Eye Care & Surgery Center NJ Bladeless LASIK Laser Cataract Surgeon Blog

Thursday, May 26, 2011

Non-Surgical & Liquid Face-Lifts

Poly-L-lactic acid (PLLA) is a biodegradable material that has been used medically for years in many forms such as absorbable sutures, plates and screws. PLLA, under the name New Fill, has been on the market in Europe since 1999 as an injectable volumizer for improvement of facial loss in HIV patients. In the United States, PLLA gained FDA approval for treatment of HIV related facial lipoatrophy in 2004. Though initially approved for use in HIV patients with facial fat loss, PLLA treatment has been also used on an off label basis for cosmetic patients. Fat loss or redistribution is the primary reason for thinning of the face in people as they get older. In July 2009, PLLA treatment was approved by the FDA cosmetically for nasolabial folds. The cosmetic PLLA product is now marketed and available to the public.

Mechanism of Action
PLLA consists of microspheres of a synthetic polymer. The microspheres are less than one micron in diameter and create a reaction that leads to growth of collagen. Studies have shown that after injection into the soft tissue, the microspheres degrade over time into carbon dioxide and water while causing stimulation of type I collagen growth. Imaging studies have shown a threefold increase in skin thickness sustained at 96 weeks. At 9 months PLLA completely disappears and is replaced by collagen. The effects of PLLA treatment have been documented in the Vega, Westminster, Blue Pacific and Apex trials to have lasting results over 24 months. More recent studies have shown the increase in skin thickness to last up to 40 months.

Thank you to Dr. Chris Thiagarajah, our guest blogger today, for sharing his insights and knowledge with us.

Tuesday, May 24, 2011

LASIK: What Are The Long Term Results?

Many people ask about the long-term benefit of LASIK, and how it will impact their eyes as they age. The general consensus (and my personal experience) is that most well-selected candidates with stable vision will retain their improved vision for many years. It is known that the reading vision changes with age and as patients of mine over the last 20 years have moved into their 40’s and beyond, they have required assistance with their near vision, usually in the form of reading glasses. I anticipate that there will be effective alternatives for near vision, such as the implant of a small device in the cornea to allow for reading vision while preserving distance vision. This has been introduced in Asia and Europe and looks promising.

There is also the advent of the use of multifocal lenses implanted into the eye to replace the natural lens. At The Eye Care and Surgery Center, we have had a very successful experience with this in our older patients who can become glasses-free as a result. Initially this was performed only in cataract patients, but we are now using these in selected patients in their 50’s and beyond as a valid method of vision correction.

Stay tuned for further advances!

Thank you to Dr. Joel Confino, our guest blogger today, for sharing his insights and knowledge with us.

Thursday, May 19, 2011

Glasses after Cataract Surgery-Will I Need Them?

Ivan Jacobs, M.D.

“As a Cataract Surgeon I have two main goals to achieve during Cataract Surgery. First, I want to remove the cloudy crystalline lens. The crystalline lens is actually an optical component of the eye that provides focusing power. Second, I want to replace the optical and focusing power that was provided by crystalline lens by implanting an intraocular lens (IOL) to provide the correct amount of focusing power to allow you to see clearly”, stated Ivan Jacobs, M.D. of The Eye Care & Surgery Center.

Joel Confino, M.D.

“Before you developed a Cataract, if you wore glasses because you were nearsighted, farsighted or had astigmatism it is now possible for us to use a carefully calculated IOL power or special IOL that can correct astigmatism so that you may not need to wear eyeglasses to see at distance after your surgery”, commented Joel Confino, M.D. “Today, it is even possible for us to select IOLs that can correct both distance and near vision so that you can decrease or even eliminate your dependence on bifocals and reading glasses after your Cataract Surgery.”

If you think you have a Cataract or have been told you have a Cataract and would like to be less dependent on glasses it is worthwhile to schedule an appointment at The Eye Care & Surgery Center to discuss advanced technology intraocular lens implants so that we can guide you as you learn about your possibilities and options for vision correction after Cataract Surgery. Please call Eye Care & Surgery Center at 908.789.8999.

Tuesday, May 17, 2011

Allergy Eyes & Allergic Conjunctivitis

What is allergic conjunctivitis and what causes it?
A clear, thin membrane called the conjunctiva covers your eyeball and the inside of your eyelids. If something irritates this covering, your eyes may become red and swollen. Your eyes also may itch, hurt or water. This is called conjunctivitis, also known as “pink eye.” Many things can cause conjunctivitis, including bacteria, viruses or allergens. Allergic conjunctivitis can affect up to 40% of the general population, 32 % of children, and it is more frequent in women than men.

When an allergen causes the irritation, the condition is called allergic conjunctivitis. This type of conjunctivitis is not contagious. Some common allergens include:

• Pollen from trees, grass and ragweed
• Animal skin and secretions such as saliva
• Perfumes
• Cosmetics
• Skin medicines
• Air pollution
• Smoke

Will allergic conjunctivitis damage my eyesight?
No. Although allergic conjunctivitis is irritating and uncomfortable, it rarely affects eyesight.

What can I do to avoid getting conjunctivitis?
Try to identify and avoid the allergens that cause your symptoms. For example, if you are allergic to pollen or mold, stay indoors when pollen and mold levels are high. You can usually find out when allergen levels are high from the weather report. Keep your doors and windows closed, and use an air conditioner during the summer months. You can also reduce your amount of allergen exposure by changing you clothes, combing your hair, or showering when coming in from the outside during high pollen days.

How is allergic conjunctivitis treated?
It may help to put a cold washcloth over your eyes for relief. Lubricating eye drops (sometimes called artificial tears) may also make your eyes feel better. Antihistamine pills (which many people take for their allergies) may also help relieve your symptoms. You can buy lubricating eye drops and many antihistamine pills such as Claritin without a prescription.

Several other types of eye drops are available to treat allergic conjunctivitis. They can help relieve itchy, watery eyes and may keep symptoms from returning. Eye drops may contain an antihistamine, a decongestant, a nonsteroidal anti-inflammatory drug (NSAID) or a mast-cell stabilizer. Some drops contain a combination of these. Some eye drops require a prescription. OTC Visine A or Naphcon A contains both an antihistamine and decongestant. OTC Zaditor is a mast-cell stabilizer. If these drops are not effective enough, then a prescription mast-cell inhibitor or mild steroid drop is usually prescribed for relief.

Do these treatments have side effects?
Many eye drops can cause burning and stinging when you first put them in, but this usually goes away in a few minutes. It is important to remember that all medicines may potentially cause side effects, so talk with your doctor before using any medicine, including eye drops.

Can I wear my contact lenses?
It’s not a good idea to wear
contacts while you have allergic conjunctivitis because the contacts may cause the conjunctivitis to get worse. Instead, wear your glasses until your eyes feel better.

Thank you to Dr. Ivan Jacobs, our guest blogger today, for sharing his insights and knowledge with us.

Friday, May 13, 2011

Glaucoma and Marijuana

Thank you to Dr. Joel Confino, our guest blogger today, for sharing his insights and knowledge with us.

Alternative medicine and therapy have been increasing in popularity in recent years. One of the areas of interest has been the treatment of glaucoma with marijuana. Glaucoma is an eye disease resulting in loss of vision from damage to the optic nerve. One of the many factors that can cause this is elevated intra-ocular pressure, or IOP. There are various standard treatments for glaucoma, including eye drops, laser surgery and standard surgery.

Marijuana has been studied with regard to potential medical benefits, (in addition to the known recreational benefits!). Many states have passed medical marijuana laws so that chronic pain sufferers and others can gain relief from some of the proven, positive effects of the substance.

An initial study in the 1970’s reported lowering IOP with the use of marijuana. The active ingredient was identified and analyzed when administered in various forms, such as via smoking, oral intake or eye drops. The lowering effect upon IOP was found to be of short duration, less than that of standard treatments such as eye drops. The best effective route of administration was via smoking, followed by oral and intravenous methods. The eye drops were not effective in lowering IOP. In addition, the quantities of the drug that were required to achieve an adequate IOP lowering effect were too high, and resulted in many well-known side effects, such as red eye, increased heart rate, decreased motor coordination, memory and concentration, as well as lung disease. As a result it has not been approved for the treatment of glaucoma.

It is possible that in the future, a more effective formulation for an eye drop will be developed. There are other potential health benefits for the eye, such as the treatment of macular degeneration, which has not yet been proven but is of theoretical interest due to the anti-oxidant effect of the drug.

In summary, marijuana will not be found stocked among the eye drops in the drugstore anytime soon, but future studies and formulations of the active ingredient could potentially lead to a method of use that is safe and effective.

Tuesday, May 10, 2011

Meet The Eye Care & Surgery Center Managers

Behind the scenes at The Eye Care & Surgery Center, is an experienced and well diversified staff. As in any organization, the whole is only as strong as the sum of its parts. Let me introduce some of the ECSC Management Team:

Director of Refractive Surgery – Jerette L. Lerner

Director of Billing – Judy McCann

Surgical Coordinator – Ellen Freeman
Longest Active Member of ECSC Family

Surgical Coordinator – Janie Ellenberger

Finance Manager – Mary LaStella

Thursday, May 5, 2011

What Makes Good LASIK Candidates?

“Each day I see many patients for routine eye exams who all seem to know that LASIK can potentially help them to be free of the hassle of eyeglasses or contact lenses”, said Corneal Specialist and LASIK Surgeon Joel Confino, M.D. at Eye Care & Surgery Center. “For most of them the question of whether they might be a candidate is causing them to hesitate in taking the next step.”

LASIK is not for everyone. Here are some things to think about to help you determine if you might be a
good candidate for LASIK and should consider scheduling a consultation to find out for sure:

  1. The great majority of patients who are nearsighted, farsighted or have astigmatism are potential candidates for LASIK.

  2. Good LASIK candidates are at least 18 years of age or older and have stable vision. This means that their eyeglass or contact lens prescription has not changed much in the last year or so. Many people do not have "stable" vision until 21 years of age, however so each person is a bit different.

  3. Good LASIK candidates have healthy eyes that are free from retinal problems, corneal scars, and any other eye diseases. They have normal corneal shapes and thickness as well as healthy tears.

  4. The best LASIK candidates are those with a lifestyle, activities or occupation in which they are dissatisfied with their contact lenses or glasses.

The best way for you or someone you know to find out if they are a good candidate for LASIK is to have an evaluation, examination, and consultation with Dr. Confino who is a Corneal Surgeon and LASIK specialist. Please feel free to contact us schedule an appointment by calling The Eye Care & Surgery Center Toll Free at 800.504.1083.

Tuesday, May 3, 2011

New Jersey UV Eye Protection Awareness Month

Eye Care & Surgery Center wishes to announce that Prevent Blindness America has designated May as National Ultraviolet Eye Awareness Month. “Most people know the harmful effects that ultraviolet (UV) rays can have on the skin. But many are not aware of the damage that they can cause to the eyes”, commented Corneal Specialist Joel Confino, M.D. of The Eye Care & Surgery Center. “Possibly the most frightening aspect of UV damage is that it is cumulative, meaning the negative effects may not present themselves until years later.”

Today almost everyone is aware of the potential damage that sunlight and ultraviolet (UV) radiation can cause to their skin, most do not know or appreciate that ultraviolet light (UV) can also cause significant damage to eye health and vision.

“Most of us wouldn’t dream of staying outside in the sun without putting on sunscreen lotion for skin protection,” said Ivan Jacobs, M.D. Glaucoma Specialist at The Eye Care & Surgery Center. “But we also need to remember to wear UV-blocking lenses and eyewear as well as a brimmed hat to protect our eyes as well.”

At Eye Care & Surgery Center we are fortunate to be able to offer patients a full range of UV protecting eyeglass lenses available to choose from. High quality sunglasses should block out 99-100 percent of both UV-A and UV-B rays. “It is also important to have UV protection in your everyday eyewear. “This is readily available to our patients through our selection of a number of UV blocking eyeglass lens materials, specialized coatings and photochromic lenses in our Optical Department”, said Philip Borker, Practice Administrator.

“We know that extended exposure to UV has been linked to many eye problems, conditions and in some cases thought to hasten the onset of eye problems such as cataracts, age related macular degeneration (AMD), certain cancers on the delicate skin around the eye and even photokeratitis, a type of sunburn of the cornea”, said Milton Kahn, M.D., Retina Specialist.

Please feel free to ask any Eye Care & Surgery Center staff member questions you might have about UV protection, eye disease and the best way to protect your eyes with the proper eyewear and lens choices. The Eye Care & Surgery Center can also be reached at 908.789.8999 to help answer questions or schedule an appointment.