Lens Replacement

The lens replacement technique is one of the most resilient eye surgery processes still in existence. There have been several game-changing innovations (e.g. phacoemulsification and multi-focal lenses) but the process has generally remained the same since we first started removing cataract from the eyes in the mid 1700s.

The lens replacement procedure is painless under local or topical anaesthetic. On the day of surgery (in a hospital) we will dilate your pupils with eye drops. We will then clean the area around your eye.

We use micro-incision phacoemulsification to perform cataract surgery. This utilises high frequency ultrasound delivered by a tiny probe introduced into the eye through a two millimetre incision. The ultrasound probe liquefies and aspirates the cataract. The ‘phaco’ device emits ultrasound waves that break up the hard lens. We then suction the remains of the hard lens with the same probe.

Femtosecond lasers can now be used to perform certain steps in the cataract surgery. The only step of any relevance is the creation of the circular opening in the membrane which contains the cataract lens material. The femtosecond laser creates a perfect circle. However, this hasn’t resulted in improved outcomes because when the membrane heals after surgery the opening loses its perfectly circular shape. Also, the femtosecond laser causes more redness, dryness and inflammation after cataract surgery so we no longer use it. We do continue to have access to the Lensar ™ femtosecond cataract laser system at Optegra Yorkshire and the Victus ™ femtosecond cataract laser system at St James’s Hospital in Leeds.

Surgical guidance systems have proved useful in assisting our surgeon to make a perfectly circular capsule open to rival that made by the laser. The surgery is more comfortable for the patient and results in less post-operative redness and inflammation.
This year we will begin using the Zepto ™ device to create a perfectly circular capsule opening.

Once we’ve removed the lens, we’ll replace it with an artificial lens implant. We fold the implant and insert it through the tiny incision. The lens then unfolds in the eye exactly where it should. We can rotate the lens implant to a specific position. This is vital for the astigmatism-correcting toric intra-ocular lens implants (IOL’s)

You can typically go home the same day and look forward to a rapid and pain-free recovery. Your vision might improve within 48-72 hours and you can return to work or your usual leisure activities within a day or two.

Advantages and disadvantages of lens replacement compared to laser eye surgery

Compared to laser eye surgery for short-sightedness, long-sightedness and astigmatism, lens replacement

• Can be used with severe prescriptions
• Is more invasive than laser eye surgery
• Has a relatively slower recovery
• Has a greater risk

Compared to PRESBYOND ™ blended vision laser eye surgery to correct presbyopia, lens replacement

• Is a permanent solution that avoids cataract in the future
• Has slightly less visual acuity
• Is more invasive
• Has a relatively slower recovery
• Has a greater risk