Since the 1970s, eye doctors have used LASIK, PRK, and other refractive surgeries to correct myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. Unlike LASIK and PRK, which are surgical procedures that alter the surface of the eye, Refractive Lens Implant surgery uses techniques and materials similar to those used for over 30 years for cataract surgery. Refractive Lens Implant surgery involves replacing the natural lens with a clear artificial lens (clear lens replacement).
Refractive Lens Implants
For individuals over 45 who are considering refractive surgery to decrease dependence on glasses and contact lenses, clear lens replacement (CLR) is an exciting option. In essence, this procedure involves removing the natural lens of the eye and replacing it with an intraocular lens (IOL) implant.
This procedure is essentially the same as a cataract surgery with lens implant, however, in this case, the procedure is completed prior to cataract development for the refractive advantage. Usually a monofocal or fixed-focus lens implant is used during cataract surgery. With such lens implants, reading glasses and/or bifocals are usually required for achieving one's best vision after surgery.
CLR changes the refractive power of the eye to give better uncorrected vision.
Multifocal lens or Restor: The multifocal lens is geared for patients that are looking to reduce their dependence on glasses. The multifocal lens is able to provide near vision, intermediate vision and distance vision – with 90% or more of patients not finding the need to wear glasses at all. This lens is not covered by insurance for refractive lens exchange and typical out-of-pocket costs are required.
Toric lens: The toric lens is geared for patients that have mild, moderate or severe amounts of astigmatism (curvature of the eye). The toric lens has one focal distance. Most patients prefer to target distance vision with a toric lens, and end up just wearing reading glasses. However, some patients with a toric lens require glasses to “fine tune” their distance vision as well. The toric lens is not covered by insurance for refractive lens exchange and typical out-of-pocket fees are required.
Traditional lens: The traditional lens has one focal distance and cannot correct astigmatism. Most patients that choose a traditional lens implant will need glasses to “fine tune” their vision for distance and reading. This lens is typically not covered by insurance for refractive lens excange and may require out of pocket cost.
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"This procedure is essentially the same as a cataract surgery with lens implant, however, in this case, the procedure is completed prior to cataract development for the refractive advantage."
The recently FDA-approved Alcon AcrySof® ReSTOR®Apodized Diffractive Posterior Chamber intraocular lens (IOL) is a landmark vision care technology providing good vision in patients for both distance and near without the need for reading glasses. Standard lens implants give good distance vision but often require the use of reading glasses for near vision.
Approved for use in patients by the FDA on March 23, 2005, the first lens implants were performed in Erie, Pennsylvania in June 2005. Those patients are now excited that they are able to see to perform tasks at a distance such as driving without glasses, as well as near such as reading the newspaper, sewing, playing cards or looking at fine print. Over 90% of patients with the ReSTOR® lens implants no longer find the need for glasses.
The FDA results of the ReSTOR® Multifocal were so good because the design of the lens is based on the highly-successful AcrySof lens implant that has been used in patients around the world for many years for standard cataract lens surgery. The ReSTOR® technology adds the Apodized Diffractive surface to this already successful lens to provide patients greater visual freedom.
Only surgeons who have completed specialized training with Alcon Surgicial and have been approved by them will be authorized to perform these lens implants. Approval requires demonstrating that lens implant calculations are being made within a very close tolerance to assure the utmost accuracy and best implant results.
"The lens of the IOL is convex on both sides and made of a soft plastic that can be folded prior to insertion, allowing placement through an incision smaller than the optic diameter of the lens. After surgical insertion into the eye, the lens gently unfolds to restore vision. The supporting arms provide for proper positioning of the IOL within the eye."
The normal lens of the eye is like a grape, having an outer skin and an inner gel-like material. When a cataract forms, the material inside the lens (nucleus) turns cloudy and interferes with good vision. Cataract surgery removes the cloudy lens and replaces it with a clear artifical lens (intraocular lens - IOL) implant.
During cataract surgery, the fine skin (posterior capsule) of the lens is left in place to support the intraocular lens implant. In some cases, through a normal process of cell regeneration, this capsule may turn cloudy forming a "secondary" cataract. The cloudy capsule interferes with good vision in a similar way a cloudy cataract lens blocks good vision. When this clouding develops, the YAG laser can be used to create an opening in the capsule and a clear path for light to enter the eye. This outpatient procedure is called Posterior Capsulotomy or Laser Posterior Capsulotomy. With this procedure, vision can be restored quickly and painlessly.
"The cloudy capsule interferes with good vision in a similar way a cloudy cataract lens blocks good vision. When this clouding develops, the YAG laser can be used to create an opening in the capsule and a clear path for light to enter the eye."
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