Refractive Lens Exchange
What is Refractive Lens Exchange?
Who is suitable for lens exchange?
What is the difference between lens exchange surgery and cataract surgery?
Lens exchange surgery and cataract surgery is essentially the same operation. In both scenario, intraocular lens is implanted to replace the natural lens. In cataract surgery the natural lens is removed because it becomes cloudy (develops cataract). In lens exchange surgery the lens is removed to correct refractive error such as short-sightedness or long-sightedness.
What different types of intraocular lenses are available?
Lens exchange procedure typically replaces natural lens with premium intraocular lens (IOL). The premium IOL is designed to provide spectacle-free vision. The lens provides focus at all distances (multifocal IOL), correct astigmatism (toric IOL) or do both (multifocal toric IOL).
Some people may not be suitable for premium IOL. In these cases, standard lens, also known as monofocal lens, is used. It will allow clear focus at a fixed distance. That means glasses or contact lenses will be needed to read a book or to work at a computer screen.
What does the operation involve?
The operation is normally carried out under local anaesthesia. Eye drops are administered to numb the eye. You will be awake during the operation but you will not feel any pain. During the operation the lens is removed using small incision phacoemulsification technique. The skin (capsule) of the lens is left behind to support the new lens implant. The new intraocular lens (IOL) is implanted within the capsular bag. Normally stitches are not required as the cut seals itself.
What happens after the operation?
What should I avoid after the operation?
How successful is the lens replacement surgery?
What are the complications of cataract surgery?
Complications during the operation
- Break in the lens capsule (Capsule rupture)
- Prolapse of vitreous jelly (Vitreous loss)
- Loss of part or the whole lens to the back of the eye
- Unable to insert premium lens due to lack of support
- Bleeding behind the retina causing permanent visual loss (Expulsive haemorrhage)
- Injury or trauma to the intraocular structures
- Enlargement of cut requiring stitches
Complications after the operation
- Prolonged inflammation of the eye
- Infection (Endophthalmitis)
- Increased pressure in the eye (Glaucoma)
- Waterlogging of cornea (Corneal Oedema)
- Detached retina
- Swelling/Fluid at the back of the eye in the retina (Macular Oedema)
- Droopy eyelid (Ptosis)
- Double vision or ghosting
- Displacement of intraocular lens
- Misshapen pupil
- Thickening or clouding of lens capsule (posterior capsular opacity)
- Unexpected refractive outcome – This means spectacle prescription much different from what was planned for. This may lead to having to wear spectacles or contact lenses all the time.
- Seeing new floaters or worsening of pre-existing floaters
- Visual disturbances (Dysphotopsia) – Seeing flashing lights, an arc of light in the corner, glare etc.