PREMIUM IOLS

Premium Intraocular Lenses In New York City

Presbyopia is when your eyes gradually reduces its ability to read up close. It is a normal part of aging. This typically begins by mid-40s. The clear lens sits behind the iris, the colored part of the eye. When you are young, the lens is soft and flexible, easily changing shape. This lets you focus on objects both at distance and at near. After age 40, the lens becomes more rigid and cannot change shape as easily. This makes it harder to read or do any work up close. There is no way to pause or stop this naturally occurring process. Bifocals, contact lenses, LASIK, or cataract surgery are ways to correct presbyopia, thus not requiring reading glasses.
Customizable vision in cataract surgery aims to minimize the need for glasses after surgery. Dr. Rapoport spends time with each patient to develop an individualized plan to determine the best outcome for each person. 
Below are some of the tools offered.

PREMIUM IOLS NYC

MONOVISION LENSES

What is Monovision?

Blended vision simply refers to Monovision with a smaller discrepancy between the eyes, increasing the need for reading glasses but making it easier to adjust to the difference between the two eyes.
Monovision and blended vision are common goals for patients over the age of 40, allowing patients to achieve good functional vision at both distance and near without the need for glasses or contact lenses.

Why Monovision?

With Monovision, Dr. Rapoport corrects your dominant eye for seeing at distance and your non-dominant eye for near vision, thereby reducing the need for reading glasses. When both eyes are functioning together, the brain naturally selects the image from the eye that has the clearer focus. Having eyes for different purposes might sound unsettling, but many patients do very well with Monovision.

TORIC LENSES

What is the Toric Lens?

The Toric intraocular lens replaces your eye’s natural clouded lens during cataract surgery. Specifically, these are astigmatism correcting lens.

How does the Toric Lens Work?

Advanced technology makes it possible to correct the cataracts that may be clouding your vision – and the astigmatism that may be distorting your vision – all at the same time.
It also has the ability to reduce or eliminate corneal astigmatism at the same time it corrects cataracts. Typically the result is improved distance vision and less dependence on eyeglasses. However, most patients still require corrective lenses for near and intermediate tasks. With the Toric lens, your distance vision can now be clear and vibrant following cataract surgery.

Toric intraocular lens

TRIFOCAL / EXTENDED DEPTH OF FIELD LENSES

What are Trifocal / Extended Depth of Field Lenses?

There are currently two lenses in the USA that are Trifocal or Extended Depth of Field Lenses – Alcon’s Panoptix and Johnson & Johnson’s Symfony Lens. Both of these lenses are excellent choices for patients with active lifestyles, from requiring precise distance vision for sporting activities, to viewing mobile devices and computer screens. The near vision with these lenses is not at the same level as that of multifocal lenses, but there is less risk of glare/ halos or of compromise in distance vision.

ALCON PANOPTIX IOL

What is the Alcon Panoptix lens?

The Panoptix lens was FDA-approved in August 2019, having been used for many years in over 70 countries. It is the first and only “Trifocal Intraocular Lens” and the most advanced IOL that is now available. Panoptix is clinically shown to deliver an exceptional combination of near, intermediate and distance vision, reducing the need for glasses after surgery. While the lens implant looks like a multifocal lens, the optics work differently. Instead of producing two distinct focal points, the lens uses ENLIGHTEN 9R) Optical Technology, proprietary design that optimizes intermediate vision without compromising near and distance vision. The lens can achieve excellent clarity at distance and a range of clear vision at near for patients receiving the lens. Before, the light would be split in two ways – for distance and for near, resulting in a potential gap in vision. With the Panoptix trifocal lens, there is no gap.
The Panoptix can correct both spherical and astigmatic corrections, and builds on Alcon’s proven AcrySof IQ IOL platform. With this lens, patients, can achieve excellent clarity at distance and a range of clear vision at near for patients receiving the lens. The unique technology allows for reading vision that is at a level in between the Symfony and the traditional multifocal lenses. Dr. Rapoport is one of the first group of surgeons in NYC to implement this lens with success in her practice.

Is the Panoptix lens for me?

The Panoptix lens is perfect if you desire glasses independence in most scenarios, are active, and want great vision at distance, intermediate, and most near. You won’t mind wearing over the counter glasses on occasion. You also enjoy cutting edge technology and want the most advanced IOL available today. The Panoptix lens will correct for presbyopia and can correct for astigmatism as well, like the Symfony. The traditional multifocal lenses do not correct for astigmatism.

What to expect from the Panoptix lens?

Our expectations for extended depth of field patients and those with the Panoptix are that they should be able to pass a driver’s test, navigate their cell phone, perform most computer tasks, and read their iPad without the need for glasses. A multifocal lens can be considered a bit stronger than the Panoptix or Symfony with regards to its ability to provide newspaper or paperback book reading vision to implanted patients. The Panoptix should be able to provide better near vision than the Symfony lens but has a higher risk of some glare and halos.

JOHNSON & JOHNSON SYMFONY IOL

What is the Abbott Symfony Lens?

The Symfony lens is the first lens to be approved by the FDA with the designation “extended range of focus” intraocular lens. While the lens implant looks like a multifocal lens, the optics work differently. Instead of producing two distinct focal points, the lens can achieve excellent clarity at distance and a range of clear vision at near for patients receiving the  lens. 
While complete spectacle independence is often our goal with our refractive cataract surgery patients, we are, of course, unable to guarantee any specific outcome. Like multifocal lens patients, patients undergoing Symfony lens implantation need to understand that they may see some halos/rings around lights when driving at night. Fortunately, the incidence of persistent and troublesome night vision disturbances is uncommon.
tecnis symfony lens

Is the Symfony Lens for me?

The arrival of the Symfony lens is welcomed news because many patients who were not good candidates for a multifocal lens may, in fact, be very good Symfony candidates. One specific group of patients consists of cataract patients with significant astigmatism. The symfony (and the Panoptix) lenses correct for astigmastim while correcting for presbyopia, while the traditional multifocal lenses do not.

What to expect from the Symfony Lens?

Our expectations for Symfony patients are that they should be able to pass a driver’s test, navigate their cell phone, perform most computer tasks, and read their Ipad without the need for glasses. A multifocal lens can be considered a bit stronger than the Symfony with regards to its ability to provide newspaper or paperback book reading vision to implanted patients. 
While complete spectacle independence is often our goal with our refractive cataract surgery patients, we are, of course, unable to guarantee any specific outcome. Like multifocal lens patients, patients undergoing Symfony lens implantation need to understand that they may see some halos/rings around lights when driving at night. Fortunately, the incidence of persistent and troublesome night vision disturbances is uncommon.

MULTIFOCAL LENSES

AcrySof® ReSTOR® IOL

What is the AcrySof® ReSTOR® Lens?

The AcrySof® ReSTOR® (Alcon) lens, FDA approved since 2005 is an intraocular lens (IOL) that corrects cataracts, with or without presbyopia. Presbyopia is the reason many patients need reading glasses as their eyes age. The result is clear vision near, far, and everywhere in between.
These multifocal lens implants feature a patented “apodized diffractive” design that optimally distributes light to distance, intermediate and near focal points, depending on the amount of ambient light available. This optimizes image quality in all lighting conditions, according to Alcon.

Could you provide an example?

For example, in low-light conditions, as the pupil dilates, more light is distributed to elements in the lens required for clear distance vision. This improves a driver’s vision of the road ahead at night, the company says. But this also means near vision may not be as crisp with the ReSTOR lens in low light as it is in bright light conditions.
AcrySof IQ ReSTOR multifocal IOLs also feature aspheric optics to reduce a specific type of higher-order aberration called spherical aberration. This reduces halos around lights at night and improves image quality for enhanced visual clarity, the company says.

What to expect from it?

More than 93 percent of people who have had AcrySof IQ ReSTOR multifocal IOLs implanted in their eyes during cataract surgery have said they would do it again, according to Alcon.
Additionally, 4 out of 5 patients in the supporting clinical study who had the AcrySof® ReSTOR® lens implanted in both eyes reported never wearing glasses again.

TECNIS MULTIFOCAL IOL

What is the Tecnis Multifocal IOL?

The Tecnis Multifocal IOL, marketed by Abbott Medical Optics (AMO), has been approved for use in the U.S. since 2009. The advanced TECNIS Multifocal Lens is an excellent option for cataract and presbyopic patients and can provide excellent vision at near, intermediate and far distances under all lighting conditions … day and night. 

Could you provide an example?

The TECNIS Lens allows people to read a menu in a dimly lit restaurant, take a walk at dusk and even drive at night. Most importantly, the TECNIS Multifocal Lens has allowed thousands of people to achieve independence from glasses. The fully diffractive surface of the Tecnis Multifocal IOL provides advanced image quality at all distances under any lighting conditions and regardless of pupil size, according to AMO.
Nearly 9 out of 10 people who have had Tecnis Multifocal IOLs implanted in their eyes enjoy freedom from eyeglasses after cataract surgery, the company says.

What to expect from it?

Nearly 9 out of 10 people who have had Tecnis Multifocal IOLs implanted in their eyes enjoy freedom from eyeglasses after cataract surgery, the company says.

DEXTENZA INSERT

What are Dextenza Inserts?

Dr. Rapoport is one of the first surgeons in New York City to successfully use the Ocular Therapetuix’ Dextenza insert to minimize the quantity and length of time that a patient has to be on drops after surgery.
The Dextenza insert is an FDA-approved bioabsorbale intracanalicular hydrogel plug that contains dexamethasone,and fulfills a huge unmet need by patients.  Dr. Rapoport inserts this device at the end of surgery by and it time releases a steroid medication over the course of the month after surgery. This allows for most patients to not need a steroid drop post –operatively. The FDA trials showed that Dextenza significantly reduced pain and inflammation and eliminated the need for a steroid drop in a majority of patients  This is a huge relief for patients who struggle to put drops in, for various reasons such as cost, cosmesis, poor dexterity, discomfort, corneal toxicity, or forgetfulness.

Why Dextenza?

This allows for most patients to not need a steroid drop post –operatively. The FDA trials showed that Dextenza significantly reduced pain and inflammation and eliminated the need for a steroid drop in a majority of patients  This is a huge relief for patients who struggle to put drops in, for various reasons such as cost, cosmesis, poor dexterity, discomfort, corneal toxicity, or forgetfulness.