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“Aging Eyes” Solutions

By: Dr. Leslie Emmert-Buck


Jennifer is an avid hiker, gardener, and kayaker. At her consultation she told Dr. Emmert-Buck that she doesn’t like that her eyes are “getting old before I am.” She doesn’t like having to carry around reading glasses to read a map while hiking. She doesn’t like having to grab her glasses to take a closer look at the buds in her garden. Basically, she doesn’t like having to deal with glasses at all. She came in to discover what her options are.

Perfect Candidate

After a thorough eye exam, Jennifer was diagnosed with presbyopia and hyperopia, making her a perfect candidate for RLE (Refractive Lens Exchange). Presbyopia (or Dysfunctional Lens Syndrome) is a naturally occurring age-related condition. The eye’s natural lens becomes more firm and inflexible, diminishing its ability to focus on near objects. It affects nearly everyone, and generally becomes more noticeable after the age of 40. Hyperopia (farsightedness) explains Jennifer’s ability to see far down a hiking path while not being able to see a map clearly.

Refractive lens exchange (RLE) replaces your eye’s aging natural lens with an artificial intraocular lens (IOL).

The Right Lens

Jennifer was surprised to hear that she had options within RLE. In fact, there is no “one size fits all” solution. She and Dr. Emmert-Buck discussed a few different choices.

Monofocal fixed-focus IOLs – These lenses provide clear vision at distance, intermediate, or near ranges, but not all three at once.

Multifocal IOLs – A multifocal lens that provides clear vision at multiple distances.

Accommodating IOLs – A type of monofocal lens that enables focus at multiple distances by shifting position in the eye.

Any of these lenses can be placed in one eye only, combined with your natural vision or a different IOL in the other eye. This type of lens solution can give you a greater range and depth of vision.

The Procedure

The procedure for refractive lens exchange is virtually identical to cataract surgery. It usually takes about 15 minutes and performed on an outpatient basis. Each eye is done separately, generally about a week apart.

Numbing anesthetic drops are used, so there is typically no discomfort. Most people report vision improvement immediately after surgery, and most return to work and resume driving within a week of surgery. Normal, everyday activities can usually be resumed after one week.

Final outcomes of refractive lens exchange can take up to several weeks.

Jennifer’s Concerns

While she likes the idea of a surgical solution, Jennifer expressed concern about an artificial lens placed permanently in her eyes. Dr. Emmert-Buck explained that you don’t feel an IOL in your eye, similar to the way that you don’t feel a dental filling. And since the lens implant is inside your eye and not on the surface like a contact lens, no one can see it.

Jennifer likes that an IOL is a permanent replacement for her natural lens and is designed to last the rest of her life. Recent studies show at least 80% of patients do not need glasses after RLE surgery, depending upon the lenses implanted.

After The Surgery

Within a week Jennifer was back working in her garden. She was back to her other favorite activities two weeks after the final surgery. “I can’t believe I waited so long to do this,” she said. “ But I’m so glad I did it at the beginning of summer and am able to really enjoy hiking and kayaking again.”

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* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.