Lens Replacement Surgery, also known as Refractive Lens Exchange, is very similar to cataract surgery but performed before cataracts develop. Book a consultation today and find out if you’re suitable.
Refractive Lens Exchange (RLE) is the procedure of phacoemulsification performed before a cataract has formed so that a clear lens is removed, it is also called Clear lens Extraction (CLE). RLE may be performed when refractive errors are too high for laser vision correction e.g. high hyperopia or high myopia or the eye is unsuitable for ICL implantation. In some cases where the angle of the eye is narrow and there is a risk of angle closure glaucoma (see glaucoma section) RLE may be preferred over laser treatment to the iris or YAG laser iridotomy.
The process of RLE is very similar to cataract surgery but because the crystalline lens is clear, removal of the lens may result in loss of accommodation (the ability to change focus to look at near objects) that most people are able to achieve before the onset of presbyopia. This means that even if a high spectacle error is treated by RLE, you will still require spectacles for close visual tasks e.g. reading.
We are able to offer a wide selection of lens types to suit your needs and the type of eyes you have. All of our lenses are premium products, there are no lenses which are better or higher or lower quality, but different lenses have different functionality and will suit different eyes and different visual requirements.
Monofocal lenses will give the sharpest image quality but the shortest range of vision or depth of focus so that reading glasses are usually required for intermediate and close visual tasks e.g. reading a newspaper. The focus of each lens can be offset slightly so that a dominant eye is clearer for distance and non-dominant eye for near. This effect called monovision or micro-monovision and you may have tried this using contact lenses before.
Extended depth of focus lenses (EDoF) increase the depth of focus by ‘stretching’ the intermediate zone of focus as well as distance vision correction, low strength readers may be required for close work but most of the time glasses are not required.
Diffractive multifocal lenses will provide the greatest range of vision and therefore the greatest independence from spectacles but this will be balanced against optical quality so that you may experience some glare or halo around lights e.g. head or taillights when driving at night. You may already experience these symptoms because of refractive error or early cataract and most people will adapt to them but they are an important consideration when choosing this type of lens implant.
David Anderson has a wide experience using many different lens types over the last 25 years so depending on your clinical examination and optical preferences can help guide you to the best choice for your particular circumstances.
Yes, there are a number of different approaches to reducing astigmatism from the placement of the entry ports during surgery to the use of toric or astigmatism correcting lenses, or combining lens surgery with laser vision correction also known as Bioptics.
David Anderson has published some of the largest studies on astigmatism in cataract surgery which can be referenced here and can advise you on the best options for your particular circumstances.
Risks with surgery are low and David Anderson has performed many thousands of operations with excellent results. Surgical procedures do carry risks however and complications can include infection, macula oedema (or swelling), seeing small dots or floaters and retinal detachment. All risks and benefit of surgery will be discussed with you at your consultation, if you are anxious about potential complications please call us so we can help alleviate any concerns that you may have.
Your eye will feel slightly gritty and may ache a little for a day or two but should not be painful. Any mild ache should settle with simple analgesia e.g. paracetamol. In many cases, people do not experience any discomfort.
We usually suggest a week or so off work and can provide medical certification if required. There are no restriction on using screens so if you would like to work from home using screens you can do so as soon as you wish. You cannot ‘strain’ your eyes by using them to watch the television, read, use a screen or a smartphone.
Our usual practice is to proceed with second eye surgery within a few days or a week of the first. Cataract surgery is very safe however, and there are circumstances in which surgery can be performed immediately sequentially on both eyes, particularly if a general anaesthetic is required.
The IOL implants are designed to be left in place for life, they do not wear out so do not need to be replaced after a period of time. They are made from biologically inert acrylic polymers.
Yes. IOLs or artificial lenses can be replaced but rarely need to be as they do not wear out, are not load bearing and do not move within the eye.
You can fly on the day of surgery but it is advisable to remain local to the hospital for the first few weeks after surgery in case you need advice or additional treatment.
Please avoid wearing eye make-up, particularly mascara for a week following surgery. Any other face make-up can be worn after 48 hours. We ask that you be careful not to rub or apply pressure to your eyes during this time.
We encourage you to be active but please avoid exercise for the first week after surgery and vigorous exercise for a second week. Taking walks can resume the next day and stretching or mobility within two or three days as long as it is gentle. Yoga and Pilates are fine to resume after a week but please avoid standing on your head!
If you have comfortable, well-fitting goggles you can swim after two weeks but ideally we would like you to avoid swimming pool water entering your eyes for a month following surgery. Many of our patients swim in the sea which is often cleaner and we recommend a two week period provided goggles are worn. After one month there are no limitations on swimming in freshwater or swimming pools.
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