For patients 50 and up a paradigm shift is occurring with refractive surgeons away from lasik towards refractive lens exchange.Refractive lens exchange involves removing the eyes natural crystalline lens and replacing it with a new generation refractive lens. As this generation moves into their 60’s and subsequent 70’s expect a much larger share of refractive surgery to move to refractive lens exchange. Unlike lasik that only has one focal point, refractive intra-ocular lenses have focuses for distance and near and in the case of translating lenses a variable focus.
Translating lenses move position within the eye to allow it change focus, much as individuals had when they were under 40. Both translating and multifocal intra-ocular lenses allow both eyes to be focused at far and at near allowing better binocular vision and more natural vision than monovision lasik.
One of the downsides to refractive lens exchange is the need for surgical lens removal. With older patients removing the normal lens is less of a problem as this lens naturally losses both flexibility and clarity. Patients with refractive lens exchange never have to worry about developing cataracts as refractive lens exchange replaces the eyes crystalline lens. It is the crystalline lens, which becomes hazy when cataracts develop.
Refractive lens exchange patients have a very stable prescription due to the fact that the cornea remains quite stable after cataract surgery (no post-operative ectasia which can happen following lasik) and the intra-ocular lens power (unlike the normal crystalline lens) does not change power over time. This means that that unlike lasik the outcomes remain stable, usually for the life of the patient. Refractive lens exchange does not create a dry problem which is much more prevalent in patients over 50 particularly women.
Lastly, cataract/refractive lens surgery has made remarkable strides in safety and invasiveness in the past 10 years. Today’s surgeries are completed with micro-incisional techniques utilizing a 2-3mm incision; leaving minimal surgically induced astigmatism and fast recovery for patients. The refractive lenses are delivered through this same small incision allowing most surgery to be completed without sutures or only a single temporary suture. Imagine having a procedure that restores reading ability, eliminates the need for glasses and that lasts a lifetime.
Article provided to the La Quinta Chamber of Commerce – GEM Publication April 2009 page 21.
http://www.lqchamber.com/pdf/gem-apr09.pdf
