Refractive Lens Exchange

The freedom of regaining your near vision

Some patients who have not yet developed cataracts are interested in surgery to eliminate glasses for distance, intermediate and near vision. Their inability to read up close is called presbyopia. In many cases, the best way to treat this is to “prematurely” remove the lens in their eyes that will eventually become a cataract, and replace it with an intraocular lens. The intraocular lens has the ability to see at distance, intermediate and near without the need for glasses. This procedure is called Refractive Lens Exchange, and it is generally reserved for patients over the age of 40.

Refractive Lens Exchange is in essentially identical to cataract surgery; however, since it is performed on individuals who have not yet developed a significant cataract, it is referred to by a different name than “cataract surgery”. During our evaluation of your eyes, we can determine if this option is appropriate for you.

This type of surgery can restore the traditional Full Focus range of vision we are used to without the regular use of glasses or contact lenses. This can mean being able to see clearly across the room, at an intermediate distance like a computer screen, and even up close to read a novel, all without having to reach for reading glasses. If you would like to gain your freedom from glasses, contacts, or readers, call us for a consultation to determine if you are a candidate.

Patients who have even a small degree of cataract formation may actually benefit from having their cataracts removed as a method of eliminating their glasses prescriptions. The reason for this is that at the time of cataract removal, an implant lens can be placed which has the prescription power necessary to reduce or eliminate the need for glasses. During our evaluation of your eyes, we can determine if this option is appropriate for you.

Presbyopia Overview

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Cataract and Refractive Lens Exchange

(Using the Crystalens, ReStor® and TECNIS® Implant Lenses)

The Crystalens is an artificial lens that has the unique ability to “zoom focus”, giving patients the ability to see well at distance, intermediate and near without glasses following surgery. In 2001, Dr. Dell performed a series of operations using the Crystalens in an FDA sponsored clinical research trial, which led to full FDA approval of the Crystalens in 2003. Data from this clinical trial involving over 400 eyes indicated that without using any glasses, nearly every patient could see well enough to pass the Texas driver’s license exam for distance vision, but could also see well enough at near to read the stock tables in a newspaper.

Qualified surgeons using the Crystalens must pass a rigorous certification process assessing their surgical skill, accuracy and proficiency. Dr. Dell serves as Co-Director of Physician Education for the Eyeonics Crystalens, and as such has personally trained hundreds of U.S. surgeons certified to use the Crystalens. For patients living outside the Austin, Texas area who wish to have surgery with Dr. Dell, arrangements can often be made to offer some of the post-operative care closer to home with one of these Crystalens certified surgeons.

ReStor® and TECNIS® are brand names of two additional artificial lenses with the ability to provide good near and distance vision. Each of these lenses uses a different optical strategy to achieve its visual goals. In certain patients, a different type of lens is used in each eye to achieve the desired result.

These artificial lens technologies are generally only appropriate for patients over the age of 50, however many patients in this age group are better candidates for LASIK. The decision of which type of surgery or implant lens is best for you is a highly individualized one, which is based on a variety of factors. Our doctors will discuss the best option for you at the time of your consultation.

IOL mixing premium lenses

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Laser Cataract Surgery

Laser Cataract Surgery is a term referring to using a femtosecond laser to assist in the removal of cataracts. Dr. Dell, serves as a consultant to LenSx, the manufacturer of the first FDA-approved laser for cataract surgery. In 2010, he became the second surgeon in the United States to perform Laser Cataract Surgery. The first surgeon to use this laser was Stephen G. Slade MD in Houston, Texas. Dr. Dell has spent the last several years working with the team that developed this laser, and educating other surgeons on this technology. In 2011, Dr. Dell served as the Program Chairman of the first major medical meeting in the United States on Laser Cataract Surgery.

Through Dr. Dell’s consulting relationships with innovative technology manufacturers, we are able to honor our commitment to provide Austin area patients with world leading technology, often years before other surgeons. Now that Laser Cataract Surgery is becoming commercially available in the US, other surgeons are beginning to adopt it. We continue working intently on bringing more accurate and efficient technology to the United States to improve the standard of care for our patients.

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