Refractive Lens Exchange at Stahl Vision, Dayton, Ohio.

Imagine being able to see your world as well as you did when you were younger, without the help of glasses and contacts, or reading glasses. Imagine youthful, energetic, vibrant vision free from the encumbering cloudiness of your aging eyes. Well, it may now be possible. Stahl Vision is the first center in Dayton to offer patients the ReSTOR, ReZoom, and Crystalens dual use lenses, a revolutionary flexible lens technology that can restore youthful vision to baby boomers and cataract patients.

Glossary: refractive lens exchange (RLE) is a synonym with clear lensectomy and PRELEX. ReSTOR, ReZoom, and Crystalens are the names of implant lenses used with refractive lens exchange. Presbyopia is the name of the condition that causes us to lose our near vision past the age of 40 something.

At a glance: Refractive Lens Exchange

Refractive Lens Exchange is becoming a popular option for those over 50 seeking to be more independent of glasses and contacts and to restore near vision at the same time! The choice of which implant is best for you involves determining the best range of vision for your lifestyle with the least amount of compromises. This is the same surgery as cataract surgery, and having this surgery now means you won't need cataract surgery later in life.

Presbyopia is the age-related eye condition that affects most people by age 51; causing near vision to fade with age, making it difficult to see things up-close. This naturally occurring condition cannot be corrected with LASIK, but Refractive lens exchange with ReSTOR, ReZoom, and Crystalens can be an excellent solution.

The unique aspect of these implant lenses is that they focus light at both near and far distances allowing patients to regain both distance and near vision. Thanks to this new technology, patients can enjoy activities like reading fine print or working on the computer without the hassle of reading glasses.

Refractive Lens Exchange (RLE) involves removing the natural lens of the eye that has lost its ability to focus at near and far, and replace it with an implant lens that allows clear vision for distance and near vision. By selection of the power of the implant lens, your doctor can correct for nearsightedness, farsightedness, and even astigmatism can be corrected for at the time of surgery. And newer generations of bifocal and accommodating implant lenses allows restoration of near vision. The result is that for the first time your doctor can offer you more natural vision that restores your vision for distance and near.

Refractive lens exchange or RLE is the same surgery as cataract surgery, something that all of us will need to have if we all live long enough. Cataracts are an aging change that leaves our natural lens cloudy. Some early “baby cataract’ changes start occurring in our 50’s, but most patients are in their 60’s or 70’s before they have cataract surgery. Early symptoms of cataracts include dulling of vision and glare from lights especially at night. Glasses do not correct these vision problems, and eventually surgery is needed to see clearly again.

Refractive lens exchange is done at our ambulatory surgery center as an outpatient procedure that takes about thirty minutes—you go in for your surgery in the morning, and go home a couple of hours later. One eye is done at a time, separated by a few weeks. Topical anesthesia with light sedation is all that is needed to keep the procedure pain free and comfortable. Best results are obtained after both eyes have been done to allow the eyes to work naturally together.

The best candidates for this procedure are over 45 years old, possibly with early cataracts, with otherwise healthy eyes, and who need glasses for both distance and near vision. For most patients life without bifocals or reading glasses is something they have dreamed to regain.

Because of the bifocal nature of these implant lenses, there is some glare and halo effect around lights at night. Less than 5% of patients find this severe, but about 20% found it noticeable. If you drive a lot at night, or have a night-time occupation, this might be a reason not to choose these lenses. The designs of these implant minimizes these disturbances by using the size of our pupil to favor distance vision at night, and near vision in brighter lighting conditions.

How is this different than LASIK surgery?
LASIK surgery can correct your distance vision, but NOT your near vision. LASIK remodels the surface of the eye, whereas Refractive Lens Exchange replaces the lens on the inside of the eye. LASIK is usually done on both eyes the same day, but with RLE we wait a few weeks in between surgeries.

What do I have to do after my surgery?
You will be using medicated eye drops for several weeks, also you will need to take a couple of days off driving and work. Your distance vision clears quickly, while adapting to using your new found near vision gets better over several weeks.

Does this mean I won’t have to have cataract surgery later in life?
That is correct. This is the same surgery as cataract surgery but done to restore your vision and means you won’t need cataract surgery later.

How much does this cost?
We charge $3190 per eye ($3490 after 6/1/2006), which includes your surgery center costs, implant lens charge, surgery fees, and measurement fees as well as your after care for a year. Insurance does not cover RLE unless you have significantly bad cataracts, not just early cataracts. We offer two financing plans to put refractive lens exchange within your budget.

12 Months Interest Free Financing—take up to 12 months to pay with no interest. Minimum payments of 3% of the balance must be made, although we strongly recommend 12 equal payments. You can apply online at www.carecredit.com or calling 1-800-365-8295, (please allow 4-5 days for processing).

Monthly Payment Option—your payments can be as low as $147 for both eyes. Apply from home by calling 1-877-559-5050 or visit www.capitalonehealthcarefinance.com, (please allow 4-5 days for processing).

The ReSTOR lens allows clear vision at distance and near, but objects at intermediate distances may still be somewhat out of focus. No lens can promise you perfect vision or that you will never have to wear glasses ever again. But in FDA studies with this lens, 80% of patients reported that they never wore glasses after the procedure. When patients did need to wear glasses, most often it was for intermediate distance, for example: piano music, computers that sit further away, top shelves at the supermarket.

How small of print will I be able to see?—percentage of patients able to see a given size print with the ReSTOR lens.

The ReZoom lens allows clear vision at distance, intermediate and near. This is a balanced lens that tries to improve distance at each distance. Near vision is NOT as good as with the ReSTOR lens, but intermediate is better. The ReZoom lens does offer better reading vision in dim light than the ReSTOR lens. No lens can promise you perfect vision or that you will never have to wear glasses ever again. Some doctors have mixed and matched lenses using the ReZoom lens in one eye for better distance and intermediate vision, and the ReSTOR lens in the other eye for better near vision.

The best way to determine which lens or combination of lenses is best for you is by coming in for a complete eye exam. Once our doctors have measured and examined your eyes, we can discuss your lifestyle and near vision needs and discuss what might work best for you.

The Crystalens functions quite differently than the ReSTOR and ReZoom lenses. The Crystalens moves and flexes within the eye allowing it to change power or accommodate. This lens allows clear vision at distance and intermediate, but objects at near distances may still be somewhat out of focus. The advantage of this lens is less night glare, and sharper contrast. But most patients still will need reading glasses for small print or if objects are close up.

The best way to determine if the Crystalens is the best choice for you is by coming in for a complete eye exam. Once our doctors have measured and examined your eyes, we can discuss your lifestyle and near vision needs and discuss which procedure will help you see your best.