Refractive Lens Exchange

Refractive lens exchange—also known as custom lens replacement or clear lens extraction—is a surgical procedure that replaces the eye’s natural lens with an intraocular lens (IOL). This lens is designed to correct common vision problems like nearsightedness, farsightedness, and astigmatism.

Often offered as an alternative to laser vision correction, custom lens replacement avoids modifying the cornea (as in LASIK) and instead uses the same proven techniques as cataract surgery. Patients benefit from long-term visual improvement and the added advantage of never developing cataracts in the future.

Advanced Intraocular Lenses (IOLs)

Patients who choose to undergo refractive lens exchange have several options when it comes to the IOL that will be implanted into the eye. This procedure uses the same IOLs as cataract surgery, and can treat all visual disorders, including astigmatism. We offer patients the most advanced premium IOLs that allow patients to see clearly at all distances. Some of the most common IOLs include Crystalens®, ReSTOR®, ReZoom® and Toric lenses.

Candidates for Refractive Lens Exchange

Custom lens replacement is typically ideal for patients who:

• Want to reduce or eliminate their dependence on glasses or contact lenses
• Are over 50 years old
• Have high myopia (nearsightedness), high hyperopia (farsightedness) or presbyopia (astigmatism), with or without cataracts
• Have early symptoms of cataracts

Many patients with extreme farsightedness or nearsightedness are not candidates for LASIK, and seek vision correction through refractive lens exchange.

Patients with astigmatism can undergo additional correction during their procedure through relaxing incisions in the outer margins of the cornea. These are known as Limbal Relaxing Incisions. These incisions create a symmetrical cornea and help reduce or even eliminate astigmatism in the eye. There are also new IOLs that correct astigmatism and allow these patients to see normally.

Refractive Lens Exchange Procedure

Refractive lens exchange is performed on an outpatient basis and uses the same techniques as cataract surgery. Instead of removing a cloudy lens, the goal of this procedure is to reduce a patient’s dependence on glasses or contact lenses by inserting a corrective lens.

Local anesthesia is applied to the eyes to minimize discomfort during this procedure. The natural lens is removed through a tiny incision of 3mm or less and replaced with an IOL that is inserted through the same procedure. Once inserted, the lens unfolds and moves into its permanent position in the eye. There are no stitches needed as the incisions can heal themselves. The refractive lens exchange procedure takes just 20 minutes to perform and offers patients significant and immediate results.

Results and Recovery from Refractive Lens Exchange

After refractive lens exchange, patients can return home the same day, and can return to work and other regular activities after a day or two. Many report immediate improvements to their vision, and vision will continue to improve as the brain adapts to the new lens. Once vision has stabilized, it will likely stay the same over time as the lenses correct vision and also prevent the patient from developing cataracts in the future. The second eye is usually treated a few weeks after the first procedure.

The extent of a patients results will depend upon your individual eyes, life , the IOL you choose and several other factors. Many patients are able to eliminate their dependence on glasses or contacts after this procedure, while others may still need glasses for driving or reading.

Risks and Complications of Refractive Lens Exchange

Since refractive lens exchange is a completely different procedure from laser vision correction, its associated risks are different as well. Some of these risks may include retinal detachment, infection, hemorrhage, visual distortion, glaucoma and dryness. The doctor will discuss these risks with the patient, along with the benefits of the procedure, before deciding if refractive lens exchange is right for the patient. Patients can minimize these risks by choosing an experienced doctor to perform their procedure.