Third World Cataract Mission Trips

Dr. Michael Wong has been fortunate to have a strong support system both in his associates at the Princeton Eye Group and his family, that allow him time to help those in need.

“I simply see the work I do overseas as an extension of what I do here locally. There are no borders to humanity,” explains Dr. Wong. His many international contacts through organizations such as Surgical Eye Expeditions and Vision Outreach International helps tremendously in the logistical planning. He plans on making annual missions in the future in addition to the significant amount of charity provided locally by the doctors of the Princeton Eye Group.

You coordinated an “eye camp in Oshakati, Namibia. Tell us about it.

Surgical Eye Expeditions connects a host ophthalmologist from a needy country with a willing volunteer such as me. Namibia is fortunate to have a dedicated “Blindness Secretariat” by the name of Helena Ndume. After a brief correspondence, I gathered my son Matthew, age 16 at the time, and hauled surgical supplies along with a caravan of Red Cross volunteers and nurses, to this impoverished area of Namibia near the Angolan border. This area had been ravaged by a civil war and drought. Those in need of eye surgery basically wait, years at a time, until an “eye camp” can be set-up, and only hope that they make it on the list. There was more work than expected, but undaunted, we worked 16 hour days and actually took care of every last person who had come, some from hundreds of miles away, many by foot. The medical situation was challenging, but the people couldn’t have been nicer or more appreciative.

Twice you’ve gone to remote villages in the Andes mountains of Peru under difficult circumstances. You performed 75 cataract surgeries and 25 surgeries for individuals with crossed eyes in Juliaca and repeated that program in Huamachuco. Describe those trips.

It was a compelling story, one to which I had to respond. The indigenous Indians of Juliaca, descendants of the Incans, are amongst the most impoverished in South America, caught between neglect and civil war. At nearly 14,000 feet elevation, the extreme UV light has caused an epidemic of cataracts. Without supplies, the local ophthalmologist was hamstrung. This adventure included my son Scott, and the two of us completed the first cataract surgeries done in that region in decades. Unprepared for the elevation and freezing temperatures, this was the most difficult trip for me from a physical point-of-view. I suffered the worst headaches of my life and developed asthma. Still worth my going, nevertheless.

The Huamachuco trip presented other challenges. Arriving at this site, the entire country of Peru underwent a general strike. The town services shut down, including the nurses at the hospital. So I “deputized” the handful of teenagers who volunteered for the trip, taught them operative technique and transformed them into operating nurses. My daughter Julia, 16 at the time, who came along thinking she would be doing some paperwork and taking pictures, was “first scrub-assistant” for the very first modern-day cataract operation in Huamachuco. I learned how much youthful exuberance and enthusiasm can do when push comes to shove.

You’ve included your family in some of your service trips. Tell us about that.

It’s more fun when you can share and learn, and never better than with your family. All three of my children have been on overseas missions with me, and they did so eagerly and have not been disappointed. My wife, an R.N., switched gears and went from being a cardiac nurse to an ophthalmic nurse so that she can come on these missions with me. It has become a family affair and an enriching one at that. I learn from these trips: about humanity, about other peoples, about myself. What the kids learn is different, as they come from a different perspective, but learning they do. Not sure what, but the experience is so different from the book learning in Princeton. I encourage young people to explore in these directions. Many say it’s life-transforming.

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Dr. Epstein’s Passion for Music Helps Raise $40,000 for the Deaf

Dr. John Epstein, a long time guitarist with a passion for music, wanted to make sure his kids shared this important part of his life. His daughters began playing musical instruments at the age of 5, and now his 11 year old daughter, Isabella, plays piano, harp, cello, keyboards, accordion and flute. His 9 year old daughter, Madeline, plays electric and upright bass, piano, and drums. His wife also plays flute and can sing. So what do you do with all that talent under one roof? Why, of course, you start a band. Thus, ‘PJ Rocker’ was born. Their first major gig was to play at Dr. Epstein’s own 40th birthday party.

In another particularly special moment, Dr. Epstein was invited to be a guest guitarist at a charity concert at the famous Canal Room in New York City to benefit the Clark School For the Deaf. His daughter Madeline joined him on bass. They played in front of over 300 people and helped raise $40,000 for the charity. Truly a night both father and daughter will never forget!

School has caused the Epstein girls to take a rest from ‘touring’ this past winter, but look for ‘PJ Rocker’ in the open-mic scene throughout the area this summer.

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Results are in: doctors who’ve had LASIK give high satisfaction rate

Surgery to correct refractive errors has undergone a tremendous evolution since inception 20 years ago. Every five years or so, the technology has leaped forward, so that each generation is ‘heads and shoulders’ above the generation before. Wills Laser Vision at Princeton is widely credited for having pioneered the latest innovations and has always been first to upgrade technology every step of the way. At this point, LASIK is now established as a mainstream procedure. Several recent surveys startlingly highlight how much so.

In a recent survey of physicians, the Journal of Cataract and Refractive Surgery, reports how beneficial LASIK can be. Over 40% of refractive ophthalmologists have had this procedure performed on themselves and nearly 90% have had a relative have it as well. The satisfaction rate was overwhelming. 96% said they would have it again. The vast majority said that they see better after LASIK than they did with glasses or contacts. None said that they saw worse. None were unhappy.

Another nationwide study conducted by Dr. Francis Price of Indiana compared LASIK patients against contact lens and eyeglasses wearers. All three groups were generally happy, but when LASIK patients were asked to compare themselves against themselves wearing contacts or glasses, they overwhelmingly touted the benefits of LASIK. The majority said they see better after surgery, with less nighttime glare than they had with contacts or glasses. The vast majority said the comfort of their eyes and convenience made a big difference. In the right person, it is clear now that the safety of LASIK supersedes the safety of contact lens use.

This presumes that the highest level of care is taken when having LASIK. This starts with the better diagnostics beforehand that can rule out improper corneas. The Pentacam analysis, available at Wills Laser Vision at Princeton, is considered the world standard for pre-op analysis. For surgery, while the expertise of the surgeon is obviously most relevant, every surgeon must have the best tools. At Wills Laser Vision at Princeton, the recognized ‘best in its class’ lasers are employed. There are two lasers involved, and Wills Laser Vision at Princeton is the only center in Central NJ that has either. The laser that does the sculpting of the cornea is the Allegretto Eye-Q 400. The ‘400’ refers to the fact that the tracking system re-aligns the laser to the center of the tracked pupil of the patient 400 times a second. This assures perfect alignment of the laser to the visual axis of the eye, even if the patient is a bit nervous and moves a little. The ‘400’ also refers to the fact that the sculpting is done with many, many, fine, delicate pulses, as opposed to the coarser ablations at 10 times a second done with competing lasers. No one else in Central NJ has this system. To prepare the eye for sculpting, another laser is used to lift up the skin overlying the cornea. The most advanced tool in the world for this is the Alcon FS200. It measures tissue particles in microns, delivering precise laser pulses finer than the diameter of a human hair. Wills Laser Vision at Princeton was the first in the Mid-Atlantic States to utilize this technology.

A recent article by Nicole Kwan on reports ‘LASIK eye surgery safe in long-term’. The article cites a retrospective study of LASIK patients by Spanish researchers that determined 10 years after LASIK, patients had healthy corneas and their vision remained accurate. The article also points out there are fewer long-term studies now because of the proven safety and effectiveness of the procedure.

Wills Laser Vision at Princeton has become the flagship LASIK center for the Wills Eye Surgical Hospital and Network. Wills Eye Hospital is commonly acknowledged to be the premier eye institute in the United States. It is not surprising that the best technology is found there. Almost all of the physicians at Princeton Eye Group were trained at Wills Eye Hospital and most are still actively involved in education of residents and other ophthalmologists.

In fact, some of the doctors of the Princeton Eye Group have undergone LASIK on the very same equipment as their patients. Dr. Epstein, Drs. Richard and Michael Wong, and Dr. Jadico, as well as the wives of Dr. Felton, and Drs. Richard and Michael Wong have also had LASIK performed by their beloved doctors of the Princeton Eye Group.

Most patients who’ve been part of the LASIK revolution will say that this procedure was life transforming. ‘A Miracle’, many have written in their post-operative reviews.

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Keratoconus and Cornea Ectasia Participants Welcome. You May Benefit from this Study

Do you suffer from Keratoconus or Corneal Ectasia?

Dr. Anita Miedziak, M.D., is conducting a clinical research trial to study and investigational treatment to stop or slow the progression of keratoconus and corneal ectasia.

You may qualify to participate if you:

  • are 12 years of age or older
  • were diagnosed with keratoconus or were diagnosed with corneal ectasia after you received refractive surgery (e.g., LASIK, PRK)
  • are able to come in for at least 8 office visits over a 12 month period

Please call the Princeton Eye Group at 609-924-9200 and ask to speak with Janet Bergan for more information and to schedule an appointment.

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New Stitchless Advances in Corneal Transplantation Surgery Speed Recovery

Dr. Anita I. Miedziak, Director of Cornea Services at the Princeton Eye Group, performs the most advanced techniques in corneal transplantation with reduced risk of astigmatism and shorter recovery times.

DSEK (Descemet Stripping Endothelial Keratoplasty) is a new option in corneal surgery. DSEK is a partial thickness corneal transplant. It is offered to patients with persistent corneal swelling due to Fuchs dystrophy, failed corneal transplants, swelling induced by prior eye surgery or the aging process of the eye. In those cases DSEK can substitute traditional corneal transplantation and is performed without sutures. The advantages of the DSEK procedure include:

Significantly faster visual recovery since no additional astigmatism is induced (2-3 months vs. over a year with standard corneal transplantation)

Chances of corneal rejection are markedly reduced • Only the diseased layer of tissue is removed instead of the entire cornea –leaving the eye stronger –maintaining its normal resistance to injury

DSEK can be combined with cataract surgery

DSEK is performed on an outpatient basis under local anesthesia and takes approximately 30 minutes. The DSEK procedure removes the unhealthy endothelial cell layer and replaces it with healthy cells from a donor cornea. In order to make the new tissue adhere to the back of the old cornea, an air bubble is used to fill the front part of the eye for an hour after surgery. A follow-up visit is required the day after surgery.

Patients can return to their normal activities within two weeks with the exception of swimming. An antibiotic eye drop is used for two weeks and a steroid drop is used for at least a year to prevent graft rejection. Rejections are rare and treatable.

IEK (IntraLase Enabled Keratoplasty) is a new revolutionary way of performing full thickness corneal transplantation procedure utilizing a laser. The IntraLase laser is used to replace the diseased cornea in a precise fashion thus reducing postoperative astigmatism and corneal surface irregularity speeding up the visual rehabilitation. The IntraLase laser procedure also reduces the need for stitches making recovery both easier and faster.

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Seeing the World Through Rose Colored…Contacts?!

Although not rose colored at all, the new Rose K™ contact lens is a welcomed advance in the treatment of Keratoconus.

Picture viewing the world as if you’re looking through a car windshield in a driving rainstorm – that’s how uncorrected vision looks to people with advanced Keratoconus. Keratoconus is characterized by a gradual thinning of the cornea, which alters its normal round shape to that of a cone. This bulging can severely affect a person’s ability to read, watch TV and see clearly enough to drive.

Keratoconus is generally diagnosed in young people around the age of puberty but can also be first diagnosed in people in their 40s and 50s. It initially presents as slightly blurred, distorted vision with a sensitivity to light and glare. It is a condition that progresses slowly and can, in the beginning stages, be easily corrected with glasses. As the condition advances, gas permeable (GP) contact lenses are often the best method to correct vision.

The complex geometry of the Rose K™ lens allows it to act in concert with the conical shape of the cornea throughout most stages of Keratoconus. As a result, the Rose K™ lens offers better comfort and optimum visual acuity. Its “breathable” material allows oxygen to flow directly through to the cornea proving excellent health to the eye. Rose K™ lenses can be custom fit by our Director of Contact Lens Services, Phyllis Rakow, to suit the varying levels of myopia and astigmatism in each eye.

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The Princeton Eye Group Provides the New Standard of Quality and Safety in LASIK

IntraLase 100% blade-free LASIK is considered to be the new standard of quality and safety in LASIK and the only technology to provide patients with a 100% blade-free experience. It has been clinically proven to be the safest and most accurate LASIK procedure available.

All Laser — No Cutting

For patients who have had reservations about conventional LASIK because it involves the use of a blade, the IntraLase FS laser is truly an option worth considering. IntraLase FS is an all-laser, 100% blade-free LASIK procedure delivering unprecedented safety and better overall vision.

The IntraLase method replaces the hand-held microkeratome blade used in creating LASIK corneal flaps with a computer-guided, ultra-fast femtosecond (fem-to-second) laser. The IntraLase FS laser has been clinically proven to take many patients to 20/20 vision and beyond. The advantages of the 100% blade-free IntraLase method are significant and include:

  • BETTER VISION: Patients achieve statistically better vision with LASIK using the IntraLase method in many cases better than 20/20.
  • IMPROVED SAFETY: Virtually eliminates potential flap complications.
  • THINNER FLAPS: Patients previously not considered to be candidates for LASIK due to thin corneas may now be treatable with the IntraLase method.

Combining 100% Blade-Free LASIK with the Allegretto Perfect Pulse Laser

Unlike other lasers that focus solely on the front center surface of the cornea, the Allegretto Perfect Pulse laser addresses the unique 3-dimensional shape of your cornea. This advanced eye tracking and treatment enables us to minimize distortions that affect glare and night vision.

Your eye movements are tracked and mapped every few milliseconds to allow the internal mirrors of the Allegretto Perfect Pulse laser to align precisely with your cornea’s imperfections. The beams of light sent from the laser are strategically released to your cornea as the position of your eye movements change from millisecond to millisecond delivering 40 times greater frequency of the pulses of light for superior accuracy and unmatched precision.

The advanced technology of the Allegretto Perfect Pulse laser provides us with the capability to produce larger optical zones, which means better results for patients with night vision issues and for patients with large pupils. Your pupil adapts to darkness by growing larger to allow in more light. The expanded optical zone enabled by the Allegretto Perfect Pulse laser compensates for these changes and provides better night vision than ever before.

As trusted physicians, we have embraced this new technology to offer you the very best of care. In addition to the benefits of IntraLase 100% blade-free LASIK, the Allegretto Perfect Pulse laser also provides:

  • ACCURACY: We are able to use the Allegretto’s advanced eye tracking system to measure light as it passes into the eye and then is reflected back. This creates an optical image of the eye, showcasing its flaws, allowing the laser’s 40 times greater frequency of the pulses of light to correct imperfections with superior accuracy and unmatched precision.
  • CUSTOMIZATION: As a result of these exacting measurements, we can now customize the LASIK procedure according to your unique vision correction needs like never before.
  • SATISFACTION: Clinical results report both near- and far-sighted patients noted

improvement to light sensitivity and night driving glare. The vast majority of patients report vision at least as well as, if not better than the vision they had with glasses and contacts before treatment.

IntraLase 100% blade-free technology is clinically proven to be safer and most accurate. With the addition of an ultra-sensitive tracking system and the Allegretto laser you get superior accuracy and unmatched precision. Wills Laser Vision at Princeton is the only center in this area with these advanced capabilities for LASIK.

The time is now. You don’t have to delay your dream of ridding yourself of glasses and contacts. Special payment plans and financing options are readily available through our office.

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Treatment for Age-Related Macular Degeneration Continues to Improve

There was a time when there was little to be done to improve or halt the progression of Age-Related Macular Degeneration (AMD). Today, there are several options available to treat the rapidly progressive form of AMD. Although approximately 90% of AMD cases are the dry form, which causes a gradual vision loss due to aging of the macula, 10% of AMD cases are the wet form which progresses quickly resulting in blurring and potential loss of central vision. Nearly 200,000 people are diagnosed with wet AMD each year.

Dr. Samuel M. Liu, Director of Retina Services at The Princeton Eye Group, is continually on the forefront of new advances for treatment of age-related macular degeneration (AMD). AMD is the leading cause of visual impairment and blindness in Americans over the age of 60. It affects more than two million people. Dr. Liu has been providing AMD patients with intravitreal Lucentis® injections for the treatment of the abnormal blood vessels that grow underneath the retina in this condition.

Lucentis® is a breakthrough treatment for wet AMD that can do more than just help maintain a person’s vision. With Lucentis®, people with wet AMD may actually see their vision improve. It is an FDA approved treatment specifically developed for the treatment of wet AMD.

Wet AMD occurs when abnormal blood vessels grow in the back of the eye. As the blood vessels grow, they can leak blood and fluid, which damage the macula. The macula–which is the center of your retina–plays a key role in your central vision. Lucentis® is designed to block abnormal blood vessel growth and leakage. In addition to the abnormal growth of blood vessels, certain proteins are thought to play a major role in causing wet AMD. Lucentis® is a treatment that targets these proteins–preventing them from causing more damage and possibly even reversing their effects.

Many people saw impressive results with Lucentis®. In key clinical studies, about 95% of patients treated with Lucentis® found that their vision stayed the same (vision loss did not progress) and up to 40% of those patients found that their vision significantly improved. However, wet AMD is a chronic condition and there is no cure. But it can become manageable by treating it monthly with Lucentis®. If you have a loved one who may have wet macular degeneration, schedule a consultation to see if treatment with Lucentis® may be an option.

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Lens Implants Provide a Full Range of Vision to Cataract Patients–Even Those with Astigmatism

Cataract patients have something to celebrate!

Not only has the AcrySof® ReStor® Intraocular Lens (IOL) revolutionized the visual acuity after cataract surgery – AcrySof® Toric IOLs now offer the same outcome for cataract patients with pre-existing astigmatism.

The Princeton Eye Group remains in the forefront of this evolving lens technology. Each of our ophthalmologists is trained to implant these advanced lenses. In fact, Dr. John A. Epstein was the first ophthalmologist in New Jersey to implant AcrySoft’s Toric IOL. As mentor and teacher, Dr. Epstein trains doctors in the art of cataract surgery at Wills Eye Hospital in Philadelphia.

Alcon, the manufacturer of ReStor and Toric IOLs has enlisted the participation of eight ophthalmologists throughout the United States to serve as clinical mentors. These eye care specialists work with Alcon to produce more effective solutions to today’s eye care issues. Our own Dr. Michael Wong is one of these eight chosen specialists.

Having participated in clinical trials for Alcon, Dr. Wong has been providing data, clinical reports and patient feedback on these IOLs for several years. He was the first in New Jersey to implant the ReStor lens. In his present capacity as clinical mentor he provides recommendations for improvements to enhance focal points and to safeguard the implant procedure. He is also one of the ophthalmologists recommended by Alcon to consult on difficult cataract surgery cases.

The results of cataract surgery with the ReStor and Toric IOLs are astonishing to ophthalmologists who can now provide better overall vision to patients who were dependent on glasses or contacts prior to developing cataracts. This new generation of IOLs provides distinct optical advantages over their predecessors with improved focal points and reduced glare. Patients with myopia, hyperopia, astigmatism and presbyopia can enjoy a full range of vision after cataract surgery without the use of glasses.

The AcrySof® Toric IOL utilizes advanced technology to correct the cataracts clouding
your vision and the corneal astigmatism that distorts your vision. Astigmatism is
characterized as a refractive error caused by an uneven curvature of the cornea. Where a normal cornea would have a curvature much like a soccer ball, the cornea with astigmatism would have a curvature more like a football. The AcrySof® Toric IOL is a foldable, single piece lens that is implanted during cataract surgery that’s designed to reduce or eliminate corneal astigmatism and significantly improve uncorrected vision.

The AcrySof® ReStor® lens is the first and only IOL that uses apodized diffractive technology to provide cataract patients with and without presbyopia a quality range of vision. It is designed to respond to how wide or small the eye’s pupil might be to provide near, intermediate and distance vision. The ReStor lens is somewhat flat near the edges, or aspheric, to improve contrast sensitivity and provide improved night vision.

Cataract surgery/IOL implantation statistically has one of highest success rates of all surgeries. The IOLs mentioned here are specialized lenses and all cataract surgeons may not be trained to implant them. Here, with The Princeton Eye Group, all of our ophthalmologists are trained to implant these advanced lenses and they share the benefit of being one of the practices at the forefront of this technology since its beginning – during the clinical trials. Talk to us about your aspiration after cataract surgery. There’s no need to settle for the monovision provided by the traditional lens implant. With today’s technology, and by working side-by-side with our doctors to choose the IOL that’s right for you, you can experience vision like never before.

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