Refractive Lens Exchange (RLE)
RLE and cataract surgery are essentially the same procedure. In both procedures, the natural crystalline lens of your eye is removed through a small incision made in your eye and replaced by a man-made Intra-ocular Lens implant or IOL. The only difference is that RLE is a totally elective procedure done to decrease the need for glasses, while also eliminating existing early cataracts. Removing the cataract in cataract surgery is done for medical reasons such as blurred vision, glare, or seeing haloes. This procedure is advantageous to those over 45 that may have the early starts of cataracts or are not ideal LASIK candidates.
CEC has a reputation as one of the leading centers for LASIK and other procedures to help patients achieve freedom from glasses. We are committed to “refractive cataract surgery” and providing our cataract patients this same level of freedom. There has been an explosion in lens implant technology recently which allows us to select a lens customized to each individual's lifestyle, hobbies, and visual demands so that excellent vision without glasses in achievable for all visual tasks; distance , intermediate, and near.
There are two types of new implants designed to provide patients eyeglass freedom even for reading.
The first type is the multifocal lens. These implants have a bifocal or trifocal optic built directly into the implanted lens that allows viewing of objects at all distances. The Alcon ReStor and AMO ReZoom™ multifocal lens implants are examples and they each work slightly different.
The second type of lens is a focusing or accommodating lens which moves of flexes inside the eye to mimic the function of the younger human lens ability to actively change focus depending on the task at hand (i.e. distance or near). The Cystalens implant is the only accommodating lens currently available.
How Age Affects Vision (Presbyopia and Cataracts)
At Southwest Eye Clinic, your doctor may evaluate the progress of your presbyopia and/or cataract formation. A cataract refers to a cloudy lens within the eye as a result of the natural aging process. Symptoms of cataracts may include blurred vision, dulling of colors, halos / glare around lights when driving, difficulty reading in low light, double vision, and a frequent need to change eyeglass prescriptions. When a cataract is removed, an intra-ocular lens implant (IOL) is placed inside the eye to replace the cloudy human lens. Presbyopia is the need for most adults over 45 to use reading glasses or bifocals in order to see up close due to a progressive stiffening and loss of flexibility of the human lens.
In the past, patients required glasses for close-up vision after cataract and lens implant surgery. Now, at Southwest Eye Clinic, there’s a better solution. Premium intra-ocular implants (IOLs) are now available, which improve vision for cataract patients, but also treat presbyopia essentially turning back the clock to give you the ability to see up close as well as at a distance without glasses. The elective upgrade to a Premium Presbyopic IOL is not covered by insurance or Medicare and will be the patient’s financial responsibility.
Know Your Choices of Premium Lens Implants
Accommodating Crystalens HD™ IOL
The only FDA approved accommodating lens modeled after the human eye. Movement of the lens on hinges mimics the younger, flexible human lens and enables you to focus at different distances. The lens gives excellent “high-definition” distance, great intermediate and good reading vision. It does not induce glare and halos. A night time driver who uses the computer is a typical excellent candidate.
Multifocal IOLs -These IOLs have bifocals built into the lens
ReSTOR™ - An Aspheric Multifocal IOL that provides good distance, excellent close vision for reading and hobbies. Best for someone whose visual priorities are up close. ReSTOR gives the best small print vision but does cause mild haloes around lights at night.
Good distance, good intermediate and computer, fair reading. Glasses are sometimes necessary for the smallest print size such as medicine bottle labels or the stock pages. Halos are most pronounced with this lens.
Refractive Lens Implants
At Southwest Eye Clinic, we are always excited to introduce new, breakthrough technologies to complement the extensive range of vision correction procedures offered at our Oklahoma City office. As a leading corneal specialist, Dr. Kurtis Weir is continually utilizing the latest, most promising advances in vision restoration, integrating the most effective of these into his practice. Among the most impressive advances in ophthalmology, Refractive Lens Implants offer patients the opportunity to restore their ability to focus without having to depend on glasses or contact lenses. Intended to replace the eye's natural lens following cataract removal, refractive lens implants are becoming increasingly functional, and the technology involved in this amazing treatment is constantly evolving.
For patients who require cataract surgery or who are encountering problems with their existing refractive lens implants, the Southwest Eye Clinic Center is proud to offer an impressive selection of lens replacement options, including revolutionary ReSTOR and Crystalens premium multifocal implants.
If you are interested in learning more about refractive lens implants and how they can help to restore your visual acuity, please contact Southwest Eye Clinic today. We would be pleased to answer any questions you might have about this remarkable technology.
The Crystalens implant flexes like your natural lens providing for vision at distance and intermediate ranges.
ReStor lens focuses much like your own human lens bringing you clear vision at distance and near. Although ophthalmologists have been using artificial lenses to replace the eye's natural lens for decades, most patients still depended on reading glasses following cataract removal. This is because these artificial lenses were non-accommodating, meaning that, unlike the natural lens, they did not adjust to focus. Fortunately, technology has advanced to the point that we are now able to replace the natural lens with an accommodating artificial lens, the revolutionary Crystalens HD, in our practice. Unlike previous artificial lenses, Crystalens HD features a hinge that allows the lens to move as you change focus, enabling you to clearly see images that are near, intermediate, and distant. In clinical tests, nearly all patients who received Crystalens HD implants in both eyes were able to see well enough to pass a driver's test, while 98.4 percent of patients were able to read newsprint without the need for reading glasses. Thanks to Crystalens HD, patients whose vision has degenerated over time have renewed hope for achieving the visual independence they enjoyed when they were younger.
ReSTOR™ Aspheric Multifocal IOL
The most recent advance in refractive lens implant technology, ReSTOR™ lens implants are able to restore near, intermediate, and distance vision. Dr. Weir is one of a select group of surgeons qualified to offer ReSTOR™ lenses, which truly represent the next generation in refractive lens implants. This new multi-focal lens has shown particular promise for facilitating near vision, which makes it a potentially ideal treatment for presbyopic patients. Indeed, the vast majority of patients who have received ReSTOR™ lens implants to date have not only experienced remarkable visual acuity while reading, but have also been able to eliminate the need for glasses for all activities following removal of the natural lens. In the coming years, ReSTOR™ lens implants figure to be an invaluable addition allowing us to "turn back the clock" patients above the age of 45.
Monofocal Aspheric IOL (Single Focus) - Standard IOLs have one focus and provide excellent distance clarity but with both eyes corrected for distance using monofocal IOLs, patients require reading glasses after surgery. Alternatively, you can choose to have monofocal (single focus) IOLs of different powers so that one eye functions primarily for DISTANCE and one eye functions primarily for NEAR vision. This is called monovision, which can reduce the need for reading glasses to some degree. New “high-definition” Monofocal Aspheric lenses have been developed that allow for greater clarity, decreased glare and improved depth of focus.
Toric IOLs for Astigmatism
AcrySof® Toric IOL for Astigmatism
Until recently, cataract sufferers with astigmatism had few options for restoring vision back to a level that eliminates glasses or contacts from everyday life. Now, there's an intraocular lens (IOL) that has been created specifically for individuals with astigmatism. This advanced technology is called the AcrySof Toric Lens, and it has the power to deliver excellent all-around vision, including distance. Patients with this IOL will still require reading glasses for near tasks after surgery.
Great results: can provide the freedom to see without glasses or contacts
Effective: specifically designed for astigmatism (up to -6.00D)
Maintenance-free: permanent solution to annoying contact lenses
Invisible: after it is implanted, it cannot be seen by the naked eye
Minimally invasive: implanting is fast and virtually painless
Biocompatible: made from Collamer, a highly biocompatible copolymer
In recent FDA trials, patients implanted bilaterally with Toric IOLs reported the following:
97% were able eliminate the need for glasses to see at distance
97% achieved vision of 20/25 or better
Often Dr. Weir may opt to treat astigmatism in his cataract patients using an (LRI), which involves making small incisions in the cornea. In addition to corneal astigmatism, some people may have lenticular astigmatism, caused by irregularity in the shape of the human natural lens. This can be corrected with the new more stabile AcrySof Toric IOL.
Blue Light-Filtering IOLs
AcrySof Natural filters both ultraviolet (UV) and high-energy blue light, both of which are present in natural and artificially produced light. UV rays have long been suspected to cause cataracts and other vision problems, and many IOLs filter them out just as your natural crystalline lens does before its removal in cataract surgery. Blue light, which ranges from 400 nm to 500 nm in the visible light spectrum, may cause retinal damage and play a role in the onset of age-related macular degeneration. Also, the new Bausch & Lomb AOV has a visible violet light filter and aspheric design to select for UV and visible violet blue-light filtration while enhancing contrast and reducing glare.
The AcrySof Natural is colored a transparent yellow in order to filter the blue light; actually, the color is similar to that of the natural crystalline lens, so the idea behind the AcrySof Natural is to re-add the protection against blue light that is lost when the natural lens is removed. According to Alcon, the manufacturer, the yellow tint doesn't alter the color of your environment or your vision quality.
Which tasks listed below do you require for good vision for after surgery?
Cost and Availability
New Medicare Policy
Seniors Have Access to ReSTOR and Crystalens Premium Lens Technology at Southwest Eye Clinic
Seniors on Medicare now can choose the premium presbyopia-correcting ReSTOR and Crystalens lenses, which treat two conditions: cataract removal with lens replacement (a procedure covered by Medicare) and presbyopia (a non-covered service). Patients who select premium multifocal IOLs will receive the standard Medicare reimbursement for cataract surgery, and can now pay privately for the presbyopic portion of their treatment.
“This Medicare policy change means that patients now have a choice in their vision correction that best suits their individual lifestyle. It also gives us the option of offering premium IOL technology for improving both vision and lives for our Medicare patients,” says Dr. Kurtis Weir. To find out if you're a candidate for ReSTOR or Crystalens, call today at (405) 703-2020.
Phakic IOLs - Featuring the Staar and Verisyse™ Lenses
Unlike refractive lens implants, phakic intraocular lenses (IOLs) do not replace the eye's natural lens but rather supplements it. Phakic IOLs, such as the revolutionary Staar Visian ICL and Verisyse™, are often ideal for patients over 21 who are extremely nearsighted and wish to eliminate their dependence on contact lenses or thick glasses. The Staar and Verisyse micro lenses provide sharp, high-definition vision and are particularly useful for patients who are not able to achieve improved near vision through custom LASIK. Because phakic IOLs are fixed into the eye and can only be removed by a doctor, they are more convenient and easier to maintain than traditional contact lenses. The procedure of implanting the lenses requires only about 15 to 30 minutes per eye, and improvements to vision are immediate.
Phakic Lens Implants “Implantable Contact Lenses” (ICL)
Can you believe we live in an age when we have “implantable contact lenses”? Imagine being able to enjoy life without worrying about your glasses or contacts. The Visian ICL (Implantable Collamer Lens) by STAAR®Surgical Company offers you freedom from nearsightedness. With the Visian Staar ICL, you could enjoy the beauty of a sunset, go snorkeling and observe amazing sea life, see a friend's smile from across the room, or simply sit anywhere in a movie theater without having to fuss with glasses or contacts.
Quality of Vision The main advantage of the Visian ICL over traditional corrective laser eye surgery is that patients may experience significant improvement in quality of vision after the lens is implanted. When compared to the results of corneal refractive surgery, the Visian ICL may produce superior vision quality as evidenced by fewer higher order aberrations. Patients experience an almost immediate visual recovery.
Wide Treatment Range
The Staar Visian ICL has proven to be effective in patients within a wide range of refractive errors. In fact, the phakic IOL can correct/reduce myopia from -3.00 to -20.00. Before now, some of these individuals were not candidates for surgical eye correction. Clinical studies have shown how the Visian Staar ICL is truly a breakthrough myopia treatment in terms of results. Because implantation of the phakic IOL does not require any structural alteration of the eye, results are predictable and very stable
What is the Staar Visian ICL?
The Staar Visian ICL is a Collamer lens placed into the eye between the iris and the eye's natural crystalline lens. By combining its focusing power with the eye's natural lens (similar to the theory behind a traditional prescription contact lens), the Visian ICL is able to correct for a wide range of myopia.
An improved quality of vision is noticed with the Visian ICL. The Collamer lens produces sharper vision than other refractive surgical procedures. Also, the unique Collamer material makes the Visian ICL "invisible" to the body. (It is not seen as a foreign object by the immune system.)
Unlike other myopia (nearsightedness) correction surgical procedures like LASIK or PRK, the implantation of the Visian ICL does not remove or alter the eye's tissue. Instead, during the refractive surgical procedure, a small incision is made and the foldable Collamer lens is inserted into the eye to supplement the eye's natural lens.
STAAR Surgical Company's implantable Collamer lenses are not permanently placed in the eye and can be removed if a prescription change is needed for further nearsightedness correction or if a cataract develops and needs to be treated.
Visian ICL FAQs
The Visian ICL (Implantable Collamer® Lens) has been gaining recognition as phakic intraocular lens that produces exceptional quality of vision. It is revolutionizing the refractive correction industry. Below are some of the frequently asked questions about STAAR Surgical Company's implantable Collamer lens.
How is RLE or Cataract Surgery Done?
The surgery is a modern, out-patient procedure. The stay at an ambulatory surgical center is just a few hours and recovery time after surgery is dramatically reduced. Many people enjoy improved vision with minimal dependence upon corrective eyewear as a result of modern cataract surgery.
Your lens will be removed with an advanced technique called phacoemulsification, or small-incision cataract surgery. After applying a local anesthetic, a tiny incision of about 1/8” is made in the front part of the eye. The natural lens is then broken into microscopic particles using high energy sound waves and gently suctioned from the eye. Then, to compensate for the removal of the natural lens, an intra-ocular lens (IOL) is implanted into the eye. This type of incision is self-healing, stronger and remains tightly sealed by the natural outward pressure within your eye.
RLE or Cataract surgery is a pain-free experience thanks to advances in anesthesia. Patients are awake during the surgery and are able to resume most activities shortly afterwards.
Thought you had to wear glasses after cataract surgery?
How do I know if I am a candidate for RLE or cataract surgery?
You may be a candidate for Refractive Lens Exchange if you:
Are over the age of 45 and having difficulty focusing on objects up close
Do not qualify as a candidate for laser vision correction (i.e. LASIK), because you are either too farsighted or too nearsighted, have thin corneas or severe dry eye
Are tired of wearing bifocals or progressives to correct your reading and distance vision
Already have cataracts starting to form.
Are already presbyopic.
There is little need to have surgery affecting the cornea if within a short period of time you will be having cataract surgery anyway or you already cannot change focus from distance to near.