What is Lens Replacement Surgery?
Lens replacement surgery refers to a medical procedure where an artificial acrylic or silicone lens is implanted into the eye to correct problems with vision. These are known as intraocular lenses, or IOLs. The surgery is carried out when a patient does not qualify for laser eye surgery, but they no longer wish to continue to wear glasses or contact lenses. The lenses are meant to last a lifetime, but if problems do arise they can be easily removed and replaced without causing permanent damage to the eye. There are three main types of lens replacement surgery: refractive lens exchange (RLE) surgery, implantable contact lens (ICL) surgery and cataract surgery.
What Are The Different Types Of Lens Replacement Surgery?
Refractive Lens Exchange (RLE) Surgery
RLE surgery is performed by making a small incision to facilitate the removal of the eye’s natural lens. This is then replaced with a permanent artificial lens which is inserted into the eye.
Implantable Contact Lens (ICL) Surgery
During this procedure, an artificial lens is placed between the natural lens and the iris (coloured part) of the eye, or just behind the iris, whilst the eye’s natural lens remains in place.
Cataracts is a condition where the natural lens of the eye becomes cloudy, preventing clear vision. Like with RLE surgery, the procedure involves removing the eye’s natural lens and replacing it with an artificial one, except that the lens which is removed is not clear but cloudy due to cataracts.
Watch David Gartry, senior consultant at Moorfields Eye Hospital, discuss the difference between RLE surgery and cataract surgery.
Am I Eligible For Lens Replacement Surgery?
Lens replacement surgery is used to correct numerous visual problems. Those who are eligible for the surgery include people with:
- Hyperopia: a condition where the patient suffers from farsightedness (i.e. distant objects are seen more clearly than near objects).
- Presbyopia: an age-related condition which causes farsightedness.
- Myopia: a condition where the patient suffers from nearsightedness (i.e. distant objects appear blurred and out of focus). Laser eye surgery is typically recommended for patients instead of lens replacement surgery however, as the results are better and more reliable.
- Astigmatism: a minor condition which causes blurred vision.
- Cataracts: an age-related condition which causes the eye’s lens to become less transparent.
The table below summarises which visual problems each type of lens replacement surgery corrects:
|Type Of Surgery||Vision Problem It Corrects|
|Refractive Lens Exchange||Hyperopia, Presbyopia, Myopia, Astigmatism|
|Implantable Contact Lens||Myopia|
As with any surgery there are some general eligibility requirements. Prior to your lens replacement surgery, your ophthalmologist will assess your ocular and overall health.
You will be deemed appropriate for the procedure if you:
- Are between the ages of 21 and 80.
- Have had an unchanging optical prescription for at least six months.
- Have thin corneas which make laser eye surgery unsafe.
- Have no infections of the eye.
- Have good general health.
- Are not allergic to anaesthetic eye drops used during the surgery.
You will not qualify for lens replacement surgery if you:
- Have diabetes, hepatitis C or herpes virus.
- Suffer from an autoimmune disease.
- Have experienced serious eye trauma or retinal detachment.
- Have a pacemaker.
- Are pregnant or breastfeeding.
- Are taking immunosuppressant drugs.
- Are HIV positive.
Types Of Lens
There are two types of artificial lens used in lens replacement surgery: intraocular lenses (IOLs) and phakic intraocular lenses (Phakic IOLs). The type of lens you will need will be determined by your visual requirements and the type of surgery you undergo, which you can discuss with your ophthalmologist.
IOLs replace the eye’s natural lens and are used in RLE surgery and cataract surgery. Phakic IOLs do not replace the eye’s natural lens but are instead placed between the lens and the iris, or just behind the iris, whilst the natural lens remains in place. Phakik IOLS are used in ICL surgery.
Intraocular Lens (IOL) Types
The four most common types of IOLs are:
- Monofocal: this lens focuses your vision at just one distance – either near, far or medium distance. Most patients have them set for clear far distance vision, with many requiring glasses for near vision tasks such as reading.
- Multifocal: this lens can allow you to see across varying distances without the need for glasses. They give you clear vision for more than one set distance.
- Accommodating: this lens allows you to focus at several different distances but unlike multifocal lenses, glasses are often required for near distance vision.
- Toric: this lens has more focussing power in just one specific region in the lens to correct moderate to high astigmatism. Patients will still need to wear glasses for all near distance tasks such as writing, however.
Some clinics also offer their patients trifocal lenses, but these are less common. Trifocal lenses are designed to allow you to see at a very high resolution at both near and far distances, while maintaining exceptional contrast sensitivity and low visual disturbance.
Phakik Intraocular Lens (IOL) Types
There are two main types of phakic IOLs:
- Visian: this lens is positioned behind the iris and in front of your natural lens. It provides you with high definition vision, and corrects moderate to severe myopia while eliminating the need for glasses.
- Verisyse: this lens is positioned in front of the iris, and is used to treat moderate to severe myopia. Like the Visian IOL, you do not need to wear glasses with the Verisyse IOL.
Lens Replacement Surgery Cost
The comparison table below shows you how much you should expect to pay per eye for the different types of lens replacement surgery from the UK’s leading eye surgery clinics. These prices are the very cheapest and are typically only offered to those with a very low optical prescription, so do not be surprised if the price you are quoted is considerably more.
|Type Of Surgery||Price Per Eye|
|Refractive Lens Exchange||From £2795|
|Implantable Contact Lens||From £2495|
It is important to remember that the cost of lens replacement surgery is largely dependent on the type of lens that will be inserted in your eye during surgery. Premium intraocular lenses cost more due to their greater sophistication which drives up the cost, yet these lenses will eliminate the need for additional contact lenses or glasses which can build up to a significant cost over time.
Intraocular Lens (IOL) Cost
The table below compares the cost of the most common types of IOLs used in RLE surgery and cataract surgery:
|Type Of IOL||Price Per Eye|
As you can see, the most basic monofocal lens is the cheapest, whilst multifocal and accommodating lenses are the most expensive since they allow you to focus clearly at a number of different distances.
Phakik Intraocular Lens (IOL) Cost
The table below shows you how much you could expect to pay for the most common types of phakik IOls used in ICL surgery:
|Type Of Phakik IOL||Price Per Eye|
Can I Get Lens Replacement Surgery On Finance?
The cost of lens replacement surgery can be too much for many people to be able to fund up front, so many clinics now offer finance packages that allow for the payment of a deposit followed by monthly amounts over a set period to help spread the cost.
This cost comparison table shows the price for different lens replacement surgeries per month for 10 and 24 months. These finance options have been obtained from the top eye clinics in the UK.
|Type Of Surgery||Deposit||10 Months||24 Months|
|Refractive Lens Exchange||From £500||From £149.50||From £69.63|
|Implantable Contact Lens||From £500||From £249.50||From £116.21|
|Cataract||From £500||From £149.50||From £69.63|
There are some factors that you should take into consideration when purchasing your lens replacement surgery through finance. Some are listed below:
- Initial deposits are usually 10% of the full price of surgery so it is important to make sure you have enough funds to cover this.
- Monthly financial instalments typically come with a fixed interest rate. For the shortest payback periods, this is often 0% meaning you only pay back the cost of your surgery. With longer payback periods however, the fixed interest rate typically increases, meaning you will pay back more than the cost of the surgery.
- Paying for things on finance may affect your credit score, so it is important to keep up with your payments.
- Make sure you read the terms and conditions of any financial agreement carefully to avoid any surprises.
Can I Get Lens Replacement Surgery On The NHS?
Lens replacement surgery is not available for free on the NHS for anyone with an optical condition where their vision issues can be corrected by wearing glasses or contact lenses. In these instances, you will need to undergo the surgery at a private clinic, where you will have to pay for the procedure yourself.
For those who suffer with cataracts where their vision is significantly affected and they have trouble carrying out everyday tasks, lens replacement surgery is available on the NHS. You will need to first need to obtain a referral from your optician in order to qualify for free cataract surgery.
Lens Replacement Surgery Procedure
- You will meet with your surgeon who will carry out a full eye examination to determine the health of your eyes, your optical prescription and the type of surgery and lenses most appropriate for you.
- The surgery takes approximately 15 minutes to complete.
- The eyes are operated on separately, with around a week’s gap between the surgery on either eyes.
- Numbing aesthetic eye drops are administered to the eye that will be undergoing surgery. This is to ensure that there is no discomfort during the procedure.
- The surgeon will make a tiny incision to the edge of your cornea.
- During RLE surgery and cataract surgery, the old lens will be carefully broken up and removed using ultrasonic assistance.
- The new artificial lens is inserted into the eye, and moved into the correct position.
- The surgery is usually completed without stitches as the tiny incision heals by itself.
- Immediate visual improvement should occur within two days following surgery.
- Patients may experience some episodes of discomfort after surgery such as blurred vision, halos and glare.
- You should also expect an increased sensitivity to light.
- Some have difficulty obtaining balanced vision in the week between having the first and second eye operated on. To avoid this, you may be asked to wear a contact lens on the un-operated eye. Once the second eye is operated on, there is normally a swift return to balanced vision.
- It should be possible to return to work within a week of surgery.
- Driving should be possible approximately 2 weeks after surgery, so you should ensure that someone is able to pick you up from the clinic following surgery.
For the best recovery, you should carefully follow all instructions given to you by the clinic after surgery. These will be provided in a hand out which you can take home with you.
Is There Anything I Should Avoid After Surgery?
Following lens replacement surgery, there are a few activities that should be avoided in order to ensure the best possible recovery. These include:
- Touching the eyes, or getting sweat, dust and smoke in them for the first month, as this could cause infection.
- Strenuous activity and sneezing, as overexertion can cause blood pressure to rise which can affect your recovery.
- Computer work and light television watching should be kept to a minimum as it can cause eye fatigue.
Lens Replacement Surgery Side Effects
Whilst recovery time for lens replacement surgery is quick, there is the possibility that you will experience some complications following the procedure.
Common side effects include:
- Temporary blurring which can last for a few days.
- Increased sensitivity to light which can last a few weeks.
- Halos or rings around lights at night, so night driving should be avoided until this stabilises.
- Sore red and irritable eyes which can last for up to 6 to 8 weeks.
- Posterior capsule opacification (PCO), which causes the back of the lens to thicken, resulting in cloudy vision. This can occur months or even years after the surgery, and is treated with YAG laser
Rarer side effects include:
- Infection of the eye, which will be treated with antibiotics.
- Retinal detachment, which occurs when the membrane at the back of the eye becomes detached after surgery. This can be corrected with further surgery but the quality of vision may not be as it was before the detachment.
- Cystoid macula oedema (CMO), which refers to when the macula, the part of the retina which provides detailed central vision, can swell following surgery. Mild cases resolve themselves or it can be treated with eye drops.