Refractive lens exchange like implantable contact lenses are capable of treating very high degrees of hypermetropia and myopia and are often considered when your prescription falls beyond the treatable range of either Lasik or Lasek. If your prescription is higher than -10.00 (short sighted) or +5.00 (long sighted) then refractive lens exchange is likely to be suggested to you by your surgeon.
Unlike implantable contact lenses, refractive lens exchange is generally considered for people over the age of 45 years old who already have problems with their near vision. Such people will be most likely wearing varifocals, bifocals, separate distance and reading glasses or be wearing multifocal contact lenses.
Put simply, the refractive lens exchange procedure involves removing your eye's natural lens and replacing it with an artificial lens (lens implant) whose power is calculated to eliminate the prescription in your glasses or contact lenses.. The natural lens inside your eye sits inside a lens capsule (like a bag) and when it is removed this capsule is left intact. The new artificial lens is then placed back into this capsule in the exact same position as your natural lens was located before it was removed.
Refractive lens exchange is generally recommended for people over 45 years old and this is because at this age people will have already started to develop presbyopia. Presbyopia describes the natural ageing process of the lens within your eye which results in reduced ability to focus things close to you e.g. reading. Consequently, when the natural lens in your eye is removed during refractive lens exchange you will no longer have the ability to focus on things close to you. If you already need spectacles for near vision as a result of your age, then this is much less likely to have an impact on you.
Refractive lens exchange can be carried out on people below the age of 45 but it is important to understand that having surgery at this age will mean that your near vision will be worse following surgery. However, this may be a small price to pay for those people with very high prescriptions if it means they no longer have to wear their incredibly thick glasses for walking around in. Over the past few years however refractive lens exchange has advanced considerably allowing both your reading vision and distance vision to be corrected. The ways in which refractive lens exchange can treat both distance and near vision is as follows:
As surgeons become increasingly confident with refractive lens exchange and the lenses available become more and more sophisticated so they try new ways of combining lenses. Some surgeons are starting to combine different types of multifocal contact lenses so as to get the best overall results. For example one multifocal lens may have a bias towards distance vision and the other towards near vision and so combining them may produce an optimal visual performance. Exactly which refractive lens exchange combination is best for you should be left to the expertise of the surgeon. Your surgeon will weigh up your prescription, lifestyle and visual requirements and come up with the best solution for you.
As yet refractive lens exchange is still considered a little bit of a compromise as you are unlikely to get perfect distance, intermediate and near vision. However if you go into the surgery with realistic expectations and your surgeon has fully explained everything to you, then it is likely to be a life changing surgery.
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