A new look at improving vision: lens replacement surgery corrects eyesight so you don't need glasses.
In the past, LASIK was the go-to procedure to eliminate the need for glasses. "While LASIK continues to be the procedure of choice for younger people, lens replacement surgery (LRS) using laser technology may make the most sense for older adults," says Rex Hamilton, MD, medical director of the UCLA Laser Refractive Center.As you age, your lens loses its flexibility. This process, called pres-byopia, leads to the need for reading glasses or bifocal/progressive spectacles as you reach middle age.
Over the years, the lens also can become progressively cloudy, a condition known as cataracts, which causes blurred vision to worsen and cannot be corrected with just a stronger eyeglass prescription.
"While LASIK treats the clear window on the front of the eye called the cornea, it does not address the main problem in seniors," says Dr. Hamilton. "As one ages, it is the lens inside the eye that causes vision to decline. LRS directly treats this. By replacing the lens of the eye with a high-tech, multifocal intraocular lens (IOL) implant, patients can see distance, intermediate, and near without glasses."
LRS can also protect you from future cataracts, adds Dr. Hamilton, since the natural lens is replaced with a synthetic implant that will remain stable for the rest of your life, and never cloud up.
Laser precision
LRS is an outpatient procedure that takes only about 15 to 20 minutes per eye. Eyes are often treated about two weeks apart. Here is how the surgery works:
* After numbing the eye, the surgeon uses a laser to make precise incisions in the cornea. The laser allows greater accuracy in terms of depth and length of the incisions compared with a traditional blade. "Every eye has a cornea that is unique in terms of thickness and curvature," says Dr. Hamilton. "The laser uses real-time image guidance, which customizes the incisions to match the unique dimensions of the. cornea."
* In the second step, the surgeon uses a laser to make a precise, circular opening in the capsule containing the lens.
* Next the surgeon uses the laser to soften the lens and break it into segments for easier removal.
* Then an ultrasonic probe is used to remove the lens material through the small incision in the cornea.
* The final step is the implantation of the new replacement lens into the capsule.
* The incisions are self-sealing. Patients see out of the eye immediately after the surgery, and the eye feels essentially normal the day after, says Dr. Hamilton.
Who is a candidate?
Lens replacement works best for seniors with cataracts and those without cataracts who are farsighted and wish to function without glasses.
However, LRS may not be appropriate for those who are only nearsighted and/or have worn glasses most of their adult lives.
"A nearsighted eye has a thinner and more delicate retina, which can more easily tear or become detached during or after surgery," says Dr. Hamilton.
Lens replacement surgery is offered at a growing number of eye surgery centers. But be mindful that LRS in an eye without a cataract is considered cosmetic and rarely covered by insurance.
Costs can range from $1,500 to more than $5,000 per eye depending on the situation and which technologies are used. (Even if you have a cataract there is often some out-out-of-pocket expense. Check with your insurance company about your coverage.)
Still, for many seniors the procedure may be worth the price in order to increase quality of life.
"Patients should consider that they are investing in a treatment that will benefit them every waking hour of every day for the rest of their lives," says Dr. Hamilton. (For more information on the procedure, visit www.uclaser.com.)
WHAT YOU SHOULD KNOW
Three types of IOLs are available to replace your natural lens, depending on your vision. Your doctor will make a recommendation:
* Monofocal fixed-focus IOLs provide clear vision at distance, intermediate, or near ranges--but not ail three at once. Toric IOLs to correct astigmatism also are classified as monofocal IOLs.
* Multifocal IOLs provide clear vision at multiple distances.
* Accommodating IOLs enable focus at multiple distances by shifting their position in the eye.
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| Title Annotation: | VISION |
|---|---|
| Publication: | Healthy Years |
| Date: | Jul 1, 2015 |
| Words: | 693 |
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