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Cataract Surgery: Beyond Standard Screening

January 16, 2018

At OCLI, we pride ourselves on keeping abreast of the latest in leading-edge technology to deliver the highest quality of care and optimal outcomes to our patients. When it comes to cataract surgery, this means offering preoperative Optical Coherence Tomography (OCT) as a value-added service.

Why is this service so important? While standard cataract screening provides a “bird’s eye view” of the eye, OCT provides a high-resolution “boots on the ground” view. This enables us to detect problems missed by standard screening which can interfere with an otherwise stellar outcome in cataract surgery.

Specifically, OCT enables us to effectively view the macula. The macula is defined as the “oval yellowish area surrounding the fovea near the center of the retina in the eye, which is the region of keenest vision.” The fovea, the part of the eye which the macula surrounds, is defined as “the small depression in the retina of the eye where visual acuity is highest.”

Without the sharp, cross-sectional image of the foveal region that OCT provides, it would be impossible for Dr. Silverman to accurately discern the relationship between the macula and the fovea and therefore to deliver the best possible results.

Today’s cataract patients have much higher expectations about their outcomes than previous generations. At OCLI, our cataract patients often present with other eye problems of which they are unaware. Without the technology to detect these other problems – problems that are only sufficiently detectable with OCT – it would be less likely we would be able to provide the ideal outcome for which we are known, particularly with our “premium” intraocular lens patients.

What do we mean by “premium”? We certainly don’t mean that some patients are more “premium” or important to us than others. “Premium” refers to the kind of intraocular lens (IOL) that a cataract surgery patient will receive.

IOL’s are artificial replacement lenses that are implanted in the eye during cataract surgery. Before the early 1980’s when FDA-approved IOL’s came into common use, the removal of cataracts meant that following surgery, patients would need to wear thick eyeglass or special contact lenses.

There are two types of IOL’s, “basic” and “premium.”

Basic IOL’s are monofocal (single-vision) and are covered by Medicare and other kinds of health insurance, whereas premium IOL’s have advanced features and are not covered by Medicare or most kinds of health insurance.

For patients who are paying out of pocket, it is especially critical for us at OCLI to use OCT to discern what type of premium lenses are necessary or what eye conditions might contraindicate their use. Without OCT, we could unwittingly “overpromise and underdeliver,” leading to an expensive mistake for the patient who is paying out of pocket – a mistake that we at OCLI are not willing to make.  

Even for our patients who are not paying out of pocket, OCT is an exceptionally valuable service since from a visual-quality perspective, premium lenses may not perform as well as monofocal lens. For example, using single-vision IOLs in patients with macular disease can cause more harm than good.

At OCLI, we’re committed to the very highest quality of comprehensive care, both medically (with the latest technology) and personally (with the friendliest service around). If you have any questions about cataract surgery or any questions at all that might lead to healthier and happier eyes, give us a call! We’re happily at your service!

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