Refractive Lens Replacement Surgery in London:

Refractive Lens Replacement is the procedure involving the insertion of an Intraocular lens after replacing it with a normal lens, not yet affected by Cataracts. This lens replacement surgery corrects the refractive error along with preventing cataracts from occurring in the future. Irrespective of the clinic you visit in London, the first and foremost step is the instillation of anesthetic drops in the eyes for initiating the surgery. This is preceded by cleaning the skin around the eyes and placing surgical covering in it to keep it clean during the entire Refractive lens replacement surgery. The eye is held open by an instrument, so you don’t blink during the process. With an operating microscope, a team of doctors create an opening, fragment the natural lens and replace it with an artificial intraocular lens.

The opening heals in time without stitches. Post your lens replacement surgery, antibiotic and anti-inflammatory drops are instilled in the eye. After post-operative care and treatment formalities, the patient is allowed to return home on the same day. However, the duration of stay after Refractive lens replacement surgery depends on the treatment modalities of your clinic in London. Some may release you on the same day, whereas some may advise staying for a night after your refractive lens replacement surgery.

Refractive Lens Replacement surgery for Presbyopia in London

Also called Prelex or Presbyopic Lens Exchange, this lens replacement surgery is a popular treatment modality if you are a Presbyopic, Myopic, Hypermetropic patient. Patients, who have been disqualified for LASIK for a thin cornea or other complications, are recommended for PRELEX lens replacement surgery. This type of refractive lens replacement surgery involves replacing the natural lens of the eye with a multifocal lens that allows for an easy focus for distance and near vision. It is almost similar to Cataract surgery.

The basic difference between Cataract surgery and PRELEX refractive lens replacement is that the former is performed to restore vision due to a car lens, while PRELEX refractive lens replacement is performed to reduce a person’s dependence on glasses or contacts. Having this multifocal lens creates a new visual system inside the eye that enables patients to have a better focus for distance, near, and intermediate images with minimal dependence on correcting lenses.

Refractive Lens Replacement Vs Lasik in London

Lasik or Laser-Assisted Insitu Keratomileusis is a surgical procedure involving refractive error correction by reshaping the cornea of the eye. Refractive Lens Replacement involves correcting refractive errors by replacing the natural lens of the eye with an Intra Ocular Lens through a lens replacement surgery. Both procedures are aimed at reducing the use of spectacles and contact lens. Additionally, both procedures are simple, safe and effective. Lasik is possible if your corneas are termed fit for the surgery. Refractive Lens Replacement is opted for when the eyes are not deemed fit for Lasik or those who have high levels of Myopia and Hyperopia that cannot be surgically corrected by LASIK.

Vision after Refractive Lens Replacement surgery

Vision just after the Refractive Lens Replacement surgery might be a bit blurry because of the effect of the drops and the viscoelastic gel placed for convenience. Your vision will improve drastically within 24 hours of the surgery. The initial vision outcome might fluctuate for 2-3 weeks because of the drops and adaptation of the IOL to the eye. As the eyes heal, you will notice a decrease in the few symptomatic complaints like grittiness and mild redness and feel an improved, consistent vision without any other discomforts.

However, there are many dos and don’ts that your doctor will tell you the following after your Refractive lens replacement surgery is over. Post refractive lens replacement, avoid rubbing eyes and do daily activities like driving, cooking/ baking, or exercising for a few weeks. Be careful that you do not splash water directly into your eyes or take a bath without a shower cap for at least a week after your refractive lens replacement surgery. Taking care of these precautions ensures that you do not compromise your vision in any way. Irrespective of the clinic you choose in London, make sure it is quick to access if you feel any discomfort.

Risks and Side-Effects of Refractive Lens Replacement Surgery

Refractive Lens Replacement Surgery being performed the same way as Cataract surgery; they share the same risks and side effects. All surgical procedures have some potential risks in them, which should be discussed beforehand by the surgeon. Possible risks include increased intraocular pressure, Endophthalmitis (infection or bleeding inside the eye), IOL detachment and retinal detachment. Post-surgery complications might result in ptosis or droopy eyes, or problematic vision because of glare and halos induced by faulty positioning of multifocal IOLs. With due care and precautions, these complications can be avoided. A good eye surgeon in London will ensure that your surgery gets done smoothly without any complications during the procedure and excellent visual outcomes after the procedure.

Refractive Lens Replacement Procedure - What's involved in Treatment

Three types of intraocular IOLs are used in a Refractive Lens Replacement procedure. They can be either Monofocal Fixed Focus, Multifocus or Accommodating IOLs. Monofocal IOLs provide clear vision but only for a particular distance i.e. distance, intermediate or near.

The aim is to enable a clear vision for driving or distance vision. Multifocal IOLs provide a clear vision for distance, intermediate and near. Their aim is to enable a clear vision for driving, using computers as well as for reading. Accommodating IOLs enables focus at different distances by shifting its focus in the eye.

Monofocals provide better contrast sensitivity and reduced glare effects but need glasses after surgery for reading and using computers. Multifocal and Accommodating IOLs provide better vision for all zones but are associated with glares and halos as side effects.

The treatment modalities for each procedure may vary depending on the clinic you choose in London and the modalities they have for such types of the refractive lens replacement procedure. At AI Vision, London, we have the best modalities to make your treatment a hassle-free affair.

Recovering from Refractive Lens Replacement Surgery

The healing process from the refractive lens replacement surgery will start almost immediately, and improvement in vision will take place with 24 hours of effect. You can get back to work in a few days and resume your normal activities. While it seems pretty simple and basic, some adaptability changes need to be taken into consideration.

The post-operative recovery leads to a mild dryness of the eyes that gets more evident in a computer. Even after using lubricating eye drops for dryness, an anti-reflection coating protective eyewear will help you deal with the glare produced by the computer screen, available in any chemist shop in London.

Similarly, a photochromatic lens coating over your protective glass will help deal with the glare induced by sunlight. Working inside the house may cause dryness because of the air-conditioning, and working outside may cause grittiness because of the dust. Antibiotics and lubricants will help provide symptomatic relief till your lens gets accustomed to its surroundings, and your vision gets constant after the refractive lens replacement surgery.
At AI Vision, London, we perform advanced surgery that takes less time to recover.

Benefits of Refractive Lens Replacement

Refractive lens replacement provides a permanent solution for refractive error in the long run in comparison to other modes of refractive error correction. You do not need to be bothered about the yearly changing of your glasses or contacts and can happily stay without glasses for life. And its recovery period is short, meaning you can get back to your normal life in a very short time post-surgery.

Additionally, it is a welcome solution for people who have high refractive errors or conditions like thin or deformed cornea where LASIK is not possible. Additionally, by removing the Cataractous lenses, you are relieved of the possibility of getting a Cataractous lens in the future. Refractive lens replacement, in either way, can prove to be the only option or an effective solution for improving your ocular health. You can get in touch with an expert ophthalmologist in AI Vision, London, for more information.

Are you a Candidate for Refractive Lens Replacement Surgery in London?

Ideal candidates for the procedure are people between 35-45 years of age with compromised accommodation. Younger candidates having better accommodation are not deemed ideal for this refractive lens replacement procedure. Additionally, candidates with high refractive errors or deformed cornea deemed ineligible for LASIK are eligible for RLE in the first place.

If you want to correct your vision due to presbyopic and refractive error, not ready to depend on spectacles or contact lenses and ineligible for LASIK, refractive lens replacement surgery would be your ideal bet. In this regard, AI Vision, London, would be your ideal bet to find the best doctors for the surgery.

Frequent asked questions (FAQs):

AI has an important and evolving role to play in improving outcomes of refractive lens exchange and refractive lens exchange surgery.

  1. At the AI Vision clinic, we utilise an artificial intelligence (AI) based system to determine the visual distances most commonly used by patients. This helps the patient and surgeon determine which lens to use for refractive lens exchange surgery.
  2. Artificial intelligence (AI) is also used to increase the accuracy of lens selection at the Harley Vision. Accurate lens selection is a key determinant of clarity of vision following refractive lens exchange. We believe that the surgeon’s experience combined with AI maximises the chance of achieving your desired visual outcome.

In the hands of an experienced surgeon, the operation takes 10-15 min. The patient can go home immediately after routine surgery, and vision usually improves significantly within a few days.

NICE guidelines (adopted by Royal College of Ophthalmologists) state: ‘having a PCR rate of approximately 2% or less is widely regarded as an indicator of surgical competence’. (NICE cataract surgery guidelines 2017).

Mukhtar Bizrah has extensive experience in refractive lens exchange and cataract surgery. Despite managing complex cases, his posterior capsule rupture (PCR) rate is 0.8%, which is one of the lowest nationally.

Refractive lens exchange enjoys a good safety profile. Risk of needing another operation is 1 in 100, and risk of permanent loss of vision (due to severe infection or bleeding) is approximately 1 in 1000. Patients who are short-sighted (condition known as myopia) have an increased risk of retinal detachment. About 20% of patients may develop clouding behind the implanted lens, which may require treatment with laser. The laser treatment usually takes a few minutes and recurrence of the problem is extremely rare.

You vision will depend on the type of artificial lens that you choose to be implanted inside the eye during the surgery. Options include:

  1. Monofocal lens: Many individuals prefer to have excellent vision in the distance, and are happy with the option of wearing spectacles (glasses) for near (reading) vision. A monofocal lens enables excellent clarity and contrast for a chosen distance (distance, intermediate or near vision). It does not allow one to see well for both distance, intermediate and near without spectacles. A monofocal lens is the least likely to result in haloes.
  2. Toric lens: This enables treatment of astigmatism, as well as the cataract. A toric lens is highly recommended for suitable individuals who have a significant degree of astigmatism
  3. Enhanced depth of focus lenses: These enable patients to see well for both distance (4 or more metres) and intermediate (about 1 metre) vision. For fine near vision, spectacles correction is often needed. They are less likely to result in haloes and glare than trifocal lenses.
  4. Trifocal lenses: These enable individuals to see well for distance, intermediate and near visual activities. The overall contrast of vision is for each distance is not as good as a monofocal lens set for a certain distance. However, these have the major advantage of allowing spectacle independence.
  5. Blended vision (also known as monovision): This means implanting a monofocal lens to enable distance vision in one eye, and a monofocal lens for near or intermediate vision in the other eye. While the idea sounds complex, a surprising number of patients opt for this and are pleased with the outcomes.

Choice of the lens is based around your preference and lifestyle, as well as the presence of other eye conditions. The above provides a blueprint, and more detailed discussion with an experienced surgeon will help you make the decision that is right for you. An artificial intelligence (AI) based device can also be used by the AI clinic to help you determine your lifestyle needs.

At the AI vision clinic, we utilise 3 key elements in our management of patients:

  1. Patient choice
  2. Clinical and surgical expertise
  3. Evidence-based treatments and artificial intelligence (AI)

Large clinical trials have not shown laser-assisted cataract/RLE surgery to improve patient outcomes nor safety of surgery. At the AI vision clinic, we therefore do not perform this procedure, as we cannot ethically justify the increased cost to the patient.

Previous laser eye surgery does not affect your ability to have refractive lens exchange. The main challenge in such cases is choosing the correct lens to be implanted inside the eye. Previous laser eye surgery affects accuracy of eye measurements, which in turn affects choice of lens to be implanted inside the eye.

Mukhtar Bizrah trained in one of the highest volume cataract surgery clinics in North America for patients with previous laser eye surgery (e.g. LASIK or PRK). Using his vast experience in this field, he is able to optimise visual outcomes and minimise risks of unexpected surgical results following cataract surgery and refractive lens exchange.

Yes, at the Harley Vision, refractive lens exchange surgery can be performed on both eyes on the same day.

No, refractive lens replacement is not a painful procedure. Numbing drops are instilled in the eyes before the surgery. So, you will not feel any pain during the procedure. After the surgery, you may feel mild discomfort during the recovery. It can be resolved by medications and post-operative care.
The cataract can’t grow back after refractive lens replacement surgery. But sometimes, secondary cataracts due to scar tissue behind the surface of the IOL may occur. You can go for a laser procedure called Yag Capsulotomy in London to clear the tissue and clean the lens.
Like every surgical procedure, refractive lens replacement comes with a set of potential complications and other things that could go wrong. But if you are getting operated by an experienced surgeon in London using the correct IOL for you along with taking care of other safety parameters, nothing can go wrong with the surgery. You can talk to an expert in AI Vision, London, for more information.
Refractive lens replacement is deemed an elective procedure and therefore not generally covered by any insurance company in London. But under your London employer, you can claim certain reimbursement in terms of corporate insurance benefits. Having healthcare credit cards or payment plan options also helps bear the cost of Refractive lens replacements surgery to a certain extent.
Yes, refractive lens replacement is permanent and is not a reversible procedure. Unlike natural lenses, IOL has a warranty of 100 years. So, you need not look for any other ocular surgeries in London to exchange or replace the lens. The lens in itself is designed to provide a permanent eye care solution.
To prepare for a refractive lens replacement surgery, first, you have to discuss your eligibility with your ophthalmologist in London. Once on the road to surgery, ultrasounds will be performed on your eye to determine the condition of the retina with the size of the lens required for your eye. Certain medications you are on will be stopped before the surgery to prevent complications, and you will be advised eyedrops 2-3 days prior to the surgery.