Types Of Lens Replacement Surgery
Lens replacement surgery is normally used to refer to one of three similar types of treatments: Refractive Lens Exchange (RLE), Implantable Contact Lenses (ICL) and Cataract Surgery, with each having alternative names and acronyms so it can be a little confusing.
Hopefully this article will untangle some of the terminology and give some clarity on the type of lens replacement surgery that may be suitable for you as well as the costs involved.
Refractive Lens Exchange (RLE)
In general, when people talk about lens replacement surgery they are referring to some type of Refractive Lens Exchange (RLE), which is also known as Refractive Lens Replacement, Clear Lens Exchange (CLE) or Clear Lens Surgery.
This is a treatment for patients suffering from presbyopia (long-sightedness normally occurring in middle and old age), hyperopia (farsightedness where objects nearby are not seen as clearly as objects in the distance) or those with a considerably thin cornea.
It is commonly used for patients over 40 who don’t qualify for either LASIK or PRK laser eye surgery but are not willing to continue using glasses or use contact lenses. It can also correct myopia (nearsightedness) but it is not normally recommended when LASIK surgery or Phakic intraocular lens (IOL) can be used.
The procedure involves removing the eye’s natural lens and replacing it with an artificial intraocular lens. As well as removing the need to continue wearing glasses or use contact lenses, the new artificial intraocular lens will also mean that the patient will not suffer from cataracts in the future as a cataract cannot form on an artificial lens.
Cataract surgery involves the same procedure as the refractive lens surgery described above, except that the lens that is removed is not clear but cloudy due to existence of cataracts. Patients have the same choice of monofocal, multifocal or trifocal lenses (see lens types below) giving them the option to also remove the need for reading glasses as well as correcting their cataracts.
Implantable Contact Lenses (ICL)
This type of lens surgery involves implanting contact lenses rather than removing and replacing the natural lens which occurs in lens replacement surgery. This new phakic intraocular lens is placed on top of the natural lens and behind the iris (the exact positioning will depend on the lens chosen). As the natural lens is not removed this procedure can be reversed at a later date.
When lens replacement surgery is performed you will either receive intraocular lenses (IOLs) or phakic intraocular lenses (Phakic IOLs) depending on your prescription and visual requirements. IOLs replace the eye’s natural lens and are used in RLE surgery and cataract surgery.
Intraocular Lens (IOL) Types
There are three types of intraocular lenses which can be used as replacements for your eye’s natural lens. The choice you are offered will depend on your eye condition and what is available at the clinic you select:
- Monofocal Lenses: Monofocal lenses will normally only fix issues with distance vision and are used for patients who don’t mind continuing to use glasses for specific tasks such as reading.
- Multifocal Lenses: The more advanced (and normally more expensive) multifocal lenses can correct long- and short-sightedness at the same time and, therefore, eliminate the need for glasses altogether.
- Toric Lenses: A toric lens is designed to correct moderate to high corneal astigmatism. It should remove the need for glasses for distance vision but you will still need reading glasses.
- Trifocal Lenses: Your chosen clinic may also have trifocal lenses which are designed to give very high resolution images and exceptional contrast sensitivity at all light conditions and distances.
Phakic Intraocular Lens (IOL) Types
Unlike Intraocular lenses, Phakic IOLs do not replace the eye’s natural lens but are positioned between the lens and the iris, or just behind the iris, whilst the natural lens remains in place. There are two main types of phakic IOLs and neither require glasses to be worn once inserted:
- EVO Visian ICL: this is the most popular implantable contact lens and has now been used used in over 1 million treatments in 75 countries. It is a refractive synthetic lens made from a collagen co-polymer lens that is placed in front of your natural lens and behind the iris.
- Verisyse: this lens is used to treat moderate to severe myopia and is placed in front of the iris.
All the options should be discussed in your consultation before you decide whether to proceed or not and costs can depend on the amount of correction required. However, several of the larger national clinics now offer fixed prices for all lens types for all patients.