介绍：In refractive lens exchange surgery, the natural crystalline lens of the eye is removed permanently and an artificial lens is implanted in its place. This allows clearer vision without having to use eyeglasses or contact lenses.



The operation is done using essentially the same procedures as cataract surgery. There is no need to be admitted in the hospital, all it takes is around 20 minutes of operation time for each eye. With the new techniques in anaesthesia, no needles are used but instead, eye drops or gels are instilled to numb the eye area.



Once anaesthetized, a microscopic incision is made on the side of the cornea. With high tech ultrasound machine, the natural lens of the eye is removed with extreme precision. The new lens is then inserted using the same tiny incision made earlier. The procedure is completed, without the need for any surgical stitches. There are no special post operative processes to do. In time, the cornea will heal itself and vision will fully improve within a month or so.



There are a variety of lens implants that can be used. The most commonly used is the monofocal lens. It is termed monofocal because it only has a single focus. This will give good distance vision but reading glasses will be needed when looking at close objects. A toric lens is another type, also used to gain the best distance vision but also corrects astigmatism. Eyeglasses will also be needed when viewing objects up close. Multifocal lenses or correcting lenses provide clear distance vision as well as near vision. Multifocal lenses are the best choice for those who do not want to be dependent on glasses for close up vision.



Refractive lens exchange is not really meant to replace laser eye surgery but rather as an alternative for people who are not suitable to undergo laser operation or the most commonly performed LASIK procedure. Since LASIK requires a certain amount of corneal thickness for flap creation and application of the laser, not everyone is a good candidate for this procedure. For myopic or hyperopic patients with thin corneas, this is where RLE becomes especially valuable.



For patients over 45 years old with short sightedness or long sightedness and with the beginnings of cataract, refractive lens exchange seems to be the more appropriate choice. A cataract is clouding of the lens of the eye that occurs naturally as a person ages. This cannot be prevented and there is no cure for cataracts except surgery. If the condition is not managed, it can severely decrease vision in later years, even in daylight. An RLE surgery is the best procedure to do in these cases because it corrects refractive errors and at the same time treats the cataract permanently. Since the replacement lens is synthetic, it will never develop cloudiness like the natural lens. Thus, for people with early cataracts, RLE is the better choice instead of waiting for the cataracts to progress enough to require cataract operation.



Refractive lens exchange however, is not limited to the older age group. Sometimes, younger people will benefit from this operation, particularly in instances where there is extreme hyperopia or long sightedness and sometimes even in those with severe myopia or short sightedness. In these patients, LASIK is generally not recommended so a lens replacement is the realistic option.



While refractive lens exchange is relatively safe, any surgery has risks and this should be discussed with the eye surgeon. The risks are similar to what people going through cataract surgery would deal with. Since RLE is a much more invasive procedure than laser surgery, there can be a bigger risk of having retinal problems after the procedure.



For people with dry eyes and other cornea problems, refractive lens exchange may be a better alternative to LASIK or other laser eye surgery procedures. For patients with high refractive errors, RLE is one of the best options. Since RLE replaces the natural lens with intraocular lens, there is no possibility of developing a cataract even as the patient ages.

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