Ophthalmologist: “Dr. Lefkowitz” Eye Expert Witness

Advances in eye surgery have improved the treatment of pathologies such as cataracts, presbyopia or glaucoma, as explained by Dr. Lefkowitz, considered the twelfth most influential ophthalmologist in the world. Surgery is one of the areas of medicine where important scientific advances are continuously taking place, and the surgical approach to Eye expert surgery witness has also benefited from great innovations in recent years.rnAccording to 'The Power List 2018' of the British scientific journal The Ophthalmologist, specialized in corneal, refractive and cataract surgery, and pioneer in the use of multifocal intraocular lenses, in refractive surgery with excimer laser and in phakic intraocular lenses.

Main Advances of Refractive Surgery

In the last decade, lenticular intrastromal surgery has been developed, called SMILE, an acronym that means small incision lenticule extraction, or extraction of a corneal lenticule by a minimal incision. This surgery avoids making a flap and invading the ocular surface, with which there are fewer dry eye problems, something very important since it is the main source of LASIK complications - laser surgery to correct refractive defects - at present, especially in middle-aged patients, and the mobilization of the flap and the biomechanical disorder and weakness caused by the flap of the cornea are avoided.

• Intraocular lenses

Systems for the correction of tired eyesight have also been developed, which using the laser, or using other devices such as intracorneal lenses or intraocular lenses, allow convex presbyopia at all its levels, although, obviously, which one or the other is used depends on the eye. It is about specifying the general corrections, depending on each case and each eye.

• Phakic lenses

Finally, intraocular lenses have undergone great changes, both in their optics and in their indications. In the case of phakic lenses –which are the ones we implant to correct high prescription without operating the lens–, enough time has passed since their creation and we already know which are the most appropriate and which are in principle dangerous because they can give rise to long-term problems.

Surgery improvements to treat cataracts and Glaucoma

Micro incisional cataract surgery improves this type of intervention, making it more effective and less damaging to the eye. Basically, it is intended to change the power of ultrasound (the greatest cause of injury to the anterior segment of the eye in surgery) by the management of fluidics, that is, the passage of fluids, being the fact that they enter and leave the eye at different pressures and speeds, which makes it possible to eliminate the cataract.

With this technique, we manage to reduce to less than a third, or even less, the time and power of the ultrasounds used in cataract surgery, improving the quality of the surgery and, therefore, its results. The most important thing is that we do all this by minimizing the incision that is, making it as small as 1 mm or less, with which the eye does not undergo refractive changes and the stability of the surgery improves. As a whole, it is a global improvement in cataract surgery through a minimization of the incision. In the future, only one puncture will be enough to remove the cataract, but this has not yet come.