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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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The IntraLase Method for a Blade-Free LASIK Experience

We know the decision to have LASIK surgery is a big one, so we take great care to determine what’s best for you as our patient. That’s why we offer blade-free LASIK treatment using the IntraLase method.

With the IntraLase method, pulses of laser light create your corneal flap, which is then lifted so the next step of LASIK — the reshaping of your cornea — can be performed. When your LASIK treatment is over, the flap is securely repositioned into place. This bladeless, computer-guided technology is 100% more accurate than most of the mechanical microkeratomes (hand-held devices with a thin metal blade) that surgeons may also use to create a corneal flap.

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New Treatment Options for Cataracts and Presbyopia

FDA approval of special high technology intraocular lenses such as the ReStor, ReZoom, or Crystalens can often provide a full range of vision , allowing decreased dependence on glasses for both distance and near tasks for cataract patients who also suffer from presbyopia.

Intraocular Lenses are surgically implanted to replace the eye’s natural lens. With multiple focusing zones, these lenses provide patients with clear near, intermediate and distance vision. Most patients will no longer require the use of glasses to improve their near or far vision.

Postoperative glare and halos have been significantly reduced through the use of the ReStor, ReZoom and Crystalens IOL. This new generation of IOL allows your doctor to custom tailor a lens choice specific to your visual needs.

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DSAEK – An Alternative to Corneal Implants

Until now, when the cornea loses its transparency due to disease or injury there has only been one option: corneal transplant.

In order for the cornea to remain clear, it must remain relatively dry. Intricate bundles of collagen form a delicate layer of cells called endothelia. The endothelia acts as a pump to keep the corneal to accumulate water and develop corneal edema. In some patients, vision is impaired due to the disappearance of the nonregenerative cells of the endothelia.

Now, same day surgery can resupply the damaged endothelia with active endothelial pumping cells without replacing the entire cornea. DSAEK, Descemet’s Stripping and Automated Endothelial Keratoplasty, can be performed with a topical anesthetic and tiny incisions requiring no stitching. The DSAEK technique accelerates recovery time and greatly reduces the potential for complications.

 

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Laser Corneal Transplantation

Corneal transplantation can now be done by laser. IntraLase Enabled Keratoplasty (IEK) is a new revolutionary way of performing full thickness corneal transplantation procedure. 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 which in turn makes recovery both easier and faster.

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Effective Treatments for Wet AMD

Since its introduction, Dr. Samuel M. Liu, Director of Retina Services at The Princeton Eye Group, has been providing patients with wet macular degeneration with intravitreal injections for the treatment of the abnormal blood vessels that grow underneath the retina in this condition. These medications include Macugen and Lucentis.

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.  Along with the abnormal growth blood vessels, certain proteins are thought to play a big part 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 Lucenti found that their vision stayed the same 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 Lucentis may be an option.

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A Bright Future for Eye Care

By Stephen M. Felton, M.D.

Imagine never needing glasses — not reading glasses, not glasses for distance, not glasses for astigmatism. That is the challenge that ophthalmology has set for itself for the next decade. It is already happening as new techniques and instruments are being developed at a rapid pace.

This is what I saw and heard at the April meeting of the American Cataract and Refractive Society in San Diego. The great advances in eye care that I personally have witnessed over the past 30 years have been truly remarkable. I would like to share them with you.

First, let me give you some perspective on eye disorders. There are eye diseases such as glaucoma, cataracts, and macular degeneration. Then there are optics disorders such as nearsightedness, farsightedness, and loss of focusing ability, or presbyopia. The primary goal has always been curing and controlling eye diseases, but more recently a lot of progress has been made in treating optic disorders, with the goal of providing excellent vision with no need for glasses. To understand these advances, you need a simplified explanation of how the eye works.

To focus light into the retina so that you can see sharply, there are two eye structures that bend light rays to a fine focus on the retina. They are the cornea, a clear window-type layer on the surface of the eye, and the lens, a clear lens-like structure inside the eye. The cornea has a fixed focus while the lens can move and change shape to provide fine focusing.

When one or both of these structures is defective and cannot focus light onto the retina, the result is an optics disorder. Either by changing the shape of the cornea or by changing the lens of the eye, fine focus – and resulting clear vision – is achieved. The procedure, popularly called LASIK, changes the shape of the cornea to correct nearsightedness, farsightedness and astigmatism. Operating on the lens can also correct optics problems, since one can replace the natural lenses with sophisticated artificial lenses (implants) that will correct nearsightedness, farsightedness, astigmatism and presbyopia – all this to make you free of eyeglasses. When the natural lens in the eye becomes diseased and clouded (a cataract), replacing it not only restores clear vision but can eliminate the need for glasses. The surgical procedures to accomplish all of the above are sophisticated, and require skilled surgeons. For this reason, cataracts are still the main cause of blindness in the world. A great number of people in underdeveloped countries just do not have the access to skilled ophthalmology.

Two examples of the level of sophistication that have recently become available and generated a great deal of excitement in San Diego are advances in ultrasonic technology to allow more efficient and safer removal of cataracts through a tiny incision, and advances in laser technology (Intralase in the United States) to allow more precise and safer preparation of the cornea flap during LASIK.

The ultrasonic method of removing cataracts, also called Phacoemulsification, has become the modern standard. The newer technology is called “torsional Phaco” and provides an extra element of safety and efficiency.

The Intralase laser in its newest model can be used to prepare LASIK flaps with a greater accuracy and safety as compared to the conventional blade technique. Some studies have show that it provides better vision results.

The study of eye diseases is also experiencing great progress. The treatment of glaucoma and macular degeneration has improved greatly over the past 30 years. These conditions are common especially in older populations groups, but to treat them, one has to diagnose them. Both conditions can occur with few symptoms, so screening and/or regular eye examinations after the age of 40 are recommended.

An estimated 2.2 million Americans have glaucoma and another 2 million have glaucoma and do not know it. Without treatment, glaucoma can cause total blindness. Macular degeneration is also a very common eye disease. It can completely destroy central (reading) vision.

In summary, there have been major advances in the treatment of eye diseases and also in the treatment of optic disorders. If you have glaucoma, it can be stopped, and if you have macular degeneration, it can be stopped or slowed down in the majority of cases. If you are motivated to eliminate your glasses this can also be accomplished in the great majority of cases.

You must of course see your eye doctor first. During a routine examination your eye doctor will be able to tell you if you glaucoma or macular degeneration, and whether you are at risk of developing these diseases.  Your eye doctor will also be able to determine whether you are a candidate for vision correction surgery by doing a few additional tests.

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