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Refractive Lens Exchange

Are you over 40 and interested in LASIK? Do you have an active lifestyle? Are you experiencing trouble driving at night. If you answer YES you might be a candidate for refractive lens exchange and not LASIK? Is LASIK really the best procedure after 40 years of age?

Too old for LASIK & Too Young for Cataract Surgery.

Once people start to enter there 40’s it’s common to experience the on-set of presbyopia and the experience of not being able to read. This is commonly mistaken for plain farsightedness but is actually much different. Presbyopia is a gradual, age related loss of the eyes ability to focus on close up objects due to the decrease in flexibility of the eye.

  • As we age, the natural lens in our eyes gets cloudy causing fuzzy near, night and distance vision.
  • The earliest symptoms start with Presbyopia (the problem with near vision that starts at age 40). These symptoms are part of Dysfunctional Lens Syndrome (DLS).
  • Eventually, the lens develops an Insurance-Grade Cataract and insurance approves Cataract surgery to fix the symptoms.
  • Unfortunately, cataracts do not become Insurance-grade until much later in life (the average age for Cataract surgery in the US is now 65).

If you want vision correction and have the beginnings of cataract coupled with presbyopia, LASIK is not going to be the best option. Since you can’t have cataract surgery or at least the form covered by insurance, your vision correction option is refractive lens exchange. This type of eye surgery is gaining popularity for people over 40 who want to decrease or eliminate their dependence on glasses or contacts. If you have refractive lens exchange you will never have to have a cataract and cataract surgery. Essentially you will be having the lens removed before a cataract completely develops.

Work with the eye doctors who care to suggest the best possible procedure.

What Happens During Refractive Lens Exchange Surgery?

Refractive lens exchange is a very similar procedure to cataract surgery. When having refractive lens exchange surgery with our San Antonio eye surgeons you can rest assured you are in some of the finest hands in Texas. Our experience with this surgery is extensive.

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Refractive lens exchange is an outpatient procedure at our San Antonio surgery center and one eye is treated at a time. The surgeries for each eye usually scheduled about one week apart.

Prior to surgery eye drops that numb your eye will be administered and you will be given an oral sedative to help you stay comfortable.

The actual procedure is quite quick. Your eye surgeon will make a tiny incision and remove your eye’s natural lens.

They will then replace it with the type of advanced technology lens implant that you and your surgeon chose during your consultation appointment.

Patients can feel pressure, but it is typically a painless procedure. Many of our patients do report no pain at all.

Recovery from RLE is similar to cataract surgery and we ask that avoid any bumping or rubbing of eyes and that you stay calm for several days. You will be given eye drops that assist with the healing process.

There are options to improve the range of vision at different distances with some of the lenses available for implantation. Astigmatism can be corrected with toric IOLs, and those that correct both ranges of vision and astigmatism are becoming available as well.

Not everyone is a candidate for these lenses, so you must make the decision along with your surgeon.

Do I have dysfunctional lens syndrome and how does this relate to refractive lens exchange?

“Dysfunctional lens syndrome” (DLS) is a term used to describe the natural degeneration of functional vision as a result of changes in the crystalline lens. Eye surgeons often categorize DLS into three main phases.

In stage 1 (42-50) – the loss of the lens flexibility causes most people to lose the ability to focus on close objects, lacing accommodation capability. This is also known that the on-set of presbyopia.

In stage 2 (50) – focusing becomes drastically more difficult, plus the discoloration of the lens starts to occur and a cataract is forming. Patients report experiencing decreased contrast especially at night.

In Stage 3 (60) – ability to focus is lost completely and a cataract has formed with the yellowing of the crystalline lens becoming much darker. Visual quality is significantly degraded however this will vary from patient to patient.

Having refractive lens exchange in stage 1 can eliminate the need for you to complete the dysfunctional lens syndrome and develop a cataract. You will not need cataract surgery if you have RLE at this point in time.

When is Refractive Lens Exchange appropriate?

Refractive lens exchange might be appropriate if you are in the early stages of presbyopia and dysfunctional lens syndrome. This time period is estimated at between 40 and 45 years old. At this age due to presbyopia and DLS, LASIK is most likely not the best option. Additionally, if you have this corneas or high levels nearsightedness this procedure would also be appropriate. Review the following categories that we would suggest refractive lens exchange.

  • Patients who have early developing cataracts.
  • People that have developed presbyopia and have difficulty reading without readers, or bifocals.
  • Patients under the age of 40 with extreme correction needs.
  • Night driving difficulty
  • Patients under the age of 40 with thin corneas.
  • Patients over the age of 40 who want to stop using eyeglasses or contacts.

What are the risks of Refractive Lens Exchange surgery?

The same risks for traditional cataract surgery apply to refractive lens exchange. No lens is as perfect as your natural lens. Your vision will never be as good as when you were young and had a flexible lens that could focus at all different distances.

There will always be pros and cons to every type of implant. Some can decrease the quality of vision, some can cause glare/haloes, some will not give you the best reading vision, and this is where your goals for post-op vision can help in your decision.

Along with one of our San Antonio refractive lens exchange surgeons, you can choose a lens that will give you the best chance for good vision. Your eye doctor will also make sure you don’t have any eye conditions that may keep you from getting one of these lenses. You have a great opportunity to determine what your vision will be forever into the future. The lens implants to choose from are vast and cover many aspects of both distance and astigmatic variables.

A Team of Experts

We offer decades of experience and San Antonio’s Refractive Lens Exchange (RLE) experts using only the latest technology combined with a suite of advanced technology implants designed to help our patients see at multiple distances.

How Do I Get Started?

Having a consultation with your doctor will give you insight into the health of your eyes, and whether or not you are a candidate for this procedure. Filling out our RLE self test about your lifestyle and your goals for your vision after surgery can help get you started in your decision for lens implants.

A discussion with your doctor will help you decide which is the best option for your lens implant. The procedure itself usually takes just a few minutes and can be done under local anesthesia at an outpatient surgery facility.