Dr. Robert Maloney believes that a well-informed patient is key to successful vision correction surgery. He wants to be sure that you fully understand what you can expect from your procedure you choose. He wants to help you care for and preserve your eyesight in the best way possible. Here, you can find the information that you need to help you make informed choices about health care for your eyes.

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Refractive lens exchange (RLE) involves removing the eye's natural lens, as in a cataract operation. A flexible synthetic lens implant is then placed inside the eye through a tiny incision to correct nearsightedness or farsightness. RLE is a painless outpatient procedure. The tiny incision closes by itself, without sutures. Visual recovery is quite rapid. As with LASIK, most patients are able to return to work the day after their procedure.

RLE is most commonly performed to treat higher levels of nearsightedness or farsightedness in patients over age forty. The optical results are superior to LASIK for these higher corrections. RLE may also be fine-tuned with LASIK if a small refractive error remains. Some surgeons use RLE to treat extremely nearsighted or farsighted patients who are not candidates for LASIK or PRK.

The major drawbacks of RLE are the risk of postoperative retinal detachment (more of a risk with nearsighted than farsighted patients) and the risks that accompany any intraocular surgery, including the extremely rare chance of an infection in the eye.

If both eyes are corrected for distance vision, RLE patients will require reading glasses after their procedure. As with LASIK and PRK, however, monovision corrections are possible with RLE to decrease or even eliminate one's need for reading glasses. Or new intraocular lenses, called presbyopic lenses, can be implanted at the time of lens extraction. These lenses allow a patient to see both near and far after the operation. For the best results, both eyes should be implanted with the multifocal lens. Certain lens designs may cause some patients to experience a loss of contrast at night and also develop halos around lights. If these symptoms become problematic, the lens can be removed and replaced with a conventional lens implant.

RLE is generally not performed on younger patients, because the surgery involves removing the natural lens, which in young people allows them to read without glasses. Either LASIK or contact lens implants is usually a better option for younger patients, because these procedures preserve reading vision.

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