Lens replacement: How does the lens replacement procedure work?
How does the lens replacement procedure work?
Essentially, we’re talking about posh early cataract surgery. So we’re using all the technological advantages that we’ve benefited from in the evolution of cataract surgery: small incision, swift and rapid return to visual function and customised lens technology then we’re taking those advantages and using them to increase people’s independence from spectacles.
In all of us, the crystalline lens inside our eyes goes on a journey.
It’s miraculous really! In our twenties and thirties it provides this ability to provide great quality vision seamlessly at all distances. We all take it for granted. Then we hit our forties and we start to notice things getting a little bit creaky! Personally, I’m starting to notice that if I’m tired, I can’t quite pull my focus in as I could a few years ago. I couldn’t feel it before but my lens has gradually changed. In years to come, as my lens hardens up it will then become a cataract.
So for my patients who are over fifty, almost all of them are showing significant symptoms of this hardening and loss of flexibility in their lenses. This is what’s known as presbyopia. For many patients in this group, lens replacement becomes a really excellent option to consider when we want to increase people’s independence from spectacles.
Now in line with my whole practice and the whole ethos of my clinic treating presbyopia requires a customised approach. It’s only by understanding people’s lifestyle and the quality of vision that they’re experiencing when they come to see me, and combining that with really careful examination and assessment on the complete set of instruments that I have at the Custom Vision Clinic, that I can determine which of the options is going to be the very best for them to decrease their dependence on spectacles.
For example, a very nice gentleman came to us three weeks ago. He was plus 2 long-sighted. There are clinics in the country that would consider him for laser eye surgery. But we found signs of significant cataracts in both eyes. It was not enough for his optician to have picked up as his acuity was still good (his ability to read the eye chart was still very good in his spectacles). But he had started to notice quality of vision issues at night time including a lot of glare from car headlights. In fact he started to limit his night driving. When we dilated his eyes, we found he had early cataracts. On our Nidek scan that we use to look at aberrations in the eye, we found his to be very high. There are a lot of imperfections in the eye because of early cataract change. And so this patient was absolutely not for laser eye surgery but absolutely for lens replacement.
And really what it’s then about is going for gold. We’ll say, “Ok, we’re going to do laser replacement here and let’s use all the technologies that we can to get the very best quality of vision and range of focus for that patient in their lifestyle.”
The treatment isn’t the same for everybody. We have different lens options. With the patient above, he was a golfer and did quite a lot of driving. For him it was about getting really good distance and intermediate vision. He didn’t mind having to put reading specs on for some activities. So I used quite a gentle multifocal lens to create very good distance through intermediate vision, maintaining really good quality vision and greatly improved night vision for him after surgery.