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Lens Replacement
Refractive Lens Exchange (RLE)
RLE is a surgical procedure for the correction of short sight (myopia) and long sight (hyperopia) to reduce your dependence on glasses or contact lenses.
Refractive Lens Exchange is an alternative to laser vision correction (LVC) in patients unsuitable for laser refractive surgery. The common reason is that the refractive error (spectacle prescription) is too large to be safely or effectively corrected by LVC.
RLE involves a surgical procedure on the eye that is very similar to modern cataract surgery. It therefore uses tried and tested techniques and technologies. In essence, RLE involves removing the natural clear crystalline lens from the eye and replacing it with a plastic PREMIUM artificial lens (intraocular lens- IOL), the focusing power of which is chosen to reduce dependence on glasses.
There are two main IOL types available in the market – monofocal and multifocal IOLs. They come with different visual advantages and disadvantages. The correct IOL for you will depend on your visual demands and requirements. A full discussion with the surgeon will help you to make the correct choice.
Lens replacement surgery costs around £3000-£4000 per eye.
Refractive Lens Exchange
Who may benefit?
RLE is best suited for patients aged over 50 years who have a spectacle prescription that is outside the range of safe LVC.
When RLE is performed on patients aged over 50, the loss of accommodation (focus adjustment) is of less concern as it has already been much reduced through ageing.
What is involved in RLE?
RLE is technically very similar to modern small incision cataract surgery. It utilises the proven technology of cataract surgery. It is performed with a local anaesthetic and is a day care procedure.
A cataract occurs when the natural lens of the eye becomes cloudy and obscures vision. The treatment of a cataract is to remove the cloudy lens and replace it with a PREMIUM Lens Implant to restore vision. With RLE, the same thing is done. The only difference is that the natural lens of the eye is clear, and the objective of the procedure is to reduce dependence on glasses and contact lenses. This is why the procedure is sometimes called Clear Lens Extraction.
RLE involves microsurgery within the eye. It must therefore be performed in a fully equipped operating theatre.
The self-sealing incision in the eye is tiny, less than 3 mms long. The foldable replacement IOL is also inserted through this tiny incision. No sutures are required.
After the surgery eye drops need to be used for about 3 weeks. Vision is often good within days, but the focus of the eye may take several weeks to finally settle.
These comments give a general guide to the nature of the procedure, but the specific details and experience will vary from one patient to another.
Pre-operative Measurements
Before the operation several measurements need to be done on the eye. This is called “Biometry”. These measurements enable the required power of the IOL to be calculated. The power of the IOL used is tailored for the individual eye. The measurements are simple and painless. They involve assessing the curvature of the cornea and the length of the eye.
The formulae used to calculate the lens power are well tried but not perfect. Because of a natural biological variability between eyes sometimes the predicted focus is not achieved. If this occurs and the unaided vision is unsatisfactory, further surgery may be required.
Types of Implant
Monofocal Lens Implants
Monofocal lens implants are a type of intraocular lens (IOL) used in cataract surgery or refractive lens exchange. Unlike multifocal or extended depth of focus lenses, monofocal lenses have a single focusing distance, typically set for either near, intermediate, or distance vision. While they can significantly improve vision at the chosen focal distance, patients may still need glasses or contact lenses for other distances. Monofocal lenses are a common and reliable option for individuals seeking cataract surgery or refractive lens exchange.
Toric lens Implants
Toric lens implants are a specific type of intraocular lens (IOL) used in cataract surgery or refractive lens exchange. They are designed to correct astigmatism, which is a common refractive error caused by an irregularly shaped cornea or lens. Unlike traditional spherical lenses, toric lenses have different powers in different meridians of the lens to counteract the astigmatism, allowing light to focus properly on the retina and improving overall vision quality. Toric lenses can be an excellent option for individuals with both cataracts and astigmatism, providing clearer vision without the need for glasses or contact lenses after surgery.
Extended Focus Lens Implants (EDOF)
An extended focus lens implant, also known as an extended depth of focus (EDOF) lens, is a type of intraocular lens (IOL) used in cataract surgery or refractive lens exchange. Similar to multifocal lenses, EDOF lenses are designed to provide vision correction for both near and distance vision. However, instead of having distinct zones for different distances, EDOF lenses work by elongating the range of clear vision, providing a continuous range of focus from near to far. This design aims to provide better visual quality and reduce visual disturbances like glare and halos compared to multifocal lenses.
Enhanced Depth of Field Lens Implants (EDOF)
Enhanced depth of field (EDOF) lens implants are a type of intraocular lens (IOL) used in cataract surgery or refractive lens exchange.
These lenses are designed to improve vision by extending the depth of focus, allowing for clearer vision at various distances, including both near and far. Unlike multifocal lenses, which have distinct zones for different distances, and extended focus lenses, which provide a continuous range of focus, EDOF lenses work by optimizing the distribution of light across the retina to enhance vision quality over a range of distances, with a particular emphasis on intermediate vision. This can reduce the need for glasses for activities like reading, computer work, and driving.
Multifocal Lens Implants
A multifocal lens implant is a type of intraocular lens (IOL) used in cataract surgery or refractive lens exchange. It’s designed to provide vision correction for both near and distance vision simultaneously, reducing or eliminating the need for glasses or contact lenses after surgery. These lenses have different zones or rings that focus light from different distances onto the retina, allowing for clearer vision at various distances.