Vision & Refractive Errors | Keratoconus | Cataract Surgery
Refractive lens exchange
Refractive Lens Exchange, or Natural Lens Replacement, is a process where the natural lens is replaced by an advanced lens Implant to correct vision. This same procedure is branded by some companies and clinics as Clarivu or NuVu or PreLex.
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We are one of the original clinics offering this revolutionary treatment for Presbyopia or age-related loss of reading vision with over 25 years’ experience.
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Viewpoint offers the full range of advanced implants to customise your treatment and to give you the vision you want.
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What is it?
The natural lens inside your eye helps you focus on images and is very flexible allowing you to focus at different distances. However with increasing age this lens becomes harder and less flexible and finds it difficult to change focus on near objects. We therefore rely on reading glasses. This condition is called Presbyopia or Dysfunctional Lens Syndrome (DLS). With time this also starts to affect distance vision and we then need both reading and distance glasses e.g. varifocal lenses. With lens replacement surgery we remove this dysfunctional natural lens and replace it with a more sophisticated advanced lens which helps you focus clearer without the need for glasses or contact lenses. The technique is similar to that used in modern cataract surgery.
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Who is it for?
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For patients who are presbyopic (aged over 40-50 years) and/or unsuitable for other refractive procedures, refractive lens exchange with advanced ‘State of the Art’ lens implants is a revolutionary breakthrough. The aim of refractive lens exchange is to reduce your refractive error (long or short sight) so that you can enjoy clearer vision without spectacles or contact lenses.
Following removal of your natural lens, an intraocular lens is placed in the same position as your natural lens. It remains there permanently. The intraocular lens offers significant advantages:
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Magnification is at the natural level
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Full peripheral (side to side) vision is retained
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Vision correction is permanent and will not change with age since the artificial implant does not degrade or change with time and is highly biocompatible
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About the procedure
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This short procedure takes only 5-10 minutes and is done under local anaesthetic. We use numbing eye drops, not needles, to completely anaesthetise the eye. The surgery is completely painless. Through a small opening (microincision), the natural lens is removed and a replacement lens is slid into its place. The recovery is almost instantaneous, with most patients able to watch TV immediately upon return to their rooms.
Improve your vision with lens replacement surgery
Types of intraocular lenses
St Helens based Viewpoint Vision Services Ltd offers the full range of advanced implants to customise your treatment and to give you the vision you want and enjoy complete freedom from glasses. These are outlined below.
Multifocal Trifocal Lens
This is the most common type of lens used for full vision correction. It provides a full range of focus allowing you to reliably focus at near. Intermediate and distance without the need for glasses at all. This high performance lens has microscopic rings etched on its surface which gives it its focusing ability. However as a result of these rings people do experience transient halos and glare from bright light. The haloes and glare do disappear with healing over time and adaption of the brain.
Trifocal Toric Lens
For people with significant astigmatism which also requires correction toric trifocal lenses are used. This allows full correction of focus at all distances. These are more complex and the lenses are custom made.
Increased Range of Focus Lenses (IROF)
For some people who are not suitable for trifocal lenses one of many lenses in this category can reliably provide good distance and intermediate focus and some near vision. They are also known by various names such as Extended Depth of Focus (EDOF) lenses and Monofocal Plus lenses. They can be used to provide reasonably good near vision by making one (non-dominant eye) slightly myopic or shortsighted. These type of lenses often produce less glare and haloes but still require a period of adaptation.
Monofocal Lens
Monovision lens provides a single point focus, usually for distance. It is the standard lens used in NHS cataract surgery. The aim is to give good quality distance vision without glasses but patients usually need glasses for intermediate and near vision. We can use the monofocal lens to adjust focus in non-dominant eye for near vision and leave the dominant eye focused for distance vision, so called Monovision or blended vision. Monovision is not tolerated by everyone due to the disparity between the two eyes.
Toric Lens
This is a monofocal lens but also has built in correction for astigmatism. Just like toric trifocal lenses these lenses have to be specially ordered and sometimes need to be manufactured to suit the individual eye. Insertion of these lenses require a more delicate and precise implantation technique compared with monofocal lenses.
‘Add-on’ Lenses
If you have undergone cataract surgery or lens exchange but have not achieved the desired visual outcome, or if you want to be able to read close up without glasses, there is now a solution to ‘fine tune’ your result. You may have undergone the implant surgery recently or years ago.
Special intra-ocular lenses designed for implantation on top of the previously placed lens are available, so called ‘add-on’ lenses are available. This can be another monofocal implant or a trifocal implant This allows your vision to be fine-tuned at a secondary procedure and is a safe and highly effective way to give you reading vision.
Piggy Back Lens Exchange
Viewpoint Vision was among the first centre in UK to offer this ground-breaking treatment. Piggy Back Lens Exchange is an extremely delicate procedure requiring exceptional surgical skills. We have carried out many successful piggy back lens implants treatments since 1996.
Piggy back lens implant treatment is used for complex prescriptions where a single implant is not enough to correct vision. A combination of two implants, both custom made for your prescription, is implanted within the eye – one inside the human lens capsule and one in front of it. This is similar to the principles described above for add-on Lenses but here the procedure is done in one go.
The Procedure
The procedure is typically performed under drop (topical) anaesthetic – no needles are used. Your pupils will be dilated with a series of eye drops and possibly with a medicine pellet under your lower lid on the ward before this.
A sticky plastic drape is placed on the eye after the surrounding skin has been disinfected with an iodine preparation.
An eyelid clip is used to keep the eyelids open. You will be asked to stare at a bright light from the microscope above your head. The short procedure takes only 5-10 minutes. The surgery is completely painless. Through a small opening (microincision), the natural lens is removed and a replacement lens is slid into its place. At the end of the procedure antibiotics are instilled in the eye and your eye is covered with a protective clear eye shield.
Can Lens Replacement Surgery be performed on both eyes at once?
At Viewpoint Vision most surgeries are performed on both eyes (Bilateral Sequential Surgery), unless you opt to have surgery to one eye at a time. To ensure maximal safety, each eye is treated independently with different batch numbers of devices and medicines for each eye, as well as instruments that are used. The whole procedure takes around 20-30 minutes for both eyes.
Aftercare and Recovery
After this you will be taken to the ward. The nurses make sure you are feeling ok, refreshments are provided and the nurses will ensure you have full instructions on using your post operative eye drops and aftercare.
You will then be able to go home and we suggest you get plenty of rest that day.
Visual recovery is typically very quick and most patients find they are able to see well enough to drive within 48 hours. The following day you can remove your eye shield but you need to keep it safe as you will be instructed to wear it at bedtime for the first week. You should then clean your eye and commence your eye drops as instructed by the nurses. Your eyes may feel very sensitive to light and watery. It is advisable to wear dark glasses during the day. This will begin to settle as the day progresses. The consultant will call you during the day to ensure you are making good progress. If there is a problem you will be seen straight away otherwise we will make an appointment for your follow up within the first 10-days
What to expect after Lens Replacement Surgery?
Adaptation (Neural-adaptation)
Your vision will gradually improve and begin to settle in the first few days and your vision may fluctuate from day to day for the first week or so. As your brain adapts the initial glare and halos will also settle as the brain will learn to suppress any unwanted information. The process may take a few weeks generally. Some patients take longer to adapt and can take up to 6 -12 months.
Dry eyes
Dry eyes are very common after surgery especially in ladies or if you already suffer from dry eyes before surgery. The eye drops are very strong and can affect the eye surface causing symptoms of dry eye and may in turn temporarily affect vision. This will improve once the drops are stopped, however it is important that these be used as instructed. You will also be provided with artificial tears to use in case this happens. We understand that all patients are different and recover differently. We will guide you through the initial healing process as necessary.
Posterior Capsule Opacification
When you have your surgery, the capsule that held your own natural lens is left in place. With time, this can thicken and become cloudy, impairing your vision. All that is required is a few seconds of YAG laser treatment in the clinic to ‘polish’ away the cloudy capsule. This usually restores clear vision within a few hours.
Prices
RLE surgery prices are an indication of usual charges. The information here is not complete and may be subject to change.
Consultation - £230
Refractive lens Exchange (monofocal lens) - £2925 per eye*
Refractive lens Exchange (premium Lens) - £3800 per eye*
Refractive Lens Exchange (piggyback or add-on lens) - £4000 per eye
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0% Interest Free Finance option available payable over 10 months. Deposits will apply.
Lens Replacement surgery packages includes:
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The cost of procedure, including the IOLand surgeons fees
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Inclusive follow-up care for up to 12 months
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Top- up laser eye surgery if required
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Reassuring 24/7 hour service
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YAG posterior capsulotomy if deemed necessary within 12-months of the procedure
Some of our other treatments
Cataract surgery
Cataract surgery is one of the most common eye surgeries performed today. It is quick, safe and a great investment to improve the quality of your life.
Keratoconus
Keratoconus is a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and change to a more conical shape than its normal gradual curve.
Laser
Laser eye surgery has changed the lives of millions of people throughout the world. Make an appointment by getting in touch.