Can I Get A Refractive Lens Exchange If I Have A Cataract?

Posted by Dr Niteen Dedhia on April 18th, 2022

Introduction

In recent times, people have been more concerned about having perfect vision without dependence on glasses. Glasses and contacts may get frustrating, even for people over 45 years. Patients would prefer an advanced procedure that helps remove the cataract and eliminate the need for glasses altogether.

Although LASIK gives a wonderful resultin correcting refractive errors, itmay not be the best option for patients with presbyopia and cataract.

There are other options for patients with presbyopia andcataract. These include Presbyopic Refractive lens exchange (PRELEX) for presbyopia and Microincision cataract surgery with Premium IOLs for treating cataracts.

What is RLE?

Presbyopic Refractive Lens Exchange (PRELEX) is amicro-surgical procedure wherein a patient with presbyopia undergoes exchange of the natural lens with an advanced IOL.

RLE is considered as a minimally invasive surgical procedure. It exchanges the natural lens of the eye with an artificial lens (Trifocal/ Extended Depth of focus/ Extended Range of Vision lens). This artificial lens is known as an intraocular lens or IOL.

These IOLs are designed to correct mild to moderate astigmatism, farsightedness and/or nearsightedness. In addition, RLE enables you to eliminate the dependence on your glasses or contact lenses permanently.

What is a cataract?

The natural lens becomes cloudy and light rays cannotpass through it, hence leading to blurry vision. This condition usually occurs with age and is known as a cataract. There are various grades of cataract.

Microincision Cataract surgery with phacoemulsification is the treatment of cataract.

A cataract becomes harder and more opaque over time affecting vision severely. Cataractous lens needs to be replaced with an intraocular lens for improvement of vision.

The cataract surgery and RLE procedure are similar in technique. Both involve the procedure of exchanging the natural lens with an artificial IOL.

The surgeon by approaching the early cataractous changes can aim to remove both the cataract and the glasses in the same procedure. If the natural lens is removed at the beginning of the cataract, the chances of developing cataracts after RLE is eliminated. Because the cataract can never develop in an artificial lens.

IOLs

There are several different kinds of intraocular lenses. These include Monofocal IOL’s , Multifocal IOL’s , Trifocal IOL’s , Extended Depth of focus IOL’s , Toric IOL’s , Toric Trifocal IOl’s. The choice of IOL for every patient is an individualised decision that you and your eye surgeon will jointly make. Your surgeon will help you select the best IOL as per to your visual and lifestyle needs.

• A Monofocal lens has one set refractive power. It helps focus light rays clearly at on particular distance and hence achieve clear vision.

With monofocal lenses a small adjustment known as monovision can be done with a combination of the two different powered lenses, one for far and one for near. Monovision is to have the ability to focus on near objects and far objects with both eyes open. The combination of the lens provides you better vision at most distances. But sometimes you still need to wear glasses for reading or seeing smaller things near you.

Premium IOLs

Premium IOLs are advanced IOLs that include Multifocal IOL’s , Trifocal IOL’s , Extended Depth of focus IOL’s. It can give you the perfect vision you’ve ever wanted.

Premium IOLs can eliminate the need for reading glasses too. These multifocal or trifocal lenses are available in all refractive powers. A biometry scan of patient’s eye will be done to assess suitability and decide the IOL as per various eye parameters.

Procedure of RLE

RLE procedure involves instillation of topical anaesthetic eye drops before the surgery. These will make your eye numb and hence procedure will be painless and comfortable.

The surgeon creates a sub 2 mm small opening in the eye. The cloudy fragments of the natural lens are removed via a laser probe. A foldable IOL is then inserted into the capsular bag via the same small opening.The entire surgery hardly takes 20 minutes to complete. But you may still have to wait for 2 hours before leaving the hospital.

Someone has to drive you home on the day of surgery. In addition, you may experience mild blurry vision for a few days after the surgery.

Are you a Good candidate for RLE?

• Patients of 45 plus age group who do not want to wear glasses.
• Patients with astigmatism, nearsightedness or farsightedness can opt for RLE.
• The patient who does not wish to wear glasses or contact lens.
• Patients wearing Monovision contact lenses or Multifocal Contact lenses may be good candidates
• Candidates who do not have significant cataracts.

Conclusion

There are multiple options are available for seeking perfect vision. This depends on your eye number, Astigmatism, age and other factors. Your doctor will advises you to choose the IOLs from a wide variety. If you have a cataract, you should know the stage of the cataract. You can even opt for RLE at the beginning of a cataract. Consult your doctor and select the best procedure wisely.

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