John Suson’s blog

I hear some Lasik surgeons talking up the fact that they do advanced Custom Lasik but they make no mention of the blades that they use in their Lasik. That's right, "Custom Lasik" and "Blade-free Lasik" are two completely separate things. Surgeons that continue to use the cheap bladed Lasik try to cover that fact by talking about their Custom Lasik but that is old news at Suson Eye Specialists. I don't think there's a Lasik center in the USA that doesn't use a Custom Lasik system and it's been that way for years. But the real technological difference has been in the advancement of the blade-free Lasik systems to make the Lasik flap. That's the technological advancement that these cheap chain centers neglect and that they always fail to mention. So they cover it up by talking about Custom Lasik so you won't know that they still use blades.

Some of these centers don't even use what I would consider the top of the line bladed flap makers (microkeratomes). Cheap blades and cheap microkeratomes of all kinds are on the market but the making of an excellent flap with a blade-free femtosecond laser system just can't be beat for its precision and safety. The cheap bladed systems may have a greater tendency for their mechanical parts to stick or fail, or for impurities and imperfections to be present on the blades themselves. So don't be fooled by the use of the word "Custom." Make sure that your Lasik surgeon specifically mentions a blade-free Lasik procedure like the one I use with the Intralase™FS Laser system. If they talk about safety and precision, but they don't say blade-free, you need to look further for a center that uses the newest, safest, most precise Lasik flap making technology.

I even heard one of these centers talk about how bad it is to put a contact lens or your finger into your eye and why their Custom Lasik technology is so much better than that. But they made no mention of the fact that they are using a steel razor blade to cut across the surface of your eye. Well, why not avoid the contact lens, your finger, AND the high speed vibrating razor blade of the old style Lasik systems? With the blade-free iLasik systems, you get Custom Lasik and a blade-free Lasik experience.

Yeah, that's right…we have Custom Lasik at Suson Eye Specialists…AND we're blade-free.

For more information about Blade-Free Lasik surgery in Milwaukee, please visit http://www.supereyes.com.

Should I Consider Lasik Eye Surgery?

Many people are curious about Lasik eye surgery as an option for vision correction instead of the traditional glasses or contact lenses that they have used for ages. Many people were told in the past that they were not good candidates but with current, up to date technology, many of these people are actually very good candidates. The reasons for having Lasik eye surgery are very personal and each individual has to look at his or her own needs, desires and lifestyle. Those things will be the major determinants on whether you should have Lasik eye surgery.

The most common reasons are either functional or cosmetic. Many people dislike wearing glasses or contact lenses for certain activities like sports. For the very young and active person, it can be more fun and easier to live that lifestyle without glasses or contacts.

I remember before I had Lasik surgery myself that it was a huge hassle to go swimming. I could not easily wear contact lenses in the pool and if I went with nothing, my vision was so poor that I could not really enjoy myself. I could not see anything or anybody around me. I eventually gave up waterskiing because it was no fun just being dragged around blind behind a motorboat.

Work issues can also be important. For me, as a surgeon, I actually found it difficult to perform surgery at a microscope with contact lenses. My glasses were so thick, however, that they also created optical distortion.

Many people just enjoy the freedom that comes with not having to putz with cleaning of contact lenses, contact related infections, or just being able to see naturally when you wake up in the morning. I remember well the initial strangeness of waking up and just seeing after nearly a lifetime of waking up blind and fumbling about for something to help you see better. At the time, I had a young child and it was great to be able to respond to her night time cries without having to stumble around helplessly.

For many of us that were so limited since childhood by our vision, it is an incredibly freeing feeling to be able to function with visual independence. At times, wearing glasses can feel like a real handicap.

Ultimately, if you were always happy wearing glasses or contact lenses, then I say to stay with what you have always done. If you wish that you could function with greater visual freedom or cosmetically prefer how you look without glasses, then you should learn more about Lasik and consider it as an option. See a professional to determine if it is even an option and to learn how Lasik is done. You can also learn about blade-free iLasik procedure.

For more information about Lasik surgery in Milwaukee, please visit http://www.supereyes.com

About the Author

Dr. John Suson MD is an ophthalmologist and a clinical instructor at the Medical College of Wisconsin. Currently, Dr. Suson is in private practice with his sister at their "Suson Eye Specialists" clinic.

Accommodation is a function of the eye, long overlooked in eye surgery because we just haven't had the technology to do anything about it. The term accommodation refers to the ability of the eye to change focus from things that are very far away (like when we are driving) to things that are very close up and small (like reading or threading a needle). If you've used a camera before, you have probably been aware of hearing the auto focus feature or noticed the lens move as the camera adjusts to the distance of the main objects in your picture. If it didn't do so, the picture would appear blurred. Your eye has the same auto focus feature, which allows us to keep the main objects in sharp focus regardless of their distance.

However, as we age, the lens in our eye begins to harden and loses this auto focus capability. Eventually, everybody begins to wear reading glasses or bifocals because of this aging effect called presbyopia. Over the years, people have tried to figure out how to eliminate presbyopia surgically, but there is no perfect way to do so. Only recently have new developments in intraocular implants given us the ability to truly mimic accommodation as it occurs in the youthful eye.

Most notably, the crystalens intraocular implant has been used very successfully in cataract surgery in elderly people. This surgery using the crystalens not only improves the patient's distance vision by removing the cloudy lens (cataract) but it also gives improved near/reading vision. The crystalens is a premium lens implant that has the ability to move in a certain way after it is placed inside the eye which is similar to the auto focus of a camera. With careful preoperative measurement, calculation, and planning, this surgery can improve distance vision while reducing the need for reading glasses or bifocals.

When we do Lasik surgery, however, we do not have the ability to implant a new lens inside of the eye. Lasik surgery is done on the cornea, which is the outer surface or clear dome shaped structure at the front of your eye. In this case, your normal lens remains intact and if you have reached the age where your lens has stiffened, it will remain so. I often have patients that want some flexibility in terms of still being able to read after Lasik surgery and we do what we can to maximize their reading without significantly compromising their Lasik outcome for distance vision. Many surgeons do a monovision correction on their Lasik patients.

Monovision is the practice of leaving the non-dominant eye nearsighted while fully correcting the dominant eye for distance. The concept goes as far back as the monocle, the one-eyed lenses seen worn in the 19th and early 20th century especially in Germany. Often, in my opinion, surgeons will overdo the monovision effect and leave the patient too nearsighted. Although, it gives very good reading vision, the large difference between the two eyes often creates problems with depth perception or dizziness. Also the compromise in distance vision becomes very noticeable to the patient and the brain is not adequately able to fuse or coordinate the different images from the two eyes.

I have had a much higher degree of success using a mini-monovision technique where I leave only a small amount of residual nearsightedness in the non-dominant eye. With this technique, I target good intermediate distance vision rather than close reading/threading-a-needle vision. The residual correction is probably only -1/2 to -1 diopters at most for these patients. This allows much better distance vision and good intermediate vision and some close reading ability. In general, in the modern world, most of our close work is done at the computer distance. Mini-monovision accomplishes this goal and reduces confusion between the two eyes or loss of depth perception. Ultimately, my goal is to maximize the patients distance vision while giving them the ability to work on a computer, see their cell phone or watch, and read a menu. More extensive small print reading, like sitting down to read the newspaper or a novel, would probably require reading glasses. For most people, this set-up eliminates the use of glasses for 90+% of their day.

Surgical options to correct accommodation have come a long way in recent times and continue to develop. If you have questions about accommodating intraocular lenses for cataract surgery, or about options when considering Lasik surgery, discuss them with your surgeon (not just a technician) prior to proceeding.

Dr. John Suson MD is an ophthalmologist and a clinical instructor at the Medical College of Wisconsin. Currently, Dr. Suson is in private practice with his sister at their "Suson Eye Specialists" clinic. For more information about Lasik surgery in Milwaukee, please visit www.supereyes.com.

There are three major reasons for having Lasik eye surgery. Those reasons are 1) visual function, 2) cosmetic appearance and 3) convenience, for example getting rid of the hassle of cleaning and disinfecting contact lenses.

Visual function is the first item to be discussed with patients exploring the option of Lasik surgery. The freedom and ability to function visually without any type of optical prosthesis (glasses or contact lenses) is a great gift. It is amazing that people survived in the world before the invention of glasses. In a pre-industrial world, people would have been helplessly handicapped and extremely dependent on others for everything if their eyesight was very poor. Even now, in modern times, just making it around the house can be extremely challenging. Lasik surgery can change all of that quickly, and reliably. It is an amazing feeling to know that if there were any kind of emergency at any time of day or night, a person whose vision has been corrected surgically can be functionally prepared to deal with it.

Cosmetically, it is nice to have the option to be without glasses or to wear sunglasses for fashion reasons. It is amazing how different people look without their glasses. A good pair of glasses can be a fashion asset, but often people simply look better without glasses. The optical characteristics can significantly change the apparent size of the eyes making them seem very small in people with high prescriptions. The color of the eyes may appear different and not as vibrant as well. Contact lenses can accomplish this cosmetic goal, but for many people they are too uncomfortable so the redness and irritation counter-balance the appearance. Many people will wear their glasses most of the time for work, etc, but when they have a social function where they want to look their best, they will wear contact lenses. This is something that many people do over the years as their eyes become intolerant of contact lenses. Having Lasik eye surgery solves this problem entirely for those people who are good candidates.

The convenience of not having to wear glasses or contact lenses becomes very obvious once someone has had Lasik eye surgery. They become used to the inconveniences over the years, so they accept that they have to deal with the contact cleaning and disinfection process, solutions, etc on a daily basis. There are contact lenses that are designed to be worn for an extended period of time (several days or a week) but the risk for infection is known to increase for those who wear them in this way. Getting up in the middle of the night always means searching about for glasses because it does not make sense to put contact lenses in for just a few minutes. Sometimes people simply fumble about blindly, rather than bothering with the glasses. Traveling on an airplane means the inconvenience of dealing with the solutions, etc, through security or in packing. Just one more thing to worry about in travel plans.

Lasik surgery can eliminate all of that hassle in your life easily. Using the modern approach of blade-free Lasik you can achieve improved visual function, appearance, and a hassle free lifestyle.}

For more information about Lasik surgery in Milwaukee WI, please visit http://www.supereyes.com

Understanding Why Advanced Lasik Technique Is So Important For Achieving Flawless Night Vision

Patients who undergo laser eye surgery at advanced clinics (where sophisticated techniques are used) have a better chance of being more satisfied with their results. One concern that myriad patients express is the fear that their night vision will remain impaired, even after they undergo Lasik eye surgery. This is quite untrue - in fact, advanced Lasik procedures will do nothing more than improve one's night vision.

Patients who undergo laser eye surgery in higher end clinics will tend to have better vision in dark situations and also have better contrast sensitivity than those who undergo old-fashioned, cheaper blade-method Lasik surgery. Contrast sensitivity is important when a person is trying to distinguish shades of gray. In the standard vision test, you read dark black letters on a white background. But the world is not necessarily so stark and many shades of gray exist. Similarly, there are shades of color that are similar going from black, to navy, to purple, etc. Improved contrast sensitivity can be important when trying to see objects of similar shades or color that sit in close proximity visually.

An article in the April 2009 issue of Ophthalmology looked specifically at nighttime driving performance for more advanced procedures compared to older, blade-method procedures. The patients who underwent the more advanced procedures significantly out-performed the patients who underwent the older procedures. These facts correlate with the general impression that the conventionally treated patients (as in, those who were treated with older surgical techniques) complained of significantly more night driving difficult that those treated with the newer methods.

Many cheap centers will try to downplay newer technologies in order to operate low cost, assembly line facilities. But it is clear that the newer technologies do make a difference. Everything from the newer systems, to eye trackers, to blade-free surgical techniques has significantly improved outcomes and/or improved quality and safety. It seems clear that the minimal cost savings is well offset by the significant increases in visual performance, night driving, and safety. You only have one set of eyes - you really only get one chance to have your laser eye surgery.

Anyone who drives an automobile inevitably has to drive at night. Even with headlights, night driving poses an increased amount of risks and dangers that simply aren't present during the daytime. The best defense against a car accident is clear, perfect vision. This is best achieved by selecting only the most advanced and reputable surgical clinics for your Lasik surgery. Don't skimp on technology, especially when it comes to something as invaluable as your eyes.

For more information about Lasik Milwaukee please visit http://www.supereyes.com.

How To Deal With Reading Vision After Eye Surgery

The normal youthful eye has the ability to focus on objects at many different distances. The eye is like a camera which can be made to focus on something at 3 ft or 20 ft and still take a good photographic image. We call this refocusing ability "accommodation" and we all have the ability to unconsciously and automatically do it from the time we are born.

The lens of the eye is very flexible and able to change shape which allows it to "autofocus" much the same as your hand-held camera. But as we get older, the eye begins to lose this ability. The lens stiffens and hardens so that it can no longer accommodate. This process is called presbyopia which means literally "old" eyes. It usually begins to occur in the early 40s and leads to the use of reading glasses or bifocals in order to see well up close.

Many people who have cataract or refractive surgery are hoping to be able to "throw away" their glasses forever. But the onset of presbyopia makes that only partially true. A patient that undergoes Lasik surgery after a certain age will still have some dependence on glasses for reading. There is no way to laser a "bifocal" onto the cornea during Lasik. However, there are ways to minimize the use of glasses for distance and near, but they require some consideration and choice on the part of the patient.

One option is choosing to use reading glasses after Lasik surgery which allows us to concentrate on optimizing their distance vision with the Lasik. This strategy tends to work best for individuals who engage almost entirely in activities or sports that require excellent distance vision only. I actually find this to be rare, because normal daily life does involve a certain amount of close up vision, e.g. reading your watch, seeing a computer, or reading a menu.

The most common strategy for dealing with close vision but avoiding reading glasses is called "monovision." Monovision involves leaving one eye (usually the non-dominant eye) slightly nearsighted. The brain has the capability of learning to use one eye predominantly for distance and the other for up close. However, the greater the difference between the two eyes, the more difficult this becomes.

In order to read a book for extended periods of time, most people over age 45 would have to be left with about -1.50 to -2.50 of nearsightedness in their non-dominant eye. This level of monovision concerns me for a couple of reasons. The distance vision is usually significantly compromised and many people will begin to reject it because of a noticeable disparity between the two eyes. As the monovision increases, it just becomes too great a blur for the brain to filter out. In some people, high levels of monovision will also cause a sense of loss of depth perception. In addition, there are some theoretical concerns with the more advanced laser treatments that intentionally leaving significant monovision may compromise the higher order wavefront laser treatments in unpredictable ways. The wavefront laser treatments are calculated based on full treatments and it is unclear what the effect of doing half of a wavefront treatment has on higher order optical aberrations.

Instead, a strategy of "mini-monovision" where there is no more than -1.00 of nearsightedness in the up close eye is advisable. Ideal would be somewhere around -0.6 to -0.75. This distance is a normal distance for working on a computer which is where much of close work is done in the modern era. Generally this mini-monovision gives good vision for 90% of our daily tasks e.g. reading your watch, cell phone, iphone, computer, menus etc. The goal at this stage is not to eliminate, but to minimize the use of glasses in the most situations that a person is likely to face in the normal course of their daily activity.

Monovision can also be used for patients that have had cataract surgery. However, lately developments in lens implant technology have offered another strategy. Standard lens implants are solid and stiff so they cannot change focus. Newer lens technologies are designed to be multifocal or are able to change shape to refocus. At this stage, they do not restore your accommodation to that of a 20 year old, but they can give back a fair amount of reading ability while maintaining good distance vision. There are plusses and minuses to these lenses as well, including some people that don't tolerate multifocal lenses and cost issues. Nonetheless, these new lens designs represent a great innovation and expansion of vision improvement surgery that was never possible before.

For more information about Lasik Milwaukee please visit http://www.supereyes.com.

Discovering The Advantages Of Newer Lasik Surgery Techniques And Technologies

In the early days of laser refractive surgery, the laser systems were relatively simple. The laser energy was produced in a relatively circular simple pattern that expanded outward. The surgeon maintained control of the treatment alignment manually while using an aiming reticle viewed through the surgical microscope.

In those days, if a patient had excessive movement or oscillation of their eye, it could be quite challenging to maintain proper centration of the laser treatment. It is always best to maintain perfect centration of treatment in order to obtain the best optical results. Any significant deviation from center can lead to suboptimal results and even induced astigmatism or other optical aberrations. Decentration and related optical aberrations were actually a rare but important complication after Lasik or PRK in its early days. Innovations in technology have reduced their incidence considerably, however.

Newer, more refined lasik surgery methods are far more sophisticated and impressive. Patients are given valium prior to Lasik which actually helps to suppress involuntary eye movement during the procedure. In addition, the patient is instructed to remain focused on a fixation light and the surgeon has an aiming reticule for aiming purposes. Nonetheless, a small number of patients do have trouble keeping their eye perfectly still during the Lasik. However, new innovations in surgical techniques have remedied these problems.

Under correction due to movement or significant decentration of the treatment zone is no longer a major concern as it was with the older systems. I've experienced patients who had what I thought was significant oscillating movements during Lasik. At the end of those cases, I felt sure that there would be under correction requiring touch up re-treatment. Yet surprisingly, I found in those particular cases, that there was little or no under correction that demonstrates to me just how well the tracking system on this laser is able to function.

Another feature of these newer systems are the IR or Iris Registration function. While performing the preoperative scanning, a photographic image of the patient's iris is taken. Several spots on the iris are identified and these are then used during the Lasik to adjust for any rotational misalignment. This feature helps to further align the eye and make sure that the treatment delivers the maximum amount of appropriate treatment, particularly with regard to astigmatism and other higher order aberrations.

As with anything else, this serves as an example to why one should always opt for higher-end, more sophisticated surgical clinics. When it comes to laser eye surgery, the surgeons who still utilize.

For more information about Lasik Milwaukee please visit http://www.supereyes.com.

How To Combat Epithelial Ingrowth After A Lasik Surgery

One well known complication of Lasik Surgery is Epithelial Ingrowth. Epithelium is the very fast growing cell layer that covers the eye. Actually, there is an epithelium that covers every part of the outside of your body. It is rapidly growing and constantly shedding and renewing itself throughout your lifetime. The epithelium should remain on the very outer surface of the body, but at times we can see it grow beneath the surface where it becomes trapped and cannot properly shed and renew itself. On the skin, epithelial ingrowth appears as a cyst or bump and has only a cosmetic consequence.

Epithelial ingrowth can happen on the eye after Lasik surgery as well. The act of creating the flap creates a space beneath the corneal surface into which epithelium can potentially grow. Epithelial ingrowth is actually very uncommon after an initial Lasik surgery but the risk increases with a second treatment. Lifting the flap again generally requires more manipulation of the flap edge which may lead to the increased risk of introducing epithelial cells beneath the flap. Surgeons are generally very careful to examine the cornea bed and under-surface of the flap to look for signs of epithelium, but still some cases of ingrowth will occur.

If there is significant epithelium growing beneath the flap, it may have to be removed. The traditional way to remove epithelium is to lift the flap and use a surgical spatula to scrape it out. Some surgeons use alcohol to treat the area as well to kill any microscopic remnants. If the epithelial ingrowth has a tendency to recur, it may be necessary to place sutures in the area to try and seal off a tract or pathway that has formed where epithelium is passing under the flap. Unfortunately, the act of lifting the flap itself is a source for potentially more epithelium ingrowth in the same or other spots.

Sometimes, there is a simpler method to kill the epithelium even without lifting the flap. Laser energy from a YAG or Argon laser can be directed at the area of the ingrowth. The epithelium absorbs the laser energy and is disrupted by it. In many cases, depending on the amount of epithelial ingrowth, it can be disrupted enough to cause it to stabilize or regress entirely. These lasers are different than the lasers used for the actual Lasik surgery and have been around for many decades before Lasik was even conceived.

The technique of using laser energy on epithelium is actually many decades old and was used as a method to whiten or delineate epithelial ingrowth in cases when it grew deep inside the eye itself rather than only beneath a corneal flap. The advantage of using a laser technique to treat the epithelial ingrowth is that no flap lifting is required. This tends to be gentler on the flap keeping it smoother and more regular in appearance. It also minimizes the risk of new ingrowth at other adjacent areas. Although the laser technique doesn't always work, because of its simplicity, it is usually worth the attempt prior to trying more invasive methods.

For more information about Lasik Milwaukee please visit http://www.supereyes.com.

How To Treat Astigmatism In Cataract And Refractive Surgery

Astigmatism is a much misunderstood concept among the general public. It's a word that many people have heard but have only a vague understanding of its meaning. Most people have a general understanding of nearsightedness (myopia) and farsightedness (hyperopia), although sometimes they get the two confused. Because of the focal power of their eyes, nearsighted people see much better up close but not very well far away. On the other hand, farsighted people see better far away than up close. If you are severely farsighted, even relatively far objects may be too close to bring into focus.

But astigmatism doesn't really fit into either of these neat categories. It is also related to the shape of the eye, but it has to do with the irregular or uneven curvature on the front of the eye or cornea. A perfect eye would be completely round or spherical, like a basketball. If you take that ball and squeeze it so that it becomes more oval like a football, then that creates the shape that leads to astigmatism. Since the astigmatic eye does not have an even curvature on its front corneal surface, light is focused differently in different directions. The effect is to create blur, ghost images, and shadowing of objects.

Many people are still under the mistaken belief that if you have astigmatism that nothing can be done for you. That is not true. In the early days of the refractive lasers, PRK and Lasik did not have the ability to correct for astigmatism. Some of the older, outdated lasers may still not have the ability to do so, but modern updated lasers are definitely able to correct for a fairly significant amount of astigmatism. Other options for astigmatism correction also exist.

Correcting astigmatism has become a major part of both cataract and refractive surgery (e.g. Lasik) for many years. Actually, astigmatism correction was done prior to the development of laser refractive surgery. During the Radial Keratotomy (RK) days, diamond blades were used to incise the cornea which would induce healing and flattening of the cornea in relatively predictable ways. RK could be performed to reduce nearsightedness and a closely related cousin, Astigmatic Keratotomy (AK), was performed to reduce astigmatism.

AK uses an arcuate incision placed peripherally in a tangential manner in the cornea. These AK incisions were placed in the axis of the steepest curvature of the cornea in order to flatten it along that meridian and cause the cornea to become more uniformly rounded. Based on a series of factors including degree of astigmatism, location, and patient age, the length and depth of the incisions were determined in a relatively predictable way to correct a given amount of astigmatism. Today, this procedure has become relatively common to reduce corneal astigmatism for patients that are already undergoing cataract surgery with lens implants. A slightly modified version called Limbal Relaxing Incisions (LRIs) is the most common method. LRIs are AK incisions that are placed as far out in the peripheral cornea as possible. It is a quick and inexpensive method to reduce astigmatism which does not require any additional laser equipment.

LRIs are also sometimes used in cases where there is a modest amount of corneal astigmatism after Lasik surgery. The advantage of doing LRIs in this case is that it is very fast healing and there is no need to relift the flap or disrupt the corneal epithelium. If there is any residual nearsightedness or farsightedness, it may be a better alternative to treat the astigmatism with a laser.

A somewhat newer alternative to treating astigmatism has come in the form of Toric IOLs (intraocular lens implants). These are lens implants that have a Toric (oval/cylindrical) lens shape and can be place into the eye after cataract surgery to reduce the astigmatism. These IOLs can work very well although positioning is quite important. If they shift position significantly, they may not adequately reduce the patient's astigmatism. Any additional residual astigmatism after Toric IOL implant could be addressed either by laser refractive surgery or by incisional LRIs.

So for those who thought there was no treatment for astigmatism, that is definitely not true. Depending on your situation, your astigmatism may be treatable by simple incisional corneal surgery (LRI), by laser refractive surgery (Lasik or PRK), or by intraocular lens implants (Toric IOLs). If you were seeking treatment for astigmatism but were told in the past that nothing could be done, you should definitely re-review your options

For more information about Lasik Milwaukee please visit http://www.supereyes.com.

Understanding The Basics Of Intraocular Lenses

Much of the media hype in the last decade has surrounded refractive surgery (specifically Lasik), but cataract surgery remains the most common eye surgery performed in the United States. Most cataracts are age related and usually become visually significant in your 70s or 80s. Occasionally, they can occur much earlier. Patients in their twenties can sometimes require cataract surgery, as people can be born with the condition.

Cataract surgery involves 2 steps:

1) A technique called phacoemulsification that uses ultrasound energy to remove the dense, cloudy lens/cataract from your eye.

2) Implanting a new lens (also called an intraocular implant or IOL).

This article deals specifically with step 2, the IOL, and some of the newer technology that is developing. In recent years, we have seen the emergence of Premium IOLs which are modified lens implants that have capabilities not previously present in standard IOLs. The great benefit of these Premium IOLs is that they have the ability to restore some degree of reading vision to the patient. A standard IOL can be measured and custom fit to an eye to a degree so as to minimize a patient's postop glasses for distance and this process is considered standard practice. However, a standard IOL has only one focal distance, so the patient is required to have glasses for reading after cataract surgery. Actually, many of us over the age of about 40 to 45 know that the aging eye loses the ability to see up close anyway well before the onset of cataracts. Premium IOLs give us the opportunity to restore some of the youthful accommodating ability of the eye to read up close while getting rid of the cataract at the same time.

The cataract surgery itself is performed in essentially the same manner regardless. The only difference is that a slightly different design of Premium IOL is implanted instead of the standard IOL. Currently, there are 2 basic designs of Premium IOLs. The first is a "multifocal" IOL. The multifocal IOL is a lens which is not just a perfectly optically spherical lens, but instead it has many different optical powers that are blended together by creating several concentric rings on the lens. The two most common lenses are the ReSTOR (Alcon) and the ReZoom (AMO). Because these lenses have multiple focal points, they can generate decent focused vision at more than one distance. This gives the effect of accommodating to vision at near as well as far away without the use of reading glasses.

The second type of Premium IOL is the true "accommodating" design. The accommodating IOL actually changes shape, flexes, or in some way alters its focal power from distance to near. In this way, it very closely mimics what the natural, youthful lens of your eye did prior to age 40. The currently FDA approved IOL of this type is the Crystalens, which has a hinged design that allows it to flex and change its focus for reading. Both of these lens designs have their own particular quirks, but for optical purposes, the accommodating lens is probably the best.

Sometimes, cataract surgery and Premium IOL implantation is combined with refractive surgery or Lasik. This combination is sometimes called bioptics and is done to maximize the visual outcome of the patient at both far and near distances. The calculations for the IOL power are very good but at times they may be slightly off, so Lasik surgery is used as an adjunct to refine the vision correction after cataract surgery.

Ultimately, the Premium IOLs offer a more advanced option to cataract patients, not only to restore lost vision due to cataract, but to turn back the clock to a degree and restore some accommodative vision for near and reading purposes.

For more information about Lasik Milwaukee please visit http://www.supereyes.com.