Refractive Lens Exchange

The term refractive lens exchange means the surgical removal of the eye's natural internal lens while it is still clear and transparent.  Normally, the natural lens is removed only when it has become cloudy enough to obstruct vision, for example, when a cataract has formed in our latter years of life. The lens exchange procedure, however, can also be used to correct very high amounts of short-sightedness or long-sightedness.  In such cases, the eye's natural lens is replaced by a lens implant whose optical prescription is specifically selected to provide sharp vision for the particular eye that is having the procedure.  The term "clear lensectomy" is also used to describe this type of procedure.

One drawback of a lens exchange is that it results in the eye losing its natural ability to focus on close-up things, for example, when reading, sewing, using a computer, etc.  Hence, reading glasses would normally be required after a lens exchange.  However, the advent of new design intra-ocular lenses (IOL's) now means that many people who have a refractive lens exchange are able to see up close, as well as in the distance, without having to constantly rely on glasses as they would have had to with older design IOL's.

Am I a Candidate?

The refractive lens exchange procedure is used if the eye has a very high prescription of short-sightedness or long-sightedness (i.e. more than could be treated by laser eye surgery).  Refractive lens exchange may also be appropriate in eyes that have a low prescription. If the natural lens of the eye is developing a cataract that would have to be removed in the near future because it would cause a significant reduction in the quality of vision.

My Procedure

The eye is 'numbed' for this painless surgery by using topical drops to anaesthetise the eye.  An ultrasonic probe is inserted through a small incision which is only 3mm long. The ultrasonic action gently breaks up the material that makes up the eye's natural lens, and the probe suctions the fragments out of the eye. Then the IOL is folded to fit through the 3mm incision.  The IOL is made from a special type of soft plastic which unfolds inside the eye, and stays in position permanently.  The whole surgical procedure takes around 25 minutes.

Visual Recovery

Visual recovery from refractive lens exchange, in most cases, is quick.  On the day after surgery patients are usually able to engage in most regular activities, with the benefit of increased visual freedom.  Some activities such as swimming and contact sports should be avoided for a few weeks.  Most patients experience some temporary blurring for a few days, and also some light sensitivity for a few weeks, therefore, sunglasses need to be worn more often than usual.

As lens exchange is an intraocular surgery, there is a small risk that certain complications may occur, and these will be discussed with you during the consultation to help decide if this type of surgery is appropriate for you.