Dr. James S. Lewis
Serving Philadelphia, Bucks County
First in the Delaware Valley
High Definition Video Advancing Ophthalmology
Ophthalmology Medical Congress
Congress location: Chicago, IL, USA
Date: 20 - 24 April 2012
ASCRS Daily Coverage - Chicago, April 21, 2012
Eyetube interview series talks with:
James S. Lewis, MD, in private practice in the Philadelphia area, reviews his presentation on high-definition video at the surgical microscope.
Interviewer: Ryan Vasan, MD
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What is the Wiggle Dance?
Anterior segment grand rounds
Sunken bag does the "wiggle dance"
by Steven G. Safran, M.D.
I consulted a panel of David F. Chang, M.D., Jim Lewis, M.D., Reay H. Brown, M.D., and John Hart, M.D., to get their thoughts on this case.
Dr. Chang felt that a YAG procedure was a reasonable first option to consider here but had somewhat low expectations for its chance of success. "I think that it is reasonable to try a YAG laser capsulotomy in the first place to attempt to create a clear visual axis. However, given the lack of zonular counter-fixation, this often will not work."
I did perform a YAG laser in an attempt to reduce the visual disturbance in the central visual axis caused by the sunken capsular bag, but this did not help matters much. The patient did not feel that things had improved much, and he was expressing an interest in having something more definitive done. Dr. Chang had some suggestions for a surgical approach. "If the patient was amenable to surgical intervention, the goal is to remove the loose capsular bag that is impairing vision and to suture-fixate the second haptic. I would use iris retractors to permit visualization and then use a dispersive OVD (e.g., Viscoat, Alcon, Fort Worth, Texas) to levitate the capsular bag into the pupillary plane, while displacing the hyaloid face posteriorly. I would try to pull the dehisced capsular bag into the anterior chamber using MST [Redmond, Wash.] microforceps through two paracentesis sites. If successful, I would then remove the iris hooks and levitate the IOL optic forward for pupil capture. I would try to push the capsular-Soemmering's ring complex off to one side so that I could suture the loose IOL haptic to the iris. After instilling acetylcholine chloride, a 10-0 prolene McCannel suture is passed and then tied with a Siepser slipknot. With a barrier to vitreous prolapse in place, I would then remove the capsular bag complex with a vitrectomy cutter via a tight limbal incision, while infusion was separately delivered with a self-retaining cannula through a paracentesis site. If vitreous were encountered earlier or if the capsular bag could not be pulled anteriorly, I would introduce the vitreous cutter through a pars plana sclerotomy with the iris retractors and anterior chamber maintainer in place."
Dr. Hart, on the other hand, would have avoided the YAG procedure here. His preference was for scleral fixation of this implant. "When I am considering an IOL fixation/reposition I would not perform a YAG capsulotomy first. … Given that he is complaining about a sudden decrease in vision and you can see that the inferior haptic and optic is tilted posteriorly, I would consider surgical intervention. Why wait until the suture supporting the superior haptic breaks? If the IOL is tilting posteriorly and suspended by a single suture superiorly, the risk of suture breakage or of the superior haptic slipping out of the suture appears great. I would recommend scleral fixation of both haptics. The superior haptic has been held in place by the suture you placed 5 years ago. Nothing lasts forever so if I were to operate, I would place another suture fixating the superior haptic to the sclera. Since he has a trabeculectomy in that area I would use a Hoffman scleral pocket technique to avoid conjunctival dissection that could result in trab failure. For the inferior haptic the technique for scleral fixation would not be as critical. I would use 9-0 prolene sutures. … Also consider removing the capsular remnants since they are free-floating in the visual axis and no longer providing support for the IOL. This could be performed with a bimanual vitrectomy at the time of IOL fixation."
Dr. Lewis also prefers scleral fixation, but he would consider an IOL exchange in this case. His focus is on removing the opacity. "Any solution to this problem should involve the complete removal of the residual capsule with the best possible vitrectomy a surgeon can perform. These patients, in my experience over the last 20 years, do best with double transscleral sulcus fixation of a CZ70BD using 10-0 polypropylene (Alcon or Ethicon [Somerville, N.J.])."
Like Dr. Lewis, I have been a big fan over the years of treating IOL dislocations with lens exchange using a scleral-fixated, single-piece PCIOL with eyelets in the haptic. This has been a "fastball" procedure for me to fix a wide variety of IOL problems once and for all. In this case, however, I wanted to minimize the patient's risk from a glaucoma standpoint and keep the surgery as simple as possible. Dr. Brown, the glaucoma specialist on my panel, was naturally concerned about this patient's glaucoma. He immediately asked me to provide VF and optic nerve imaging information prior to considering further options.
Dr. James S. Lewis Announces New Ophthalmology Suite in North Philadelphia
Dr. James S. Lewis invites patients to the renovated Eye Institute of Salus University. This state-of-the-art North Philadelphia facility includes the James S. Lewis, MD Ophthalmology Suite specializing in cataract, cornea and LASIK Surgery.
The accomplished Philadelphia LASIK and cataract surgeon Dr. James S. Lewis has been honored by the dedication of this Specialty Care Center. Salus’s state-of-the-art facility is located at the clinical center of the Pennsylvania College of Optometry, a reputable institution that recently completed a $12 million dollar expansion and renovation project.
Dr. Lewis’ suite is equipped with the latest diagnostic and therapeutic equipment in order to provide advanced care for North Philadelphia Cataract, Cornea, Glaucoma and LASIK patients. For cataract patients, Dr. Lewis offers micro-incision cataract surgery with premium intraocular lenses, including nanoFLEX, nanoFLEX Plus, Crystalens, ReSTOR and Tecnis Multifocal Lenses. For laser eye surgery patients, Dr. Lewis offers LASIK and Epi-LASIK, a sophisticated refractive surgery procedure that he has been performing for more than six years. Patients with cataract and glaucoma can become spectacle and glaucoma drop-free with combined Cataract and AquaFlow™ surgery. This minimally invasive glaucoma surgery is performed without sutures and provides extremely rapid visual rehabilitation. Dr. Lewis has performed more AquaFlow procedures than any other US surgeon. He also offers Staar’s Visian ICL, for patients who are not ideal LASIK candidates as well as those who simply prefer a reversible, flap-less alternative with unparalleled optical and visual performance.
Premium care through superior technology
Premium care through superior technology
James S. Lewis, MD, and The Eye Institute of Salus University
Creating the premium practice means staying “ahead of the pack” in a number of areas, not the least of which being the technology aspect of ophthalmology. At The Eye Institute of Salus University, James S. Lewis, MD, has done just that, creating a high-tech yet inviting environment for his patients.
“I’ve been interested in imaging, particularly video imaging, even before I started my practice,” Dr. Lewis told Premier Surgeon. “It’s the perfect match because ophthalmology lends itself to the creative use of optics, ultrasound, laser interferometry and laser techniques.”
Dr. Lewis’ love of technology can be seen in every aspect of the well-appointed office. Within the waiting areas, patients watch educational videos on large-screen, high-definition LCD and plasma monitors, and each surgical procedure is recorded to DVD using top-of-the-line cameras so patients can view their surgery at home. Images by Peter Olson Photography.
See all the photos and read the complete article.
Top Surgeons Highlight Key Blades
October 2011 Cataract & Refractive Surgery Today
Blades From Mastel Precision
These gems represent true craftsmanship.
BY JAMES S. LEWIS, MD
If you have the luxury of having a meticulous instrument technician or a nursing staff with a great deal of respect for ophthalmic surgical tools, then no other instrument is as rewarding to own as a diamond knife from Mastel Precision (Rapid City, SD). Doug Mastel’s company has been catering to elite eye surgeons since the early days of RK. The Mastel name is the Aston Martin of ophthalmic diamond scalpels (Figure 1). For nearly 3 decades, the company has designed, refined, and advanced the science of diamond blades. Beginning with specialized handles and footplates and pushing the boundaries of the blade’s size, shape, and sharpness, Mastel is continually innovating and enhancing the surgical experience. Once you have used these instruments and become accustomed to their aerodynamics, consistency, and quality, you will find it very difficult to accept anything less.
Read the entire article
Premier Surgeon Feature
Dr. James S. Lewis has been photographed for the November/December Premier Surgeon 2011 publication.
World renowned photographer Peter Olson has taken wonderful photos of our practice. The Elkins Park office was the scene for a comprehensive photo feature in Premiere Surgeon November/December 2011 issue.
visit the PS250 site
American College of Ophthalmic Surgery
EyeWorld Special Coverage: Corneal / External
THE EYE INSTITUTE - Unveiling the "New" Eye Institute
During the last 12 months, The Eye Institute has been transformed from a tired, 30-year-old building to a vibrant, state-of-the-art clinical facility.
by Cheryl Guttman Krader in Paris
Anterior segment OCT imaging (RTVue, OptoVue) post-LASIK revealed the presence of a stromal tissue gap between the distal flap edge and peripheral untouched cornea in eyes whose flap was fashioned with a 60 kHz femtosecond laser (IntraLase, AMO), reported James Lewis MD, at the XXVIII Congress of the ESCRS in Paris, France.
Download the article
Everything you wanted to know about Cataracts!
read the article announcing cataractphiladelphia.com
All your questions about cataracts, are answered at
What would you do?
Case presentation: The patient is a 32-year-old white man whose occupation is a welder. He states that he started to note blurriness in his vision 2 years ago and that it has since worsened, especially during night driving conditions. He has no history of trauma and no medical or family history of these symptoms. He is not on any medications and is otherwise healthy.
Approach 3: James S. Lewis, MD
Eighty percent of patients are right-handed. The more-advanced cataract in the closer right eye may be hastened by the greater exposure (inverse square law) to ultraviolet-B radiation in a right-handed welder.
Read the article
Clinical Results Promising for NanoFlex Collamer IOL
Clinical Results Promising for
NanoFlex Collamer IOL
“This is not hocus-pocus. This is real. In my practice I describe nanoFlex as a ‘no-cost’ premium lens. I haven’t put in a premium lens other than the nanoFlex since reviewing this data,” Dr. Lewis said.
Cataract and Refractive Surgery Today
Europe November 2010 issue.
Read the article
NanoFlex Collamer IOL
Unanticipated stromal tissue loss
STAAR's Collamer Accommodation Study Team (CAST).
Focus on the LASIK flap's Creation:
Sub Bowman's Keratomileusis
Ophthalmology Times featuring James S. Lewis, MD
Correcting Your Vision with Laser Surgery
Correcting Your Vision with Laser Surgery
Salus University's newsletter Eyesight Fall 2009,
has been published. Dr. James Lewis contributes to this volume.
Download a copy here
Bladeless Corneal Transplantation News
Ocular Surgery News
Microkeratomes are here to stay
My ideal femtosecond laser would be small enough to fit under my excimer platform and eliminate the need to move patients from one device to another; rarely need service and when necessary the manufacturer could ship me a loaner unit overnight; not leave tissue bridges and therefore allow me to lift all flaps atraumatically; not leave air bubbles in the stroma or anterior chamber and would never produce a surgical delay or prevent iris registration; produce almost no inflammation and would not require intensive topical steroids; consistently create perfect flaps between 95 µm and 105 µm with a 3.5-mm hinge and 8.5-mm diameter; be almost devoid of diffuse lamellar keratitis; be disposable and portable; and not have a click fee. Last but not least, it would cost under $40,000, have an annual maintenance contract less than $4,000, and cost less than $100 to operate per case.
Read the entire COUNTER Point by James S. Lewis, MD
Blade microkeratome may still have a role in flap creation
Automated blade creates thin, precise and resillient flaps, surgeon says.
James S. Lewis, MD; Marcus Devlin, OD
The latest in mechanical microkeratome.
I could see the flaps were 30% thinner using the One Use-Plus SBK than what I had ever achieved with a mechanical microkeratome. The device required no learning curve and provided good consistency, reproducibility and ease of use.
Read more by James S. Lewis, MD; Marcus Devlin, OD
Now Playing on YouTube.com
jslewisMDPC has a growing library of video files for you to watch on youtube.com
This movie clip is showing a Thin-Flap LASIK procedure: SBK in high definition.
Thin-Flap: Moria's OUP SBK
This movie is a showing the Epi-LASIK procedure proformed by Dr. Lewis: Advanced Surface Ablation in high definition.
Epi-LASIK: Advanced Surface Ablation
Salus University is PCO's new name
FDA Recalls LASIK Treatment Algorithms
FDA Recalls LASIK Treatment Algorithms
In April 2007, Cataract & Refractive Surgery Today reported that Alcon Refractive Horizons Inc. (Orlando, FL) issued a safety alert for the Ladar6000 excimer laser. Surgeons were directed to discontinue using the laser for myopic CustomCornea procedures (Alcon Laboratories, Inc., Fort Worth, TX) due to reports that the laser was creating central islands in patients' corneas.
This week, the FDA issued a Class 1 recall for the CustomCornea algorithms used by the Ladar6000 laser to correct myopia with (M3) and without (A7) astigmatism.? According to the FDA's notice, these algorithms "caused corneal abnormalities ('central islands') … [and] resulted in decreased visual sharpness (visual acuity)." The agency warned that these adverse effects may not be correctable with additional laser-based surgery or with eyeglasses or contact lenses.
At press time, Alcon Laboratories had deactivated the recalled algorithms in all of the Ladar6000 lasers in the US.
1. 1. FDA Web site. Class I recall: Alcon Refractive Horizons, Inc. Ladar6000 excimer laser system. Available at: www.fda.gov/cdrh/recalls/recall-022107.html. Accessed June 14, 2007.
Dr. Lewis DOES NOT USE THIS LASER!!!!! OR THESE Algorithms!!!!
Read the article
Tiger Woods has had an Enhancement
Eyes of Tiger Woods is one of many tour players who have had LASIK laser eye surgery. Has it helped their games, and can it help yours?
New faster Server
check out the new speed any Wednesday..
Visian ICL granted FDA Approval
Ocular Surgery News - TOP STORIES 12/27/2005
Visian ICL granted FDA approval
MONROVIA, Calif. An implantable, foldable collamer lens for the correction of myopia has been granted regulatory approval in the United States, according to the device’s marketer.
STAAR Surgical’s Visian ICL “allows an incision up to 50% smaller than competing technology, and its placement in the eye behind the iris provides a more aesthetically pleasing outcome,” the company said in a press release. The lens received Food and Drug Administration approval for the correction of myopia in adults, STAAR added.
STAAR said it will begin shipping the phakic IOL to “trained doctors” in 6 to 8 weeks. The lens is already approved for sale in 41 countries, including those in the European Union. STAAR said the lens has been implanted in more than 40,000 eyes worldwide.
“We believe the ICL offers patients and their doctors opportunities to achieve higher quality visual outcomes compared with competing technology, and this characteristic will be an important growth driver of the refractive phakic implant market,” said David Bailey, president and chief executive officer of STAAR.
The Visian ICL is a refractive phakic implant intended for placement in the posterior chamber of the eye. The approved models are indicated for the correction of myopia in adults with myopia ranging from 3 D to no more than 15 D with astigmatism no more than 2.5 D at the spectacle plane, and the reduction of myopia in adults with myopia ranging from 15 D to 20 D with astigmatism no more than 2.5 D at the spectacle plane, in patients 21 to 45 years of age with anterior chamber depth of 3 mm or greater, and a stable refractive history within 0.5 D for 1 year prior to implantation, STAAR said.
Mr. Bailey said more than 860 surgeons have completed the first phase of training, which focuses on correct technique.
STAAR said training courses and educational symposia will be a focus for the company at upcoming industry conferences, such as the Royal Hawaiian Eye Meeting next month in Maui.
Copyright ®2005 SLACK Incorporated. All rights reserved.
OSN Supersite link
Temperature, humidity, barometric pressure and dew point can effect. That is why our sterile operating suite is fully climate controlled with a temperature of 68 (+/- 2) degrees and 42 (+/- 3) percent humidity at all times. Furthermore, our laser is calibrated between patients to guarantee consistency.
Make sure the facility you choose maintains a constant environment for their laser.
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We have moved. Please note our new location.
Intraocular Contact Lenses
Intraocular Contact Lenses receives Approval
by the Advisory Panel of the FDA
Dr. Lewis expects to offer this LASIK-alternative to his patients before the end of the year. Patients who can't have LASIK or who don't want laser corneal surgery will benefit from this breakthrough. The Intraocular Contact Lens (ICL) is inserted in a five minute procedure. No removal, cleaning, maintenance, or replacement is necessary. In fact, patients forget the ICL is inside. The benefits include natural vision without fluctuation, dry eye, or the risk of irregular astigmatism.
"Our first task is to contact all those patients we've had to turn away from LASIK for medical reasons", Lewis said. "Staar Surgical has made it possible for almost all patients to dramatically reduce their dependence on glasses and contact lenses."
Dr. Lewis has been performing this procedure abroad during the last five years and was one of the first surgeons certified by Staar.
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Wills Welcomes Dr. James Lewis for LASIK.
Dr. Lewis will begin performing LASIK at Wills Eye Bucks County and perhaps other Wills Eye locations.
This is the first time Dr. Lewis has performed LASIK outside his own operating suites but it is not the first time he has worked with the Wills Eye Staff. In fact, half of each week he is in the Wills Eye Operating rooms of Bucks County, Plymouth Meeting, and NorthEast Philadelphia.
Dr. Lewis will be accompanied by his LASIK coordinators and surgical technicians to supplement the outstanding Wills Eye staff. (Some were originally members of the Wills Eye Family.)
"We are happy to add this option for our patients", Lewis said. "The Wills name stands for quality, excellence, and compassion in our area."
While there is additional cost to use this facility many patients prefer having LASIK in this setting. Feel free to call us for more information.
LASIKDVD has arrived!
Our complete LASIK Seminar on DVD has arrived.
Learn about LASIK at your own pace and in your own home.
View over 2 hours of surgery, staff interviews, testimonials, and post-operative evaluations filmed in our office.
Test your LASIK knowledge and
see Dr. Lewis in the OR and with patients.
Get your free copy hereand get free shipping directly to your home or office.
Wavefront Analysis and LASIK
The 11 o'clock news just finished a brief report
on a new kind of LASIK. It is really "old news".
Each LASIK procedure, when done correctly, is customized.
We are the only center in Pennsylvania and South Jersey with the
equipment to measure your corneal wavefront.
Special techniques to maintain a prolate corneal contour (and thereby avoid glare) have been part of our standard surgery for years. i.e. no added cost!
Feel free to stop in and discuss LASIK and recent advances in surgery.
Schedule your free evaluation or get your free LASIKDVD and attend a full LASIK Seminar without leaving the comfort of your home.
Wavefront for LASIK arrives
We have obtained the first NIDEK OPD-SCAN ARK-10000 in the region. Recently approved by the FDA this Hartmann-Shack wavefront analyzer combines dynamic skiascopy, corneal topography, keratometry, autorefraction, and corneal refractive power analysis.
This device gives us a method of anticipating your post-operative QUALITY of VISION.
Wavefront data will make your decision to have LASIK more scientific.
Accurate and Reliable Data for Optic Diagnostics
The NIDEK OPD-Scan II provides information on corneal topography, wavefront, autorefraction, keratometry and pupillometry in one unit, utilizing state-of-the-art imaging and analysis technology developed specifically to measure normal to highly aberrated eyes.
The system offers a variety of data maps to provide information on the total refractive error, wavefront, corneal shape, internal aberrations and visual quality of the eye, allowing highly accurate and reliable information for optic diagnostics.
Nidek stomps Alcon's LADARVISION
POINT/COUNTERPOINT: IS IT SAFER TO CREATE THE LASIK FLAP WITH FEMTOSECOND TECHNOLOGY THAN A MECHANNICAL MICROKERATOME?
by Mitchell A. Jackson, MD, and James S. Lewis, MD
NIDEK Wins Patent Case Against Alcon/Summit
-Gamagori, JAPAN, December 20, 2002-
NIDEK Co., Ltd. of Gamagori, Japan today announced that it has received a favorable ruling from the United States District Court for the District of Massachusetts, holding that NIDEK's EC-5000 does not infringe two patents owned by Summit Technology, Inc. Alcon Laboratories bought Summit Technology, Inc. in 2000.
In the case Summit Technology, Inc. v. NIDEK Co., Ltd., et al., a jury returned a verdict in favor of Summit in September 2002. NIDEK immediately filed a motion for judgment as a matter of law, asking the Court to overturn the verdict as legally insufficient on a number of grounds. NIDEK's motion to the Court demonstrated critical defects in Summit's proof of infringement. In a 31 page comprehensive opinion, District Court Judge Edward Harrington agreed with NIDEK, holding that no reasonable jury, having considered all of the evidence in the light most favorable to Summit, could have found that NIDEK's EC-5000 device infringed Summit's patents. Even under this most stringent standard, NIDEK prevailed and was not found to be infringing on Summit / ALCON patents.
The result of this ruling means that the jury's verdict has been completely overturned and vacated. Judgment as a matter of law that the EC-5000 does not infringe either Summit patents will be entered in NIDEK's favor. This ruling thus represents a complete victory for NIDEK in the trial court in this hard fought case.
"We are extremely pleased and grateful with this final decision from the court," stated Mr. Hideo Ozawa, President of NIDEK Co. Ltd. "The judge's ruling reaffirms our belief that the EC-5000 does not infringe on the patents of our competitors. NIDEK remains committed to its customers and, as a result of this ruling, NIDEK's customers are free to continue using their EC-5000 without the threat of an injunction. NIDEK is able to continue to market and sell the EC-5000 in the US market without interruption. NIDEK has over the last 30 plus years focused its efforts on developing new and innovative, quality products for the visioncare industry. We will continue our efforts to develop and introduce new products and solutions for the visioncare professional and their patients around the world," added Mr. Ozawa.
For further information contact:
Public Relations, Planning Dept.
NIDEK Co., Ltd.
Read the NIDEK press release at their site
Test your LASIK IQ
This site provides information for patients, their families, and interested members of the public on a variety of common vision problems and therapies. The material on the site has been reviewed for accuracy and balance by panels of leading eye surgeons who comprise the ASCRS Foundation's Eye Surgery Education Council (ESEC).
Eye Surgery Education Councile
Moria One Use Microkeratome
Tiger Wood's surgeon uses the same instrumentation.
We use the best microkeratome
to produce your LASIK flap.
Most specialists consider this the only way
to achieve an optimal LASIK result.
Click on the article below if you'd like to see what Tiger Wood's doctor, (Mark E. Whitten, MD) has to say.
He claims to have had fewer abrasions (pain), less DLK (inflammation), and greater consistency with the disposable micorkeratome by Moria.
This wasn't even available when Tiger had his LASIK!
Many surgeons won't use this device
because it is so expensive!!
We think it is worth it.
We know you will too!
Demand the Moria One-Use Microkeratome
for the best possible LASIK results.
Large pupil treatment approved by FDA.
NIDEK Receives FDA Approval For Increased Optical Zone
Allows for Expanded Treatment Options in LASIK
-Fremont, CA, USA, November 6, 2001-
NIDEK, Inc. announced today that it has received supplemental pre-market approval from the U.S. Food and Drug Administration for the NIDEK EC-5000 Excimer Laser System to utilize an increased optical zone during the LASIK procedure. The NIDEK EC-5000 is now FDA-approved for a 6.5 mm optical zone in the treatment of myopia and myopia with astigmatism, as part of LASIK. This expanded optical zone may be used with a 7.5 mm transition zone in treating myopia and myopia with astigmatism using LASIK.
"Increasing the size of the optical zone approval opens the door for expanded treatment parameters and options on the EC-5000," commented Hiroshi Okada, vice president and general manager, NIDEK, Inc. "It is our continued endeavor to provide refractive surgeons with state-of-the-art tools to treat a broad range of refractive errors using our innovative, technologically advanced platform."
The increased optical zone will allow refractive surgeons greater ability to treat larger areas on the cornea during the LASIK procedure. This may also prove to be beneficial to patients who have pupils larger than normal, and were previously not candidates for LASIK.
Read the article at the NIDEK site
, Elkins Park, Conshohocken LASIK Patients
At his state-of-the-art laser eye surgery Philadelphia facility, Dr. Lewis performs a variety of advanced vision correction procedures. In addition to offering LASIK, he has multiple years’ experience helping Philadelphia, Elkins Park and Bucks County Epi-LASIK and Visian ICL patients realize their dreams of clear vision without glasses.