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A patient's guide to eye surgery sponsored by the London Eye Hospital

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London Eye Hospital, a dedicated ophthalmic hospital treating all eye conditions, with state-of-the-art facilities in Harley Street and Wimpole Street.
Eye surgery

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Lens implants treatment guide

Implantable lens

Lens implants are used either to replace the natural lens in cases of cataracts and other lens damage, or to replace or supplement the natural lens to enhance vision in cases of long sight, short sight or astigmatism. Lens implants are permanent and designed to last a lifetime, although implantable collamer lenses (ICLs) can be removed and replaced easily if your vision significantly changes.

Refractive lens exchange

In refractive lens exchange (RLE) lens implants are used to replace the existing lens:

  • Monofocal lenses that have equal power across the lens and provide good general distance vision.
  • Toric lenses that correct both shortsightedness and astigmatism.
  • Multifocal lenses that allow for both good distance and close up vision.
  • Trifocal lenses that give intermediate vision as well as distance and close up.
  • Light adjustable lenses that are adjusted a week after implantation using UV light to sculpture the final shape of the lens in the eye.

People who have monofocal or toric lens implants usually require reading glasses for close up work, since the replacement lens is not able to adapt its focal length in the same way as a natural lens. The most advanced lens implants usually give the recipient complete freedom from glasses and contacts.

Phakic lenses

Phakic implantable collamer lenses do not replace the existing natural eye lens, but sit in front of it like an internal contact lens. Since the natural lens is retained, this type of implant provides a far wider range of vision and the recipient does not normally require reading glasses.

Once implanted, phakic lenses cannot be seen in the eye, as they cover the whole of the pupil opening and have their edges tucked under the iris.

Who are lens implants suitable for?

Lens implants are a vital part of any procedure where the existing lens has to be removed and replaced, such as cataract surgery. However, lens transplants, especially ICL transplants, are becoming more and more common for people who have short or long sight, but who are unsuitable for corrective laser surgery. These include

  • People with a short sight prescription greater than -10.0D.
  • People with a long sight prescription greater than +6.0D.
  • People with thin corneas.
  • People at risk from complications of laser surgery.

ICL transplants can correct prescriptions up to -25.0D in short sight and +12.0D in long sight, as well as astigmatism up to 5.0D. These are all severe visual defects.

Phakic lens implants are normally only recommended for people under 45, who have a good quality natural lens. In older people, this lens has often started to degenerate, making full lens replacement a more practical option.

Lens implant surgery

Lens implant surgery is usually done under local anaesthetic on an out-patient basis. Both the removal of the existing lens (if required) and implantation of the replacement or supplementary lens, are done through a very small incision. The procedure takes less than half an hour.

You will only be able to have one lens implanted at a time. If you need lens implants in both eyes, you may need to wear a single contact lens, or specially adapted glasses in between the two treatments. The second implant is usually done around a week after the first.

It can take a day or two for your vision to fully recover following full lens replacement. You can notice much faster improvements after implantation of a phakic lens.

Risks and complications of lens implants

Phakic lens implants carry few risks, as the surgery is limited to a small incision and the lens is made of a special material to reduce the possibility of rejection by the body.

Full lens replacement carries additional risks, as it’s a more extensive procedure. The most common complication is posterior capsule opacification. This occurs when the back of the replacement lens becomes thicker and clouds the vision and further surgery is then required.

Rare complications include rejection of the lens by the body, retinal detachment, glaucoma or a reduction in vision, especially at night.

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