Refractive lens exchange, also called clear lens extraction, replaces the eye’s natural lens with a Presbyopic correcting intraocular lens (premium IOL) in patients wishing to correct farsightedness, nearsightedness or presbyopia without undergoing a corneal modification procedure such as LASIK. There is a variety of premium IOLs available, and they each have their own set of advantages. No single IOL works best for everyone, and only your ophthalmologist can determine the most appropriate IOL for your visual needs. The most effective lens depends on each patient's individual preferences and goals for their vision.
The refractive lens exchange procedure is the same as that used in cataract surgery; the only difference is that refractive lens exchange is performed to achieve refractive correction rather than cataract removal. Refractive lens exchange involves a rapid recovery and offers patients dramatic improvement in vision quality.
After surgery, patients enjoy clearer vision and greater focusing power almost immediately. Many eliminate or significantly reduce their dependence on glasses or contact lenses, and vision remains stable over time. This procedure also prevents the patient from developing cataracts in the future thus eliminating a need for cataract surgery later in life.
You may be a candidate for refractive lens exchange if you:
Although refractive lens exchange is considered safe for most patients, there are certain risks associated with any kind of procedure. You can discuss these risks, along with the benefits of this procedure, before deciding whether or not it is right for you.
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Patients with astigmatism who are undergoing cataract surgery can choose to have limbal-relaxing incisions made to reduce their dependence on glasses for clear vision. Limbal-relaxing incisions are tiny incisions made around the edge of the cornea, called the limbus. These incisions "relax" the cornea's steep curvature and improve the way the eye focuses light. Limbal-relaxing incisions have been shown to heal faster and cause fewer side effects than other astigmatic keratotomy (AK) procedures.
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During cataract surgery, the clouded lens in the eye is removed from the lens capsule and replaced with a clear, artificial lens called an IOL. Weeks, months or years after the surgery, some patients experience a decrease to their vision. This sometimes happens because the lens capsule becomes cloudy or wrinkled, blurring the patient's vision once again. This affects about 1 in 3 people within 5 years of having cataract surgery. It is sometimes called an "after cataract" or secondary membrane.
If an examination confirms that this is the case, and if the clouded capsule prevents the patient from doing what he or she wants or needs to do, then a YAG capsulotomy may be recommended. This simple procedure uses a YAG laser to open a window in the back of the lens capsule and restore clear vision. YAG capsulotomy is a painless outpatient procedure that takes less than 10 minutes. Vision improvement is quick, and the patient can resume normal activities immediately.
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