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Specialty / Refractive Lens Exchange

Presbyopia is a common age-related vision disorder occurring in our early to mid 40’s. Some people with presbyopia who are interested in vision correction procedures are surprised to learn that they will still need reading glasses after LASIK, PRK, or ICL. Find out if a Refractive Lens Exchange can help you eliminate glasses.

A Vision Correction Procedure That Eliminates the Need for Future Cataract Surgery

Our team of board-certified ophthalmic surgeons provide a wide range of vision correction procedures that can provide optimum results and help you achieve your specific vision goals. If you have been diagnosed with presbyopia or have high hyperopia (farsightedness), a Refractive Lens Exchange may be the best procedure to help you reduce and even eliminate the need for corrective lenses and preclude future cataract surgery.

 

What is Refractive Lens Exchange and can it help me?

Refractive Lens Exchange (also referred to as Lens Replacement Surgery) is a vision correction procedure that treats presbyopia, a common age-related disorder that occurs in our early- to mid- 40’s and high hyperopia (severe farsightedness). As we age, the flexibility of our eye’s natural lens gradually dissipates, making it difficult to focus on near objects. If you have been diagnosed with presbyopia but desire freedom from glasses or contacts, Refractive Lens Exchange may be your best option for vision correction. It can help eliminate your need for corrective lenses and preclude future cataract surgery.

Refractive Lens Exchange (also referred to as Refractive Lensectomy or Clear Lens Extraction) is an elective vision correction procedure that can be used to treat presbyopia (an age-related disorder that affects our near vision) and hyperopia (farsightedness: those who can see far away). The procedure is similar to traditional cataract surgery in many ways. Like cataract surgery, your surgeon will remove your eye’s natural lens. During your Refractive Lens Exchange procedure, your natural lens is replaced with an artificial multifocal lens that will allow you to see at all distances and eliminate the development of cataracts in the future. Refractive Lens Exchange is not covered by insurance.
 
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Refractive Errors and How They Affect Your Vision

When we look at an object, a complex chain of events happens. First, light enters the eye through your cornea, where it is bent (or refracted). It then passes through the pupil and into the lens where it is bent (refracted) again. Finally, the light comes to a point and focuses on the retina, allowing you to see. Nearsightedness, farsightedness, and astigmatism occur when there’s a problem accurately bending or refracting incoming light; this is where the term refractive error comes from. These are some common refractive errors that cause vision impairment.
 
FARSIGHTEDNESS
Farsightedness (hyperopia) results when the cornea is too flat or the eyeball is too short, which causes the light rays to focus directly behind the retina. Near objects appear blurry to those with hyperopia. Some farsighted people cannot focus on distant or near objects.

PRESBYOPIA
Presbyopia is a result of natural aging. As our eye’s natural lens losses elasticity, near objects appear blurry. Tasks like reading and seeing up close objects becomes increasingly difficult. This happens in most people during their 40s.

Refractive Lens Exchange can correct severe hyperopia and presbyopia by replacing the eye’s natural lens with an artificial lens, allowing for clearer vision at a range of distances without the need for glasses or contacts.

 

All-Laser, Blade-Free Refractive Lens Exchange

One of the most notable advancements in vision correction is the development of all-laser, blade-free technology. All-laser, blade-free vision correction provides a fast, safe, and precise way to improve your vision. Similar to bladeless cataract surgery, blade-free Refractive Lens Exchange allows our surgeons to perform an exact, individualized procedure customized to your specific vision needs.

As a forward-thinking practice, we are dedicated to staying abreast of technological advancements in the medical industry that can benefit our patients. In 2012, we became one of the first practices to utilize the most advanced form of vision correction, the femtosecond laser. Instead of using blades to make incisions in your eye, your surgeon will use lasers to create smaller, more precise incisions.

All-laser, blade-free Refractive Lens Exchange is performed individually on each eye, approximately a week apart. If you have astigmatism, this will be corrected using the femtosecond laser during the procedure. Below is a video that provides an in-depth look at the Refractive Lens Exchange (also referred to as Lens Replacement Surgery):


 

In general, all-laser, blade-free Refractive Lens Exchange is performed in two steps:

  • Your surgeon will use a laser to make tiny incisions on your cornea. Once these incisions have been made, your surgeon will use a tiny vacuum probe to remove your eye’s existing lens.
  • Once your eye’s natural lens has been removed, the artificial lens will be implanted into the eye. It will stay in your eye permanently.

Our team of board-certified, highly trained Refractive Lens Exchange surgeons include Dr. Kathleen C. Leone, Dr. Matej Polomsky, Dr. Christopher Covington, Dr. Travis Jenkins, and Dr. Samantha Watson. For more than 20 years, we have helped patients eliminate their need for glasses or contacts. We will work with you to determine the best vision correction procedure for you!

 

Is Refractive Lens Exchange Right For Me?

Refractive Lens Exchange can be an ideal vision correction procedure for people who have been diagnosed with presbyopia. Careful consideration will be made to determine if you are a good candidate for Refractive Lens Exchange. First, you will need to come into our office for a comprehensive consultation. During this comprehensive consultation—which takes approximately 2 hours—we will conduct a dilated eye exam and perform several diagnostic tests to evaluate the health of your eyes, document your refractive error, and map your unique eye characteristics. You will also meet with one of our experienced Refractive Lens Exchange surgeons to discuss your vision goals and develop a personalized vision correction treatment plan specific to your needs.

While many factors are considered to determine true candidacy for Refractive Lens Exchange—age, prescription strength, and ocular history being a few—there are some questions that can generally help you determine your potential candidacy.

  • Are you at least 40 years or older?
  • Are you generally in good health?
  • Do you have a stable prescription for at least one year?
  • Have you been told by your optometrist that you’re free of cataracts?

 

Schedule your comprehensive consultation today to find out if you are a candidate for Refractive Lens Exchange.

 
Sometimes, a Refractive Lens Exchange is not indicated for various reasons. Wilmington Eye offers several other vision correction procedures that your surgeon can discuss with you, should this be the case.
 
LASIK
LASIK greatly improves your vision by reshaping your cornea using a laser. It is an ideal procedure for patients with moderate myopia or astigmatism. Learn more about LASIK.

PRK (Photorefractive Keratectomy)
Like LASIK, PRK greatly improves your vision by reshaping your cornea using a laser. However, instead of creating a flap in the cornea, the protective (epithelial) layer is removed. Learn more about PRK.

ICL (implantable Collamer Lens)
Best suited for patients with moderate to severe nearsightedness, implantable collamer lenses permanently correct your vision. A small opening is created in the eye and the lens is inserted and tucked behind the iris. Learn more about ICL.
 
No matter what your vision goals are, our surgeons can discuss your options for vision correction and help you reduce or eliminate your dependence on glasses or contacts.

 

What to Expect During and After Refractive Lens Exchange

Once our surgeon has determined that Refractive Lens Exchange is the best vision correction procedure for you, it’s time to prepare for surgery day.
 

During Refractive Lens Exchange

Refractive Lens Exchange is similar to traditional cataract surgery and is performed at an outpatient surgical facility. You will need to arrange for transportation to and from the procedure. Once there, IV sedation will be administered to make you as comfortable as possible during surgery. Then, your surgeon will make a tiny incision in your cornea and remove your natural lens. The natural lens will then be replaced with an artificial, foldable multifocal lifestyle lens.

Each eye will be done on separate surgery days, usually 7 days apart. Each procedure will be performed in the same manner. The entire procedure for each eye is completed in less than 20 minutes. However, please plan on being at the surgery facility for a couple of hours.
 

After Refractive Lens Exchange

You will be seen for your first post-operative exam within 24 hours following each procedure. During this exam, your surgeon will ensure that each eye is healing accordingly. Blurry vision and light sensitivity are expected as visual recovery occurs gradually after Refractive Lens Exchange surgery. Most patients can resume normal activities a week following the completion of both surgeries. However, full recovery and stabilized eyesight can take weeks and, in some cases, months.

Months following your Refractive Lens Exchange surgery, some patients may notice blurry vision after experiencing weeks and sometimes months of clear vision. During your Refractive Lens Exchange, an artificial lens was put inside the lens membrane (called a bag or capsule). In some patients, this capsule (or bag) can become cloudy or wrinkled, causing blurred vision. To treat this, we perform a simple, 5-minute procedure in office, called a posterior capsulotomy (also commonly referred to as a Yag procedure). During a Yag procedure, we use a laser to create a small opening in the back of the capsule. This allows light to pass through again for clear vision. The procedure is performed in our office and there is little- to no- downtime following a Yag procedure.

Another important thing to remember for the long-term care of your vision is continued routine eye care. While cataract surgery has been completely precluded, we highly recommend yearly eye exams to ensure the health of your vision. If you don’t have a regular optometrist, we can recommend one of our board-certified, highly trained optometrists to help you manage and maintain your new vision.

 

The True Cost of Refractive Lens Exchange

Our goal is to help you achieve your vision goals, whatever they may be. During your comprehensive evaluation, we will discuss procedure costs for Refractive Lens Exchange. We will also discuss affordable financing options available through CareCredit. Our fees for your vision correction procedure include:

  • All pre-operative measurements and exams
  • A personalized and flexible surgical plan
  • All post-operative checkups for 12 months
  • Please note that there are no hidden fees or variations in pricing based on your refractive errors.

     

    The Risks of Refractive Lens Exchange

    Due to its similarities to cataract surgery, the risks of Refractive Lens Exchange are also similar. Like cataract surgery, some associated risks include:

    • Infection
    • Retinal detachment
    • Dislocated IOL
    • Increased eye pressure (ocular hypertension)
    • Edema (swelling)
    • Loss of vision
    • Need for reading glasses in the future
    • Glare or halos
    • Light sensitivity
    • Droopy eyelid
    • Bleeding

    While many of these side effects are temporary, there have been rare instances of reported long-term problems. However, your surgeon can explain any risks or side effects during your initial consultation.
     
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Surgical Specialties