Refractive Lens Exchange (RLE) Replaces Your Eye’s Natural Lens With A Soft Gel Intra Ocular Lens (IOL) To Correct Your Refractive Error And Achieve Sharper Focus. Refractive Lens Exchange Is A Better Surgical Procedure Than Lasik Surgery For People Over 40 With Hyperopia.
Refractive Lens Exchange Surgery procedure is virtually identical to cataract surgery.
Patients over 40 with a deteriorating vision for distance (hyperopia) can benefit from refractive lens exchange to lessen their reliance on glasses. The difference between RLE and Cataract Surgery is that in refractive lens exchange, your lens being replaced is clearer, and your pre-surgery vision has not been reduced before surgery, by a cloudy cataract lens.
People who are middle-aged or older may have the beginnings of cataracts, that eventually could worsen, and require cataract surgery. Refractive lens exchange can be considered an excellent treatment for the early stages of cataract before a person suffers any vision loss due to a cloudy lens.
A new intra ocular lens is a permanent replacement for your natural lens and is designed to last the rest of your life.
Since the lens is situated inside your eye and not on the surface like a contact lens, it is not visible to the naked eye, and you cannot feel it.
In the 1970/80’s RLE for cataracts was usually only performed if the patient was 20/70 vision or worse in the better eye. Now the guideline is “if a cataract is sufficient to interfere with the activities of daily living surgery is advised”
But, increasingly, people who have the initial stages of their lens starting to go cloudy ( with minimal vision loss) opt to do Refractive Lens Exchange surgery, while they are still physically healthy enough for surgery, even if their vision is not yet impeded by a cloudy lens. Refractive Lens Exchange Surgery is only done once per eye, so doing it early makes sense
Once a patient gets into their eighties other medical problems can sometimes make major surgery difficult .. and a person then has to put up with vision loss in later years, which could have been prevented by earlier RLE surgery.
There are several choices of IOLs to insert during Surgery
Monofocal IOLs can be just distance and use glasses for reading. Or Multifocal IOLs can be one eye distance and one eye for reading (useful for people who have worn contact lenses in this way)
There are now different types of Multifocal IOLs. A multifocal lens that can be used for distance, intermediate, and reading. Or a newer form of multifocal IOL called an accommodating multifocal which works in the same way as the natural lens in your eye by contracting to see to read.
Recently given FDA approval as a MULTIFOCAL IOL, and achieving good results, is a new IOL called multifocal which has brought in a more advanced design in multifocal IOLS
Each multifocal IOL has advantages and disadvantages in terms of the best-uncorrected vision it produces at near, intermediate, and far distances, as well as the likelihood and degree of visual disturbances such as halos and night glare that might occur after surgery.
Should you as a patient go for, monofocal IOLs or multifocal IOLs?
There could be potential advances in technology which you may miss out on when you choose a new multifocal IOL today, “The future lens may offer improved quality of vision, but once you have refractive lens exchange that basically eliminates it as an option”
Or advances in technology may be many years away…it is difficult to make that judgment decision with a multifocal IOL, and will depend on various personal factors…. but if you are planning on having distance IOLs fitted and wearing reading glasses then the technology for these is excellent and an easy decision to make.
How do you find out if you are a good candidate for Refractive Lens Exchange?
The first step is to have an Eye Examination and then discuss with the Optometrist or the Ophthalmologist the possible options which are available to you for RLE, and if your age and your optical prescription are the most advisable for refractive lens exchange surgery.
You will be asked to do some general medical checks to confirm that you are OK for Surgery
The VE Medical Surgery Centre offers a very modern, same-day, Private Surgery facility in Rodney Bay with a team with a lot of experience in RLE Surgery.
The Surgery team of Ophthalmologist, Surgery Nurse, Anesthetist, and Care Attendant provide excellent service to make your RLE experience as easy as possible.
A cataract is a dense, cloudy area that forms in the lens of the eye. It begins when proteins in the eye form clumps that prevent the lens from sending clear images to the retina. The retina works by converting the light that comes through the lens into signals. The retina sends the signals to the optic nerve, which carries them to the brain.
While a cataract develops slowly over time, it
eventually interferes with your vision. Some people end up with cataracts in
both eyes; however, they usually don’t form simultaneously.
Cataracts are common in older people, with over 50%
of the people in the United States having cataracts or have undergone cataract
surgery by age 80.
Types of Cataracts
There are
different types of cataracts and they are classified based on where and how
they develop in your eye. They are:
Nuclear Cataracts: These form in the middle of the lens and cause the nucleus, or the centre, to become yellow or brown.
Cortical Cataracts: These are wedge-shaped and form around the edges of the nucleus.
Posterior Capsular Cataracts: These form faster than the previous two types and affect the back of the lens.
Congenital Cataracts: These, which are present at birth or form during a baby’s first year, are less common than age-related cataracts.
Secondary Cataracts: These are caused by disease or medications. Diseases that are linked with the development of cataracts include glaucoma and diabetes. The use of the steroid prednisone and other medications can sometimes lead to cataracts.
Traumatic Cataracts: These develop after an injury to the eye, but it can take several years for this to happen.
Radiation cataracts: These can form after a person undergoes radiation treatment for cancer.
What Causes Cataracts?
There are several underlying causes of cataracts, including:
An over-production of oxidants, which are oxygen molecules that have been chemically altered due to normal daily life
Smoking
Ultra-violet radiation
Long-term use of steroids and other medications
Certain diseases, such as diabetes
Trauma
Radiation therapy
Symptoms
of Cataracts
Common symptoms of cataracts include:
Blurry vision
Difficulty seeing at night
Seeing colours as faded
Increased sensitivity to glare
Halos surrounding lights
Double vision in the affected eye
The need for frequent changes in prescription glasses
Risk Factors of Cataracts
Risk factors associated with cataracts include:
Older age
Heavy alcohol use
Smoking
Obesity
High blood pressure
Previous eye injuries
Family history of cataracts
Over-exposure to the sun
Diabetes
Exposure to radiation from X-rays and cancer treatments
Diagnosing Cataracts
At Vision Express in Saint Lucia, where we perform
minor and major eye surgeries, your doctor will perform a comprehensive eye
exam to check for cataracts and to assess your vision.
Your doctor will put drops in your eyes to make
your pupils bigger, making it easier to check the optic nerve and retina at the
back of your eye for damage. Other tests your doctor might perform include
checking your sensitivity to glare and your perception of colours.
Prevention of Cataracts
To reduce your risk of developing cataracts, please
follow these crucial steps:
Protect your eyes from UVB rays by wearing sunglasses outside
Have regular eye exams
Quit smoking
Eat fruits and vegetables that contain antioxidants
Maintain a healthy weight
Keep diabetes and other medical conditions in check
Treatment of Cataracts
If you’re unable or uninterested in surgery, Vision
Express will help you manage your symptoms. However, our very attractive
payment plans ensure that you get the right care you need. We can also suggest
stronger eyeglasses, magnifying lenses, or sunglasses with an anti-glare
coating.
Surgery
Surgery is recommended when cataracts prevent you
from going about your daily activities, such as reading or driving. It’s also
performed when cataracts interfere with the treatment of other eye problems.
Extra-capsular surgery involves removing the cloudy
part of the lens through an incision in the cornea. After surgery, an
artificial intraocular lens is placed where the natural lens was.
Cataracts can interfere with daily activities and
lead to blindness when left untreated. Cataract surgery is one of the most
successful procedures in the world.
Generally, studies have shown that people are living longer these days and there seems to be a direct correlation between a healthy lifestyle and minimal years of disability. In those studies, it was determined that people with healthy lifestyles lived longer and also experienced fewer years of being ill compared to those not adopting healthy lifestyles. This should be enough reason to inspire people to adopt a healthy lifestyle because it’s never too late to start doing something good.
There are many ways to improve one’s health through a healthy
diet and exercise — even well into old age. In fact, lack of physical activity
and regular exercise coupled with poor diet can contribute to high blood
pressure, heart disease and heart attacks, lack of sexual activity, and a poor
health-related quality of life.
In order to truly appreciate the value of a healthy lifestyle as
older adults, it’s important to acknowledge the physical and emotional changes
that occur within us as we age. Having such awareness of the changes reduces
the surprise effect. On the emotional level, we struggle with the loss of loved
ones, careers, and independence. On the physical level, our bodies are less
vibrant as they were when we were younger.
These changes notwithstanding, we can still live a quality and
fulfilling life. Below are some important ways to live your life during your
older years by maintaining a healthy lifestyle.
Diet Is Very Important
It is a very important for seniors to practice healthy eating habits. But as you advance in age, some noticeable changes will occur, including slower metabolism and changes in your sense of smell and taste which can ultimately affect your appetite.
Shopping for appropriate food and preparing it will not be a
walk in the park, either. If this occurs, it’s advisable to reach out to family
members or your health provider for assistance. There are also community programmes
that provide healthy food to seniors.
If you are able to prepare your own food, it’s important that
your diet is rich in fibre, vegetables, fruits, whole grains, and lean protein
(meat) which keep you energetic and aid your slow digestion.
Making your food taste and look good also encourages your
appetite. Always stay hydrated — even when you do not feel thirsty — as water
keeps your energy levels up and makes your skin smooth and looking young. If
possible, eat with friends, family, or neighbours; this allows you to keep in
touch with them and be more encouraged to eat despite your reduced appetite.
Eating right also helps you to maintain a healthy weight, which decreases
your risk of certain types of arthritis and diabetes. Avoid smoking cigarettes since
they are seriously harmful to your body and predispose you to lung cancer,
heart disease, osteoporosis, and bronchitis. The chemicals in cigarettes also
damage the skin, causing you to look older than you really are.
Stay Active!
Studies have found that exercise is a top contributor to living longer as it adds more years to your life. If you have not been exercising before, don’t be too hard on yourself because it is never too late to start. Just start!
The benefits of exercise are numerous and rewarding:
Prevents memory loss (dementia)
Produces eel-good hormones (endorphins)
Helps to reduce chronic pain
Increases muscle mass from weight training and improves metabolism
Improves quality of sleep
Improves flexibility, balance, and good posture
Boosts the immune system
Practicing
yoga also relieves discomfort caused by arthritis and fibromyalgia. So before
you enroll in any exercise programme, be sure to consult your healthcare
provider. Start out small and build up slowly over time. Do something you enjoy
to keep you motivated, such as cycling, golfing, walking a pet, gardening, or
swimming.
Exercise
with a friend or a family member or join a class; that way, you keep each other
motivated. Yoga is also a great form of exercise. Muscles stiffen and shorten
when we do not exercise, but stretching improves that. So try stretching for at
least five minutes daily and you will notice the difference.
Exercise The Brain!
Keep your brain active by feeding your creativity, especially now that you are retired and no longer challenged by your career. While physical exercise helps keep your brain alert, other activities like word games, crossword puzzles, learning a new language, and learning a new skill can keep your brain strong.
Stay Positive And
Stay Connected
There
are many difficult challenges that come with getting older, such as losing
loved ones, your independence, and your health. Despite all these things, you
must remain strong and try to navigate through these challenges. Below are some
few tips you can follow:
Accept the thingsthat have changed in your life, even though
this will be difficult. However, accepting and letting go of things out of your
control reduces your stress levels.
Remind yourself of the things
that you are still grateful for, such as the family and friends.
Reach out to other people who
may be experiencing similar issues as yours. Join a support group or volunteer
in the community to help you focus less on your own hardships. Socialize with
people and spend time with at least one person daily. Physical interactions
ward off depression and are much better than texts or emails. Make new friends.
Although your older friend may have moved away or died, you can still make new
ones and share memories with them.
Acknowledge how you feel, especially
after the loss. Don’t bury your emotions; facing them is the only healthy way
to work through them. Talk to a friend, family member, or professional. Keeping
a journal can also be helpful.
Maintain a sense of purpose.
Retirement does not mean your life is without purpose. You still have a lot to
contribute to the world. Now is a great time to write your memoirs, reflect on
your life experiences and the lessons you learned from them. You now have more
time to spend time with your family members. Take up a new hobby or focus on an
old one. Travel and see your city or your country or learn a new language,
sport or musical instrument. Visit the museum, go to a concert, or a play.
These activities will help you maintain your sense of joy.
Sleep comfortably. Many adults suffer
from sleep problems as they get older, including waking up often during the
night, insomnia, and daytime sleepiness. Low quality sleep is caused by poor
sleeping habits, but you can use the following tips to improve that:
Keep Artificial Light To A
Minimum. Artificial light suppresses
the production of hormones responsible for causing sleepiness called melatonin.
Switch off the television and computer an hour before you sleep and use
low-watt bulbs.
Improve Bedtime Rituals. Take a warm relaxing bath or listen to slow music before your
bedtime.
Create A Space That Is
Conducive To Sleeping. Invest in a comfortable
mattress and ensure your bedroom is dark, quiet and cool.
Exercise Regularly. Especially a few hours before bedtime promotes better sleep.
Prevention Is
Better Than Cure
There are several precautionary measures you can take to improve the quality of your life, including:
Seeing your health professional on a regular basis and following their recommendations on screening and preventive measures. These may include yearly flu shot, screening for breast cancer, cervical cancer, checking blood pressure, etc.
Paying
attention to your body and alerting your healthcare
provider immediately if something feels off. For instance, if you feel dizzy or
unsteady, it’s important to follow up on this with your doctor to avoid a fall.
According to the Center for Disease Control and Prevention (CDC), falls were
listed as the first cause of death-related injury among seniors.
Keeping
your home safe by making sure that all rooms
are well lit, moving furniture that can be an obstruction, ensuring that electrical
and gas appliances are safe and up-to-date, looking out for wiring that’s loose
or rugs or carpets that can cause a fall. Also ensure that your home is
properly insulated.
At Vision Express,
we do our best to ensure that we not only give you the information you need as
it relates to your eyes, but our expert and dedicated team also goes above and
beyond to ensure that you see the world clearly. Part of our job is to also
provide answers to the many questions you have about your eyes.
Question: I have been told I have a cataract. What happens now?
Answer: If you have been told that you have a cataract, there is no need to be overly
concerned as you are not alone. Each year, millions of people worldwide have
cataract surgery. Thanks to advanced surgical procedures and technology,
cataract surgery is not only one of the most frequently performed surgical
procedures, but also one of the safest and most successful surgical procedures
that you can have. At Visio Express, cataract surgery is performed on an out-patient
basis and usually only requires a few hours of your time from beginning to end.
Cataract procedure can be performed under local anesthetic. At Vision Express Surgery Centre, the team on the day of surgery comprises the Ophthalmologist, the Ophthalmic Surgery Nurse, the Anaesthetist and the Pre- and Post-Surgery Caregiver.
Question: What happens on Surgery Day?
Answer: When you arrive at VE Medical Centre in Rodney Bay, and change into a surgery
gown, the nurse will begin by placing eye drops in your eyes to dilate your
pupil and numb and anesthetize the surface of your eye. Several sets of eye
drops may be administered for Cataract Surgery. The use of eye drop anesthesia
is sufficient for most cataract patients so that they feel just about nothing
and experience little, if any, discomfort at all.
During your Cataract Surgery, you will be
aware of the surgeon, the staff and the operating room surroundings, but will
not be able to see images or the surgery being performed. Expect to see team
members in scrub uniforms and surgical gowns, and wearing masks to protect the
sterile area. During the surgery, you should not experience pain and minimal,
if any, discomfort.
The procedure involves a very small cut
being made in the eye, the cloudy cataract lens is removed and the new IOL
inserted. The VE Medical team also use the phaco-emulsifaction equipment to
remove the lens and clean out the lens cavity. The cut to remove the lens made
by the Surgery Team at Vision Express is very small and normally requires no
stitches. Your surgeon will complete the surgery by placing some antibiotic
drops and possibly some anti-inflammatory drops in your eye to prevent
infection and swelling.
The surgery takes less than an hour. After
the surgery, you will rest for a while and then go home. The surgeon will
normally ask you to wear an eye patch for a couple of days and you will need to
use eye drops to reduce any possibility of infection. You will return for a
post-surgery visit 24 hours after the surgery and then a week later for a final
post-surgery check-up.
Here’s a review from Linda Hastilow,
following her Cataract Surgery performed in January 2016 at VE Medical: “I had a cataract operation yesterday, and
must praise the surgeon Dr. Alejandro and the staff. Their attention to detail
with care and comfort was superb. The impressive part is the operating room, so
well-equipped with hi-tech equipment and highly-trained staff. From what was a
very nervous patient, not anymore — now full of confidence.”
Question: Which Intraocular lens is right for me?
Answer: There are several choices of IOLs to insert during Surgery — Monofocal IOLs
can be just distance, and you use glasses for reading. This is the choice most
cataract patients make. They are comfortable to have back clear distance vision
and are happy to have a pair of glasses for reading or there are now different
types of Multifocal IOLs. A multifocal lens can be used for distance,
intermediate and reading. Or a newer form of multifocal IOL called an
accommodating multifocal which works in the same way as the natural lens in
your eye by contracting to see to read.
Recently given FDA approval as a
multifocal IOL and achieving good results is a new IOL called Technis Symfony,
which has brought in a more advanced design in multifocal IOLS. Each multifocal
IOL has advantages and disadvantages in terms of the best uncorrected vision it
produces at near, intermediate and far distances, as well as the likelihood and
degree of vision disturbances such as halos and night glare that might occur
after surgery.
When you come for your pre-cataract
surgery appointment, your Ophthalmologist at Vision Express will discuss the
options and make the best suggestion. Full measurements will be taken to get
the correct IOL for you.
Question: I think my vision is getting cloudy from a
cataract. What do I do?
Answer: Step one is to go for a full eye examination with the Optometrist who will tell
you the cause of your cloudy vision. If it is a cataract, then relief is at
hand because cataract surgery can restore your vision. The Ophthalmologist will
do a full pre-cataract surgery examination and you will need to go for some
routine medical checkups to confirm you are okay for surgery. Then just plan
the surgery day and let the excellent surgery team at VE Medical in Karlione
Court, Rodney Bay, take care of the rest.
Frequently Asked
Questions (FAQs) About Cataract Surgery and Pre-Surgery
Question: What will happen at the pre-surgery?
Answer: At your appointment with Dr. Garcia, we will do a full assessment of your eye
health and complete a lens calculation. We will also check your lens
prescription and order this accordingly. The date of your procedure will also
be confirmed.
Question: Will my GP require any
forms to be signed?
Answer: Yes. At the
pre-surgery appointment, we will give you forms for your GP to complete in
order to confirm your general health is well enough for surgery.
Question: Will
you check my blood pressure at the pre-appointment?
Answer: Certainly. This is a vital part of your health screening. We will also give you an overview of ‘do’s and ‘don’ts’ so you are in the best possible health for your surgery.
Question: What time will my surgery take place?
Answer: We only perform day surgery. Your appointment will either be in the morning or
the afternoon.
Question: Will
I need someone to take me home?
Answer: Yes. You will not be able drive and highly recommend you have a friend or loved one to assist.
Question: What about my partner/friend? Will they need to wait throughout the surgery?
Answer: No. We will call and text them half an hour before the surgery finishes or
whenever is convenient to them.
Question: Will
I need to come back?
Answer: Yes. We have a post-surgery appointment to check your progress and to confirm your eye health is in excellent condition.
Answer: Yes. The price is inclusive of the pre-surgery, surgeon fees, lens implant and the post-surgery appointment.
Question: How much deposit do I need to put down?
Answer: We normally ask for a 25%
deposit at the pre-surgery appointment and the balance on the day of the
appointment if paying in full. Discuss your payment options with the team at
Vision Express.
BUT Cataract Surgery is covered by medical
insurance. If you don’t have medical insurance coverage, then Vision Express
can arrange an interest-free payment plan with your Credit Union, or a two-year
Vision Express “Vision Plan” with FastCash.
