Refractive Lens Exchange

Presbyopia is inevitable with aging. Most people begin to lose their reading vision in the mid-forties, and almost everyone needs reading glasses to read comfortably after the age of 50. Farsightedness (hyperopia) can also make reading difficult, if not impossible, without correction.

What is Refractive Lens Exchange?

Also known as lens replacement surgery, refractive lens exchange is a surgical procedure similar to cataract surgery that involves replacing the natural lens of the eye to treat presbyopia. If you have cataracts, you do not have to wait for them to fully develop to become a good candidate for refractive lens exchange. This procedure actually prevents cataracts, as the intraocular lens (IOL) used to replace the natural lens does not age.

Many people with these conditions are frustrated to learn that LASIK and other laser techniques are not the best options for treating age-related farsightedness. Fortunately, thanks to advances in technology, Dr. Manoj Joshi at Shivam Eye Hospital, a highly experienced eye surgeon, skillfully performs refractive lens exchange to achieve long-term correction of presbyopia and hyperopia.

How is Refractive Lens Exchange performed?

This procedure is performed on an outpatient basis with topical anesthesia and intravenous sedation. Dr. Nemi will make small incision to provide access to the natural lens. A laser may be used to create the incisions, soften the natural lens, and treat astigmatism if necessary. The natural lens is removed and replaced with an intraocular lens (IOL).

Who is a good candidate for Refractive Lens Exchange?

This treatment is best suited for men and women who are not good candidates for LASIK or laser eye surgery. Refractive lens exchange may be the only treatment option besides corrective eyewear for people with presbyopia or moderate to severe hyperopia. You may be a good candidate for this procedure if you:

  • Are over the age of 40
  • Have presbyopia and want to reduce the need for glasses or contact lenses
  • Have moderate to severe hyperopia
  • Are not a good candidate for LASIK and want an alternative treatment

What types of lenses are used in Refractive Lens Exchange?

Extended depth of Focus IOLS

The unique advantage of this type of replacement lens is continuous elongation of focus from distance to intermediate tasks. This makes it easier to see a computer, smartphone, or tablet or the dashboard of your car. Low-power over-the-counter reading glasses may be helpful for reading with low light or fine print after refractive lens exchange with extended depth of focus IOLs.

Monovision IOLS

In refractive lens exchange using monovision IOLs, each eye gets a different lens. The dominant eye receives the lens designed for distance vision, and the non-dominant eye is used for reading and viewing close objects. A similar practice is sometimes used with contact lenses.

Multifocal IOLS

These lenses work in a similar way to bifocal glasses. A correction is made around the periphery of the lens to allow for clarity when reading or doing up-close activities. The middle part of the lens is calibrated to create clear central vision for distance ranges.

Accommodating IOLS

These lenses are monofocal. However, the focus can be changed by shifting the position of the lens in the eye.

What can I expect after Refractive Lens Exchange?

You may resume your normal activities the day after the procedure. You would require follow-up visits to monitor healing and evaluate vision improvement. Most patients experience improvement in their vision immediately after refractive lens exchange. Many men and women who undergo this surgery see dramatic improvement and no longer need glasses or contact lenses – and a greatly improved quality of life.