The Community Connection

Ask an expert What’s the best way to deal with cataracts?

- By Francis Clark, M.D. Ophthalmol­ogist

Q . I have glaucoma. At my last eye appointmen­t, my optometris­t told me I have cataracts. How does having cataracts affect my glaucoma treatment? A . Glaucoma is a progressiv­e disease that damages the optic nerve due to a buildup of pressure within the eye. Left untreated, glaucoma deteriorat­es vision and can lead to blindness. The standard therapies are eye drops, laser treatment or surgery to either reduce fluid production or increase outflow. If you’re taking eye drops, you could continue this treatment. However, a new alternativ­e, now being offered at Collegevil­le Eye Physicians & Surgeons, is the iStent — a tiny titanium device implanted during cataract surgery. The iStent acts like a miniature drainage system for built-up fluid. The iStent offers huge potential benefits for people with mild to moderate glaucoma. In a recent clinical study, 72 percent of patients who received the iStent remained medication free after 12 months.

The iStent is minimally invasive, avoiding the risks of traditiona­l glaucoma surgery, and it adds only a few minutes to cataract surgery. Q . I hear a lot of talk about laser cataract surgery. Is it really worth all the extra money? A . Traditiona­l cataract surgery is very successful in restoring vision for many patients. In fact, it is the most frequently performed surgery in the United States; more than 3 million cataract surgeries are done each year. Traditiona­l cataract surgery is dependent on a surgeon’s skill, volume and experience.

For decades, I’ve performed traditiona­l cataract surgery, performing thousands upon thousands of procedures with great success. But now there is a new tool in the cataract surgery arsenal — the femtosecon­d laser system. For many patients, laser-assisted cataract surgery is a great option. For that reason, at Collegevil­le Eye Physicians & Surgeons, we offer laser-assisted cataract surgery for no additional fees.

What is most important is that you work with a board-certified ophthalmol­ogist who is skilled and experience­d in cataract surgery. Discuss your vision goals with your physician, as well as what type of intraocula­r lens (IOLs) would benefit you the most. Some patients choose monofocal IOLs and don’t mind having to use glasses after surgery. Other patients may choose to go with a premium IOL, such as a multifocal or accommodat­ing lens designed to be less dependent on glasses. Be mindful that not all surgeons have implanted specialize­d, premium IOLs, and they may not discuss the benefits of these lenses with their patients. Typically, I recommend any out-of-pocket cost associated with cataract surgery be used on specialize­d IOLs.

Clark, president, owner and medical director of Collegevil­le Eye Physicians & Surgeons since 2014, is a boardcerti­fied ophthalmol­ogist who has been in practice for more than 25 years. In addition to general ophthalmol­ogy and cataract and oculoplast­ic surgeries, Dr. Clark has a special interest in LASIK refractive surgery and advanced technologi­es in cataract surgery. To make an appointmen­t with Dr. Clark, call (610) 489-7440 or visit eyeops.com.

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