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DR. JAMES GILLS: We use special lenses for special cases. Our philosophy is to do the best for the patient. We ask ourselves what we would want done for our eyes. Then we modify and use four different types of what we call premium lenses for the patient so that the patient can receive the best quality of vision, the safest quality of vision, and the least need for glasses. The first lens we use which is a premium lens is called a Tecnis lens. The Tecnis lens is a lens that the government has found to cause less glare at night when the patient drives. All lens systems cause glare at night. With cataracts that’s one of the first things that you notice is increased glare at night. Many times the glare will be worse after cataract surgery because the lens isn’t exactly refracted out right or there isn’t a tint on the glasses. But with the new Tecnis lens you have less glare and with this extra government reimbursement we pass it on to the patient at no extra charge to them. Many people charge extra for these things, we don’t charge extra for these. It is a special lens that gives the patient better quality of vision by FDA studies.

The second lens we use is called Collamer lens. It’s used for people with diabetes and many other conditions. Or silicon may be used. This Collamer lens works well when you have to use silicon and other surgeries. It also adheres to the capsule harder than any other lens. The Collamer lens is an exceptionally good lens when you have retinal complications. So it is another premium lens.

The third premium lens is the lens which I had talked about previously which is an astigmatism lens called a toric lens. The toric lens correct astigmatism. It will correct two and half diopters of astigmatism. You can basically use this lens along with a relaxing incisions and correct astigmatism. Their astigmatism correction may be one of the biggest factors for many patients that come here. Patients are referred here from all over the world for these astigmatism corrections and we may do five or six times the amount of astigmatism that is normally seen in a practice. As a result of this our astigmatic correction is very important and we are very proud of how well we can correct four, five, or ten diopters of astigmatism with a lens at the time of the cataract surgery.

The next type of lens that I really want to talk to you about is the Crystalens. It’s one of the most exciting things I’ve seen in the last two decades. The Crystalens is something that I would have today for my eyes if I could and needed surgery. It’s used even for people with clear lenses who want to get rid of glasses. We use this lens to enable people to have a better depth of focus. One of the biggest problems with people who have glasses after any type of cataract surgery in presbyopia they have a hard time focusing between their computer and their reading. When you focus on near vision with the crystal lens it can read the computer and the reading and all of this can be done without shifting back and forth. Then the lens can be modified for the distance intermediate and thus the patient has very little need of glasses. They may desire to utilize them for the first few years of driving and leave them in the car or on the dashboard. But the Crystalens has provided a better quality of vision for most patients than before they had the cataract surgery. So this is not only an improvement over their cataracts, it’s an improvement over where they were before cataract surgery. The people that don’t choose this lens come in two weeks or a month later and say, “Can I have my lens changed for a Crystalens?” And you say, “I’m sorry but we can’t do that and really be fair about it because it won’t get the same results as it should.”

The Crystalens has proved to be an excellent lens to enable people to be less dependant on glasses. Now there is a bigger biological variability in the refraction and secondary modifications and tweaking of their corrections are necessary probably in 10% of the cases. But this is well worth it because this one purchase, the Crystalens, is something that will be with you forever. You may go on vacation or buy a car. It costs the same thing as a Crystalens. The vacation is soon gone, the car you trade in shortly after. The Crystalens is with you for the rest of your life and it may be one of the most important decisions our patients make.