Because of the growth in Refractive Lens Exchange and Presbyopia treatment, at the San Jose Eye Institute, we have decided to focus our refractive practice exclusively in these two areas and are no longer performing Laser Refractive Surgery at this time.
An increasing number of patients are inquiring about refractive surgery to reduce their dependency on glasses or contact lenses. We are experienced in all aspects of refractive surgery, including laser as well as non-laser procedures. We are determined to provide excellence in patient care, ensuring the well-being of our patients and the health of their eyes. We are highly selective as to which refractive surgery is best suited for each patient. Some patients are excellent candidates for Laser Vision Correction, such as LASIK or ASA. Others are better suited for non-laser refractive surgical techniques, such as refractive cataract surgery, piggyback IOL’s, and ICL’s. We believe the most important factor influencing the decision on the most appropriate procedure is whether or not a patient has presbyopia.
Presbyopia refers to the loss of the ability to read and the need for bifocal glasses as one ages. When corrected for distance vision, everybody will eventually develop presbyopia, usually when they are in their mid 40’s. To become free of glasses or contacts, both the far and the near vision need to be addressed. The most common options are: (1) the creation of monovision (one eye sees far, and the other sees near) using Laser Vision Correction, (2) the use of Refractive Lens Exchange to achieve monovision and (3) the use of Refractive Lens Exchange to allow each eye to see far and near independently. Monovision works well for most patients, but may not be a good long term solution as the presbyopia worsens, and may not be an option that everyone can tolerate. We believe the use of Refractive Lens Exchange to allow each eye to see far and near independently is the best long-term solution that address presbyopia.
RLE refers to Refractive Lens Exchange. Patients with any refractive error (myopia, hyperopia, astigmatism) and are presbyopic are candidates.
Just as in cataract surgery, the patient’s natural lens is removed and a special intraocular lens is inserted in its place. These premium intraocular lenses allow patients to see far and near at the same time. They comes in a large range of powers and can treat almost any refractive error. In fact, many patients outside the limits of Laser Vision Correction may still be candidates for Refractive Lens Exchange. Because the cornea is not altered in shape, the quality of vision is also typically better than with Laser Vision Correction.
As a general rule, patients with cataracts (regardless of whether the cataract is mild or dense) are not ideal patient’s for Laser Vision Correction for three reasons: (1) The laser treatment cannot improve any vision lost because of the presence of the cataract. (2) Following Laser Vision Correction, the vision will most likely decline as the cataract develops. (3) With the current technology, it is much more difficult to predict the refractive outcome of cataract surgery if the patient has had a prior history of Laser Vision Correction.