Comprehensive Vision Care for Various Conditions at Eye Center of New York

LASIK and PRK (and similar laser vision correction treatments such as SMILE) are some of the most common procedures performed in the world. Not surprisingly, with age, more and more post-LASIK (also known as post-refractive) patients find they now need cataract surgery.

At Eye Center of New York, we operate on post-LASIK patients routinely. We work with our patients and referring doctors to find the correct intraocular lens (IOL) for post-LASIK and PRK eyes. We understand that you’ve already invested in your eyes and enjoyed independence from glasses and contacts, so we try to maintain, fine-tune, or even expand your vision with cataract surgery.

In addition, our diagnostic tests, high-resolution corneal scans (topography and wavefront aberrometry), advanced formulas, and newer IOLs allow us to give our post-LASIK, PRK, or SMILE patients excellent results. We utilize technologies such as:

• The latest post-refractive formulas
• ORA intraoperative aberrometry
• Femtosecond laser
• Extended range of vision IOLs (such as Symfony Optiblue)
• The Rx Sight Light Adjustable IOL 

We take on the most complex of these patients -— including ones that have had multiple laser treatments and enhancements over decades.

Radial keratotomy was the earliest vision correction procedure and was eventually replaced by LASIK and PRK in the late 1990s. For the many patients who had successful RK in the ’80s and ’90s and enjoyed decades of good vision, many are approaching the age where they may have cataracts. 

RK poses challenges such as patients having overcorrected glasses or contacts, vision fluctuation, and the risk of opening previous RK scars. Dr. Raviv operates on many RK eyes, and we employ technologies such as: 

• Post-RK formulas
• ORA intraoperative aberrometry
• Toric IOLs
• Extended depth of focus IOLs (such as Symfony Optiblue)
• Small aperture IOLs, such as the IC8 (Apthera)
• The Light Adjustable Lens (LAL) 

We can operate through tiny incisions that avoid RK cuts and, if necessary, use a scleral entry (as opposed to corneal) when patients have had a high correction, such as 8 or 12-cut RK. Some of the most aberrated RK eyes may still require rigid gas permeable (RGP) or scleral contact lenses afterward.

CK was a laser vision correction for farsightedness in the early ’00s. Unfortunately, its effects wore off, so the treatment fell out of favor. Thankfully, peripheral corneal spots resulting from this procedure are not visually significant and do not affect the ability to achieve great results with IOLs.

Corneal segments (such as Intacs) have mostly recently been used to stabilize a corneal condition called keratoconus or corneal ectasia. When approaching cataract surgery in an eye with Intacs, we can, in most cases, leave them in if they are stable and provide value to the cornea. If there are any signs of erosion or malposition, they would be removed first, and the eye is then given time to heal before cataract surgery planning can occur.

Corneal inlays are thin circular discs that were surgically implanted in the central cornea under a LASIK flap or specially created pocket. They were used to help patients treat presbyopia and minimize or eliminate reading glasses and were used in the non-dominant eye to help it see nearer while keeping the other eye for distance. Most patients with cataracts can proceed with surgery while leaving corneal inlays in, although some patients with the Raindrop that have signs of extrusion or continued dry eye symptoms may need to have them removed before cataract surgery.

The implantable contact lens (ICL) is an IOL that is implanted in the eye bilaterally to treat high myopia (nearsightedness). It’s typically used in eyes that are above the safe LASIK treatment range or in eyes with corneal shapes that aren’t amenable to LASIK.

Millions of ICLs have been safely placed, but a small percentage of ICL patients may develop a cataract earlier than expected (which is called an anterior cortical cataract). Other ICL patients may simply develop age-related cataracts. Dr. Raviv has treated many of these young, post-ICL cataract patients using a special surgical technique to remove the ICL and then perform cataract surgery, typically with a full focus IOL (multifocal IOL or EDOF IOL) that not only restores glasses-free vision for distance but can also maintain or enhance it for near vision.

Astigmatism is a common condition that causes blurry or distorted vision. It’s caused by an imperfection in the curvature of your eye’s cornea or lens that makes light enter the eye at more of a bend than necessary. Some patients know they have astigmatism and have been correcting it with glasses or toric contact lenses, while others don’t realize they have astigmatism. For cataract surgery with astigmatism, we use state-of-the-art devices to precisely map out and characterize the issue (a biometer, a high-definition topographer, and a keratometer). We aim to reduce astigmatism as much as possible to reduce or eliminate reliance on glasses. This is typically done with an astigmatism version of an IOL, known as a toric IOL. Our monofocal, multifocal, and extended depth of focus (EDOF) IOLs all come in a toric model. By matching your new implant to your existing corneal astigmatism, we can make your vision incredibly sharp.

For low levels of astigmatism, below the available toric IOL powers, we use the femtosecond laser to make precise, small, peripheral corneal relaxing incisions that can subtly make a slightly oval cornea more round. Every human heals slightly differently and some patients can “heal” with some unexpected leftover astigmatism. For these cases, we can use Rx Sight Light Adjustable Lens (LAL) to further fine-tune astigmatism in the first few weeks after cataract surgery. With the LAL, astigmatism can be treated after healing, while with standard lenses, a PRK or LASIK laser fine-tuning can be done typically at three months post-op, if needed.

When we perform cataract surgery, we replace the natural lens (which has become cloudy) with a new man-made clear lens, known as an intraocular lens (IOL). In years past, cataract surgeons removed the natural cloudy lens and placed an approximate monofocal IOL power lens, expecting that the patient would continue to wear glasses indefinitely.

Now, IOLs come in thousands of different “sphere and cylinder powers,” and by customizing each IOL to each eye, we can fix farsightedness or nearsightedness with close-to-LASIK accuracy. If we use a multifocal or extended depth of focus (EDOF) IOL, we can even bring intermediate and near vision into clear focus and eliminate the need for glasses.

With refractive cataract surgery, we don’t only fix the clarity of the eye, but also its focus. This is done using a femtosecond laser and hyper-customized IOL to minimize or eliminate any pre-existing farsightedness, nearsightedness, or astigmatism — and, therefore, the need for glasses.

Defined as the gradual loss of the ability to see things clearly up close, presbyopia happens to everyone, typically by their 40s. When we’re younger, our natural lens is flexible and allows us to focus from distance to near without a second thought, but the lens stiffens as we age, necessitating glasses, such as bifocals or progressives, or contact lenses.

We always discuss presbyopia with a prospective cataract surgery patient. If you’re in your 60s or 70s, you are likely familiar with your near-vision limitations and can better understand the differences in your vision with a monofocal or a multifocal IOL.

For cataract surgery patients in their 20s to 40s, we don’t recommend a monofocal IOL because it can prematurely induce presbyopia. In our younger cataract patients, we strongly recommend an EDOF or multifocal IOL option that will most likely mimic or enhance their current vision.

While most contact lens wearers use soft, disposable contact lenses, RGPs provide excellent vision for certain prescriptions. When we evaluate an RGP-wearing patient, we can determine if customized refractive cataract surgery could eliminate their need for RGPs in the future. This is possible in most cases, except in cases such as moderate to advanced keratoconus, or highly irregular corneas from trauma or other causes.

Once we decide that we will try to eliminate the need for RGPs, we measure the corneas without RGPs for a few weeks because they affect the cornea and can provide incorrect measurements when planning an IOL. Staying out of RGPs is difficult for some of our patients but is worth the time for lifelong contact lens independence. In some cases, an optometrist can temporarily switch RGPs to soft contact lenses during this time.

Contact lenses are widely used to correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. Even multifocal contact lenses are available.

When we evaluate a cataract surgery patient who wears daily contact lenses, our goal is to give them even better vision post-operatively — and without the future need for contact lenses. Contacts are fine, but as we age, our eyes become drier, and many patients will become less tolerant of daily contact lenses as they grow older. Cataract surgery is the ultimate opportunity to fix the issue once and for all.

For this procedure, we typically measure the eyes out of soft contact lenses for three days and soft toric contact lenses for about one week. This allows the cornea to return to its original state.

Prism is used in glasses when the two eyes are not perfectly aligned with each other and to treat double vision. Typically, a patient with prism in their glasses before cataract surgery will need prism after. Our goal with cataract surgery in these eyes is to bring the two eyes as close together refractively as possible so they can have balanced vision. We can also involve the expertise of a strabismus surgeon, who can evaluate the patient before and after cataract surgery to see if the muscle imbalance can be corrected by eye muscle surgery in lieu of prism.

As we age, just about all of us will develop cataracts as well as AMD, a condition in which the retina deteriorates and slowly loses its high-definition vision. AMD is an all-encompassing term that can range from mild, subtle pigment changes to severe AMD with visual loss. 

Cataract surgery has not been shown to affect the progression of AMD. These are two separate conditions that commonly exist as we age. 

For “dry” AMD, we recommend AREDS vitamins to slow its progression. In cases of “wet” AMD, where abnormal blood vessels leak proteins and lipids, intravitreal injections can maintain or restore vision.  

We typically recommend a monofocal IOL for AMD patients, as opposed to multifocal IOL implants. In some cases, an extended depth of focus (EDOF) IOL (such as the Symfony Optiblue) can be used successfully for a fuller range of vision. Many AMD patients enjoy significant improvement from modern-day laser refractive cataract surgery, which simultaneously corrects the clarity and focus of their native eye.

Anti-vascular endothelial growth factor (anti-VEGF) therapy involves the administration of drugs designed to inhibit the activity of vascular endothelial growth factor. This approach is used to treat specific cancer types and address age-related macular degeneration.

Patients with eyes that receive repeated intravitreal injections also sometimes need cataract surgery. The cataract may obscure the retina’s view for the treating retinal specialist and needs to be removed to improve the management and treatment of the retinal condition. Removal of the cataract may also improve the vision significantly, even if can’t make it perfect.

When we evaluate AMD patients, wet or dry, we try to assess what contribution the cataract is causing to their decreased vision vs. the retinal contribution. We can then make a more informed recommendation for surgery.

Cataract surgery in a setting of anti-VEGF injections is something we see daily. We typically will schedule the surgery in between the injections; your retinal specialist can help guide the timing. And we utilize techniques such as femtosecond laser that decrease any chance of complications. We have also treated cases where a cataract suddenly develops after an injection, with excellent results.

ERMs are small membranes that wrinkle the retina and negatively impact vision. They become more common as we age. ERMs can have no symptoms and are found in routine pre-op retinal imaging, or they can cause central distortion of vision.

It’s important to identify them on the preoperative visit, as they may be contributing to poor vision. The presence of a significant ERM will limit post-operative vision (after cataract surgery), so a monofocal IOL is usually chosen over a multifocal IOL.

A retinal surgery called a pars plana vitrectomy with membrane peel can be performed to remove the membrane and improve vision. We may consult with a retina surgeon, if needed, before or after your cataract surgery.

Cataract surgery in eyes with ERM has a higher risk of a post-operative condition called cystoid macular edema (CME). With CME, post-op eyes get blurry vision a few weeks after surgery due to fluid buildup under the ERM. We use a combination of steroid and non-steroidal anti-inflammatory eye drops to prevent and treat CME, should it occur.

For surgical retinal diseases, the primary surgery performed is called a pars plana vitrectomy (PPV), which can be utilized to fix retinal detachments, macular holes, epiretinal membranes, vitreomacular traction, floaters, and more.

Eyes that have undergone a vitrectomy (PPV) will all have relatively rapid cataract progression from months to a few years following the vitrectomy surgery – almost universally.

We therefore see many of these types of post-vitrectomy cataracts. The medical literature does find a higher rate of cataract surgery complications in these cases, on average. By utilizing femtosecond laser, a supracapsular surgical technique, and decades of experience in these types of eyes, we ensure low complication rates akin to routine cataract surgery.

The good news is that depending on the underlying retinal pathology treated, many post-vitrectomy cataract patients may still be candidates for the most advanced type of IOLs.

A scleral buckle (SB) surgery is a type of retinal surgery used for certain types of retinal detachments. It can be used instead of, or along with, a pars plana vitrectomy (PPV) to reattach a retina.

Unlike a PPV, a scleral buckle does not typically increase the rate of cataract formation. A scleral buckle does change the refractive error in the eye by making the eye longer and therefore causing patients to be more nearsighted. This means that most post-SB patients have to bump up their eyeglass prescription on the operated eye — sometimes signficantly.

Cataract surgery can be successfully performed in eyes with scleral buckles, usually without added risk. Many retina specialists feel that despite the original pathology that led the SB, these retinas are now well reinforced and supported by the buckle and do not have a significant increased rate of having an RD after cataract surgery.

In recent years, laser treatment for floaters, or small flecks of collagen that appear to drift in your vision, has become more popular. It’s a safe and effective way to eliminate this bothersome phenomenon.

Rarely, the laser can impact the posterior capsule and create a rapid onset cataract – typically within a day of the laser. This type of cataract is high-risk, as there may be a small tear in the posterior capsule. It takes a cataract surgeon with specific experience in these types of eyes. Dr. Raviv has handled cases like these and can arrange a procedure with a retinal surgeon, if needed.

Patients with diabetes develop cataracts earlier than non-diabetics and may require cataract surgery up to 10 years earlier. Sometimes diabetes can affect the retina’s blood vessels and cause bleeding and retinal swelling, a condition called diabetic retinopathy. This condition is best managed by good systemic sugar control as well as a combination of retina laser, intravitreal injections, and, sometimes, vitrectomy surgery.

We perform cataract surgery in diabetic eyes routinely and succesfully. The retina needs to be closely followed following cataract surgery, as it the retinopathy may temporarily flare and require more intensive treatment, such an intravitreal injection. Cataract surgery also clears the view for the retina specialist and their diagnostic imaging devices for continued follow-up.

At the Eye Center of New York, we often have patients ask us if they have the worst nearsightedness we’ve ever seen. Our answer: Far from it. We’ve successfully operated on people in the -30 diopters (D) range, in addition to the more typical -10 to -20D range.

High myopia, also known as degenerative myopia or pathological myopia, is a type of nearsightedness that requires a glasses correction of -6.00D or more. Cataract surgery in very myopic eyes has been associated with an increased lifetime risk of retinal detachment (RD). But high myopia is already a risk factor for lifetime RD, even without cataract surgery. Most studies that show this risk from cataract surgery are population studies that do not account for current real-world practices and variables.

In our practice, to minimize the risk of RD after cataract surgery, we use a multi-prong approach. First, patients are sent to a retinal surgeon before and after surgery to get a careful peripheral retinal examination and, if necessary, a prophylactic retina laser to seal any weak spots. For the cataract surgery, we utilize a femtosecond laser to break up the cataract, which minimizes the amount of time or energy we need to spend in the eye.

Our high myopia patients are some of our happiest, as we are able to fix their myopia and astigmatism with cataract surgery by customizing their intraocular lens (IOL). Many patients who were not LASIK candidates are finally able to fix their vision with cataract surgery.

RP is a family of retinal degenerative conditions that can have a genetic or familial component. RP patients tend to lose peripheral vision but maintain good central vision. RP patients also tend to get a certain type of cataract, called a PSC cataract, that can affect their central vision.

In these cases, cataract surgery is successful in clearing the lens-related central vision loss. Only monofocal IOLs are recommended in cases of retinal degeneration to preserve the best vision possible.

Glaucoma and cataracts are common eye conditions that are often confused. A cataract is a cloudy lens that occurs in just about every human as they age and is remedied by a one-time cataract surgery with an intraocular lens (IOL) implant, whereas glaucoma is a chronic condition of high eye pressure (save for some exceptions) that leads to optic nerve damage and permanent visual loss.

Glaucoma treatment starts with early identification and lowering eye pressure through daily eye drops, in-office laser treatment, and/or glaucoma surgery. The treatments all work by lowering the eye pressure so optic nerve damage can be slowed and vision preserved.

The good news about cataract surgery with POAG or OHTN is that most glaucoma patients can manage their condition with daily, long-term eye drop therapy. For some, minimally invasive glaucoma surgery (MIGS) is an option to lower pressure following cataract surgery. We typically place micro-stent(s) into the eyes to create a drainage channel at the time of cataract surgery. Two FDA microstents, Glaukos’ iStent and Alcon’s Hydrus stent, have been shown to have long-term efficacy and can even eliminate the need for eyedrops in some patients.

Pseudoexfoliation (PEX) is a common, age-related issue on the cataractous lens. To the ophthalmologist, PEX may present as small, dandruff-like particles on the anterior lens capsule. PEX can lead to high eye pressure and glaucoma, for which many patients use daily eye drops.

PEX also weakens the support structures that hold the natural lens (the cataract) called zonules. This can lead to a higher rate of cataract surgery complications in an inexperienced surgeon. The zonules are akin to trampoline strings that hold the cataract in place and can wobble, stretch, and tear in PEX eyes, necessitating further surgeries in some cases. In addition, the pupils of PEX patients don’t dilate well and can require extra steps, such as pupil stretching during cataract surgery.

Dr. Raviv employs cutting-edge femtosecond laser-assisted cataract surgery to treat PEX. Decreasing surgical complications in PEX eyes comes down to impeccable technique, honed over thousands of procedures by the surgeon. As Dr. Raviv operates on PEX eyes at almost every surgical session, complications are minimal.

Pigmentary glaucoma is a type of open-angle glaucoma in which pigment from the iris (the colored part of the eye) clogs the eye's drainage system. The same approach as in POAG is used with cataract surgery, with good efficacy of MIGS stents such as Hydrus.

Broadly speaking, there are two types of glaucoma: open-angle and narrow-angle. The majority of cases are primary open-angle glaucoma (POAG) and have what appears to be a normal internal drainage channel on exam. Narrow-angle is when the eye’s shape and configuration create a crowded or shallow approach to the drainage channel. This is frequently treated by laser iridotomy.

Narrow-angle glaucoma can be caused by cataracts. As the eye matures, the lens of the eye becomes thicker, much like a tree trunk. In susceptible eyes (usually those that are farsighted), the lens pushes the iris forward, crowding the drainage pathway (known as the angle).

Cataract surgery or refractive lens exchange (RLE) can permanently cure the eye from its narrow-angle state. The newly implanted intraocular lens (IOL) is much thinner than the removed, mature cataract, opening the drainage channel for good.

Cataract surgery in only one eye involves the removal of a clouded lens to improve vision while leaving the other eye untouched. We tailor your treatment to preserve and enhance the patient’s vision in the operated eye, often resulting in improved overall visual function without affecting the untreated eye.

With Alzheimer's patients, we take a specialized approach that rests at the intersection of ophthalmology and geriatrics. Careful preoperative assessments and postoperative care are essential to address the unique challenges associated with cognitive decline, ensuring patient safety and successful visual rehabilitation.

For individuals with dementia, we develop a comprehensive strategy that considers cognitive impairments. In collaboration with caregivers and the individual’s regular healthcare providers, we aim to optimize preoperative evaluations and postoperative care, providing personalized solutions for successful visual improvement.

Cataract surgery in Parkinson's patients involves navigating motor challenges to achieve optimal surgical outcomes. Our collaborative approach between ophthalmologists and neurologists using advanced technologies ensures patient safety and successful visual rehabilitation in the presence of Parkinson's disease.

Cataract surgery in patients with tremors necessitates precision techniques and may involve advanced technologies such as femtosecond lasers to counteract the impact of tremors during the procedure. These measures enhance surgical accuracy, ensuring successful visual outcomes for individuals with tremor-related challenges.

Cataract surgery in patients who cannot lie flat is approached with customized positioning solutions, such as reclining chairs or adjustable beds. This ensures both patient comfort and surgical feasibility, allowing for a safe and effective procedure tailored to the unique needs of individuals unable to assume a traditional flat position.

Cataract surgery without general anesthesia often involves the use of topical anesthesia or regional blocks to minimize discomfort. This less invasive approach is suitable for individuals who may have contraindications or preferences against general anesthesia, providing a safe and effective surgical experience.

Cataract surgery in individuals with diabetes focuses on meticulous management of ocular complications. Close monitoring of blood sugar levels, preoperative optimization, and postoperative care are paramount to prevent and manage diabetic-related issues during the recovery period, ensuring successful visual rehabilitation.

Cataract surgery in individuals with HIV requires a comprehensive assessment of immune status and overall health. Collaborative care with infectious disease specialists is emphasized to optimize surgical outcomes and manage potential complications associated with the patient's HIV status.

Cataracts typically manifest with older age, but they can affect individuals in their 40s and 50s. Dr. Raviv emphasizes the importance of early detection and intervention. Our practice employs state-of-the-art diagnostic tools, allowing for timely and effective treatment plans.

Whether you’re in your 40s dealing with early-stage cataracts or in your 50s with more advanced symptoms, our team tailors interventions to suit your age-specific needs. Early intervention often leads to better visual outcomes and an enhanced quality of life.

Cataract surgery in a 90-year-old individual involves a personalized approach considering age-related factors and overall health. Despite advanced age, careful preoperative evaluation ensures the safety and efficacy of the procedure, allowing older patients to benefit from improved vision and enhanced quality of life.

Cataract surgery in individuals over 100 years old demonstrates advancements in medical care. Rigorous evaluation and personalized care ensure successful outcomes, contributing to an improved quality of life through enhanced vision even in this advanced age group.

Cataract surgery in individuals with blood or platelet disorders demands meticulous planning to minimize the risk of bleeding. Collaboration with hematologists and vigilant postoperative monitoring ensures a safe surgical outcome, addressing the specific challenges posed by the patient's blood or platelet condition.

Cataract surgery in individuals with claustrophobia incorporates strategies to alleviate anxiety, such as conscious sedation or creating a more open surgical environment. Collaborative efforts between the surgical team and anesthesiologists focus on managing the patient’s psychological concerns, ensuring a comfortable and successful surgical experience.

Cataract surgery in individuals with ocular albinism requires specialized attention due to unique anatomical and visual characteristics. The surgical approach is tailored to optimize visual outcomes while addressing the challenges posed by albinism-related factors, providing individualized care for this genetic condition.

Cataract surgery at a young age involves addressing early-onset cataracts to provide long-term visual benefits. The procedure is approached with consideration for the patient's age and unique circumstances, utilizing advanced surgical techniques tailored to the needs of younger individuals to ensure successful visual rehabilitation.

Cataract surgery on individuals taking blood thinners involves careful management to minimize the risk of excessive bleeding during the procedure. We ensure careful coordination between the surgical team and the prescribing physician to determine if temporary cessation or adjustment of the blood-thinning medication is needed before surgery, ensuring a safe and successful outcome.

Cataract surgery on patients using aspirin or antiplatelet therapy necessitates a balanced approach to prevent potential bleeding complications. In collaboration with the prescribing physician, we may decide to continue aspirin at a lower dose or temporarily discontinue it before the surgery to strike a balance between minimizing bleeding risk and preventing thrombotic events, ensuring an optimal outcome.

Cataract surgery on individuals taking Coumadin (warfarin) involves meticulous coordination with the prescribing physician. The anticoagulant effect of Coumadin may be temporarily reversed or adjusted before surgery to minimize bleeding risks. Close monitoring and collaboration ensure a safe surgical experience, balancing the need for anticoagulation with the surgical procedure’s safety.

Cataract surgery on individuals using newer anticoagulants like Eliquis, Pradaxa, or Xarelto requires careful coordination between our team and the prescribing physician. Strategies may include temporarily stopping or adjusting the dosage of these medications to manage bleeding risks during the surgery, ensuring a safe and successful cataract procedure.

Cataract surgery on individuals taking medications like Flomax, Rapaflo, or Uroxatral for benign prostatic hyperplasia involves consideration of potential intraoperative floppy iris syndrome (IFIS). We may modify our approach to minimize complications associated with these medications, ensuring smooth cataract surgery and optimizing visual outcomes for patients with urinary symptoms.

Cataract surgery in individuals undergoing chemotherapy (aka chemo) poses unique challenges due to potential systemic and ocular side effects. We offer collaborative care with the patient’s oncologist is crucial to time the surgery appropriately, taking into account the patient's overall health and immune status. Preoperative assessments may involve optimizing the patient's systemic condition and closely monitoring for any ocular changes associated with chemotherapy to ensure the safety and success of the cataract surgery.

Cataract surgery in cancer patients involves a multidisciplinary approach to balance the visual needs of the patient with their overall oncological treatment plan. We will time surgery to coordinate with the patient’s oncologist to minimize interference with cancer treatments. Additionally, careful preoperative evaluation and postoperative care are essential to address potential challenges associated with the patient's systemic condition, ensuring optimal visual outcomes.

Cataract surgery following ocular melanoma treatment requires specialized consideration due to the impact of previous therapies on ocular structures. We will collaborate with patients’ oncologists to assess the ocular health post-treatment and determine the optimal timing for cataract surgery. Close monitoring and a personalized surgical approach are essential to address any complications associated with ocular melanoma treatment, ensuring successful visual rehabilitation.

Cataract surgery after plaque brachytherapy for ocular tumors demands careful evaluation of the eye’s radiation effects. We work with oncologists to assess the post-treatment ocular condition and decide on the appropriate timing for cataract surgery. We then tailor the procedure to address any radiation-related changes.

Cataract surgery following orbital radiation poses challenges related to radiation-induced changes in the eye's structures. By collaborating with radiation oncologists to assess the impact of treatment on ocular health, we can schedule cataract surgery for optimal results. Our personalized surgical approach considers the effects of orbital radiation, and meticulous preoperative and postoperative care is undertaken to achieve optimal visual outcomes for patients who have undergone this type of radiation therapy.

Cataract surgery in individuals with Fuchs' Dystrophy, a condition causing corneal endothelial cell dysfunction, may pose challenges due to compromised corneal health. Our approach often involves techniques to minimize endothelial cell damage, such as using specialized instruments or employing femtosecond laser technology. In some cases, combined procedures, such as cataract surgery with endothelial keratoplasty, may be considered to address both conditions simultaneously.

Cataract surgery in the presence of a cloudy cornea or corneal scar requires a customized approach to ensure optimal visual outcomes. We employ specialized techniques, including femtosecond laser technology or manual corneal incisions, to minimize disruption to the scarred tissue. In some cases, additional procedures like corneal transplant may be considered in conjunction with cataract surgery to address both the cataract and corneal opacity.

Cataract surgery in individuals with keratoconus, a condition characterized by corneal thinning and distortion, demands careful preoperative planning. We use advanced diagnostic tools to assess corneal stability, and intraocular lens (IOL) choices are tailored to the altered corneal shape. In some cases, simultaneous procedures like corneal cross-linking may be considered to enhance corneal stability alongside cataract surgery.

Cataract surgery following corneal transplant, especially after procedures like Descemet's Membrane Endothelial Keratoplasty (DMEK) or Descemet's Stripping Endothelial Keratoplasty (DSEK), requires precise planning. Our team coordinates with corneal specialists to ensure compatibility between the transplanted cornea and the intraocular lens choice. Close monitoring and specialized techniques, such as suture management, are employed to optimize visual outcomes in these complex cases.

Cataract surgery in the presence of Salzmann’s nodules, small inflammatory nodules on the anterior lens capsule, may require careful management. We may opt for meticulous capsule polishing techniques during cataract surgery to minimize the impact of these nodules. Attention to detail in surgical planning and execution ensures successful visual rehabilitation in patients with this condition.

Cataract surgery in individuals with dry eye syndrome involves preoperative strategies to optimize ocular surface health. Lubricating eye drops, punctal plugs, or anti-inflammatory medications may be prescribed to manage dry eye symptoms before and after surgery. We may also employ techniques to minimize the disruption of the tear film during the procedure, promoting a more comfortable recovery.

Cataract surgery in individuals with MGD, a common cause of evaporative dry eye, may involve preoperative measures to improve gland function. Warm compresses, lid hygiene, and therapeutic agents are often recommended. We may address MGD-related symptoms to enhance postoperative comfort and optimize visual recovery.

Cataract surgery in individuals with EBMD requires careful attention to the corneal epithelium. Techniques such as gentle epithelial debridement and the use of protective measures like bandage contact lenses may be employed to minimize complications and ensure optimal visual outcomes in individuals with EBMD.

Cataract surgery in individuals with ocular herpes simplex virus (HSV) requires special consideration to prevent viral reactivation. Antiviral medications may be prescribed before and after surgery, and we may take precautions to minimize trauma to the cornea, where the virus may reside. Close monitoring and proactive management help mitigate the risk of herpetic complications during the cataract surgery and recovery process.

A congenital cataract is present at birth or develops during childhood, affecting the eye’s natural lens. Special considerations for cataract surgery involve early intervention to prevent amblyopia (lazy eye) and choosing an appropriate intraocular lens (IOL) to support visual development in pediatric patients.

A posterior polar cataract is a specific type where opacities form at the back of the lens capsule. Special precautions during cataract surgery are required to avoid disrupting the posterior capsule and causing complications such as posterior capsule rupture. We employ advanced surgical techniques to ensure careful removal.

Dense cataracts have a high degree of opacity, making them challenging for standard cataract surgery. Special considerations involve using advanced phacoemulsification technology and techniques to efficiently break down and remove the dense cataract material while minimizing stress on the eye.

White cataracts are characterized by a milky or white appearance, reducing visibility during surgery. We may adjust our surgical approach to enhance visualization, utilizing appropriate lighting, and potentially employing femtosecond laser technology for precise incisions in order to safely and effectively remove the cataract.

Traumatic cataracts result from eye injuries and may present unique challenges in cataract surgery due to associated ocular damage. Special considerations involve addressing any additional eye injuries, carefully assessing the extent of trauma, and planning the surgery to optimize outcomes while managing potential complications resulting from the injury.

Radiation cataracts develop as a result of exposure to ionizing radiation, such as in cancer treatments. In these cases, we’ll work to assess the impact of radiation on ocular tissues, choosing appropriate surgical techniques, and implementing measures to minimize the risk of radiation-related complications during cataract surgery.

Pseudoexfoliation cataracts are associated with the presence of abnormal protein deposits on ocular tissues. With careful management of weak zonules, we can minimize potential complications during surgery. Techniques such as capsular tension rings may be used to stabilize the lens capsule and enhance surgical outcomes.

Subluxed or dislocated cataracts occur when the natural lens shifts or partially dislocates within the eye. We’ll work to assess the degree of subluxation and plan surgical maneuvers to address the displaced lens, as well as potentially use additional devices or techniques to stabilize the lens during cataract surgery.

Cataract surgery in patients with ptosis, or a droopy eyelid, may require additional considerations to address both visual and cosmetic concerns. We may collaborate with oculoplastic specialists to determine whether ptosis correction should be performed concurrently with cataract surgery, ensuring optimal functional and aesthetic outcomes.

Cataract surgery following Bell's Palsy, a condition affecting facial nerves, requires careful evaluation of facial muscle function and tear production. We can coordinate with neurologists or facial rehabilitation specialists to assess and address any residual facial weakness. Consideration of facial symmetry and tear film stability is crucial in optimizing visual outcomes post-cataract surgery.

Cataract surgery after eyelid lift surgery (blepharoplasty) involves strategic planning to ensure harmony between the rejuvenated eyelid appearance and the intraocular lens choice. For these patients, we aim to achieve both functional improvement through cataract removal and aesthetic balance by preserving the results of eyelid lift surgery.

Cataract surgery in individuals who have undergone BOTOX injections requires careful consideration of the effects on periocular muscles. We may need to adapt surgical techniques to address altered muscle dynamics and ensure a comprehensive preoperative assessment is taken to optimize surgical outcomes.

Cataract surgery in individuals with Grave’s disease, an autoimmune condition affecting the thyroid and eye muscles, demands a meticulous approach. By coordinating with endocrinologists and oculoplastic specialists, we can address potential complications related to eye muscle involvement.

Cataract surgery in individuals with deep-set orbits may present challenges due to limited access and potential for glare. Specialized surgical techniques, including careful incision planning and intraocular lens selection, aim to optimize visual outcomes while addressing the anatomical challenges associated with deep-set eyes.

Cataract surgery in small eyes requires customized planning to accommodate the reduced ocular dimensions. Smaller incisions and specific intraocular lens choices may be made to ensure a safe procedure and enhance visual outcomes.

Cataract surgery in individuals with strabismus, or crossed eyes, may involve collaboration with strabismus specialists. In these cases, we aim to optimize ocular alignment and visual outcomes through careful intraocular lens selection and surgical planning. Addressing both the cataract and strabismus concurrently contributes to comprehensive visual rehabilitation.

Cataract surgery in individuals with nystagmus, or involuntary eye movements, may involve coordination with neurologists or specialists in eye movement disorders. We may adapt our surgical techniques to account for rhythmic eye movements, ensuring safe and effective cataract removal while addressing the unique challenges associated with nystagmus.

Allergies to specific eye drops, such as nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, benzalkonium chloride (BAK) preservatives, or antibiotics, may necessitate tailored preoperative planning for cataract surgery. Substituting allergen-free medications, utilizing preservative-free formulations, or employing alternative medications can help prevent adverse reactions during the surgery.

Allergy to povidone iodine, commonly used as an ocular antiseptic, may necessitate alternative antiseptic solutions, such as chlorhexidine or hydrogen peroxide. A thorough [reoperative assessment will ensure a safe and aseptic environment during cataract surgery for individuals with this specific allergy.

Allergy to sodium hyaluronate, a common component in viscoelastic solutions used during cataract surgery, necessitates adjustments in the choice of intraocular substances. Utilizing alternative viscoelastic agents without sodium hyaluronate, such as hydroxypropyl methylcellulose (HPMC) or chondroitin sulfate, can mitigate allergic reactions.

Cataract surgery in individuals with uveitis, or inflammation of the uvea, demands careful preoperative management to control inflammation. Collaborative efforts with rheumatologists or immunologists may involve optimizing systemic treatment. We can attune our surgical techniques and postoperative anti-inflammatory measures to this issue so we can prevent uveitic flare-ups and ensure successful visual outcomes.

Cataract surgery after BrightOcular color-changing iris implant is possible, although it poses several challenges and requires careful consideration. Potential complications include difficulty in visualizing structures, altered anatomy, and increased risk of complications like bleeding or damage to the implant. At Eye Center of New York, we employ specialized surgical techniques to address the unique challenges posed by the implant, carefully planning the procedure to minimize risks and optimize outcomes.

Cataract surgery in individuals with aniridia, a congenital absence or partial absence of the iris, requires careful planning due to associated visual challenges. Intraocular lens selection is crucial to minimize light sensitivity and optimize visual outcomes. Collaborative care with low vision specialists may be beneficial in maximizing visual rehabilitation for individuals with aniridia undergoing cataract surgery.

Cataract surgery in individuals with Marfan's syndrome, a connective tissue disorder, necessitates consideration of ocular manifestations such as lens subluxation. Coordination with geneticists and cardiovascular specialists is essential for comprehensive preoperative assessment. We ensure the right surgical techniques and intraocular lens choices are used to address the unique challenges associated with cataract surgery in individuals with Marfan's syndrome.

Cataract surgery in individuals with iris or lens coloboma, characterized by a gap or defect in these structures, requires a customized approach. Preoperative assessments focus on the extent of the coloboma and associated visual implications. Surgical techniques may involve iris reconstruction or specialized intraocular lens placement to optimize visual outcomes in these cases.

Cataract surgery in individuals with a small pupil poses challenges during surgical visualization and maneuverability. We employ specialized techniques, such as iris expansion devices or pharmacological agents to dilate the pupil, to overcome these challenges.

Cataract surgery in individuals with a lazy eye (amblyopia) involves strategic planning to optimize visual outcomes. Coordination with pediatric ophthalmologists may be necessary, especially if amblyopia developed during childhood. We may consider additional interventions, such as patching or vision therapy, to enhance visual rehabilitation in conjunction with cataract surgery.

Cataract surgery in individuals with strabismus, misalignment of the eyes, may require collaboration with strabismus specialists. At the Eye Center of New York, we aim to optimize ocular alignment through careful intraocular lens selection and surgical planning. We can address both the cataract and strabismus concurrently to offer our patients comprehensive visual rehabilitation in these cases.

Diabetes can impact ocular health, leading to the development of cataracts. At the Eye Center of New York, we provide comprehensive care for diabetic patients. Our integrated approach utilizes advanced technology and surgical techniques, considering the unique needs of diabetic individuals.

Collaboration with endocrinologists and diabetic care specialists is integral to our approach. By addressing both the cataracts and the diabetic condition, we strive to improve overall eye health and maintain optimal vision for diabetic patients.

Cataract surgery in the presence of pseudoexfoliation involves addressing a condition where abnormal protein deposits accumulate on the lens surfaces. During the surgery, special attention is given to managing the potential complications associated with pseudoexfoliation, such as weak zonules, by employing techniques like capsular tension rings to ensure optimal outcomes.