Before surgery Dr. Coad will thoroughly examine your eyes to determine whether
lens implant surgery is an option you should consider. Although refractive
lens implant surgery may be a better alternative in many cases, some patients
with certain eye diseases, such as diabetes and glaucoma, may not be good
candidates. However, if you have been diagnosed with cataract(s), these refractive lens implants are a good alternative to the conventional monofocal IOLs.
In this procedure the natural lens is left in place,
and the lens implant (Visian
ICL) is inserted into the eye, in front of the
patient's natural lens. The implant is placed either
in front of the colored iris (anterior chamber) or
between the iris and the natural lens (posterior chamber).
With this technique the lens implant helps the patient's
natural lens to bring objects into focus. And because
the natural lens is not removed, the eye retains its
ability to accommodate (change focus between distant
objects and near objects). Unlike some refractive procedures,
phakic lens implant surgery can be reversed.
Phakic Lens Implant surgery is performed on
an outpatient basis. While the patient lies
on his or her back, the area around the eye
is prepared. First, a local anesthetic is
used to numb the eye. Then, the surgeon makes
a small incision (about 1/6")
and inserts the lens implant. The entire
procedure takes less than 30 minutes to complete.
Unlike Phakic Lens implant surgery, CLR involves removing
the natural lens and replacing it with a new lens implant.
This procedure is recommended for people over age 45
who wear bifocals, since their natural lens has already
lost its ability to change focus (accommodate) between
distant and near objects. Three techniques are used to overcome this loss of
accommodation: bifocal or multifocal reading glasses
or contact lenses, multifocal or accommodating (Crystalens, ReSTOR, ReZoom) lens implants and monovision.
A multifocal lens has several correction levels built
into different sections of the lens. After surgery
with a multifocal implant, the brain automatically
selects the section of the lens that will give the
clearest view of a particular object, whether near
or far. The third option, monovision, adjusts one eye
for distance and the other for close-up vision. Again,
after surgery, the brain learns which eye to use to
bring objects into clear focus. Both the multifocal
lens and monovision techniques allow patients to read
or drive a car without glasses.
CLR is performed on an outpatient basis and takes
only about 15-30 minutes to perform. First, your eye
will be numbed with a local anesthetic. Then Dr. Coad
will make a small incision in your eye and gently remove
your lens using ultrasound. Finally the lens implant
will be inserted to replace your old lens. An eye patch
may be used temporarily after surgery and to protect
the eye while you sleep until the eye heals. 
Shortly after surgery you will be allowed to go home. Your vision may be blurry
immediately following the procedure, so someone else will need to drive you
home. Any mild discomfort you may experience can be relieved with an over-the-counter
pain medication.
Most patients can return to their normal schedule,
including driving, within a day or two. Dr. Coad will
probably recommend that you keep your hands away from
your eyes and avoid heavy activity for a few weeks
while your eyes heal. Lens implants require no care
and can be left in place, giving you good vision for
the rest of your life.
Everyone's eyes are different, but in many cases lens
implants can reduce or eliminate the need for glasses
or contact lenses. Consultation with Dr. Coad prior
to surgery is important to determine estimated benefits
and possible complications.
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