As we age, our natural lens gradually loses its focusing ability. This is a normal part of the aging process and affects everyone. It first becomes noticeable in our 40’s with blurry near vision and the need for reading glasses. As it progresses, the distance vision can also be affected and require bifocal correction. Then our lens will start to become cloudy in our 60’s and 70’s resulting in cataracts. Once the cataracts become significant, cataract surgery is necessary to see well (the average age for cataract surgery is 73). This involves surgically removing the cloudy human lens and replacing it with a permanent clear artificial lens implant. We all eventually get cataracts; therefore, we will all eventually have our natural lens replaced.
Lens implant technology has advanced considerably over the past 20 years. We now have a variety of multifocal lens implants that can correct both distance and near vision, eliminating the need for reading glasses or bifocals. One doesn’t have to wait for cataracts to develop to take advantage of this exciting technology. Refractive lens exchange, or lens replacement surgery, is an elective procedure that involves replacing the natural lens with a multifocal lens implant to correct the vision at all distances, from far to near. It is the most permanent form of vision corrections surgery available. The artificial lens implant will never lose its focusing ability or its clarity, and cataracts can never develop.
The Lens Replacement Procedure
The procedure is similar to iLASIK and both eyes can be treated on the same day. Anesthetic eye drops are used to numb the eye and a mild sedative is administered. Through a 3mm corneal incision, a circular opening is created in the lens capsule and a small ultrasound instrument is used to break up and remove the human lens material. The artificial lens is then injected through the small incision and placed inside the lens capsule, which will seal around the lens implant locking it in place. The incision seals without stitches and the entire procedure takes about 10 minutes per eye. There is a mild pressure sensation but no pain during the surgery. Vision can be blurry immediately afterwards and patients are encouraged to go home and rest for the remainder of that day. Most people are seeing well enough the next day to resume full activity, including driving and working.
Frequently Asked Questions About Lens Replacement
Is iLASIK a better option?
Whether to go with lens replacement or iLASIK depends not only on the patient’s age, but the amount of correction they need. iLASIK is preferable for younger patients who don’t need reading glasses or bifocal correction. If reading correction is needed, usually around age 45, we recommend lens replacement over iLASIK.
Is lens replacement an option for patients with previous LASIK or RK?
Yes.
How is astigmatism compensated for with lens replacement?
Dr. Oursler can address small amounts of astigmatism with laser corneal relaxing incisions at the time of surgery. Higher amounts of astigmatism are treated with a toric version of the multifocal implant.
Does insurance or Medicare cover the cost for lens replacement?
Insurance or Medicare does not cover the cost of lens replacement for presbyopia patients. However, if a patient has developed visually significant cataracts, insurance or Medicare will cover the cost of surgery for a standard IOL. For an additional charge, patients may opt to upgrade to the newer presbyopia correcting lenses.
Can I use my Flex Spending Account?
Your company may offer a Flex Spending Account, which allows you to set aside pre-tax dollars to pay for your medical expenses. Use our FSA Savings Calculator to find out how much you can save by using your FSA to pay for lens replacement.
Where will I have my procedure done?
At Graystone Eye we have our own surgery center attached to our Hickory, NC, location. This feature allows us to ensure ease and convenience for our patients while keeping facility fees down.
