefer to wear glasses for prolonged reading. The vast majority of multifocal IOL patients experience freedom from glasses for tasks such as driving, watching TV, using a cell phone and computer, looking at photos, reading price tags, magazines, product labels, receipts, and menus
  • Intermediate distance tasks (i.e. computer and arm’s-length reading) typically require a mild over-the-counter reader
  • 24-month, no-interest financing available
  • AIO is the first practice to offer extended range of vision for cataract patients

    Lisa Cibik, MD, FACS and John Nairn, MD, leading cataract surgeons at Associates in Ophthalmology, were the first surgeons in Western Pennsylvania to implant the FDA approved Symphony Multifocal Toric intraocular lens (IOL) that provides cataract patients with an extended depth-of-focus and astigmatism correction. This allows patients with significant astigmatism to receive the benefits of a multifocal IOL which is one of the first of its kind.

    “While IOLs have been the mainstay of cataract treatment for many years, we are thrilled to offer this advancement in technology to our patients,” said Lisa Cibik, MD, Director of Cataract Services. “The Tecnis Symfony Extended Range of Vision IOL provides a new option for patients that may result in better vision across a broader range of distances.”

    Traditional monofocal IOLs have been limited to improving distance vision. The Symfony IOL improves visual acuity at close, intermediate and far ranges and, therefore, may reduce the need for patients to wear contact lenses or glasses after cataract surgery.

    • Specifically designed for patients with astigmatism
    • Can reduce or eliminate the effects of astigmatism and significantly improve uncorrected distance vision
    • Most patients will still need glasses for all near and mid-vision activities
    • 24-month, no-interest financing available

    What You Should Expect Before and On the Day of Surgery 

    Prior to the day of surgery, your surgeon will discuss the steps that will occur during surgery. Your surgeon or a staff member will ask you a variety of questions about your medical history. You will be sent to your primary care physician for a history and physical. You should discuss with your surgeon which, if any, of your routine medications you should stop taking prior to surgery. Prior to surgery, several eye scans will be done and calculations made to determine the appropriate power intraocular lens to implant. A specific artificial lens is chosen based on the measurements of your eyes. 

    Eye drops will be prescribed for you to use several days before your surgery. 

    It is important to remember to follow all of your preoperative instructions. 

    Arrangements should be made with family or a friend to be with you and to transport you to and from the surgery center. 

    After leaving the operating room, your will be brought to a recovery area for a brief time. The nurses will go over the instructions for the eye drops that your surgeon has prescribed. You will need to use them for a few weeks following your surgery. While you may notice some discomfort, most patients do not experience significant pain following cataract surgery. If you do experience decreasing vision or significant pain, you should contact your cataract eye doctor immediately. 

    What You Should Expect After Cataract Surgery 

    Following surgery, you will need to return for visits within the first few days and again within the first few weeks after surgery to assure your eye is healing properly. During this time period, you will be using several eye drops that help protect against infection and inflammation. You will have some restrictions on activities such as not driving for a day or so, no swimming for a week, no heavy lifting. Within several days, most people will notice that their vision is improving. You will likely be able to return to work and resume normal physical activities after the first few days.

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    FAQs for Cataract Surgery

    While traditional cataract surgery is fully covered (except for deductibles or co-pays) by private medical insurance and Medicare, bladeless cataract surgery requires patients to pay out-of-pocket for the portion of the procedure that insurance does not cover. For this expense, we offer interest-free financing options through Care Credit.
    The LenSx laser places tiny incisions on the cornea (outer clear covering of the eye) in specific areas to “relax” the eye to a rounder shape, like a basketball. The precision of using the laser instead of a blade results in better outcomes.
    In traditional cataract surgery, surgeons make several tiny manual incisions with a blade, then remove or aspirate out the cloudy lens (cataract) using ultrasonic vibrations. The natural lens is replaced with a new artificial intraocular lens (IOL). With LenSx, our cataract surgeons are able to make the incisions with a significantly higher degree of precision and without using a blade. Along with LenSx’s real-time image-guided feature, the surgeon can see the activity taking place in the eye during surgery. This helps the surgeon perform several important steps:
    • Anterior Capsulotomy – an incision that opens the clear, cellophane-like capsule which wraps the eye’s natural lens
    • Lens Fragmentation – softening and breaking up of the eye’s cataract
    • All corneal incisions – all incisions of the cornea related to cataract surgery, including astigmatism-lessening relaxing incisions.
    At AIO, bladeless cataract surgery lasts an average of 5-10 minutes, depending on the complexity of the procedure.
    Cataracts affect more than 20 million Americans age 40 and older. According to the American Academy of Ophthalmology, by age 80 more than half of all Americans have cataracts.
    Yes. Each year, eye surgeons perform 3 million cataract surgeries in the United States, making it the most common surgical procedure in this country.
    The benefits of LenSx are improved surgical precision and control, as well as reducing stess induced to the eye during surgery. With respect to precision, LenSx automates the most challenging procedures in cataract surgery by creating the highest level of precision available with a cool laser instead of a blade. As for control, LenSx offers real-time images that guide the surgeon for proper alignment and better management of astigmatism (irregular eye shape that produces blurred vision) than traditional methods allow.
    A cataract is the gradual clouding of the eye’s natural lens which distorts vision. Cataracts are the leading cause of vision loss in adults 55 and older.
    The femtosecond laser is one that emits pulses with durations between a few femotoseconds [1 quadrillionth (1/1,000,000,000,000,000)] of a second and hundreds of femtoseconds.
    The LenSx laser is a bladeless, computer-controlled eye surgery tool that ensures the highest-precision surgical incisions for cataract surgeries. The laser replaces the traditional hand-held blade to optimize all incisions for enhanced, reproducible surgical performance. This technology breakthrough provides the surgeon with real-time, three-dimensional visualization for true customization of the patient’s lens replacement procedure. Our surgeons can use LenSx to customize a patient’s surgery by using the LifeStyle intraocular lens to eliminate blurred vision caused by astigmatism (irregular eye shape) and presbyopia (loss of flexibility in the eye’s lens and surrounding muscles), allowing the patient to see clearly from all distances without glasses or contact lenses.

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