Learn More. The Peer-to-Peer request must be received by Maryland Amerigroup maryland prior authorization Care within two 2 business days of the initial notification of the denial. The intent of the Peer-to-Peer is to discuss the denial decision with the ordering clinician or attending physician. For specific details prioe authorization requirements, please refer to our Quick Reference Guide. Certain carefirst mental providers require prior authorization regardless of place of service.
Vroman said. Ideal candidates should have normal, otherwise healthy eyes with no macular degeneration or diabetic issues, Dr. Vroman said, and these patients should be highly motivated in seeking spectacle independence.
Spectacle dependence. Those patients with the most dependence on spectacle correction poor distance and near acuity would obviously benefit the most, Dr. Mackool added. Axial length. Mackool does not offer the refractive lens exchange procedure to men with an axial length of 25 mm or greater.
This is much greater than in any other group of patients undergoing cataract-implant surgery. We found that the rate of retinal detachment for women with an axial length of 25 mm or greater was approximately 0. Patients should have less than 2. Alio pointed out. Alio has no financial interests. Mackool is a consultant to Alcon and participated in the ReStor clinical trials. Packer has received travel, research and honoraria funds from Eyeonics and Alcon.
He has done consultant work for Advanced Medical Optics. About Foundation Museum of the Eye. Richard Mills' Opinions, to By Laura J. Diffractive Design The AcrySof ReStor Alcon features a 6-millimeter optic that contains a central diffractive portion surrounded by a purely refractive portion. Efficacy Evaluated The greatest advantage of the ReStor lens as compared with other multifocal, accommodative or pseudoaccommodative lenses is its efficacy, according to Dr.
Intermediate Vision Questione The design of the ReStor lens provides one focus at infinity and a second near focus at about 14 inches. Adjustment Period Studies of the Array lens suggest that patients need approximately three months following bilateral implantation to adapt to the multifocal optical system, Dr. Glare, Halo and Opacification Any multifocal lens, whether refractive like the Array or diffractive like the ReStor, will produce a halo or blur circle around point sources of light, Dr.
Candidates and Consideration Ideal candidates should have normal, otherwise healthy eyes with no macular degeneration or diabetic issues, Dr. Most Commented. Loading, please wait There are no comments available. Most Viewed. This technique is referred to as modified monovision, and is weighted toward better distance vision than near vision.
According to a leading vision care industry analyst, most cataract surgeons in the U. This total fee includes all aspects of the procedure, including the lens and follow-up exams after surgery. Note: This information is for general education purposes only.
It is not to be used as a substitute for medical advice from your eye doctor or refractive surgeon. Images and text on this site belong to Ceatus Media Group. Copying or reproducing any text or graphics from this website is strictly prohibited by copyright law. Please read our copyright infringement policy.
Skip to site menu. Facebook Twitter You Tube.
When first working with the Restor lens, you should also reject patients whose jobs entail driving at night, because they may have difficulty with oncoming headlights and possible halos during the first postoperative weeks. Medically, exclude patients with more than 1. If they have already undergone refractive surgery, calculating the correct IOL power will be very difficult, so such patients also are not candidates for this lens.
Finally, individuals who have a monofocal lens in one eye or who do not qualify for bilateral implantation are also poor candidates. Avoid taking measurements immediately after corneal contact. Have patients discontinue wearing their contact lenses until you can obtain stable repeatable corneal values.
It is important for a second technician or physician to confirm readings that differ by more than 0. When possible, compare the patient's precataract refractive error with the bilateral IOL calculations for consistency. Use the average of multiple, consistent measurements in your calculations and delete the outliers. Chair time before surgery will minimize postoperative complaints. At this point, patients are receptive and willing to listen. They will be cooperative and understanding. Addressing complications after they have occurred is problematic, because patients will be defensive and hard to comfort.
Preoperatively, patients should be aware of the possibility of nighttime issues with lights. Warn them about their potential for glare and halos but let them know that these symptoms should decrease in time. Explain to patients that they will attain their best visual outcome after undergoing surgery in both eyes. They should understand that the quality of their vision between procedures is not going to be completely satisfactory.
Write notes on your preoperative conversation in the patient's clinical chart. During the first few postoperative days, previously hyperopic patients commonly remark that their optimal reading and intermediate computer distance have become shorter. As time passes, these distances will grow, but it is best to forewarn patients about this phenomenon so that they do not become worried.
Based upon considerable research I opted for the multifocal, which he was using Vivity. Initially, I was very impressed with the brightness of my vision after the first implant right eye.
My vision was blurry at all ranges near, mid, and far from the onset. I was told this was normal and would improve over time as my eye healed.
I had and still have "Perfect" vision for all distances. I can read without glasses, and see my golf ball traveling through the air for the first time in years. I have to say the procedure for my left eye is a tremendous success. To make matters even worse Once again I went to my optometrist at the 2-month mark and she said she couldn't see anything with her equipment, but in time I even emailed Alcon to see if it was possible for the surgeon to implant the lens "backwards", and what the effects of doing so would be if this were to happen.
After two weeks Edited 20 months ago. I'd try to get in to see the doctor sooner than that June date they gave you if possible. That said if there was some ocular pathology with the eye you'd think they would have caught it in the pre-op exams. It sure sounds like something is not right with the right eye. They can miss with the selection of the lens power, but I suspect that would not cause equal blurriness at all distances.
The lens can be off center, or tilted as well, and that may be a better explanation of an issue at all distances. Is this lens a toric version to correct astigmatism? If so, there is a chance it could be implanted or has rotated out of the correct angular position.
It does not have to move far to make the vision worse instead of better. I am hopeful the ophthalmologist who removed my cataract and implanted the Vivity lens will have the ability to provide an accurate diagnosis of my issue. If it's a lens issue I am sure it would be an easy fix. I would be satisfied. If it were me I'd just want to make sure it's not something urgent first before waiting until June.
Posted 2 months ago. I am experiencing exactly what you have stated above. Second eye done, is great. I was also told my brain needed to adjust to this vision. This situation is pretty frustrating after spending extra for these specialty lenses. Edited 12 days ago. Thanks for your post. It is helpful. I am sorry to hear about your right eye. I would get a second opinion from a different ophthalmologist in a different clinic as soon as possible.
Mar 23, · This extends the market-leading AcrySof ® IQ platform to a broader population of the nearly 2 million cataract patients with treatable levels of astigmatism who undergo . Jun 1, · patient selection Subjectively exclude hypercritical patients, those who have unrealistic expectations, and those who do not mind wearing glasses. When first working with . Apr 26, · Initially, I was very impressed with the brightness of my vision after the first implant (right eye). My vision was blurry at all ranges (near, mid, and far) from the onset. I .