Many patients over the age of 40 who have not yet developed cataracts are interested in vision correction but LASIK may not be one of the best option. After the age of 40 some people develop an inability to read things up close and this is known as presbyopia. In many cases, the best way to treat this is to "prematurely" remove the lens in their eyes that will eventually become a cataract, and replace it with an intraocular lens.
Refractive Lens Exchange (RLE) is gaining popularity as an affordable surgical option for people over 40 who want to decrease or eliminate their dependence on glasses or contacts. When we are young, the natural lens acts like the zoom function in a camera, allowing us to focus up close, without the need for reading glasses or bifocals. As we age, the lens progressively becomes dysfunctional resulting in loss of near vision (presbyopia) that requires the use of reading glasses or bifocals. With aging the lens also progressively becomes hard, yellow and cloudy (cataract), which blocks and scatters light reducing visual quality, quantity and color perception.
What is Refractive Lens Exchange?
Refractive Lens Exchange is commonly referred to as clear lens extraction or presbyopic lens correcting intraocular surgery. RLE is an emerging type of refractive surgery very similar to cataract surgery. Like many other types of refractive surgery, including LASIK eye surgery, Refractive Lens Exchange corrects nearsightedness and farsightedness. The desired refractive result is achieved with the insertion of a lens implant known as an IOL. Refractive Lens Exchange is a great option for an ophthalmologist to utilize when vision problems extend beyond the limits of lasers. For example, if a patient is too nearsighted but also has a reading issue one of these new multifocal lenses may be a good option. Prior to the advent of the multifocal lens refractive surgeons often performed monovision LASIK or simply just corrected the myopic disorder and then the patient just required glasses for reading. This type of refractive surgery may also be useful if a patient has extremely thin corneas, which would preclude laser surgery. Several visual situations could lead your surgeon to choose refractive lens exchange as your best option for vision correction. As reading vision problems begin to set in for many people in their 40s and 50s this type of surgery starts to make a lot more sense. Due to the multifocal capabilities of these new lens implants you now see at both far and near distances. Since cataract surgery is on the horizon and your natural lens will be removed you may consider this option ahead of time.
Because Refractive Lens Exchange is a procedure using the same technique as cataract surgery the procedure is regarded as relatively safe and effective. Although AAO guidelines prohibit ophthalmologists from calling this surgery safe it is clear that millions of eyes have received intraocular lens implants during cataract surgery and have had successful outcomes. With the advent of the new multifocal IOL, patients experience excellent vision after surgery. The main difference between these two surgical types is that one is for cataract removal and the other for insertion prior to a ripened cataract.
The Refractive Lens Exchange Procedure
Refractive Lens Exchange uses the same technique used in cataract surgery. This technique has been used for decades and is the best method for cataract removal and lens insertion. During the surgical procedure the patient is first prepped using a local anesthetic and drops. After the eye has been sterilized the surgeon will make a 2.5 to 3 millimeter incision in the eye. In order to see inside the eye our doctors perform this delicate surgery with a powerful magnifying microscope. A device known as the emulsifier is inserted to the eye and begins to remove the natural lens. Once all of the lens material has been evacuated a foldable intraocular lens is inserted in the same place as the old lens. Refractive lens exchange is performed on an outpatient basis and only one eye is treated at a time. After the surgery is complete you will be required to go home and rest for the remainder of the day. Most patients report rapid visual improvement immediately after surgery.
Advantages of Refractive Lens Exchange
- Reduces the dependence on glasses and contact lenses
- Rapid visual recovery
- Excellent results without the using a laser
- Eliminates the need for cataract surgery in the future