The doctors of Doctors Eye Institute have participated in clinical research for more than 25 years. They have helped develop many of the glaucoma medications currently prescribed for the treatment of glaucoma. Our involvement in clinical trials enables our doctors to provide patients with the newest and most predictable forms of treatment even before FDA approval. We have been able to reduce the number of drips required to control intraocular pressures from as many as four to only one, by testing combination therapies and longer lasting medications.

Participation by our patients gives them the opportunity to evaluate these medications, many times being compensated for their commitment to research. The most rewarding aspect of participation is the knowledge that you are able to enhance glaucoma treatment not only for yourself, but for your children and grandchildren as well. (Glaucoma is a hereditary disease.)

At this time we are screening patients for a new study that will begin in December 2008. This is a “comparison” study, meaning that we will compare the results of two already FDA approval formulas, Travatan Z and Xalatan. All patients will receive active medication throughout the study. It is a 3 month study requiring only 3 visits.

If you are currently using Xalatan only for IOP control and are interested in finding out more about this study, please call Dorothy Jett at (502) 891-3563.

Intraocular Lens (IOL)

 Apodized Diffractive
Apodization is the gradual tapering of the diffractive steps from the center to the outside edge of a lens to create a smooth transition of light between the distance, intermediate and near focal points. Diffraction involves the bending or spreading of light to multiple focal points as it passes through the lens. On the AcrySof® ReSTOR® IOL, the center of the lens surface consists of an apodized diffractive optic. This means that the series of tiny steps in that center area work together to focus light for near through distance vision.  

The refractive region of the AcrySof® ReSTOR® IOL bends light as it passes through the lens to a focal point on the retina. This outer ring of the AcrySof® ReSTOR® IOL surrounds the apodized diffractive region and is dedicated to focusing light for distance vision.

To learn more about the ReSTOR™ IOL go to:

http://www.acrysofrestor.com

Another “premium” IOL is the Crystalens manufactured by Bausch & Lomb.

Crystalens is an accommodating intraocular lens that, unlike a standard IOL, can treat both a person’s cataracts andpresbyopia—loss of near and intermediate vision. You probably noticed in your forties that you started to lose some of your up-close vision and had to start wearing reading glasses.

Crystalens not only treats your cataracts (a clouding or hardening of your lens), but can also reduce or eliminate your dependence on glasses. It does so by recreating accommodation similar to your eye’s natural lens. The unique Crystalens can reduce or eliminate glasses for most activities, including: reading a book, working on the computer, and driving a car.

Crystalens was modeled after the human eye. Like the natural lens, it uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs.

To learn more about the Crystalens IOL go to:

http://www.crystalens.com

Medicare Patients

Further good news is that the Centers for Medicare and Medicaid Services announced that they will now allow Medicare beneficiaries to choose these more expensive lenses as long as they pay for the extra cost themselves. Doctors and Medicare patients will have the freedom to select technology to treat cataracts that is consistent with the patient’s lifestyle. Previously, the government paid most of the price of treatment, including surgery, insertion of a traditional intraocular lens, and one pair of eye glasses or contact lenses. Doctors were not allowed to exceed Medicare’s established price for the procedure or to ask patients to make up the difference for the multifocal lens. Medicare patients couldn’t pay extra for a better lens even if they wanted to. Now the rules have changed.

In the past few years, some of patients chose us because they were looking for experience. Drs. Melvyn M. Koby and David W. Karp founded Doctors Eye Institute over 35 years ago.

They have been serving the Louisville area delivering the finest eye care using the latest technology available. Dr. R. Scott Hoffman joined the team over ten years ago and is now a full partner in the practice specializing in cataract surgery. 

Some patients chose us because they were looking for more than general eye care. They also want cosmetic eye care. Dr. Albert E. Smolyar offers his abilities as both an Ophthalmologist and a cosmetic eye surgeon to Doctors Eye Institute.

Other patients simply need routine eye exams for glasses and contact lenses. We are fortunate to have one of Louisville’s finest optometrists, Dr. Christopher Stroud, O.D. specializing in that area.

Our ultimate goal is that you receive a warm welcome, exceptional eye care and an overall pleasant experience when you visit Koby Karp Doctors Eye Institute. Call for an appointment (502)897-1604.

New breakthroughs in lens technology allow patients who have cataract surgery to choose a multi-focal lens instead of a single focus lens that often requires some patients to continue to wear glasses. The new multi-focal lenses, however, can often virtually eliminate the need for glasses.

Still other patients with multi-focal lenses will only need glasses when reading or doing close-up work.

This new multi-focal technology replaces the single-focus IOL’s (intraocular lenses) allowing for all ranges of vision: near, mid-range and distance.Drs. Melvyn Koby, David Karp, Scott Hoffman and Albert Smolyar are now making the multi-focal intraocular lenses available to their patients having cataract surgery.

Further good news is that the Centers for Medicare and Medicaid Services has announced that they will now allow Medicare beneficiaries to choose these more expensive lenses as long as they pay for the extra cost themselves. Doctors and Medicare patients will have the freedom to select technology to treat cataracts that is consistent with the patient’s lifestyle.

Previously, the government paid most of the price of treatment, including surgery, insertion of a traditional intraocular lens, and one pair of eye glasses or contact lenses. Doctors were not allowed to exceed Medicare’s established price for the procedure or to ask patients to make up the difference for the multifocal lens. Medicare patients couldn’t pay extra for a better lens even if they wanted to. Now the rules have changed.

Cataract surgery is generally performed on an outpatient basis using local or topical anesthesia. It is done when the patient’s daily visual needs require it.

During the procedure, the cloudy lens is removed from the eye. One method of cataract removal uses high frequency sound waves to gently break the cataract into tiny pieces. These pieces are then removed by delicate suction. Then the focusing power of the natural lens is restored by replacing it with a permanent intraocular lens implant.

Two things: New medications and the newer laser procedures. The new medications are easier to use. The latest laser procedures for glaucoma are very effective and in many cases they can reduce or eliminate the need for medications..

“What are the advantages to the glaucoma patient?”

These advances can reduce the requirement for medication thereby saving the patient money. Newer laser procedures can make difficult cases much easier to treat.

- Melvyn M. Koby, M.D.   

“What’s the most exciting advance in Cataract Surgery so far?

”2.2 mm micro-incisions and the Multi-focal lens implants such as RESTOR and CRYSTALENS

“What does that mean to the Cataract patient?”  

Smaller incisions for cataract surgery means shorter healing time and more rapid vision recovery for most patients.  2.2 mm micro-incisions with new ultrasound equipment for cataract surgery may also reduce the chance of rare but serious infections. The new Multi-focal lens implants allow patients who are good candidates the opportunity to enjoy good distance and reading vision with minimal or no need for glasses following the cataract procedure.        

- R. Scott Hoffman, M.D.

“What is the most exciting advance in Cosmetic Eye Procedures so far?”

The introduction of Botox® injections as well as very safe injectable gels such as Juvederm™ and Restylane®, has provided very effective tools to help patients who seek to smooth out wrinkles and folds on the face instantly.

“What does that mean to the patient?” 

Now our patients can have dramatic and immediate correction of facial imperfections as well as lip augmentation without surgery. The effect lasts for months.  The injections produce minimal discomfort and are performed in the office. Affordability and reversibility of the effect are other major advantages over surgical procedures. We offer free consultation to those interested in using these very effective procedures to improve their appearance.                     

- Albert Smolyar, M.D.

 “What is the most exciting advance in Contact Lenses so far?” 

Silicone Hydrogel lens material for contact lenses. This allows up to 8 times more oxygen through the lenses than previous lens materials.  

“What does that mean to the contact lens wearer?”

Throughout the course of the day you get significantly more oxygen to the cornea often translating into a more comfortable wearing experience with less end-of-the-day dryness and redness. Our patients love them!                  

- Christopher Stroud, O.D.

The doctor needs 2 consistent assessments before determining the desired correction. We will look at the stability of your cornea by performing keratometry readings and corneal topography.  We will also measure your refractive error with and without dilation. 

These assessments are very important in the outcome of your laser procedure. Wearing glasses instead of contact lenses during this time can be inconvenient and uncomfortable for some patients but the results after laser surgery will make up for this short time.

If you are unwilling or unable to adhere to our guidelines for pre-op assessment, please feel free to discuss this with your doctor. We all want the best result for you.

If you have glasses, please bring them to the office with you. This may be helpful in determining refractive stability.

You will be given a copy of the informed consent for refractive surgery to read while you are waiting to see the doctor. Please discuss any questions or concerns with our staff or the doctor after you have read them.

We will also discuss the cost and payment options with you on the day of your evaluation.

We are excited about the wonderful results that we have seen after laser vision correction and look forward to providing you with the freedom of not wearing glasses or contact lenses.