POTENTIAL COMPLICATIONS WITH REFRACTIVE LENS EXCHANGE
Refractive lens exchange is a safe procedure, and complications are rare. Still, you should be aware of possible side effects and potential problems, which are discussed following.
RESIDUAL NEARSIGHTEDNESS OR FARSIGHTEDNESS
As with other refractive surgeries, we can’t be sure you’ll achieve exactly the vision that was planned. We do detailed measurements of your eye prior to surgery to achieve the most accurate possible result, but each person responds to the surgery differently and heals slightly differently. Even if your vision isn’t perfect, it should still be very good. If the imperfection is bothersome or disappointing, a LASIK enhancement surgery can be done to correct the small residual refractive error. Normally, we wait three months before doing the LASIK touchup to let your eye heal fully.
STARBURST OR HALOS AROUND LIGHTS AT NIGHT
Everyone, whether or not they have had RLE, experiences some starburst or halos at night. These night-vision disturbances occur when you are in a dark environment and look at a small bright light, such as a headlight or a streetlight. Halo is the glow that surrounds the light source, and starburst is little spiky rays of light that emanate from the light source. Look carefully at a headlight or streetlight tonight so you understand what I’m talking about.
You may notice more starburst and halos after RLE. These symptoms usually are not bothersome, but some find them annoying in dim-light conditions, such as driving at night. If you elected to have a multifocal IOL, you will typically notice four or five small halos around lights at night.
If you develop more starburst or halos after RLE, there are treatment options. Glasses with a light prescription for night driving can help, as can the use at dusk of eyedrops that reduce the size of your pupils.
DYSPHOTOPSIAS
It is possible for light coming from your far peripheral vision to pass through the pupil and reflect off of the edge of the IOL. When this happens you will typically see a light or dark arc in your far peripheral vision. This is called a dysphotopsia. It can be annoying because it looks as if something is getting in the way of your peripheral vision. It will not affect your central vision or your clarity of vision. It is similar to seeing the frame around a pair eyeglasses, but less bothersome because it is more peripheral. These disappear in most people during the first year after surgery.
POSTERIOR CAPSULE OPACIFICATION
When the natural lens is removed, the membrane that surrounds the natural lens, the capsular bag, is left in place to hold the new IOL implant. The back part of this membrane is called the posterior capsule. Sometimes, the posterior capsule becomes cloudy after surgery, caused by the body’s natural healing response. This cloudiness—which can develop months or years after your surgery—is called posterior capsule opacification. It is quite common and affects younger patients more often than older patients.
Posterior capsule opacification can be quickly and safely corrected with a three-minute outpatient procedure called YAG laser capsulotomy. Your eye surgeon will use a laser beam to make a small hole in the back of the posterior capsule, allowing light through. The procedure is painless and requires no incision or sutures.
OTHER POSSIBLE COMPLICATIONS
There are a variety of possible but rare complications from RLE. In perhaps 0.5 percent of eyes, a break in the posterior capsule can occur during surgery. When this happens, it may be necessary to use an IOL different from the one you chose before surgery. Infection can occur, in fewer than one-tenth of 1 percent (0.1 percent) of patients. This is treated with an operation, called a vitrectomy, to remove the infection and inject antibiotics into the eye. Accumulation of fluid in the macula can cause blurry vision and can usually be managed using antiinflammatory eyedrops. Swelling of the cornea can also cause blurred vision. Rarely, the IOL shifts or rotates within the eye. If this occurs, it can be repositioned surgically, although wearing thin eyeglasses usually solves the problem.
Retinal detachment is a separation of the retina from the inner wall of the eye. This is very rare in farsighted eyes, but less rare in highly nearsighted eyes (which is why we prefer to do RLE in farsighted eyes). It is treated with another operation, called retinal reattachment surgery. Symptoms of retinal detachment include a shower of new floaters, much like a swarm of bees, in your vision, or repetitive flashes of light in your peripheral vision, akin to fireworks. The most distinctive symptom is a curtain moving across your vision in the affected eye. If you have these symptoms after RLE, notify your doctor immediately.
Although it is possible to lose your vision in the eye from RLE or any operation, these rare complications can usually be treated successfully if caught in time.
Frequently Asked Questions About RLE
