Robert Chang, MD

Products And Services

• Cataracts

  What is a Cataract? Cataract is a disease of the lens, typically leading to slow vision loss which can be reversed with cataract surgery, the most common procedure performed in the US. There are different types of cataracts affecting one or both eyes, which can develop at different ages. Once the vision can no longer be improved with glasses or contacts, and is causing problems in daily life, then elective cataract surgery may be recommended. How is Cataract Treated? Currently, cataracts are removed via a short outpatient minimally invasive procedure, typically under local sedation. A replacement lens is chosen based on visual needs and glasses wear. Dr. Chang offers both extended depth of focus and trifocal (multifocal) intraocular lenses to reduce glasses dependence. About Cataract Surgery Resource Links to learn more about cataract Basics: https://www.aao.org/eye-health/diseases/what-are-cataracts More advanced: https://eyewiki.org/Cataract What is a Refractive Cataract Surgeon? After cataracts are removed, there are several lens choice options to replace the natural lens. The standard lens implant placed without any additional charge is called a monofocal lens with a single focus point which is generally set to make eyes see well at distance. A refractive cataract surgeon offers premium lens upgrades for an additional charge (like LASIK) in place of monofocal lenses to reduce glasses dependence. This means managing astigmatism with toric lenses and choosing the Vivity or Panoptix multifocal lens depending on if your eye is a good candidate. Another option is also monovision if familiar with that previously while wearing contact lenses. Dr. Chang specializes in complex cataract, refractive cataract, and cataract combined with glaucoma. He has performed thousands of surgeries since 2009 using the latest diagnostic measurement and lens removal technologies. He wants to help you achieve your best potential vision.

  Link: Cataracts

• Glaucoma

  What is Glaucoma? Glaucoma is a group of diseases which share progressive optic nerve damage leading to irreversible blindness over time. Most glaucoma, if detected early enough, can be controlled as the eye pressure is lowered in order to outlive losing sight. Because it does not cause much symptoms until the late stage, it is important to have good follow-up with your doctor with regular testing to prevent vision loss. These tests include fundus imaging, OCT measurements, eye pressure checks, and visual field testing. How is Glaucoma Treated? Currently eye pressure is lowered through medications, laser, and procedures, some of which are less effective but safer and others which are more effective but have more risk. Dr. Chang offers all of the many approved ways to lower pressure and will help guide making the best individualized decision using as much available personalized data as possible. Some of these newer interventional options include the A) hydrus stent, B) OMNI trabeculotomy, C) KDB goniotomy, D) ECP endoscopic laser, E) Xen stent, and F) istent. About Glaucoma Surgery Most procedures are outpatient, performed under local sedation anesthesia, and take anywhere from 30 minutes to a little over 1 hour. The recovery can be a few days to weeks or longer depending on the procedure type. The newer interventional options tend to have fast recovery with minimal pain. Resource Links to learn more about glaucoma Basics: glaucoma.org More advanced: https://eyewiki.org/ Office Visit Expectation Dr. Chang is very thorough with testing and answering questions, and thus visits may take up to one or two hours. Please bring any copies of old records in hand to your visit, if available by requesting them. Also, it is best to communicate via the Stanford MyHealth app, and thus please download this and activate it in the office.

  Link: Glaucoma

• Types Of IOLs

  A wide range of replacement lenses are available to cataract patients, each offering different advantages for post-surgery vision. The most effective lens to use depends on the patient‘s individual preferences and goals for their vision. The lenses eliminate the need for glasses or contacts after cataract surgery, providing most patients with convenient, effective results for their specific vision conditions. Multifocal IOLs Multifocal IOLs allow for full vision correction at near, intermediate and far distances, completely eliminating the need for eyeglasses or contact lenses for most patients. Some IOLs can also correct astigmatism. The procedure to implant a multifocal IOL is performed at the conclusion of cataract surgery. These choices were not always available for cataract patients. In the past, cataract surgery only involved monofocal lenses, which could only focus on objects near or far, but could not adjust to accommodate varying distances. These patients still had to rely on glasses or contact lenses after surgery in order to see clearly at all distances, especially for those older patients suffering from presbyopia. Accommodative IOLs Crystalens is the only FDA-approved presbyopia correcting intraocular lens (IOL) that corrects vision through accommodation. The Crystalens IOL is made with flexible silicone that has hinges on each side allowing it to move with the eye muscle, flexing and accommodating seamlessly so you can focus on the objects around you at any distance. In other words, it dynamically adjusts to your visual needs. Accommodation is the ability to shift focus between nearby and distant objects, providing sharper vision at multiple distances in order to minimize the use of glasses. Other IOLs are unable to accommodate and those patients may require additional vision correction with glasses or contact lenses. Toric IOLs Intraocular lenses are used during cataract surgery to replace the damaged lens of the eye with an implant that clears up and corrects vision, oftentimes leaving patients with little to no dependence on glasses. Up until now, patients with astigmatism did not have the same opportunities that other cataract patients have had in correcting their condition with the types of IOL lenses that were available. Typically, the astigmatic patient would need an additional surgical procedure, such as refractive surgery or LASIK, to correct their vision after the procedure. If the patient did not want to undergo another surgical procedure, the only option for correction would be the use of either contact lenses or glasses to address their astigmatism. Toric IOLs are able to accommodate for the condition of astigmatism. Toric IOLs are specially designed to correct astigmatism along with overall vision during cataract surgery, offering complete vision correction.

  Link: Types Of IOLs