Refractive Lens Exchange (RLE)
23 May 2013 23:10 #331
RLE is increasingly being promoted but is not as cut and dried as presented. Should the desired result not be achieved after lens exchange then a laser enhancement is offered. However more than one laser enhancement may in fact be required.
I needed a yag laser capsulotomy for capsular opacification/secondary cataract in less than a year and this not only caused me to suffer constant, shadowy movement within my vision (floaters) but also caused a shift in the lens implant with an associated change in my prescription!
The possibility of needing yag laser was mentioned to me at the consent appointment and is on the consent form but there is nothing about the possibility of being left with floaters, or that it might cause such a change in vision necessitating yet further laser.
These possible consequences from treatment with yag laser should be on the consent form and discussed with the patient.
Increasing numbers of patients under the age of 45 are contacting MBE with problems following RLE surgery, some only in their twenties!
"Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. Many patients' first symptoms are strong glare from lights and small light sources at night, along with reduced acuity at low light levels. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the lens's transparency."
NB: There is a high risk of retinal detachment with RLE surgery.
When I asked him recently an eminent specialist told me that, unless it was an extreme prescription, he would only provide RLE to patients aged 50+ .
Yet Optical Express routinely offer this procedure as an option to laser, putting the patient at unnecessary risk of retinal detachment - which at least two MBE clients I know so far have suffered as a result of RLE.