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The Ultimate Refractive Procedure With Dr. Alberto Martinez, A World Renowned Surgeon

What is a REFRACTIVE LENS EXCHANGE “RLE” WITH MULTIFOCAL INTRAOCULAR LENS IMPLANT?

With aging or due to trauma, disease or medications, the natural crystalline lens becomes cloudy. This condition is called a cataract. When cataracts become visually significant, cataract surgery can be performed to replace the natural lens with an intraocular lens. In some circumstances, the natural crystalline lens is removed prior to the formation of a visually significant cataract. This is called a REFRACTIVE LENS EXCHANGE “RLE”. The natural lens is replaced with an intra-ocular lens in order to attempt to correct farsightedness or nearsightedness, or to reduce the symptoms of presbyopia. This surgery is performed so that the natural vision will be improved, thereby reducing dependency on glasses or contact lenses. In some cases of refractive lens exchange, there may be an early cataract that does not significantly interfere with corrected vision, and which would normally not require surgical removal. There are alternatives such as wearing eyeglasses that are completely safe; any surgery has inherent risks. Only the patient can decide if the potential benefits outweigh the risks. This surgery is entirely elective, there for not cover by Medicare and commercial insurances. The most common lens implant Dr. Martinez uses and recommends to his patients is the ReSTOR multifocal lens implant, uniquely designed to improve vision at all distances – up close, far away and. Most of his patients that have received the ReSTOR (In cataract surgery and refractive lens exchange procedures) are exceedingly happy with the results, and many called it “a life-changing procedure”

Dr. Martinez has performed many of these procedures with outstanding results.

Advantages of RLE

RLE can effectively correct high amounts of nearsightedness and farsightedness that may not be adequately corrected by LASIK. It also is a viable alternative to LASIK for eyes with corneas that may be too thin for laser vision correction.

Other advantages of RLE include:

RLE Risks and Complications

The risks and potential complications of refractive lens exchange are virtually the same as those for cataract surgery. If you are considering RLE, you must be willing to accept these risks, which can occur even when RLE is performed flawlessly by a skilled and experienced refractive surgeon or cataract surgeon.

RLE risks and potential complications include:

Candidates for RLE should meet these criteria:

Dr. Martinez thinks the best candidates for RLE are people with moderate to high hyperopia (farsightedness) and people with hyperopia who also are over age 45 and have presbyopia.

Examination Prior To Surgery, Procedure and Post Operative Care

Prior to surgery, a measurement of corneal curvature (keratometry), the length of the eye (axial length) as well as an intra-ocular lens calculation (biometry) will be performed to determine the best estimate for the proper power of the implanted lens.

The day of the surgery, the eye will be made numb by the surgeon with either drops or an injection (local anesthesia). The natural lens of the eye will then be removed by breaking it up into small pieces with a vibrating needle (phaco-emulsification) or pulses of water. These pieces are gently suctioned out of the eye through a small, hollow tube inserted through a small incision in the eye. After the natural lens is removed, the intra-ocular lens (IOL) of the power determined during the pre-operative examination will be inserted into the eye. The incision required to perform this operation can be self-sealing, but it may require closure with very fine stitches (sutures). After the surgery, patient will be required to have a few follow-up examinations.

During the immediate recovery period, eye drops are needed for 2 to 6 weeks, depending on the individual rate of healing. Even though the goal is to reduce dependency on glasses or contact lens, they may still be required for further improvement of distance vision, reading vision, or both.

Patient should be able to resume most normal activities the next day; however, there will be some limits upon physical activity. Usually, visual correction is stable within 3-4 weeks; however, in some circumstances the recovery can be delayed for additional weeks or months.

Benefits Of Surgery

The farsighted (hyperopic) eye is out of focus because the length of the eye is too short for the curvature of the cornea. This causes light rays to focus behind the retina. The nearsighted (myopic) eye is out of focus because the length of the eye is too long for the curvature of the cornea. This causes light rays to focus in front of the retina. The light rays can theoretically be brought to a clear focus on the retina by inserting an intra-ocular lens with the proper power. Although this will theoretically improve natural distance vision, close vision will still require additional glasses for reading.

The intraocular lens can also be calculated for near vision; however, then visual correction such as glasses or contact lenses will be needed for distance vision. Some patients may also elect to have one eye set for distance and the other eye set for near vision. This is called “monovision.”

The ReSTOR® IOLs is an advanced intra-ocular lense that have a dual focus, far and near, simultaneously. Best results are obtained when used in both eyes, but the lenses can be used in one eye only. In clinical studies, about 80% of ReSTOR lens patients had no need for glasses at all, once the eyes had healed. The other 20% reported occasional use of glasses or contact lens. This group could elect to have another surgical procedure such as LASIK to further reduce dependency on glasses. In that event, there would be an additional fee for the second procedure.

Visionary Ophthalmology is the area's premiere Ophthalmology serving Bethesda, Rockville, Potomac, Silver Spring, Washington DC, Maryland and Virginia.