Refractive Lensectomy

 

Refractive lensectomy is correcting the nearsightedness and farsightedness by replacing the eye’s natural lens with an artificial intraocular lens (IOL). This is also called the refractive lens exchange. This procedure is performed to reduce your dependency on glasses or contact lenses or you’re not a suitable candidate for laser vision correction. At The University of Houston College Optometry Surgery Center we are pleased to offer our patients the first FDA approved, advanced precision based technological breakthrough in refractive lensectomy. The Computer Guided femtosecond (LenSx) laser helps surgeons to customize the refractive lensectomy procedure to your eye. Also our Optiwave refractive analysis (ORA) system provides continuous assessment of your eye allowing precise refractive measurement to provide you with the best suitable IOL. When you choose our facility to perform your procedure you will enjoy the benefits of a bladeless surgical procedure using the LenSx laser and the ORA system with precision, and comfort. Ask your eye care provider if bladeless refractive lensectomy is right for you.

For years refractive lensectomy surgery has been performed using a scalpel to enter the eye. Now, a laser is used to make a much smaller incisions into the. This means less time is needed for the surgeon and, less discomfort and faster recovery time for the patient. Prior to the implementation of the laser, this opening was made by hand. The opening was not always precise and could vary in size and location (not always centered). If you have elected to proceed with refractive lensectomy surgery, below please find some more information that will help you with your decision.

What are the advantages of LenSx laser (bladeless) vs. traditional cataract surgery?

Precision and Accuracy

The LenSx laser uses a range of highly advanced technologies to capture precise images and measurements and uses the data to perform the critical procedures in refractive lensectomy surgery with precision and accuracy. This precision has made the lens placement and post-operative outcomes more predictable, greatly enhancing the benefits of lens implants.

Safety and Comfort

Most people do not feel any pain at all during the bladeless cataract procedure. The procedure takes usually ten to thirty minutes.

Custom Tailored for your Eyes

Every human eye is a little different in terms of size, depth, and curvature of the cornea and other key features. Therefore, the LenSx laser incorporates a variety of highly advanced technologies to obtain precise measurements and images to perform the most critical and delicate procedures in refractive lensectomy surgery.  For example, The laser is also capable of making additional incisions that relax the cornea to adjust for astigmatism.

Which Intraocular Lens (IOL) is right for you?

Prior to surgery a series of diagnostic tests will be performed on your eye so that your eyecare provider can determine the power and type of implant (IOL - Intraocular lens) needed for you. Every eye is different and so there is no “one size fits all”. This will be done several days or even weeks in advance of your surgery. Also, during your surgical procedure the refraction of your eye is measured using the Optiwave refractive analysis (ORA) system to confirm your IOL prescription. 

Lens Implant Options

There are different intra-ocular lens implants (IOL’s) available to help you reach your post- operative visual goal. These lens options are considered either “Standard / Conventional” or “Premium”.  Your insurance company will fully cover “Standard / Conventional” IOL’s.  “Premium” IOL’s will require an additional out-of-pocket expense.

  • “Standard/ Conventional” IOL: 

- Monofocal IOL:

Presently, Monofocal IOL’s are the most commonly used lenses. These lenses provide patients with one focal point.  Most commonly these lenses correct only for distance vision, unless the patient has a pre-existing astigmatism.  Patients who have had Monofocal IOL’s usually require reading glasses.
  • “Premium” IOL’s:   
- Toric IOL: 

benefits those people who have astigmatism.

- Multifocal IOL: for those who want to be free from glasses.

- Accommodating IOL: 

for patients who want some range of vision but do not mind wearing reading glasses for small print.

Not all Premium IOL’s are good options for all people.  Your eye care provider will discuss with you the IOL that will best meet your goals.  

On the day of your surgery you will report to the surgery center at your appointed time. You can expect to be there for 2-3 hours.  This is to insure proper preparation of the eye and recovery time.  Once surgery is completed you will be discharged to the care of a responsible adult to drive you home. You will have to put in a few more drops that evening and will most likely want to rest. The days after surgery you will follow up as instructed by your surgeon and continue taking your drops. You will have some restrictions on your activities for a few days.

*Even though cataract surgery is a very routine procedure, it is still surgery. Be sure to get all of your questions answered and follow all instructions.*

Below please find more detailed Pre & Post Operative Instructions 

Pre-Operative(Before Surgery)Instructions

  • Do not eat, drink, or chew anything for 8 hours prior to arriving at the surgery center. This includes water and mints, candy, gum and chewing tobacco. There are few special considerations to this guideline. Please call to speak to a Pre-Op nurse if you have any concerns.
  • Do not consume alcohol 24 hours prior to your surgeryRefrain from smoking12 hours prior to your surgery. These substances can cause you to have adverse reactions to anesthesia and medications.
  • Brush your teeth on the morning of your procedure but do not swallow any water.
  • Bathe or shower on the morning of your procedure to minimize the risk of infection.
  • Please do not wear any eye make up.
  • Wear comfortable clothing such as a shirt or blouse that doesn’t need to be pulled over your head and low-heeled shoes.
  • Leave valuables at home except what is needed to take care of any financial obligations you may have.
  • Contact lenses may not be worn during your procedure. Either leave them at home or bring a case for their safekeeping.
  • Health changes should be reported immediately to your physician, even if the changes seem minor such as fever, cough, rash, or a cold.  Please notify your physician if there is a possibility that you are pregnant.
  • Arrange for a responsible adult to drive you home and stay with you for the first 24 hours following your procedure because the effects of anesthesia and sedation will make you drowsy for that period of time.
  • Arrive at your scheduled time that was assigned by the Pre-Op nurse.  If you have not been contacted by noon the last business day before your surgery, call the Pre-Op nurse at (713) 743.7167.

Post-Operative (After Surgery) Instructions

After leaving the surgical suite, you will be moved to are covery area where our staff will care for you until you are awake and comfortable. As soon as your condition is stable and you have a responsible adult to drive you home, you will be discharged. You will be provided with instructions for home care. Please follow these instructions and be sure to ask questions if there is anything you do not understand.

A nurse from UHCO Surgery Center will call you at home one business day after the procedure to check on your recovery. If you have not been contacted, please call and ask to speak to a Post-Op Nurse.
For your well-being, we recommend that you wait at least 24 hours before you:
  • Drive or use power equipment
  • Eat a heavy meal
  • Consume alcoholic beverages
  • Take medication not approved by your physician
  • Sign important papers or make important decisions
  • Stay by yourself

List of IOL manufactures and lens choices we offer

Alcon

  • AcrySof IQ ReSTOR IOL (Multifocal IOL)
  • AcrySof IQ Toric IOL (Astigmatism IOL)
  • AcrySof IQ (Monofocal IOL)

Abbott Medical Optics

  • Tecnis Multifocal IOL
  • Tecnis Toric IOL
  • Tecnis 1-Piece IOL

Baush & Lomb

  • Crystalens AO Lens
  • Trulign Tori IOL
  • Akreos AO Lens
  • SofPort Advanced Optics (AO) Aspheric Lens

STARR Surgical

  • Collamer IOL
  • Silicone IOL
  • Acrylic IOL
  • Toric IOL