Refractive Lens Exchange

Refractive lens exchange surgery may be an option for individuals who are not suitable for Laser Vision Correction. This procedure replaces your eye’s crystalline lines with an artificial intraocular implant that has been calculated to correct your refractive error (myopia or hyperopia) and presbyopia leading to clearer and sharper unaided vision.

The surgery is usually performed under local anaesthesia with sedation and takes 30 minutes on average. There are many choices of intra-ocular implants available today (Monofocal, Monofocal Toric, Multifocal, Multifocal Toric) (pics of different implants) and the choice of implant depends on the status of the patient’s eye and his or her preference. In general, monofocal implants give good distance visual in the absence of astigmatism but reading glasses will still be needed unless monovision is opted for (Monovision is a situation where the master eye is set for distance vision and the other eye set for near vision.

Not everyone is suitable for this and a monovision trial is necessary beforehand). Toric implants are able to correct pre-existing astigmatism and are useful in correcting the visual distortion that it causes. Lastly, multifocal implants are used to alleviate the symptoms of presbyopia or ‘lao hua’. In general, patients with multifocal implants enjoy good functional vision without the need for reading glasses although side effects of glare and haloes may occur in dim light conditions.

Fortunately, these visual side effects tend to get better with time. A newer method of Refractive Lens Exchange surgery where a femtosecond laser is used for part of the procedure is also available (FLACS or Femtosecond Laser Assisted Cataract Surgery). The downtime after cataract surgery is usually 3-4 weeks and medicated eye drops needed for about 6 weeks. Vision is usually clear on the first day but may take about a week to improve in some cases.