What is a cataract?

A cataract is a clouding of the naturally clear lens of the eye. This lens is crystal clear at birth but clouds up as you age. In rare instances cataracts may form at younger ages for different reasons. - Rodger H. Silverstein, M.D.

What are the symptoms of a cataract?

Because the lens has become cloudy, a person with cataracts may experience any or all of the following symptoms:

How will I know if I need my cataracts removed?

Most of our patients know when there is something wrong with their vision. They will even come in asking if they have a cataract. The ophthalmologist is the only person who can best determine when the cataract should be removed. This will be determined on the basis of many physical and social factors. - Niki A. Silverstein, M.D.

Do I have to wait until a cataract is "ripe" to have it removed?

Absolutely not. In the past, when my father removed cataracts, the eye surgeon would need to wait until the cataract was "ripe" or hard, because that made is easiest to remove the hardened lens. This is referred to as traditional cataract surgery, and we still perform it under certain circumstances. No-Stitch surgery can be performed on a ripe cataract, but it is very difficult. The current "No-Stitch" method is our method of choice and offers many benefits over traditional surgery. - Rodger H. Silverstein, M.D.

What is "No-Stitch" cataract surgery?

No-Stitch cataract surgery, also referred to as small-incision cataract surgery or microsurgery, involves using an instrument called a phacoemulsifier. Though this instrument is often referred to as a laser, it is not. This instrument is inserted through a tiny hole in your cornea. The instrument then produces sound waves which break up the lens. The pieces are then vacuumed out through this same tiny hole, and a new, folded lens inserted through the hole. This new lens opens up like a butterfly unfolding its wings once it is in the right place.

The slit heals quickly, often requiring no stitches or only a single stitch to close it. This make the recovery process very quick , much quicker than with traditional surgery.
- Niki A. Silverstein, M.D.

Do I need a hospital stay for cataract surgery?

Cataract surgery is performed on a one-day outpatient basis. We work out of several excellent local hospitals. - Rodger H. Silverstein, M.D.

How many cataract surgeries have you performed?

Between my wife and I and our associate, we have performed many thousands of cataract surgeries in our 20+ years as eye surgeons. - Rodger H. Silverstein, M.D.

What about those "1-800-Cataract" ads and other fancy ads I see on TV?

Beware of services such as these. We believe that you won't get the care and services you need from places such as these. Oftentimes you may find it difficult to see your surgeon after the surgery is performed.

We urge you to find an eye physician who will personally take care of you from start to finish, handling all the pre-op care, the procedure itself and the follow-up care. In our practice, our physicians and staff stand by you from the minute you walk in our offices and are diagnosed with a cataract until months- or even years after, you continue to come to our office after we've performed the surgery. We are with you all the way!

We also suggest that the physician you choose for your cataract surgery be easily accessible to your home, so you can easily get you there in a matter of minutes, not hours.- Niki A. Silverstein, M.D.

Is the surgery covered by Medicare?

We accept Medicare assignment for this surgery. - Niki A. Silverstein, M.D.

What procedures do you perform?

We perform LASIK for the correction of nearsightedness and farsightedness and PRK and RK for the correction of nearsightedness. All procedures correct astigmatism as well. We have successfully treated people with nearsightedness in people from -1.00 diopters and up, from age 18 and up. We can also correct farsightedness up to +6.00 diopters.
- Niki A. Silverstein, M.D.

Is everyone a good candidate for LASIK?

No. We do not believe that everyone is. Everyone's eyes are different. We don't believe in a one-size fits all procedure, or a one-size fits all laser for that matter either.

Some people are best suited for LASIK, others PRK yet others do wonderfully with RK. An evaluation of your eyes, lifestyle and health will help us determine together with you which procedure would give you the best outcome. - Rodger H. Silverstein, M.D.

What lasers do you use?

We offer our patients a choice of Excimer lasers. The lasers we use are maintained by state-of-the-art laser centers.

Each laser has slightly different benefits. At the Refractive Surgery Centers of NJ, we can choose the laser that is best suited for your individual eyes. - Rodger H. Silverstein, M.D.

Do you perform the procedure at your office?

We conduct all of the pre-op testing and follow-up care in our modern offices. RK is performed in its entirety in our office as well. LASIK and PRK are performed at one of the state-of-the-art laser centers that we are members of, depending on which laser we use.
- Niki A. Silverstein, M.D.

What is the work-up?

The work-up is a comprehensive series of tests we perform on you to determine the exact measurements of your eyes. These measurements play a very significant role in the outcome of your procedure, as they are crucial to the operation of the laser.

At our practice, your readings are always checked and rechecked by an ophthalmologist.
- Niki A. Silverstein, M.D.

Will my vision stay good forever?

Yes indeed! Studies indicate that the eye remains stable after the procedure. Barring unforeseen eye diseases as one ages, you will not likely become more nearsighted, more farsighted, or have more astigmatism. However, around age 40, presbyopia will set in, which is an age-related weakening of the muscles that control your eyes. You will need reading glasses to compensate for this. However, some people opt for a procedure called "monovision" which can eliminate the need for reading glasses.

In addition to monovision, there are some other remedies for presbyopia on the horizon.
- Rodger H. Silverstein, M.D.

What is monovision?

Monovision is great news for everyone over 40. At around age 40, presbyopia occurs. This is the age-related weakening of the muscles necessary for sight, and it means that at around this age everyone will have trouble focusing on objects close up.

Even if you have had refractive surgery, presbyopia will occur around this age and you will need "readers". Though most people who have had refractive surgery are so thrilled that they don't have to wear glasses like they used to, they don't mind slipping on an occasional pair of readers.

However, if you want to be free of readers we can give you monovision. In monovision we sculpt a different prescription into each eye, so you can see near out of one eye and far out of the other. Monovision is not for everyone, though some of our patients love it.

In our office we strongly recommend that you "try out" monovision before you have it done. We give you contacts with different prescriptions to give you the same effect that monovision would. This will give you a very good indication of whether or not monovision is right for you.

Also, ask us about a new laser on the horizon which may treat presbyopia in the future.
- Rodger H. Silverstein, M.D.

Are there any risks for LASIK, PRK and RK?

Though there are some risks with any surgical procedure, the incidence of problems with these procedures is quite low. Also, each procedure presents specific risks and benefits.

The most common side effect is seeing haloes or starbursts around lights, which everyone sees to a certain degree even without the surgery. Every possible measure will be taken to reduce the possibility of a problem after the procedure. We are a team of board-certified ophthalmologists, including a corneal specialist, who have spent our lives taking care of people eyes. We encourage you to talk to us about your concerns, and be rest assured that we have the experience to handle anything that may arise. - Niki A. Silverstein, M.D.

Have you heard about the websites which harbor complaints about refractive surgery?

Yes, and we frequently view these sites to see what's going on across the country and around the world. We are proud to say that you will not find our name or any of these sites, nor have there been any complaints registered against us with any state or local governmental agency. We strive for a 100% satisfaction rate. We are choosy about our candidates and we will only perform a procedure if we surmise that you will be 100% satisfied with it.
- Rodger H. Silverstein, M.D.