Our Surgical Center

The PanOptix® lens is the first and only trifocal lens available in the United States. It is the latest advancement from the Acrysof® Family of Lenses – the most implanted cataract replacement lenses worldwide. Dr. Doxanas has had great success with these new lenses. They even make a lens for patients with astigmatism. With the PanOptix lens, you can gain increased independence from glasses – even if you have astigmatism.

Why you can take comfort in the AcrySof® PanOptix® lens:

• The AcrySof® PanOptix® lens comes from Alcon, the world’s leader in lenses for cataract surgery.
• The Alcon AcrySof® family of lenses is the most widely used brand for cataract surgery.
• The history of the AcrySof® family of lenses speaks for itself: more than 100 million AcrySof® IOLs have been implanted worldwide.

In a clinical study, 129 patients were asked about their experience with the PanOptix® Lens:

• 99% of people with the PanOptix® Lens would choose the same lens again
• 98% of people with the PanOptix® Lens would recommend it to family and friends
• 80.5% of people with the PanOptix® Lens reported that, within the past week, they never had to wear glasses to see

For more information, go to www.mycataracts.com

References

1. Alcon flagship AcrySof intraocular lens reaches 100 million implants and counting [news release]. Fort Worth, TX: Alcon Laboratories,
   Inc; September 29, 2017. https://www.alcon.com/media-release/alcon-flagship-acrysofr-intraocular-lens-reaches-100-million-implants-and-counting. Accessed March 18, 2019.
2. AcrySof^® IQ PanOptix^® Directions for Use.
3. Groessl EJ, Liu L, Sklar M, Tally SR, Kaplan RM, Ganiats TG. Measuring the impact of cataract surgery on generic and vision-specific quality of life. Qual Life Res. 2013;22(6):1405–1414. doi:10.1007/s11136-012-0270-z.
4. Kohnen, Thomas. (2015). First implantation of a diffractive quadrafocal (trifocal) intraocular lens. J Cataract Refract Surg. 41. 2330-2332. 10.1016/j.jcrs.2015.11.012.

The AcrySof® ReSTOR® lens is a breakthrough lens for cataract surgery that lets patients see from near to far, usually without glasses. An innovative optical technology called “apodization” makes the AcrySof® ReSTOR® lens uniquely effective, especially when placed in both eyes. A similar technology has been used for years in microscopes and telescopes to improve image quality and has now been patented for use in intraocular lenses by Alcon. Most AcrySof® ReSTOR® lens patients find they can read a book, work on the computer, drive a car- day or night- and play golf or tennis with an increased freedom from glasses. You may experience visual disturbances. Additionally, some side effects with AcrySof® ReSTOR® IOL may make it more difficult to see in low lighting conditions; therefore, increased care should be taken when driving at night.

To see a simulation of how AcrySof® ReSTOR® can improve your vision after cataract surgery, head over to Alcon’s website here.

Why you can take comfort in the AcrySof® ReSTOR® lens:

• The AcrySof® ReSTOR® lens comes from Alcon, the world’s leader in lenses for cataract surgery.
• The Alcon AcrySof® family of lenses is the most widely used brand for cataract surgery.
• The history of the AcrySof® family of lenses speaks for itself: more than 100 million AcrySof® IOLs have been implanted worldwide.
• AcrySof® ReSTOR® patients are so please with their vision, nearly 94% said they would have the AcrySof® ReSTOR® implanted again.
• The AcrySof® ReSTOR® lens is an advanced type of multifocal IOL. But it may not be right for you. Talk to you eye care professional about the options within the AcrySof® family of lenses for your cataract surgery.

In choosing your cataract replacement lenses, your eye care professional will take into account many aspects of your eye health. But you will also be asked to consider your lifestyle. How much reading or computer work do you do? What are your hobbies? Do you drive at night?

You can find out more at https://www.mycataracts.com/

The Acrysof® Toric lens is a foldable, single piece intraocular lens that an eye surgeon implants during cataract surgery to replace the clouded lens. The unique design of the Acrysof® Toric IOL makes it possible to reduce or eliminate corneal astigmatism and significantly improve uncorrected distance vision. Acrysof® Toric lens provides QUALITY distance vision, independent of eyeglasses and contact lenses. The Acrysof® Toric lens is made of the same biocompatible lens material already successfully implanted in more than 25 million eyes since 1991. Sometimes, the surface of the cornea is curved more like a football, with both flatter and steeper curves. When the surface of the cornea has an uneven curvature, vision becomes distorted. This common irregularity, called a “corneal astigmatism,” causes blurred or distorted vision because lights rays are not focused at one spot to provide clear vision. A person who has both a cataract and a corneal astigmatism will not regain high-quality distance vision after surgery to remove the cataract unless the astigmatism is also corrected.

The proven performance of Acrysof® Toric lens can allow you to meet your vision goals with less dependence on glasses for distance vision.^1,2

More than nine out of 10 cataract patients achieve distance vision of 20/40 or better

To see a simulation of how AcrySof® Toric lens can improve your vision after cataract surgery, head over to Alcon’s website here.

You can find out more at https://www.mycataracts.com/

References

1. AcrySof^® IQ Toric IOL Directions for Use.
2. Lane SS, Ernest P, Miller KM, Hileman KS, Harris B, Waycaster CR. Comparison of clinical and patient reported outcomes with bilateral AcrySof^® Toric or spherical control intraocular lenses. J Refract Surg. 2009;25(10):899-901.

^†Compared to a monofocal IOL.

The LenSx laser is an advanced precision based technology that operates with unmatched precision. The LenSx laser adds computer control to keys steps of the cataract surgery. Its unique software control system analyzes high resolution OCT images of the eye. This helps the surgeon to design a customized procedure visualizes and performs the procedure on command from the surgeon. To further enhance accuracy, a patient interface connects your eye to an image guided surgical unit. This ensures that both the LenSx laser and the surgeon commanding it have precise, real time images at all times during the laser procedure.

Benefits of laser assisted cataract surgery:

• A bladeless, advanced procedure,
• Critical parts of the operation: incisions, capsulorhexis and lens fragmentation are precisely performed,
• Personalized surgical experience,
• Comfortable, relaxed setting.

Laser assisted cataract surgery is a new and exciting technology that will revolutionize cataract surgery. Similar to LASIK refractive surgery, the normal approach was to use a blade keratotome to create a corneal flap prior to corneal ablation. A femtosecond laser was then developed to create a flap (intralase) with dramatic improvement in efficacy and long term results. We now have a similar situation with cataract surgery. The LenSx, femtosecond laser, in association with advanced computer and imaging technology, will create a more predictable cataract procedure. There are only 100 LenSx lasers in the United States and Baltimore Eye Physicians is proud to be at the forefront of this technology.

Complete eye health includes healthy eyes and healthy eyelids. Common eyelid problems include excessive eyelid skin and droopy eyelids (ptosis). Ptosis can cause eye discomfort, limit vision, and affect appearance. Fortunately, it can be identified and corrected appropriately. This is often covered by medical insurance if the symptoms are affecting your lifestyle. Surgery to improve the appearance of the eyelids is called blepharoplasty. The goal of the procedure is to remove extra skin, muscle, and fat to achieve a more youthful appearance. Early in Dr. Doxanas’ career he recognized the role of the eyebrows which accentuates upper eyelid abnormalities. Failure to recognize eyebrow changes compromised surgical results.  As such, the eyebrows and the eyelids are considered as a functional unit.  Anatomic studies have identified the eyebrow fat pad in the lateral 2/3 of the brow as an important factor in brow contour and fullness. Patients with prominent low-set brows generally have a more pronounced brow fat pad. As such, the transeyelid brow elevation procedure was developed. In conjunction with a standard blepharoplasty, and through the same eyelid crease incision, the brow is addressed. Dissection is carried above to the eyebrow allowing debulking or sculpting of the brow fat pad and elevation. A second or separate procedure for brow elevation are therefore avoided. This combined procedure is a much more efficient means of brow elevation, much less expensive, and less invasive than the standard option.  Attention to the eyebrow position will result in a more youthful and permanent result.

Before   

After      

Before  

After     

Dr. Doxanas is a Board certified ophthalmologist with a special interest in eyelid surgery.  Fellowship trained in eyelid surgery, he is also certified by the American Society of Ophthalmic Plastic and Reconstructive Surgery. Practicing for over thirty years, he specializes not only in the functional, but cosmetic anomalies of the eyelids. Pioneering new approaches to eyelid surgery, he wrote a book, Clinical Orbital Anatomy and contributed approximately 40 additional scientific articles and chapters, most of which are related to eyelid abnormalities.

A posterior capsulotomy is a surgical procedure that is sometimes necessary after cataract surgery. A cataract surgery removes a cataract (the cloudy lens causing blurred vision) from its cellophane-like lining called the lens capsule. An artificial lens (called an intraocular lens, or IOL) is then inserted into the capsule to replace the natural lens. Weeks to years after cataract surgery, the capsule may become cloudy or wrinkled and cause blurred vision.  If your vision becomes worse after cataract surgery, it is important to contact your ophthalmologist. If a cloudy or wrinkled capsule is discovered, a posterior capsulotomy may be recommended when you are not able to see well enough to do things you like or need to do. A posterior capsulotomy is a simple laser procedure that makes an opening in the back , or posterior, part of the capsule to restore your normal vision. A special laser is targeted at the back of the capsule and makes a small opening. The technique is painless and only takes a few minutes. It is performed on an outpatient basis, in our surgical center. Anesthesia, if necessary, is applied using eye drops. You should notice improved vision quickly, if there are no other problems with your eye. Unless your doctor advises otherwise, normal activities can usually be resumed immediately.

As with any surgical procedure, rare complications can occur, including:

• Detachment of the retina (symptoms of a retinal detachment may include a curtain or cobweb that goes across your vision, or the sudden appearance of many floaters in your vision);
• Increased intraocular pressure;
• Dislocation of the IOL through the posterior capsule opening;
• Inflammation in the eye, possibly requiring treatment with steroid eye drops.

Be sure to discuss potential complications with your ophthalmologist before surgery.

Laser iridotomy is a surgical procedure used to treat angle-closure glaucoma. This laser procedure is also performed in patients who are at risk for angle-closure glaucoma. As with many medical conditions, it is preferable to treat patients at risk and thereby avoid vision loss. Using a laser, a small hole is made in the iris to create a new pathway for the aqueous fluid to drain from your eye. The new drainage hole allows the iris to fall back into its normal position, restoring the balance between fluid entering and leaving your eye and lowering the eye pressure. The surgery is performed by your ophthalmologist on an outpatient basis. Your eye will be numbed with eye drops. A contact lens is placed on your eye to precise guide for the laser. A hole about the size of a pinhead is made in your iris. The actual procedure will only take a few minutes. You should have someone drive you home afterwards.

What is a laser trabeculoplasty?

Laser trabeculoplasty is a type of eye surgery that treats open-angle glaucoma. With glaucoma, aqueous humor does not drain properly from the front of the eye. Pressure builds in the eye, which damages the optic nerve. If it is not treated, glaucoma leads to blindness. Laser trabeculoplasty helps fluid drain properly again, lowering your eye pressure.

No treatment can fix damage already done to the optic nerve. But laser trabeculoplasty can help prevent further damage from glaucoma.

In open-angle glaucoma, fluid does not flow out of the eye as well as it should through the drainage angle.

How is laser trabeculoplasty performed?

Laser trabeculoplasty is done in an outpatient surgery center. Your eye surgeon uses laser energy to treat your drainage angle. This makes the drainage angle work better over time, helping to lower eye pressure.

A laser treats the trabecular meshwork so that fluid flows out of the eye as it should through the drainage angle.

Eye Words to Know

Optic nerve: A nerve at the back of your eye that connects to your brain. The optic nerve sends light signals to your brain so you can see.

Aqueous humor (“aqueous”): Clear liquid inside the front part of our eyes. It nourishes the eye and keeps it inflated. Aqueous is different from tears, which are outside the eye.”

Drainage angle: The area of the eye where the aqueous humor drains from the front of the eye.