There are two main reasons that the eye’s natural lens is removed: either the patient is farsighted and requires an artificial lens for improved focusing, or the patient’s natural lens has developed a cataract and is blocking sharp vision. Refractive lens exchange (or refractive lensectomy) is a procedure nearly identical to cataract surgery, in which the impaired natural lens is replaced with an artificial one. But with this procedure, unlike cataracts, the eye’s natural lens is clear, so its replacement usually serves to correct either farsightedness or focusing difficulties.
As an alternative to LASIK and phakic intraocular lens implants, refractive lens replacements use a new artificial lens to refocus the light on the retina rather than changing the shape of the cornea. Traditionally, refractive lens exchange has always resulted in a loss of accommodation, because the eye’s natural lens, which normally manages the eye’s ability to change its focus, is replaced with a non-accommodating artificial lens. But now, thanks to recent advancements, refractive lens exchange can also effectively correct flawed vision while maintaining the eye’s natural focusing capability.
During the procedure, the doctor will begin by making a small incision on the eye in order to remove the natural lens through a process called phacoemulsification, which uses ultrasound to break the lens into pieces for removal. The incision is made either at the far edge of the cornea or in the sclera (the white of the eye), and is also used for the placement of the new implant.
The implant will not change the outward appearance of your eye, and though the exact shape and size of each implant varies from eye to eye, all are held in place by small flexible loops called haptics that are attached to the lens. Implants are intended to last a lifetime, and are made of materials like silicone and acrylic that will not irritate your eye.
Your distance vision should be good within just a day or two of the procedure. Your intermediate and near vision may be blurred initially, and reading glasses could be necessary at this time. Your vision at these distances should improve within two weeks, however, and you will be asked to read without glasses to strengthen your eye’s focusing muscles. Your vision can continue to improve for up to a year following the surgery.
Refractive lens exchange can be a good option for patients whose high degree of correction makes them unsuitable for LASIK, or whose farsightedness can be better alleviated with a new lens. The invisible artificial lens permanently replaces your natural lens without affecting the shape of the cornea or the outward appearance of your eye.