Cataract Surgery Los Angeles Best Surgeon Techniques

What are the options for fixing a dislocated lens implant after cataract surgery in Los Angeles?

 I saw a patient recently, with a history of complicated cataract surgery. His cataract surgery was done in Beverly Hills by a good surgeon but he experienced some difficulties after surgery.  His lens implant (IOL = Intra-Ocular Lens) was dislocated and he couldn’t see well.

He had an IOL placed in the sulcus, then a pars plana vitrectomy with silicone oil, then finally a procedure to remove the silicone oil. He was left with an inferiorly dislocated lens implant — often termed a sunsetting IOL since it looks like the sun slipping below the horizon.

The patient was symptomatic from this displaced lens which was now slipping below his visual axis. And the droplets of silicone oil on the silicone IOL didn’t help things either.

A sunsetting IOL which is now moving out of the visual axis and is inducing chronic inflammation in this eye. A droplet of silicone oil is noted on the anterior IOL surface.

What are the options for treatment?

1. Do nothing surgically, but the patient will continue to be plagued by visual problems and the IOL may sunset further and cause iris damage.

2. Suture the existing IOL to the back of the iris for stability, but what if one of the haptics is damaged? Can the silicone droplets be completely wiped free from the IOL?

3. Remove the existing IOL and suture a new three-piece acrylic lens to the back of the iris.

I’m inclined to recommend choice 3, but the challenge in that surgery will be keeping a formed globe during the procedure. For this, I will likely choose an anterior chamber maintainer to prevent this uni-cameral eye from becoming distorted or deflated during the IOL exchange procedure. Then the Osher modification of the Siepser knot technique will be used to suture the haptics to the iris.

I’m scheduled to see the patient again in the next few weeks, at which point we’ll talk more about the options and he’ll make an informed decision. I’ll let you know how it goes.

For more information, see here:
Uday Devgan MD, Cataract Surgery Specialist at the Maloney Vision Institute in Los Angeles

Cataract Surgery in Los Angeles with the ReZoom and ReStor Multifocal Lens Implants

There are many options to achieve a wide range of vision for patients who are planning cataract surgery. At the Maloney Vision Institute in Los Angeles, we are experts in the full spectrum of vision surgery, including all of the FDA-approved premium lens implants, including the Crystalens HD (Crystal Lens HD) by Bausch & Lomb, the ReZoom Multifocal Lens by Advaned Medical Optics (AMO), and the Acrysof ReSTOR (ReStore) Aspheric Multifocal Lens by Alcon Laboratories.

The Acrysof ReSTOR (ReStore) Multifocal Lens implant by Alcon is implanted in this eye — notice the bulls-eye rings in the center of the lens — these give the near vision in addition to the distance vision. http://www.acrysofrestor.com/

The ReZoom Multifocal Lens implant by Advanced Medical Optics (AMO) has 5 zones on the lens providing vision for near, intermediate, and distance ranges.  http://www.rezoomiol.com/

All of these lenses are implanted at the time of cataract surgery in order to give a wide range of vision.

Q: How do you know which lens is best for you?

A: You need a thorough eye examination, consultation, eye measurements, and a discussion with an eye surgeon who specializes in vision surgery to determine which lens will best suit your needs and your individual eyes.

For a Free Cataract Book and more information, contact the Maloney Vision Institute at telephone 310-208-3937 or visit our website at http://www.MaloneyVision.com

The Best Cataract Surgery Requires the Best Optics and Best Equipment in Los Angeles

A highly-skilled, top-rated surgeon requires the best optics and best equipment possible in order to produce the best results — and that means the safest surgery with the best vision for the patient. For a general eye doctor, who does a few surgeries, gives glasses, treats itchy eyes, and concentrates on general eye checks, it’s just not possible to purchase these technologies. For a surgeon who specializes in just vision surgery, like Uday Devgan MD, of the Maloney Vision Institute, several million dollars have been invested in just purchasing the best lasers, the best optics, the best equipment, and the best technology for ocular surgery.

Among the newest equipment are the two new Zeiss Lumera Surgical Microscopes — each one costing more than a new BMW. This revolutionary new microscope allows for better visualization of surgery and makes the surgery safer for the patient.

the OLDER microscopes give a dim view during surgery.

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The NEW Zeiss Lumera Microscope gives the best view during cataract surgery in Los Angeles surgeon Uday Devgan MD’s practice.

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If you’re thinking about cataract surgery, make sure that you select a surgeon who specializes in just ocular surgery and has invested in the best equipment possible. There’s a reason why more than 100 eye doctors and their families have had their eye surgery done with Dr Uday Devgan and Dr Robert Maloney at the Maloney Vision Institute in Los Angeles.

For a Free Cataract Book and more information contact us at telephone 310-208-3937 or visit our website at http://www.MaloneyVision.com

Prof visits Los Angeles Cataract Surgeon to learn Crystalens HD (Crystal Lens Implant) Cataract Surgery Best Techniques

Japan is a very high-tech place — you can see the engineering in the cars and electronics that they build. Cataract Surgery in Japan is also high-tech and Bausch & Lomb is launching the Crystalens HD (Crystal Lens Implant) Accommodating Lens by starting with the best. Professor Kanjiro Masuda MD is Chief of Cataract Surgery at the University of Tokyo, and to learn about the Crystalens HD first-hand, he came to Los Angeles to the Maloney Vision Institute to visit Uday Devgan, MD, FACS.

 

 Since we have been using the Crystalens (and now the Crystalens HD) for years, we were able to show this famous Japanese surgeon many patients with superb results years later. He had seen my picture on the official Crystalens website (www.Crystalens.com - and click on “For Professionals”) from Bausch & Lomb.

The new Crystalens HD is the only FDA-approved accommodating lens implant — it gives a wide range of vision to patients undergoing cataract surgery in Los Angeles at the Maloney Vision Institute (www.MaloneyVision.com for more info). If you can understand some of the technical information, you can also see the Bausch & Lomb Surgical website:

http://www.bauschsurgical.com/cataract/crystalens/default.aspx

here’s a picture of this new Crystalens HD (Crystal Lens Implant) for Cataract Surgery in Los Angeles:

 

If you’d like more information and a free cataract book, please contact the Maloney Vision Institute in Los Angeles at 310-208-3937 or www.MaloneyVision.com

Theme Directory

It’s been a long time since themes.wordpress.net stopped accepting new themes. Since then most theme authors have been distributing their themes from their own sites, without a good centralized place for people to browse, search, comment on, and rate themes. With the success of the plugins directory, we’ve wanted to have those same benefits in a theme directory. Today is the day we start making that happen, with the introduction of wordpress.org/extend/themes/.

Bringing the new theme directory under the WordPress “extend” umbrella allowed us to take advantage of all the infrastructure that has already been built up to support WordPress.org. If you’ve browsed through the plugin directory, you’ll feel right at home in the new theme directory.

We’ve gone through great lengths to make this as painless as possible for theme authors. You don’t need to know anything about Subversion (our back end magic takes care of all that for you), just login with your WordPress.org username and password and go to the upload page. From there you upload your regular theme zip file and we take care of the rest.

Once you upload your new theme we do a few automated checks for some of the requirements for each theme. If we find one that you missed we’ll provide you an error and description of what needs to be fixed. When a theme upload has been accepted we’ll send you an email and put it in the queue to be reviewed, to make sure we didn’t miss anything. After the theme has been approved you’ll get another email letting you know that the theme is now live.

That catches you up to where we’re at today. When you finish that theme you’ve been slaving over, upload it to the new directory and let us know what you think. Since so much has changed since the old theme directory we’re starting fresh from zero. If you’ve got specific questions or suggestions contact us and we’ll do our best to get them answered.

In Los Angeles, to be your best as a surgeon for Cataracts, Cataract Surgery, and ICL Implantable Contact Lens Surgery, you need skills >>>

And what’s the most demanding surgery in ophthalmology? The very difficult “Ruptured Globe” — that’s what we eye surgeons call an eye (”The Globe” in ophthalmologist lingo) that has suffered such severe trauma that it literally gets ruptured open. These injuries are serious emergencies and they demand the very best in surgical skills — often in the middle of the night.

I truly enjoy ocular surgery — it’s my passion. And while I spend most of my week in private practice in Los Angeles, at the Maloney Vision Institute, I am also Chief of Ophthalmology at Olive View UCLA Medical Center, a large Los Angeles county hospital and part of UCLA Medical School. It’s the place where the UCLA resident eye surgeons / ophthalmologists get the lion’s share of their surgical training and I’m fortunate to be in charge.

At Olive View UCLA Medical Center, I teach techniques of intra-ocular surgery to the UCLA ophthalmologists every week — everything from cataract surgery to complex ocular reconstruction. I started the first program in the US to teach resident eye surgeons how to implant and use the new accommodating lens implants (such as the Crystalens, Crystalens HD, and Crystal Lens) as well as multi-focal lens implants (AMO ReZoom, Alcon ReSTOR, AMO Tecnis are examples). But I also enjoy teaching techniques of ocular reconstruction after trauma. Some people call me crazy since I do a large amount of the ocular trauma surgery in Los Angeles for zero surgeon fee. Charity is important, particularly for those patients without an medical insurance who are in critical condition from trauma.

So it’s the July 4 weekend and I’m fast asleep. At 3:30 AM I receive a phone call from one of the doctors about a severe ocular trauma — a young man was at a party and he was attacked and hit in the face with a glass bottle. The result was severe facial and ocular trauma — the eye was ruptured and his vision was lost. If you are really itching to see the picture of the trauma, email me at info@maloneyvision.com and I’ll send you a link. The patient was induced into a deep sleep with anesthesia and the eye was completely numbed. A clean, sterile blue sheet was placed over his body with only his eye exposed in order to keep things free from infection.

The challenge in this situation is to repair the eye and restore as much vision as possible. This requires extensive intra- ocular surgical skills since repairing these eyes is technically quite difficult. This surgery required three hours — compare that to the 5 or 10 minutes needed for a routine cataract surgery, or the 3 to 5 minutes needed for an ICL Implantable Contact Lens Surgery or a LASIK Surgery. In the end, the lacerated, ruptured eye was successfully repaired and I’m hopeful that the patient will recover some vision, particularly after another future reconstructive procedure. Of course, it’s far better to avoid trauma, especially when it comes to your eyes, but rest assured that in dire emergencies like this, there are surgeons who will happily help you — and for free. For the other eye surgeons that may be reading this blog, if you would like to volunteer your services to help these patients with ruptured globes, please contact me.

So what does all of this have to do with Cataract Surgery, Crystalens HD Surgery, Visian ICL Implantable Contact Lens Surgery, or even LASIK Surgery in Los Angeles? Your visual results after ocular surgery are directly dependent on the technical skills and judgment of your surgeon. And the most challenging ocular surgery, requiring the highest level of surgical skill, is severe ocular trauma.

If you would like more information about ocular surgery, or for a free copy of our Cataract Book, please contact us at http://www.MaloneyVision.com or via telephone at 310-208-3937.

“I need the best eye surgeon in Los Angeles to help my 8 year old son!”

This was the cry for help from a very sweet and concerned mother who had seen literally a dozen different eye doctors looking for who she felt was the best eye surgeon in Los Angeles. Am I the best eye surgeon in Los Angeles? There’s no way to know, but this patient’s vote of confidence and the more than 100 other eye doctors who have had surgery at my private practice lead me to believe that we’re certainly in the running. If this lady has confidence in me and has hand selected me as the best eye surgeon for her son, then it is my duty to give her son the very best. She did not have private medical insurance to cover the cost of surgery — I told her not to worry, that it would be my pleasure to donate the surgery at no cost to her. Somethings in life are far more important than money, and that a large portion of my current surgical volume is, in fact, charity surgery.

Her son, Trevor, was born with ocular problems and lost the vision in one eye after a series of complicated surgeries done in another state. He now only had one eye and that eye had a congenital cataract that was becoming worse. Trevor was now 8 years old and the poor vision in his only remaining eye was limiting his school work and his learning was suffering. How could he be expected to learn how to read when he couldn’t even distinguish the letters?

Trevor is smiling, personable youngster and he has a great attitude despite having such a severe visual handicap. You can see a picture of his eye below. The large whitish/yellowish spot that is blocking his vision is the congenital cataract. I am using tiny instruments (smaller than a sewing needle) to carefully perform his surgery.

Trevor had an additional ocular problem called Posterior Lenticonus which makes his surgery far more difficult — literally, on a scale of 1 to 10 in difficulty, this case was an 11. This is why other surgeons had chosen not to do his surgery, but instead to refer him.

Cataract surgery in young patients is far more difficult than in adults due to the elastic nature of the children’s tissues. I have developed instruments and techniques to successfully do these challenging cases.

You can see my instrument line (The Devgan Signature Series) from Storz.com:

http://storz.com/productDetail.aspx?productId=1918

The best techniques for Trevor’s surgery would be the ones that I developed for use on newborn babies. See here for a landmark article that I wrote in the number one read eye surgery journal, Ocular Surgery News:

http://www.osnsupersite.com/view.asp?rID=21439

We gently induced a cozy sleep for Trevor with the anesthesia and then I performed his surgery. It took only minutes and it was done without bleeding and without sutures.

If you would like to see a video of Trevor’s surgery, you can view it on youtube:

http://www.youtube.com/watch?v=_HKu9Q7ld3Q

It’s a video that is intended to teach other eye surgeons so it is graphic and has technical surgical descriptions.

When he woke up from the anesthesia, we knew that we had succeeded — Trevor smiled and literally asked, “Oh my gosh, does everyone see this clearly!?!”

This is an actual picture of Trevor’s eye just after the surgery. You can see that the whitish spot from the cataract is all gone and his eye looks crystal clear. The tiny amount of redness at the upper right corner is from the antibiotic medication I put to prevent an infection since it’s his only eye.

So who’s the best eye surgeon in Los Angeles — you may never know, but Trevor and his Mom certainly believe that they do!

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If you know of someone who has an extremely difficult cataract or other visual problem, we would be happy to see them for a free consultation. If you simply have a regular, adult, age-related cataract and you’re seeking cataract surgery, then your case will be far easier. While 90% of my private practice is for routine adult cataract surgery, LASIK surgery, and ICL implantable contact lens surgery, I truly enjoy the 10% of cases that are challenging.

For more information and a FREE Cataract Book, contact Uday Devgan MD at the Maloney Vision Institute in Los Angeles at 310-208-3937 or http://www.MaloneyVision.com

“I had cataract surgery done elsewhere and I’m not happy…”

I recently saw a very nice patient — a 68 year old retired executive who had cataract surgery done elsewhere. The surgery looked reasonable and I think the surgeon did a competent job. But the patient was not happy since his resultant vision was not what he wanted.

 The patient received multi-focal lens implants, which are lenses that split the incoming light into zones: one for reading (about 15 inches away) and the other for distance (about 20 feet away). This works well for some patients as long as they understand the limitations: these multi-focal lenses can cause visual side-effects like glare or halos. For this particular patient, he had done lots of research and he asked his original cataract surgeon to take the multi-focal lens out and to replace it with a full-range FDA-approved accommodating premium lens implant. The surgeon referred the patient to me.

Performing a lens exchange (often called an “IOL Exchange” since IOL is the medical abbreviation for Intra-Ocular Lens) is a challenging surgery and many surgeons prefer to refer these to a specialty center like the Maloney Vision Institute in Los Angeles.

I examined the patient and I determined that she would benefit from the IOL Exchange Surgery — a tricky procedure, but I get referred patients like this frequently. So commonly that I literally have written an article about my best technique for this surgery in a medical journal called Review of Ophthalmology.

Click here to read the article: http://www.revophth.com/index.asp?page=1_13612.htm

The following are intra-operative photos of the technique of IOL Exchange:

• step 1: gently dissect the old multi-focal lens free
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• step 2: put in the new Crystalens high quality optic lens implant
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• step 3: take out the old lens implant
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• step 4: at the end of the case, the eye looks great
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I have a teaching video of how to perform this surgery (it’s designed to teach other eye surgeons, so the video is graphic and the terminology is technical):

http://youtube.com/watch?v=uH0ZKfUF3k4

The patient did great and was quite pleased with the resultant outcome. If you have a similar situation and you’d like to speak with patients who have undergone IOL exchange, or receive a free cataract book please contact us at http://www.maloneyvision.com

Diamonds for the Best Cataract Surgery Results in Los Angeles

I know what you’ve been told, “Diamonds are a girl’s best friend”.

  

But even more importantly,

 Diamonds are a Cataract Surgeon’s Best Friend.

Q: How do you do a cataract surgery, which means removing the old cloudy human lens (the cataract) and replacing it with a crystal clear man-made lens implant, without ever using a steel blade to cut the eye?

A: You use a gem-quality diamond — it’s tiny (less than 1/8 of an inch wide) and it’s super thin (thinner than a sheet of paper), and it allows the cataract surgeon to enter the eye painlessly and without bleeding. It’s much finer and more precise than using an old-fashioned steel blade, but the cost is 500x more so only select surgeons opt to spend the money for the diamonds. A full set of diamonds for cataract surgery costs as much as a new BMW, thus limiting their use to just the super specialists.

In the picture above: the diamond has a gold handle and the diamond itself is clear and gem-quality. I have drawn a dotted green box over the diamond tip so you can see how it works. The ring device is to hold the eye still. The patient feels nothing and sees nothing.

I used the best diamonds (Swiss made) when I did my own father’s cataract surgery, and I do the same for every patient’s surgery.

They’re your eyes — and your eyes deserve the best.

Teaching the Best Surgeon Techniques of Cataract Surgery in Los Angeles

I truly enjoy teaching techniques of cataract surgery here in Los Angeles at local meetings and as Chief of Eye Surgery / Ophthalmology at a major UCLA Hospital, but also across the country, and around the world. Just put “Uday Devgan” into google.com and see what I mean:

Click here to Google search “Uday Devgan”

The important thing to remember about any medical, surgical, or technical field is that evolution of the techniques is constant. The way I do surgery now is definitely not the way I did it 10 years ago. The technique evolves to become better, safer, less invasive, and with better quality vision every year.

This evolution towards the best cataract surgery technique consists of:

• the best surgical equipment
• the best surgical technique
• the best surgical private practice
• the best surgical staff and clinic faculty
• the best surgical judgment and committment to the patients

I think that it’s not possible for an ophthalmologist (an Eye MD) to be in expert in everything from glasses to contacts, allergies to astigmatism, glaucoma to cataracts, retinal disease to cross-eye kids, etc. If you’re a jack of all trades, you may be a master of none.

This is why the Maloney Vision Institute is dedicated to specializing in the surgical correction of vision. Our goal is to deliver the highest level of vision correction to our patients while giving them the best surgical experience — exactly the way we would do it for our own family members. I’ve done surgery on my father’s eyes and on Dr Maloney’s father’s eyes, and I give the same high level of care to every patient I see and every surgery I perform.  It’s the reason why more than 100 eye doctors and their family members have had surgery at the Maloney Vision Institute.

The best vision requires the best optics and the best surgical techniques.

see more at:

www.maloneyvision.com