Clear Lens Replacement is an exciting option - for individuals over 40 who are considering refractive surgery to decrease dependence on glasses and contact lenses. This procedure entails removing the natural lens of the eye and replacing it with an intraocular lens (IOL) implant. The procedure is essentially the same as a cataract operation with lens implant, however, in this case, the procedure is completed prior to cataract development for the refractive advantage.
A second alternative for patients who are considering lens replacement surgery but who do not embrace the notion of wearing reading glasses following surgery, is monovision. With monovision, the traditional monofocal IOL implant is inserted bilaterally, however, the patient's dominant eye is corrected for distance and the non-dominant eye is corrected for near. This option is not tolerated by everyone. To determine whether this is a good option for you, Dr.Ghosheh offers a monovision contact lens trial. Patients tolerating monovision with likely tolerate this option.
For individuals over 40 who are considering refractive surgery to decrease dependence on glasses and contact lenses, clear lens replacement is an exciting option. This procedure entails removing the natural lens of the eye and replacing it with an intraocular lens (IOL) implant. The procedure is essentially the same as a cataract operation with lens implant, however, in this case, the procedure is completed prior to cataract development for the refractive advantage.
Lens replacement is a procedure that is more invasive than LASIK or PRK with consequent greater risks. However, it may be an excellent alternative to these procedures for people already wearing bifocals or for those who do not qualify for other refractive procedures due to extremes of refractive error. Because lens replacement requires entering the eye to place the lens implant, the patient has a small risk of infection inside the eye that is not present in LASIK or PRK. Unlike these procedures, however, clear lens replacement avoids any treatment of the cornea and instead changes the refractive power of the eye in a potentially more natural position.
Because clear lens replacement requires removal of the natural lens of the eye, the patient is subsequently unable to focus at near (accommodate). This is why CLE is best suited for patients over 45 who are already wearing bifocals. One potential solution to this problem of accommodative loss is implantation of a premium IOL implant. These implants allow focusing at both near and far, allowing patients to read small size print and drive a car without glasses, following implantation of the lens in both eyes.
The Crystalens is an intraocular lens (IOL) that is designed to mimic the eye's natural ability to focus on objects at multiple ranges. Often used in conjunction with cataract surgery, the Crystalens provides a continuous range of vision, from distance to intermediate to near reading vision without the need for glasses or contact lenses.
Standard (single vision) lens implants do not provide the same range of vision as the Crystalens. Most people who have single vision lens implants MUST also wear glasses to correct middle and near vision. In the two year clinical trial for FDA Approval of the Crystalens, it was shown that 88% of Crystalens patients could see better at all distances than the 36% of patients implanted with a standard lens.
Dr. Ghosheh will perform a thorough examination and advise you on a customized treatment plan for correcting your vision. If you are in general good health, and not prone to chronic infections, uncontrolled diabetes, or other health problems, you may be a good candidate for implant surgery. If you have already had cataract surgery, you will not be a candidate for Crystalens, though people who have had corneal refractive surgery previously are acceptable candidates as long as the eyes are in good health.
While both eyes are susceptible to developing cataracts, if only one eye has a cataract, only one implant is necessary. If both eyes have cataracts Dr. Ghosheh may elect to implant the eye with the worse vision, or the "non-dominant" eye first. If Dr. Ghosheh deems it necessary to implant the other eye, he will most likely wait 2-3 weeks before the second surgery based on the results of the first.
The Crystalens procedure is typically performed in an outpatient surgical facility. You will arrive at the surgery center about an hour before the procedure. You will be given eye drops to anesthetize your eye and dilate your pupil as well as some medications to help you relax. Once in the operating room, you will lie down on a comfortable bed, a microscope will be positioned over your eyem and you will be asked to look up into the light of the microscope.
The actual surgery usually takes less than 20 minutes. Dr. Ghosheh will stabilize your eye with a device to keep your eyelids open. You will feel no pain, only slight pressure on your eye. All you have to do is relax and hold still.
Once the surgery is complete, additional drops will be placed in your eye to prevent infection, decrease inflammation, and keep your pupil dilated. A patch may be placed over your eye and someone will need to drive you home. Once at home, you should rest for the remainder of the day. You should avoid touching or rubbing your eye as well as any strenuous activities. You will need to come in the day after surgery to have the eye patch removed and your eye examined.
Dr. Ghosheh may give you additional medications to put in your eye for the next week or two. These drugs help the eye heal, leaving no residual effects.
The medical procedure which implants the Crystalens is the same safe, proven cataract surgery performed annually on over 7 million eyes globally. Over 40 million procedures have been done in the last 25 years. However every type of surgery is not completely risk-free.
Complications of cataract surgery range from minor, usually temporary side effects, to sight-threatening complications. Fortunately, significant sight-threatening complications are extremely rare, and include, but are not limited to, infection, hemorrhage, and retinal detachment. Dislocation of the lens and the need for additional surgery, such as lens removal and replacement are also possible risks of the procedure. In addition, people with existing medical conditions such as diabetes, high blood pressure, chronic inflammatory conditions, and chronic infections are at a higher risk of developing complications. Current data indicates that 98% of people have no complications after cataract surgery and more than 95% have improved vision.
Dr. Ghosheh will perform a thorough examination and fully inform you of any increased risk of a complications.
Typically, you will be able to return to normal activities within several days after implantation with some limitations. Your eye may be sensitive to touch and bright light, but you should be able to drive and return to work in two to three days.
It is important that you avoid heavy lifting or straining that would increase the pressure in your eye for several days after surgery. You also must avoid rubbing or pushing on your eye. You should refrain from activities that could increase your chances of getting hit in the eye. And you should wear protective sunglasses when outdoors.
You can shower and wash your hair as long as you avoid getting soap or shampoo in your eye. Refrain from using eye makeup, lid liner, and mascara for several weeks after implantation. You should avoid public swimming pools, hot tubs, or other sources of bacterial contamination for several weeks.
Consult your doctor on recommendations for specific activities.
Dr. Ghosheh will advise you as to how often your eyes need to be checked – generally the day after surgery, after 2 to 4 weeks, and again around 3 to 6 months after surgery. Thereafter, an annual exam is usually sufficient unless you have a specific problem.
Since each patient's vision is different and unique, the cost for the Crystalens procedure will vary.
Insurance coverage varies greatly from policy to policy and state to state. Generally speaking, private insurance may cover the cataract surgical procedure and anesthesia and may also allow a certain additional amount for the artificial lens implant. The insured is then required to pay a deductible as well as any additional amount above the primary coverage. (Some patients are completely responsible for payment - not all insurance companies will cover some of the patient cost).
Payment for conventional IOLs furnished in an outpatient setting is covered by Medicare. However, providers have generally not offered beneficiaries presbyopia-correcting IOLs because the costs for this advanced technology substantially exceed Medicare's payment.
Dr. Ghosheh and staff will review your insurance coverage and your surgical alternatives prior to your cataract surgery. It may also be beneficial for you to contact your insurance carrier.
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Advanced Eye Medical Group has been providing excellence in eye care in Orange County for the past 25 years. Since our opening in 1982, we have had the privilege of helping thousands of our patients with their vision.