Laser Eye Surgery At Visualase
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Refractive Lens Exchange
What is Lens Exchange?
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Mr Christopher Heaven. Patient overview on Lens Exchange.
Not everyone is suitable for laser treatment. Refractive Lens Exchange may be an alternative; particularly for those over 50.
The aim of this procedure is to alter the refraction (or focus) of the eye by removing the natural lens of the eye and replacing it with a plastic artificial lens. This plastic lens is called a "lens implant".
Intra-ocular surgery
The natural lens is located within the eye just behind the pupil. The operation therefore involves micro-surgery performed inside the eye. This is different from laser refractive surgery which works by reshaping the cornea and is done on the outside of the eye. Refractive Lens Exchange is similar to modern small incision cataract surgery and so uses tried and tested technology.
Who may benefit?
This procedure can be used to correct both short sight (myopia) and long sight (hyperopia) that is too large to be safely and/or effectively corrected using laser surgery.
It is best suited to those patients aged over 50 years. This is because when the natural lens of the eye is removed all ability to adjust the focus of the eye is lost. This natural focusability of the eye is called "accommodation". It is slowly lost with ageing. This is why, for those who have good distance vision, near spectacles are usually required after mid 40's. When "Refractive Lens Exchange" is performed on those patients aged over 50 the loss of accommodation is of little consequence as it has already been lost through the ageing process anyway. The procedure may still be performed on younger persons but near vision spectacles will be a new requirement for such patients.
Unlike the natural lens of the eye in a young patient the standard lens implant has a fixed focus, i.e. these types of lens implants do not have focus adjustment. Lens implants with focus-ability have recently come onto the market, but their long term effectiveness is still uncertain.
In some cases in order to achieve the best or desired focus for the eye it is necessary to combine Refractive Lens Exchange with other techniques. For example in eyes with large refractive errors (e.g. high myopia) Lens Exchange may be used to correct the bulk of the error and some laser treatment (e.g. LASEK) may be used to correct or refine any residual defocus. This approach is called Bioptics.