Keys to Quality RLE Surgery

Choose a surgeon you trust, especially when it comes to experience. An experienced surgeon typically performs more than ten surgeries per week. In addition, their entire team should be made of highly-trained ophthalmic professionals. Have they authored books and research papers? Do they lecture on cataract or refractive surgery? Do they receive referrals from other surgeons? Have they done surgery on other eye surgeons? Researching your surgeon online should easily answer these questions.

Your surgeon should fully explain RLE and all your options. Get educated on these options so you can make the best one for your life.

This can be hard for a patient to evaluate, but it is critical. The most important thing is that the surgeon is comfortable with all state-of-the-art technology that goes into RLE surgery. This includes wavefront analysis, intraoperative aberrometry, topography, and a variety of lens types that go in the eye. These technologies will help to determine which lens is best for your eye.

The health of your tear film plays an important role in how clear or blurry your vision may be. If the tear film is unhealthy, it can often be treated before surgery to help support the clearest possible vision afterward.

For the best vision results after surgery, the retina needs to be healthy. OCT provides a highly magnified view of important retinal structures to maximize the health assessment of the retina.

The cornea provides about 70% of the focusing power of the eye because of its curvature. This curvature needs to be smooth for sharp vision. If it’s irregular, it can lead to irregular vision. Your surgeon should use technology like the Nidek OPDIII Topography, Pentacam, or other topographers to measure corneal curvature and thickness, then quantify their relationship.

The corneal endothelium is the layer on the back side of the cornea; microscopically, it looks like a honeycomb. This layer is constantly pumping water out of your cornea to keep it clear for crisp vision. If corneal thickness is increased, analyzing this layer determines if thickness is the cause of blurring. 

Your surgeon should have the ability to perform this test.

Pupil size can vary from patient to patient, and certain lens implants may perform better with pupils of certain sizes. By measuring your pupils in both dim and bright light, your surgeon can recommend an implant that best fits your eyes, lifestyle, and typical lighting conditions. It is also helpful to understand your glasses prescription in different lighting so your surgeon can better evaluate your night vision needs and personalize your RLE treatment plan. 

Fluid in the eye drains through the angle where the cornea and iris meet. Imaging this area can help your surgeon evaluate the overall health and anatomy of the eye and identify any concerns, such as a narrow drainage angle or risk for angle-closure glaucoma, that may need to be considered when planning your RLE procedure. 

A thorough evaluation of your natural lens helps your surgeon understand how it may be contributing to changes in your vision and whether RLE is an appropriate option. Technologies such as the HD Analyzer and iTrace can provide additional information about optical quality and light scatter to support treatment planning.

Wavefront technology measures how light travels through the eye and can identify optical irregularities that affect vision quality. These measurements give your surgeon additional information about your eye’s optical system and can help guide refractive planning and lens implant selection. 

Advanced RLE surgeons typically only use numbing eye drops to avoid complications associated with numbing by needle. It also provides the fastest recovery. However, anesthesia professionals should be on hand to provide relaxation medication (usually orally) and often there is no need to start an IV.

In the past, surgeons couldn’t measure if an implant put in during surgery had the proper power until the next day. ORA with VerifEye is a revolutionary new technology that allows the surgeon to measure the optical power of the eye during surgery to maximize accuracy of the procedure.

During RLE, the eye’s natural lens is removed through a small opening. This can be performed using traditional surgical techniques or with laser-assisted technology. Your surgeon should be able to explain the approach they use for lens removal and how it fits into your treatment plan. 

Optical biometry, using technology such as the Lenstar or IOLMaster, accurately measures the length of the eye, the curvature of the cornea, and other important dimensions used to calculate the appropriate lens implant power. Additional measurement methods may also be used when needed to confirm these calculations and help personalize your RLE treatment. 

RLE is typically performed through a small, self-sealing incision that usually does not require stitches. This approach is designed to support healing while minimizing changes to the shape of the cornea. 

This may be the most important one. Some surgeons use only one or two lens implant options. However, new premium lenses can be customized to lessen your dependence on glasses, correct high levels of astigmatism, or even eliminate glasses altogether. Choose a surgeon who can help you weigh all lens options, including traditional implants, aspheric implants, toric implants, multifocal implants, and accommodating implants.

After RLE, some patients may benefit from additional laser vision correction to further refine their vision. Your surgeon should take a refractive approach, considering your complete visual goals rather than simply replacing the natural lens with an implant. Your surgery center should also have access to advanced laser vision correction technology, allowing your care team to make additional adjustments when appropriate. 

Patients can become anxious waiting for an upcoming surgery. Choose a surgeon with a system that allows you to have surgery within a month, so you can get on with life.

Surgeons who carefully track their outcomes can confidently inform patients of the results, continually refine techniques, and critically evaluate new technologies. Tools such as proprietary tracking software allow the surgeon to carefully measure outcomes and provide ideal alignment of lenses at the time of surgery.