Each year thousands of patients come to Dr. Jason P. Brinton seeking what we call visual freedom, or crisp, clear vision free of glasses and contact lenses. We accomplish this through LASIK and its six variations – SMILE, Visian ICL, PRK, Raindrop inlay, Kamra inlay, and RLE.

About Presbyopia

By the time most of us reach our early 40s, we begin to find ourselves holding books, menus, and newspapers away from our eyes in order to see them. We may sit farther from our computer screens or struggle with sewing projects. We simply can’t make out words or details when they are close to our eyes. This condition is called presbyopia, and is often confused with farsightedness.

Presbyopia is caused by natural thickening and loss of flexibility of the lens inside of our eyes. Much like a camera lens stuck in one place, our lenses become unable to fine-tune to see many of the details we were once able to see.

In years gone by, our parents and grandparents had to accept these changes as part of getting older. Thankfully, we don’t.

More and more people are choosing Custom Lens Replacement surgery St Louis (also called RLE) to not only correct and restore vision, but also to keep cataracts from developing or progressing, and to avoid future cataract surgery.

Through a Custom Lens Replacement, the eye’s natural lens is replaced with an artificial intraocular lens (IOL) to correct vision loss due to nearsightedness, farsightedness, astigmatism, presbyopia, or cataracts. Not only is vision greatly improved, but the positive changes are lasting.

Custom Lens Replacement in St. Louis: What to Expect

It is amazing that something as limiting as presbyopia or cataracts can be resolved in just 15 minutes, but it’s true. In our St. Louis facility, a Custom Lens Replacement procedure takes just a few minutes to complete, and the visual freedom patients obtain can be dramatic.

On the day of the procedure, plan to be at Brinton Vision for about two hours. You will need someone to drive you home, as your vision will likely be blurry immediately following the procedure.

Just as if you were going to an eye examination, you don’t need to wear special clothes or change your attire while you’re here. The only thing we’ll add to your outfit is a small, blue cap which you’ll wear during the procedure.

Prior to beginning, we will repeat some of the same tests that were conducted during your Brinton Vision Ocular Analysis so that Dr. Brinton has the most accurate information possible about your vision.

When you’re ready for the procedure, numbing eye drops will be administered so that you are comfortable during the Custom Lens Replacement procedure. You will likely experience what some patients refer to as seeing a light show or looking through a kaleidoscope, but Custom Lens Replacement (CLR) patients should not experience pain. In a quick 15-minute procedure, the lens will be replaced through a small opening. Sutures are not typically needed as the incision is small and self-healing.

After the procedure, you will receive easy-to-follow instructions and a written handout on how to use your eye drops. Our highly trained surgical technicians will answer any questions you may have, and Dr. Brinton will provide his personal phone number, should you have concerns once you return home.

Even though Custom Lens Replacement surgery involves the replacement of the lens, no eye patch is needed. People typically return to work or other normal activities the next day. What’s more, Custom Lens Replacement (CLR) eliminates the need for future cataract surgery. A Brinton Vision Ocular Analysis will determine if Custom Lens Replacement is a good solution for you!

“For the first time since lens implant surgery was first performed in 1949, we can customize a lens implant in our patients’ eyes after the fact to meet their individual vision needs. This is done in our office with a light after giving patients a few weeks to heal and experience their new eyesight.” Dr. Jason Brinton

The advanced technology opens up avenues of treatment not previously available to patients seeking LASIK and cataract surgery.

“For many patients, cataracts aren’t the only condition affecting their vision. They may also have myopia, hyperopia or astigmatism. The Light Adjustable Lens is unique in that I can address more than just the cataracts, and my patients can experience better vision than they may have thought possible. This is a game-changer for cataract surgery patients.”

How the Light Adjustable Lens (LAL) Procedure Works

For more information about the Light Adjustable Lens, contact Brinton Vision at (314) 375-2020

FAQs

What kind of lasers do you use?

As the only practice in St. Louis with multiple femtosecond and excimer laser platforms under one roof, we are better equipped to customize treatment options. We utilize the following lasers:

Intralase iFS laser — 150 Hz

This Intralase laser has been the gold standard of femtosecond LASIK flap makers since its inception in 2002. The iFS is the 5th and newest generation in this laser family, improving the speed of its predecessor by 2.5x. It can create a flap in under 10 seconds and also fashions the pockets we use for KAMRA® Inlay procedure.

VISX S4 IR

This is one of our two excimer lasers. More LASIK cases have been done on the VISX laser than on any other laser in the world. It is also the laser approved for use in U.S. fighter pilots and NASA astronauts.

Allegretto Wavelight

This is the second of our two excimer lasers used for LASIK. The Allegretto Wavelight laser is the fastest excimer laser in the country (the Schwind laser is the fastest excimer laser in the world).

Zeiss Visumax — 500 Hz

This is one of our two femtosecond lasers. A femtosecond is one quadrillionth of a second. This is our newest laser and is the fastest femtosecond laser in the world, firing at 500Hz. It is also the only laser in the world that can do SMILE, a third-generation laser vision correction procedure. SMILE is a 100 percent femtosecond laser-based procedure.

Yag laser

This is a laser that we can use with EVO ICL and Custom Lens Exchange surgery.

How Long Does Custom Lens Replacement Surgery Last?

Custom lens replacement surgery, formerly known as refractive lens exchange (RLE), is a type of vision correction surgery that replaces the eye’s natural lens with an clear implantable lens. This artificial lens, known as an intraocular lens (IOL), corrects refractive error in the eye (abnormalities in the size or shape of the eye that can affect sight) and sharpens the eye’s focus. This correction reduces or eliminates the need for single vision glasses, bifocals, progressive lenses, trifocals, contact lenses, and reading glasses.

There are three categories of IOLs commonly used today in St. Louis eye surgery centers for custom lens replacement surgery. Each of these lenses replaces your eye’s natural lens. The kind of IOL you receive will depend on your visual needs and eye health.

Monofocal or fixed-focus IOLs offer clear vision at a single focal point, whether near, mid-range, or far. These lenses excel at vision quality, and will give the sharpest vision possible. Patients often boast about the clarity of their vision with these lenses. Toric versions of this and other IOLs also correct astigmatism.

Multifocal intraocular lenses allow clear vision at many distances, including far, intermediate, and near. Common multifocal IOLs include Johnson & Johnson’s Tecnis Multifocal line, Alcon’s Restor line, and Alcon’s PanOptix trifocal IOL line.

Extended depth of focus, or EDOF IOLs, can provide good distance and intermediate vision. However, these lenses typically do not give the patient ideal near vision for reading without the need for reading glasses.

Custom lens replacement surgery – also referred to as refractive lens exchange (RLE), dysfunctional lens replacement (DLR), clear lens exchange (CLE), and refractive lensectomy – is a surgical procedure that works best for people with both presbyopia (over-40 vision) and either hyperopia (farsightedness), myopia (nearsightedness), or astigmatism. Because the degree and type of refractive error may affect your own results and surgical risks, not all of our St. Louis patients qualify for refractive lens exchange.

Is RLE surgery in St. Louis permanent?

Once the intraocular lenses are installed and the refractive lens exchange procedure is finished, the changes are long-term. These lenses are created of specialty medical grade acrylic and cannot grow or change like the eye’s natural lens. The lens is designed to be a lifetime solution to the vision problems that were occurring before. Once the lens implantation has taken place, the patient’s vision can improve and become sharper and more focused.

Can you have custom lens replacement after LASIK?

The short answer is yes. A custom lens replacement surgery (refractive lens exchange) procedure is, in one sense, a preventative cataract surgery. A cataract is a clouding of the eye’s natural lens as an individual ages, which makes it difficult to see. Everyone who lives long enough will eventually develop a cataract, causing their vision to blur as their internal lens ages and becomes cloudy. LASIK eye surgery is performed on the cornea, or the eye’s outer lens, and is unrelated to natural cataract formation that comes with age. Those who have had a LASIK procedure will still experience the natural lens changes of the eye that occur with age and will need to have cataract surgery or refractive lens exchange. Therefore, it is very common for our St. Louis LASIK patients to have custom lens replacement surgery many years later to correct the aging changes that all eyes undergo and help preserve the clarity of the patient’s vision.

Refractive lens exchange and cataract surgery are both types of lens implant surgery, however, the reason to have the surgery and the desired outcome for each of these surgeries is quite different. In order to have standard cataract surgery, patients must wait until their vision has declined significantly and is not correctable with glasses or contact lenses. Many patients will find it difficult to drive or perform basic daily functions due to the decline in their vision. The goal is to restore vision while continuing to wear glasses including: single vision glasses, bifocals, progressives, computer glasses, and/or reading glasses to see.

Custom lens replacement surgery is also a lens implant surgery, but that’s where the similarities with cataract surgery stop. It is performed to correct nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. Notice that I didn’t say anything about cataracts. Most of our St. Louis refractive lens exchange patients don’t want to wait for further vision loss and cataract formation before having their vision corrected with RLE. With RLE, the goal is for patients to attain clear vision without glasses. Most of our patients have little to no need for glasses, bifocals, or readers of any kind. Talk to your Brinton Vision surgeon about specific expectations for your eyes and circumstances.

Can custom lens replacement surgery be redone?

Patients who have had cataract surgery do not usually qualify for vision correction surgery at Brinton Vision, though there are exceptions. At your Brinton Vision Ocular Analysis your surgeon can determine whether you qualify for vision correction surgery.

If you have hyperopia, myopia, presbyopia or astigmatism and think you might be a candidate for refractive lens exchange (RLE), check out our free 60-second self-test. Call Brinton Vision at 314.375.2020 and set up a Brinton Vision Ocular Analysis today to learn more about refractive surgery, including specific risk and benefit information relative to your own eyes.

How Much Does Custom Lens Replacement Cost?

As with LASIK or any vision correction procedure, refractive lens exchange candidates are prudent in their research and begin the process with lots of pertinent questions. One of the most common is, “How much does lens replacement surgery cost?”

What are the biggest factors affecting custom lens replacement (CLR) costs?

With any reputable health care provider, the quality and thoroughness of care will have a greater impact on the cost of custom lens replacement surgery, formerly called refractive lens exchange (RLE), than just about anything else. For this reason, the valuable gift of eyesight—or any other aspect of our health and wellbeing—is never a place to cut corners.

When evaluating the quality of care a prospective LASIK and vision correction surgeon can provide you, measure them by these three yardsticks:

● Expertise

● Technology

● Time

Expertise. Seek out surgeons who are well-educated, have fellowship training in refractive surgery, and are board-certified in ophthalmology. Look for surgeons who are supported by professional, well-trained staff. Visit the practice website for details about their credentials and read patient reviews for specifics about their experience with the practice.

Technology. It is no small matter to equip a refractive surgery center with sophisticated, top-tier diagnostic and laser surgery equipment, but surgeons who care about precision will spare no expense to acquire the very best technology. This does add to the cost of surgery, but patients benefit from the combination of a skilled surgeon utilizing the very best equipment to perform a precise custom lens replacement surgery. Ask your doctor or medical technician for information about the equipment that will be used on your eyes.

Time. Eye surgery can be an intimidating process, particularly when there are so many unknowns for the average patient. This is why an investment in manpower is so important. Patients at Brinton Vision, for example, can count on a great deal of personal attention from a caring staff. Not only are medical technicians available to answer questions by phone, email, or text message, but each patient has the opportunity to consult with his or her surgeon before and after surgery to fully understand their procedure and aftercare, and to ask questions. Our surgeons provide their personal cell phone number to Brinton Vision patients on the day of surgery and encourage our surgical patients to call with any questions.

Brinton Vision will never sacrifice any of these important investments, because we firmly believe these are vital to providing the excellent care necessary for the best possible vision outcomes for our patients.

Finally, how much RLE–now custom lens replacement surgery–costs will also depend upon location. The same procedure and care in a high-cost-of-living location such as New York City or San Francisco will usually cost much more than it would in the affordable Midwest, even if everything else is the same. While we would never recommend price-shopping for LASIK, do ask yourself if you are paying a premium because of ultra-expensive real estate when considering a LASIK surgery cost quote. Always remember to focus on obtaining expertise, technology and time.

As of 2019, according to a broad, nationwide survey of cataract and refractive surgeons, standard lens replacement to address presbyopia surgery costs between $4,700 to $6,900 per eye.

Keep in mind that there are several things that can affect what you pay out of pocket for LASIK plus its modern alternatives. These factors include the patient’s treatment plan, the quality of care provided, how the surgical fees will be paid, and other common variables.

Is custom lens replacement surgery covered by insurance?

Here’s the rub: Insurance companies regard vision correction procedures such as refractive lens exchange to be elective, meaning they are not medically required. This does not mean our procedures are cosmetic – most people don’t have these procedures to improve their looks. They want to improve their visual performance. Our procedures are all IRS-qualified medical expenses that can be deducted from taxes, subject to certain rules. Patients can typically use dollars from health savings accounts (HSAs), flexible spending accounts (FSAs), and health reimbursement accounts (HRAs) to cover part or the full cost of custom lens replacement in our St. Louis center. This is not true for cosmetic procedures, which are not considered an IRS qualified medical expense. You cannot use HSA, FSA, or other tax-free funds for cosmetic procedures.

So, why the mention of insurance for lens replacement surgery (formerly RLE)? Because St. Louis refractive lens exchange is a great option for patients with cataracts, or at risk for cataracts. If patients wait years for cataracts to develop and impair their vision, then a portion may be covered by insurance, but who wants to wait years for their vision to worsen to such a degree where this may be possible? Most of our patients want to have their vision fixed, crisp and sharp, and do it when they’re young enough to enjoy it.

Through custom lens replacement surgery (CLR, formerly RLE), the eye’s natural lens can be replaced with an IOL that addresses other issues with vision. There are similarities between refractive lens exchange performed here in St. Louis and cataract surgery – but there are also important differences. With RLE, the natural lens is replaced with an implantable lens that also corrects nearsightedness (myopia), farsightedness (hyperopia) and astigmatism, reducing or eliminating the need for eyeglasses and contact lenses.

Brinton Vision also works with lenders to provide payment options for our patients, with zero down payment at low or no interest. (Ask our team about financing, and discuss tax deductions with your tax preparer.)

Does the lens implant last forever?

Well, as forever as you last! By definition, refractive lens exchange replaces a misshapen or cloudy natural lens with a biocompatible lens. The new lens doesn’t disintegrate, and the old lens does not grow back. Most custom lens replacement surgery patients can expect the vision they obtain to outlast them. RLE also has the added benefit of preventing the formation of cataracts in the future.

Is lens replacement surgery worth it?

We at Brinton Vision certainly think so, based on the many life transformations we’ve witnessed over the years. However, we also know that when it comes to any medical treatment, the quality of your results will depend greatly on your surgeon’s experience, technology, and time described above.

How Long Does It Take to Recover from Custom Lens Replacement Surgery?

Refractive lens exchange (RLE), also known as custom lens replacement surgery, is a type of vision correction procedure in which one or both of the natural lenses of the eye are replaced with a focused artificial lens. This intraocular lens (IOL) corrects eye prescription issues such as nearsightedness, farsightedness and astigmatism, and is an alternative to waiting for cataract surgery. It’s a precise, 15-minute procedure and most patients notice visual improvements within hours of surgery.

Recover from refractive lens surgery – steps and process

As you explore St. Louis refractive lens exchange surgery options, you may wonder, how long does it take to recover? As in completely healed. Many factors affect the healing process, including patient age and overall health, home environment, and personal habits, for example. While complete healing runs a matter of weeks, most patients experience enhanced vision within hours of the surgery and feel that their vision is clear enough the next day to resume normal activities, such as driving. The process of healing from custom lens replacement surgery follows the general timeline outlined here:

Day of refractive lens exchange

The eyes have an amazing capacity for healing, and that process begins immediately after patients leave our St. Louis practice following refractive lens exchange. In some cases, our patients are seeing better even before they have left the clinic. For example, in 2019, Dr. Stephen Haring, an experienced and highly regarded St. Louis eye doctor, chose Brinton Vision for his custom lens replacement surgery. Immediately following his procedure, several of his St. Louis eye doctor colleagues, who were watching, wanted to look at his eyes. We spontaneously brought Dr. Haring directly from the laser room into one of our patient rooms, and less than 60 seconds after the conclusion of his lens replacement surgery he was able to see 20/20 and use his cell phone with his surgery eye.

Even if you feel your vision is clear enough to drive home or resume strenuous physical activity on the day of your lens implant surgery, we advise our patients to become a couch potato for the day and take it easy! Reading, using a computer, cooking, or working at a desk are fine and will not hurt your eyes, however, do follow your Brinton Vision surgeon’s instructions and use your eye drops. You will have your Brinton Vision eye surgeon’s mobile phone number, so feel free to call if you have any additional questions.

After custom lens replacement surgery

Awakening the morning after RLE surgery is often described by our patients as a miraculous experience. Those who have worn glasses or contacts their whole life will tell us it is surreal to awaken and see their alarm clock across their room or turn to their partner and see their glowing smile without the necessity of glasses or contacts. Those who previously struggled with up close reading are amazed that they can pick up their cell phone off their nightstand and read a text message, check the news, or send an email.

You will come to Brinton Vision and see our smiling faces the next morning as we conduct your one-day follow-up visit. This appointment is usually brief and involves a thumbs up and a lot of high fives. After this visit we clear practically everyone to return to work and resume normal activities!

Patients may shower, drive, go shopping, go out to eat, work, and perform their usual daily activities at this point. The only exception would be if your work involves one of the following:

● swimming under water, like if you are a scuba diving instructor

● anything that could cause your neck veins to bulge or your face to turn red, like if you are a piano mover

● anything that would cause a direct impact to the eye, like if you practice martial arts

● Patients who have unique or unusual daily activities are welcome to ask their experienced Brinton Vision surgeon for guidance. While everyone heals at a different pace, your St. Louis eye surgeon will monitor your progress closely and provide any needed care.

During the first few weeks you will continue to take your eye drops. Most patients notice common side effects at this time, including glare and halos around a point source of light (like car headlights at night, particularly in the rain) and dry eyes. These side effects typically improve as the eyes heal.

This is an exciting time when many patients tell us that they see things they cannot even remember seeing before. It’s as if they have a new lens on life. You can continue to get more crispness and sharpness in your vision over the course of the first few months. Remember also that it takes time to adapt to your vision, even if it is clearer.

When can I lift after RLE surgery?

It can be tempting for a dedicated gym enthusiast to start pumping iron as soon as humanly possible—fitness fanatics hate to lose progress—but your doctor will want you to avoid the Valsalva maneuver for the first week after lens implant surgery. The Valsalva maneuver involves forceful attempted exhalation against a closed airway, and can cause your neck veins to bulge and your face to turn red. This can happen with heavy weightlifting or powerlifting. Everyday lifting is fine, however this is a good time to review proper ergonomics. If you are lifting a 3-year-old into the car or picking up several bags of groceries, keep a strong back and lift with your knees. The idea behind avoiding the Valsalva maneuver is to avoid putting pressure on your eye, which could affect healing. So no karate, breakdancing, or strongman competitions until you get the all-clear!

How much can I lift after RLE surgery?

It depends on you. For our St. Louis custom lens replacement patients, our guidance is to avoid the Valsalva maneuver. A simple guideline is, if whatever you are lifting is heavy enough and strenuous enough that your neck veins are bulging or your face is turning red, don’t lift it.

Can I exercise after lens replacement surgery?

Yes! Most of our patients will walk the dog the next morning before coming in to see us or do their usual elliptical workout. Avoid the Valsalva maneuver.

How can I reduce the risks of refractive lens exchange?

The most effective way to minimize the risks of any procedure, including custom lens replacement surgery, is to attend all of your follow-up appointments and closely follow your surgeon’s instructions. One of those instructions will be to keep your healing eyes lubricated. Your doctor will show you which eye drops to use. Eye drops aid in healing, keep you seeing your best, and keep you comfortable in the process.

Does Custom Lens Replacement Improve Vision?

Absolutely! Lens replacement improves vision! But to understand how custom lens replacement surgery (formerly called refractive lens exchange) does this, it helps to know more about what’s going on in the eye to cause these vision issues in the first place.

Nearsightedness, farsightedness, astigmatism and other refractive errors are the result of an abnormally shaped eye. When light passes through the cornea (the very front surface), the convex curve bends and focuses it onto the surface of the retina, helping us see the world. However, if the cornea is misshapen or the eye itself is too long or too short, this will cause light to bend, or refract, incorrectly. Instead of pointing light precisely on the retina, the refractive error redirects the “bend” of the light in front of the retina or behind it, leading to blurriness or distortion near, far or everywhere.

Similar to laser vision correction procedures, lens replacement corrects the refractive error. Rather than reshaping the cornea, like in a laser vision correction procedure, this procedure replaces the natural lens which sits behind the iris, or colored-part of the eye, with a manmade intraocular lens (IOL). This ensures that light entering the eye can focus properly on the retina. This means that people will see sharper images, will have reduced or no dependency on eyeglasses or contacts, and better color perception.

IOL procedures, such as refractive lens exchange (RLE), now known as custom lens replacement surgery, that are being done at Brinton Vision in St. Louis, have been used successfully to treat presbyopia (over-40 vision) and high hyperopia (farsightedness). These lens replacement procedures are an especially effective option as a cataract surgery alternative for patients who aren’t candidates for LASIK, PRK or SMILE.

Cataract patients who are candidates for RLE may have their cloudy natural lenses removed and replaced with a prescription IOL during the same procedure. This not only removes the cataracts but also corrects other common vision problems and prevents the formation of cataracts in the future.

There are different types of intraocular lens in use today (monofocal, multifocal and toric, for example) but not everyone is a suitable candidate for RLE or other lens replacement procedures. Additionally, your unique vision needs and lifestyle may dictate a different treatment approach or qualify you for a range of treatment options.

Your Brinton Vision doctor may recommend custom lens replacement (refractive lens exchange) in one or both eyes, the same lens prescription for both, or even a different lens for each eye. At Brinton Vision we customize each treatment to a patient’s needs, desires and lifestyle. (We address monofocal versus multifocal lenses in greater detail in another blog.)

The decision-making process about lens replacement may feel overwhelming, especially if there is more than one possible treatment plan, but the doctors and surgeons at Brinton Vision are well equipped to walk you through your options and recommend the one most likely to yield the best long-term results.

Custom Lens Replacement Surgery for Nearsightedness (Myopia)

While refractive lens exchange has high success rates and is considered extremely safe, it’s not for everyone. Your Brinton Vision Ocular Analysis is the first step to determining candidacy for this type of procedure. Due to the fact that RLE is an intraocular procedure, it does carry a higher risk of complications, such a retinal detachment, than laser vision correction procedures.

Myopic patients in particular are naturally at a higher risk for retinal detachment than those with hyperopia (farsightedness), presbyopia (over-40 vision) and astigmatism due to the increased length of the eye itself. Your Brinton Vision doctor will discuss in detail risk of complications, as well as other alternative procedures that may carry less risk if you qualify.

Refractive Lens Exchange for High Myopia

The risk of retinal detachment following a lens extraction is slightly higher naturally for mildly myopic patients, than those with other types for refractive error. This risk increases further in those patients who are extremely nearsighted patients due to the increased length of the eye itself. Even so, RLE and other lens replacement procedures are still considered very safe. Anyone considering custom lens replacement should discuss the risks and benefits in detail with their eye doctor.

For many people with severe myopia, the prospect of better-than-ever vision, and decreased or no reliance on glasses and contacts, more than outweighs the relatively low complication risk of RLE.

Lens Replacement Surgery for Farsightedness

Patients with mild farsightedness are often not considered to be good candidates for lens replacement procedures such as refractive lens exchange if under the age of 50. Mild hyperopia can sometimes be treated with LASIK or PRK. Your Brinton Vision doctor can advise you if you’re a good candidate for LASIK or any of the LASIK alternatives we offer.

Patients with moderate to severe hyperopia are not generally considered candidates for LASIK or PRK but can often be treated with RLE depending on age.

Is Custom Lens Replacement Surgery Safe?

LASIK, plus all of its modern alternatives are among the safest, most effective surgical procedures ever known. There are millions of vision correction procedures performed around the world each year, yet patient satisfaction is somewhere north of 96 percent and complications are rare. In fact, after thousands of surgeries, the doctors at Brinton Vision have seen very few complications relating to this surgical procedure. So, is custom lens replacement surgery (formerly called refractive lens exchange) safe? You bet!

Although eye surgery is safe, it is not totally without the risk of complications. We would be remiss if we didn’t have a real discussion about the most common risks associated with custom lens replacement and other lens replacement procedures. But don’t fret—we’ll also give you easy ways to reduce your own chances of complications!

What are the most common lens replacement surgery complications?

Procedures such as LASIK and PRK take place only on the surface of the eye to reshape the cornea and correct refractive errors. At Brinton Vision, these particular procedures are laser-based, further reducing direct human contact with the delicate ocular tissue. Naturally, this precision carries miniscule risk.

The placement of an intraocular lens (IOL) is a different animal. Due to the fact that this procedure involves removing the natural lens and replacing it with a manmade version, this is done manually by the surgeon and involves opening the eye, therefore, inherently creating more opportunities for complications.

Certain minor side effects are common after an IOL procedure. Most are not considered complications and are nothing to worry about. If ever concerned about your progress, please reach out to the Brinton Vision medical team to ensure your healing is on track. The common side effects following a custom lens replacement (refractive lens exchange) procedure include:

Vision fluctuations/disturbances. Most patients experience visual disturbances of some kind after lens replacement surgery—glares and halos, starbursts and blurred vision. Nighttime vision can be difficult in the first weeks with the new lenses but typically resolve over the first few months.. If the problem worsens or continues for longer than expected, consult with your experienced Brinton Vision doctor.

Eye irritation/Dryness. Most patients experience eye irritation and scratchiness following lens replacement. This can last a few days, a few weeks or even a few months, but it typically resolves over the course of time! Your doctor will provide you with multiple strategies, including eyedrops to ease symptoms and aid in healing.

Redness. Sometimes patients notice small, red blotches on the white part of their eyes after RLE. They can be unsightly—even scary-looking—but they are not dangerous. These will gradually fade over the course of approximately 7-10 days.

There is only slightly more risk with custom lens replacement surgery than with PRK or LASIK, and most complications are not a direct result of the surgery itself. Patients who experience certain complications—difficulties that go beyond the usual side effects—should call their doctor for follow-up care. Some complications are as follows

● Dislocated intraocular lens

● Ptosis (droopy eyelid)

● Detached retina (most common in patients with high myopia)—symptoms include: increase/change in floaters, flashes of light, or curtain/veil in the vision

● Ocular hypertension (high eye pressure)—often no symptoms but the medical team will check you eye pressure at each post-operative visit

● Eye infection—redness, heat, swelling, oozing.

● Bleeding inside the eye

● Decreased vision—indicated by excessive or prolonged haziness. This is most often caused by a thickening of the tissue which holds the new IOL. This can be corrected easily with a non-invasive laser procedure.

Is Custom Lens Replacement FDA approved?

The U.S. Food and Drug Administration has a variety of important duties. First and foremost, this federal agency is responsible for the regulation of more than 6,000 medical devices used and sold in the United States. Additionally, the FDA conducts numerous trials to test the safety of medical devices and drugs, and grant approval for their use in patients.

The FDA is not responsible for approving medical procedures. In fact, there is currently no government or private entity that directly regulates or approves surgical procedures. However, the FDA does regulate the devices used in lens replacement, including the lenses, laser equipment, surgical supplies, medications, and more. The doctors, surgeons and medical staff must also work within the laws and regulations that govern all health care workers.

So, while custom lens replacement surgery (refractive lens exchange) and other lens replacement procedures are not FDA-approved, everything involved with the lens procedure must meet their high standards and safety provisions.

How can I get the safest custom lens replacement surgery experience?

Lens replacement is safe and effective for those who qualify, and complications are rare. However, it’s important to know that lens in general, the higher the refractive error—especially with myopia—the greater the risk of retinal detachment a patient naturally has. Other risks include swelling, inflammation, infection and visual disturbances such as glares and halos.

As with any surgical procedure, you can mitigate your own risk by following the detailed post-operative instructions given to you as you heal. The Brinton Vision medical staff will send you home with your post-surgical instructions plus medications you’ll need for proper healing. Instructions may include, but are not limited to:

● Take it easy while you heal: no weightlifting, core or body-weight exercises, judo, gymnastics or any other strenuous activity until you’re cleared to resume your regular (or new) workouts.

● Steer clear of dust, dirt and debris. If you can’t avoid these environments, wear protective goggles during the immediate post-operative period

● Stay away from any potentially dirty water including: lakes, rivers, streams, hot tubs or pools. This reduces the risk of infection. The only liquid that should hit your eyes right after vision correction surgery is the medicated eye drops prescribed by your doctor.

● DO NOT RUB YOUR EYES. This is never a good idea, but especially so during the healing process.

In the unlikely event that you develop an infection, retinal detachment or other complication, know that your Brinton Vision doctor is well equipped to diagnose, treat or provide referrals to ensure the best treatment from any complication you may experience. Vision loss from ocular surgery complications is very rare.