Since the 1970's eye doctors have used LASIK, PRK and other refractive surgeries to correct myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. Although the procedures have been very effective on patients needing mild to moderate vision correction, they have been less effective on patients with more significant vision impairment.

New techniques using lens implants can improve vision and reduce or eliminate the need for glasses in patients requiring moderate to severe correction for myopia or hyperopia. Unlike LASIK and PRK, which are surgical procedures that alter the surface of the eye, Refractive Lens Implant surgery uses techniques and materials similar to those used for over 30 years for cataract surgery. With these procedures, either a refractive intraocular lens is placed in front of the patient's natural lens (phakic lens implant) or the natural lens is replaced (clear lens replacement) with a clear artificial lens.

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.