Refractive Lens Exchange or Clear Lens Exchange
Posted , 10 users are following.
Hi all
RLE is the same procedure as cataract except it's an elective procedure done on people who don't have cataracts. I'm considering having this done in Malaysia (I live in Singapore). If I go ahead I'll go over the border to Johor Bahru (JB) so I can get there and back relatively easily for appointments. The cost in JB is half the price of having it done in Singapore.
I will be 50 next year and I have been wearing glasses for short-sightedness since I was 14 (I wore soft contact lenses for most of my 20's and early 30's but stopped due to them becoming uncomfortable). My prescription is currently around -5.5 in both eyes with some astigmatism in both. I apparently have borderline keratoconus as well. I also now have a problem with seeing close-up and I wear glasses with progressive lenses in them but find myself taking them off for close-up reading because I can see better without them.
My sister had the same op at Moorfields in London three years ago (she went with the monovision option). She has no regrets (her eyesight was -10 so she was far worse than me) and has had no problems with her eyes since the op - she occasionally wears reading glasses for close up work but mostly she's spec free.
In the last 5 years I've spent over SG$6000 on glasses (I have progressive sunglasses too) and no doubt I'll need more glasses in the coming years. The RLE op will cost me about SG$6000 and hopefully I'll be mostly spec free for the rest of my life (if I do need specs they should be relatively cheap compared with my current glasses).
My concerns about the RLE surgery are mostly to do with what is the best option for me regarding lenses. I know my surgeon will advise me based on the tests they do and my lifestyle choices but I also want to do my own research (I have my first appointment on 30 Sept) as this is a big decision to make.
I've decided that I won't be able to handle not being able to see close-up (as currently I can just take off my glasses if I want to be able to see close up). I do a lot of reading and computer work (I'm a teacher). I would be willing to sacrifice some far distance vision for very good close-up and intermediate vision - so I wouldn't mind wearing glasses for driving or watching movies but I'd like to be spec free the rest of the time. If I have to wear glasses all the time for near distance then there's no point me doing the op!
There's so much conflicting advice regarding monofocals, multifocals, trifocals, monvision or mini-monovision and although I've read many of the posts on this site, I'm still not sure which way is the best.
Has anyone got any experience with trifocals? These seem like a possible option but of course there's the problems of glare at night which seems to be standard with all multi and trifocals.
I'd like to hear from anyone who has had their lenses replaced regarding which option they went with and how their eyes are faring so far.
Thanks in advance!
My reasons for wanting to do the op is because I'm just so tired of wearing glasses and I find that I can't see properly with the progressives (near, intermediate, far) - everything is either blurred or slightly distorted.
1 like, 14 replies
Fifav CaroZim
Posted
I didn't want to get glasses and decided to have both eyes implanted with oculentis multi focal 5 weeks ago. Have had double vision ever since. Surgeon said this is very rare but not unheard of and said best to change lens so I had my right eye exchanged for the symfony Toric yesterday. Today very blurry and pupil still dilated so unsure how it will go but I am remaining optimistic and pray I never see double again. I will update as days go by
Eye-Kan-Sea CaroZim
Posted
You may consider the multifocal I had planted 5 weeks ago in my left eye. It's a German brand made in the Netherlands. It so happens their Asia headquarters is in Singapore. The Intraocular Lens (IOL) I have is
" Oculentis Mplus X."
Most multifocals are made with rings. Each having a different focal length. The drawback of rings is at night, light enters the eye and is reflected off the edge of each ring thereby creating a lot of glare and halos. Oculentis uses a special patented high tech machine that forms each focal length in one mold. Therefore there is minimal glare and halos. Oculentis claims near, intermediate and far vision are all very good. The "X" is especially good for near vision (300-400mm). Since your sight isn't so bad at -550d, you may be able to achieve 20/20 or 20/30 vision. Then you wouldn't need glasses at all except for sun shades.
My nearsightedness is -850d in the left eye. The IOL was able to reduce the the poor sight by -575d and achieve -275d. I rely on mono vision since my right eye has not been operated on yet. Vision in the right eye is -700d. My left eye acurity is about 20/60 or 70. Not good enough for driving, but good enough to get around. I have opted to go without glasses.
I too spent thousands of US$'s on glasses with high density progressive lens. My last group of glasses I bought were all Alain Mikli -- very very expensive. I was working then. I wore glasses since I was 5 and to go without glasses is a blessing. The money spent on cataract surgery and IOL implants is dwarfed by decades of blowing money on glasses! I also tried contacts a few times, but failed miserably because of blood shot eyes.
The drawback of my IOL is in indoor lighting and cloudy days. Sight is not focused except for near vision. That may just be me and may not be typical of others. On the other hand, contrast and colors are terrific. I hated wearing glasses, but I had no choice. Now the quality of sight is better although it's mono 20/70 vision in one eye.
Investigate into Oculentis. The parent company is SwissMed. By the way SwissMed was started by Polish medical practioners using Swiss investment. They have their Asia headquarters in your city, Singapore.
Fifav Eye-Kan-Sea
Posted
I had the oculentis M plus and that's the one I have problems with, the horizontal split in the multifocal is the issue.
Eye-Kan-Sea Fifav
Posted
Mplus has a horizontal split? I thought there's no visual split between near, intermediate and far focal lengths. It was formed without splits. The X is a refined version of the Mplus.
CaroZim Eye-Kan-Sea
Posted
Thanks for the reply - I'll do some research into this lens.
Sue.An CaroZim
Posted
Hi CaroZim - just my personal opinion but I would never have this surgery unless I 100% needed it for cataracts. Certainly not to rid myself of glasses. Perhaps one day when there is a perfect lens or one that can be adjusted after implanted it could be an option.
I too am young for cataract surgery at 53 (I wore glasses since 12 for nearsightedness) and had the Symfony extended focus lenses implanted in both eyes 4 weeks and 10 weeks ago.
Research lots but more importantly make the right choice in surgeon - not based on price. I am very happy with my outcome - haven't worn glasses since surgeries. But I do have issues with night driving (which I knew beforehand from my surgeon) due to the concentric circles and glare around outside lights at night.
Be prepared to make a compromise. The best comment my surgeon told me to prepare me for that was most are elderly when faced with a lens exchange usually for cataracts and they've lost both far and near sight and are very happy after cataract surgery. With younger patients like me and you with the ability to read without glasses - we need to compromise. There are lenses that will give you far intermediate and distance but they have some interesting night visuals with circles glare and halos at night. If you drive a lot at night these can affect your ability to drive safely at night. Monofocal lens will give you one distance and not usually cause the nighttime issues (but no guarantee they won't) and you'll need glasses anyways unless you do a bit of mini monovision.
Keep researching and find a very good surgeon if you want to proceed with this.
CaroZim Sue.An
Posted
Thanks for your reply Sue-An. I take your point about not doing the operation unless you absolutely have to and obviously I don't have to - for me it's a personal choice. RLE is basically the alternative to lasik for people who can't have lasik for whatever reason. I've been wanting to get my eyes fixed for years so I'm quite keen to do RLE but obviously I don't want to end up with worse eyesight than I currently have!
I will make a final decision about whether to go ahead after I've had my first appointment (30 Sept) and met the surgeon. If I don't feel comfortable about anything then I won't do it.
I'm thinking maybe toric monofocal lenses with either micro-monovision or full monovision might be my best option as the multifocals and trifocals seem to have more issues associated with them. I currently don't drive at all as I can't afford to own a car in Singapore, but I won't be here forever and wherever I end up I'll definitely be driving again.
If I go ahead with it I'll post my experiences like you have done as I think it's really helpful to be able to read about people's experiences.
Sue.An CaroZim
Posted
Nizza594 CaroZim
Posted
Hi!
I'm only 33 years old and had RLE done purely to lose my glasses (+8.50 and +8.75, with -3.00 astigmatism). I was technically long sighted but believe me, I could not see a thing at distance any better than I could see near without my glasses. With glasses my vision was very good, I had no other eye issues.
I had the Carl Zeiss Toric Trifocal lenses fitted in both eyes and I would do it again in a heartbeat. I haven't worn glasses for anything since surgery just over 2 months ago, I feel like I'd benefit somewhat from a pair of readers for certain tasks, but I can read my phone and the tiny print on an eye drop bottle without glasses. I'd actually say my vision is sharper than it ever was with glasses, but also things appear smaller which I guess is to be expected after wearing such strong glasses.
Side effect wise... distance vision was very blurry for a good 3 weeks to 1 month, after that it started to get much better. Nightvision was not good, halos not a big deal but the glare effect from artificial lights was really bad.
Just over two months in and the improvement is huge!! I can see very well at night, driving is no problem at all (impossible in the first 2 weeks!).
The only real issue that I have is this sensation of a shadow in my peripheral vision, I THINK it's improved slightly but can't be sure, I'm definitely still aware of it.
All in all, for the vision I know have, I have no regrets at all!! Why wait till cataracts eventually come, only to be another person who says they wish they'd have done it years ago!
CaroZim Nizza594
Posted
Thanks Nizza594 - good to know you've had a good experience with the trifocals and great to hear you chose to do RLE and are happy with the decision. I will look up the Carl Zeiss trifocals you mentioned - there are actually too many options out there! Very confusing at times.
It is a big decision to have surgery on your eyes but I'm really fed up with wearing glasses. I tried to have lasik about 7 years ago and was told I couldn't have it (thin corneas and borderline keratoconus). So now here I am at nearly 50 and (hopefully) a good candidate for RLE. I am really excited about the prospect of being mostly glasses free for the rest of my life - how liberating it will be!
britkennels Nizza594
Posted
I've just found this website and I'm so glad I did. Nizza, you are describing me nearly to a "t." I have -8.0 w/astigmatism and -8.5. I'm 60 and have been searching for an answer for years. Each time I spoke with a new eye doc about the latest and greatest procedure, my eyes never qualified (lasik and all of the others before it). Hubby just had the Carl Zeiss trifocals for his cataracts (71) and his amazing bounce back w/in one day of surgery gave me the courage to speak to his doc. We live in Mexico, so we have access to lenses which aren't available in the US. Everything I've read encourages me to go ahead with the procedure. I'm so tired of wearing contacts that get blurry from protein deposits, no matter how much I clean, not-quite-great-eyesight, still needing lenses for reading (and near vision keeps deteriorating way faster than expected). I've got cataracts beginning, so I've finally decided to go ahead and do this. While I'm still scared spitless, your reply and hubby's own experience have really helped a lot.
Thanks so much for sharing!
Nizza594 britkennels
Posted
Hey!!
No problem, I am glad that it could provide some inspiration! I am now 10 months post surgery and I have absolutely no problems with my eyesight. The shadows that I mentioned in my last post of completely gone! I haven't worn a pair of glasses for anything in almost a year and not a day goes by that I don't appreciate it!! In fact I've literally just come in from riding my bike in the rain and remember how impossible that was with glasses on!!
10 months in I'd say that the only things you'll need to come to terms with is that....
1) You need good lighting!! Lighting is so important with these artificial lenses, sometimes in low light conditions you may feel like you can't see a small print and need glasses, but then shine a light on it and it will be crystal clear. That takes some getting used to, for example my girlfriend always has her phone set to a dim light setting and whenever she goes to show me something, I need to increase the brightness to see it properly!
2) Artificial light sources have a glare effect that improves massively over time, but never truly goes away. It's not problematic (might be in the first few weeks!) but you'll notice that your vision feels slightly strange when around a lot of artificial high intensity lights. I notice that every time day starts to become night, my vision feels strange for a bit but then it's fine, it's like my pupils take longer to dialate or something?! I'm not entirely sure what's going on but it's not a big deal, just something I'm aware of.
3) Your eyes no longer accomdate to every distance. You will notice that there is a "sweet spot" for reading, for me it's about 12 inches from my face. Move it further away and it loses focus, move it closer and it loses focus. Sometimes if we can't see something very well we tend to instinctively move it closer to our eyes, but this won't help after surgery, you'll see what I mean, but you'll get used to it!
Overall the pro's far outway the cons. Being a fairly young man at 34, I have my vision back, I have my face back, and I have my lifestyle back!
Best thing I ever did!
Best of luck to you!
britkennels Nizza594
Posted
1) Your description about light is exactly what hubby was telling me when he looked at smaller print. Since I can't see squat without readers, having to adjust light would be an improvement.
2) I think slightly strange vision won't bother me because that's what I have now. Since I've worn contacts for 44 years (ugh), there is a noticeable difference in my overall vision. While I'm safe to drive and live relatively normally, there is a slight "off" to my vision. The best way to describe it is as if I were sitting in the doc's office in front of the retinoscopy. You know that moment between power (?) switches when one is too much and the other not enough? That's how I feel...like a small nudge would make it all right.
3) Again, anything has got to be better than what I currently have. I truly envy you for being young and having this available to you. Each time I tried to have something done for my eyes, other than lens replacements, I was told that I wasn't qualified due to the need for too many cuts (RK)--something I will always be eternally grateful happened as so many are having serious problems now, not enough cornea for the necessary correction (LASIK), even lens replacements (too scared)and so on. Now that it's no longer an option to avoid making any decisions (cataracts beginning), I'd rather do this when the eyes are relatively healthy.
I am scared (rhymes with) spitless, but not because of the procedure, but simply the fear that I'll be that 1 in "X" that has the oddball complication that leads to blindness. It won't stop me, but reading first person accounts like yours have really helped. The eye doc is absolutely amazing and has developed a very strong rep in the ex-pat community (we talk a LOT in forums). When I go in, there's a retinologist who'll do a check and will be there in case of any problems. That makes me feel more comfortable because I do have thin retinas (bad doc story below) and large eyeballs(!). Anything that can be done to make it all go smoothly is in place. Now, it's just a matter of waiting until a specially ordered lens for astigmatism arrives (the other Zeiss is here).
the bad doc story is why I ended up seeing Dra. Claudia. I went for an updated contact prescription with Dr. Bad and he went through the usual motions. Suddenly, he just looked at me and announced that I had thin retinas as though he'd just discovered I had an STD. It was the weirdest sensation ever. He never bothered to tell me just what that meant or how it could affect my life. This could have had a truly bad ending because I was on a bicycle trip and got hit by a passenger bus. My well-padded (thank goodness) ass went flying around 15-20 feet. I didn't know that I could have had a retinal detachment/tearing and loss of sight because Dr. Bad never warned me about hard contact. Please understand, I accept that I'm 100% responsible for myself and I actually did look up what thin retinas meant, but the dots weren't connected because the man I'd paid to inform me of my eye's health never gave me any input other than what I had. Isn't that a bit like telling someone that they have appendicitis and then going to the next patient?
So sorry this has turned long and into a rant; it wasn't my intention. I just wanted to let you know why I appreciated your sharing your story and how much it has truly helped firm up my resolve. I know it needs to be done; now I feel better informed. I hope to do the same when mine is over (near the end of the month). Again, BIG thanks!
sarah41720 CaroZim
Posted
Hello,
I've seen this event on Facebook, its a free information evening for cataracts and lens exchange treatment in Solihull. Might be worth a visit.
https://www.facebook.com/events/234911640388765/
Just a thought