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Lens Replacement Surgery

Lens replacement surgery (also called Clear Lens Exchange) involves removal of the eye’s natural lens, located behind the colored iris, and its replacement with an artificial lens called an intraocular lens (IOL). When light enters the eye through the cornea (clear front dome) and the pupil (black center of the iris), it travels through the clear lens and focuses on the retina, the eye’s “camera film”. Please see How the Eyes Work: Overview.

Lens replacement is done to correct two vision problems that are very different but each involve the eye’s lens.

  • Cataracts:  Cataracts are opaque areas in the lens that block and scatter some of the light, causing blurriness and loss of vision. Please see Cataract Symptoms for more details. In past years eye surgeons advised their cataract patients to postpone surgery until their vision had reached the 20/200 level, which is severe nearsightedness. However, lens replacement surgery is now very safe and techniques have improved. Now the decision as to when to have this cataract treatment is made by the patient and doctor together.
  • Presbyopia:  When the lens becomes unable to change its curvature for near vision, that is called presbyopia and it occurs in mid-life for everybody. Presbyopia causes are not fully understood. It is most often treated with reading glasses, but some people choose to have an IOL implanted.

Lens Replacement an Alternative to LASIK

If it is determined that you are not a good LASIK candidate, a lens replacement could be a good option. It offers the same long-term solution and would relieve you from the inconvenience of glasses or contact lenses. Please see Intraocular Lenses for more information.

The Lens Replacement Procedure

Lens replacement is a short outpatient procedure done on one eye at a time. It uses local anesthesia and you may have a mild sedative as well, to help you stay relaxed.

Typical procedure steps are:

  1. Your eye surgeon makes a very tiny incision next to the cornea, outside the field of vision.
  2. He or she inserts a tiny probe which transmits ultrasound and this dissolves the lens.
  3. The lens fragments are gently removed using suction.
  4. The IOL is inserted through the same incision and placed in the same membrane pocket (capsular bag) that the natural lens previously occupied. Your eye surgeon inserts it folded and once it is in the capsular bag he positions it correctly. This is done slightly differently depending on which IOL you have chosen to use.

The procedure takes about 30 minutes for each eye. No stitches are required to close the incision, as it will heal by itself. There is also no eye patch required.

In cases where cataracts are advanced, the lens may be too dense to be fragmented by ultrasound. Then a technique is used called extracapsular cataract surgery. A larger incision is made and the lens is removed in one piece. After the IOL is in place, some suturing is necessary to close the larger incision.

There is also a technique (rarely used) called intracapsular cataract surgery. It removes not only the natural lens, but also the capsular bag that holds it. The IOL is then positioned in front of the iris. This technique can be used in cases of severe eye trauma.

Lens Replacement Recovery

Recovery is usually short and you may be able to resume normal activities as early as that evening or the next day. There will be several follow-up visits so your eye surgeon can monitor your recovery – the first is a day or two after surgery and the others are within a few weeks. If you had extracapsular or intracapsular surgery, recovery is a little longer, since the incision was larger.

You will have eyedrops to guard against infection and inflammation. Your eye surgeon will give you printed instruction for self-care in the weeks after surgery and it is very important that you follow them exactly. You will be advised not to lift heavy objects and not to stoop or bend forward.

When your healing is complete and your new vision is stabilized, your eye doctor will fit you with glasses, if necessary. That will depend on your vision to begin with, which IOL you have used, and your lifestyle.

For more information, please see one of our cataract information pages:

If you would like to locate a lens replacement surgeon in your area, please contact us today.

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