Ophthalmic Options for Seniors
Lens replacement, called refractive lens exchange (RLE), is the surgery used to treat cataracts, and it can correct presbyopia. Presbyopia is the loss of near vision that develops with age and creates the need for reading glasses or bifocals. RLE is more invasive than LASIK. It is not the go-to option for presbyopia in patients who do not have cataracts, but it is the best solution for some. If you are developing cataracts and suffering from presbyopia, RLE can solve both problems at once.
Why Lens Replacement?
Cataracts and presbyopia are both problems with the lens of the eye. Cataracts cloud the lens. In presbyopia, the lens loses flexibility and can no longer make the fine adjustments needed to focus on small details up close.
When your natural lens is replaced with an artificial intraocular lens (IOL), cataracts cannot grow back. If you do not yet have cataracts, you will not develop them after RLE.
Although there are other surgeries that address the vision problems of presbyopia, such as monovision LASIK and presbyLASIK, they do not address the underlying problem with the lens itself, and that may continue to worsen. This is no different to gradually needing to increase the power of your reading glasses. You do not have to worry about artificial IOLs getting stiff with age.
Types of IOLs
There are several types if IOLs to choose from:
- Monofocal IOLs give clear vision at only once distance – near, intermediate, or far. You can choose which distance you prefer and you will need to wear glasses or contacts to see other distances clearly. Or, you can choose monovision which means one eye is set for near vision and the other is set for intermediate or far vision, and your brain chooses the best image. This requires an adjustment period and reduces depth perception. Some people cannot adjust.
- Multifocal IOLs have several zones of focus, and your brain chooses the best image. This also requires an adjustment period.
- Accommodating IOLs are attached to your eye muscles and move just like your natural lens does to focus the light on your retina.
- Toric IOLs are used to treat astigmatism.
Realistic Expectations
While RLE can give you significantly better vision, no type of artificial IOL will be comparable to your natural lenses when you were 20 years old. If your presbyopia is mild, you may not be overly impressed with the results of lens replacement. After RLE, you may still need to wear glasses for certain activities. Have an honest conversation with your ophthalmologist about what you can really expect from RLE and whether it is the right procedure for you.
To learn more about lens replacement and other options for presbyopia, find an ophthalmologists in your area.
