Consultant Ophthalmic Surgeon
Refractive Lens
Exchange
| What is a Refractive Lens Exchange?
Refractive Lens Exchange (RLE) is a surgical procedure performed to replace the eye’s natural lens with an artificial one to restore clear vision, similar to a cataract surgery. The main difference is that RLE removes the natural lens before it has become clouded with a cataract giving the opportunity to people to rely less on glasses.
It is performed usually as an alternative for patients unsuitable for LASIK surgery and in recent years, it has become a popular treatment option to correct presbyopia (long-sightedness), myopia (near-sightedness) and astigmatism.
Mr. Kopsachilis will meet with you to evaluate your eyes and visual needs in order to determine the best lens option for you.
There are three main types of Premium Intraocular Lenses, which may be suitable for you, which will increase the chance of you not needing glasses after surgery.
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Toric IOLs, which allow the correction of pre-existing astigmatism.
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Multifocal IOLs are similar in concept to bifocal or varifocal glasses, except that the lens is within the eye; the goal of these lenses is to allow the ability to see both distance (e.g. driving) intermediate (e.g. computer work) and near (e.g. reading) without glasses.
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Toric multifocal IOLs combine the advantages of both these types of lenses.
| Toric | Multifocal | Bifocal
Toric lenses
When most people think of an eye’s shape, they think of round structure, like a basketball. In truth, most eyes are more rugby ball-shaped, with the eye being a little squashed in one direction. This irregularity is known as astigmatism and is easily corrected with glasses, but, if marked, a patient’s vision without glasses will be quite poor.
A toric IOL is a bespoke lens placed inside an eye to correct a patient’s astigmatism, at the same time reducing the patient’s short- or long-sightedness. After surgery, the chance of needing glasses for distance is greatly reduced, although without the simultaneous placement of a multifocal lens (‘toric multifocal’), patients should still expect to need reading glasses. Cataract surgery in patients with marked astigmatism using standard, non-toric IOLs does typically lead to improvements in vision, but patients will typically need glasses for distance and near vision following surgery.
Multifocal lenses
Multifocal lens implants feature a patented "apodized diffractive" design that optimally distributes light to distance, intermediate and near focal points, depending on the amount of ambient light available. This optimizes image quality in all lighting conditions.
With such lenses, about 90 % of people achieve day-to-day spectacle independence, meaning that typically they can both drive, use their smartphone and read, e.g. a restaurant menu, without glasses. For more prolonged reading, such as a novel, however, many patients still choose to wear reading glasses.
In the dark, some patients do complain of haloes around lights; However, these tend to subside with time due to the neuroadaptive effect of the human brain.
Bifocal lenses
Bifocal Lenses are presbyopic asymmetric segmented multifocal lenses designed to improve contrast sensitivity, minimize halos and glare, and provide superior near, intermediate and distance vision and can be used in patients with conditions that normally would contraindicate the use of a traditional multifocal lens.
Monofocal Intraocular Lens
The front of the eye
Multifocal Intraocular
Lens
Toric multifocal lenses
These lenses combine the benefits of both toric and multifocal lenses, i.e. simultaneously improving astigmatism and aiming to achieve spectacle-independence for distance and near.
The TECNIS Eyhance IOL
This is a new monofocal lens which features a continuous change in power from the periphery to the centre of the lens, creating a unique anterior surface that improves intermediate vision, maintains distance image quality comparable to aspheric monofocal lenses, and delivers a profile of photic phenomena similar to monofocal lenses.
| Try the simulator
Zeiss Lens manufacturer built this useful tool to better explain some of the differences and limitations of the various lens designs. These principles apply to Cataract and RLE surgery as well, because the same lenses are available for both types of surgery.
Click the image to visit the simulator now.
| Further information on Refractive Lens Exchange
Click the images below for more information about the lenses Mr. Kopsachilis uses.
If you have further questions, please check our FAQ's page by clicking here.
You can also reach out using our contact form, or request a in person consultation by clicking here.
