Refractive Lens Exchange (RLE) / Cataract Surgery

RLE / Cataract surgery using the very latest advanced monofocal, toric and multifocal lenses

The lens inside your eye may need to be replaced if it becomes cloudy (a cataract), or if your eyes are not suitable for laser vision correction. In both cases, a replacement lens is implanted. Intraocular lenses can also correct short-sightedness, long-sightedness and astigmatism.

Which lenses do we use?

Lens choice is one of the most important decision in cataract surgery. Mr Gore uses only the very latest lenses to provide you with the vision that you need every day. During your consultation, he will discuss with you which option would be most suited to your particular requirements.
Mr Gore uses both the Zeiss AT LISA and PhysIOL FineVision toric trifocal lenses.
A standard (monofocal) lens implant will correct your distance vision as clearly as possible. Many people have some astigmatism as well, when means the cornea at the front of the eye is slightly oval in shape. A toric monofocal lens will be required to treat astigmatism to provide properly focused vision. Many patients with monofocal lens implants benefit from monovision where the focus in one eye is brought within an arm’s length such that with both eyes open you have a spread of focus (far and near). This helps to improve intermediate and near vision (particularly computer use), but glasses will likely still be required to read comfortably. One in 3 (33%) patients do not need reading glasses at all with monofocal monovision lens surgery.

Multifocal lenses can provide a far greater range of focus. Trifocal lenses target near, intermediate and distance vision. Four in 5 (80%) of patients will be spectacle-free with trifocal lenses; the remaining 1 in 5 (20%) may require reading glasses for some tasks. The potential downside of trifocal lenses is a comprise in the quality of distance vision as well as optical side effects (glare and haloes), particularly at night.

Mr Gore uses the Zeiss AT LARA EDoF lens.

Extended Depth of Focus (EDoF) is the next generation technology in multifocal lens design. EDoF lenses let you see clearly at far and intermediate distances. They provide greater spectacle independence than monofocal lenses, while inducing less visual side effects compared to trifocal lenses. This balance of increased spectacle independence and less visual phenomena is particularly attractive to patients with an active lifestyle, who wish to be spectacle-free for most of their daily activities but are more sensitive to halos and glare. EDoF lenses are a particularly good option for patients who have had prior laser eye surgery.

Adjusting the focusing of EDoF lenses with the non-dominant eye slightly near-sighted (mini-monovision) can further improves reading vision. This means that with both eyes open, you have the advantages of both monofocal and multifocal IOLs: greater freedom from glasses and fewer side effects.


Try the simulator

A picture speaks a thousand words, or in this case, a simulator from lens manufacturer Zeiss. This useful tool will explain some of the differences and limitations of the various lens designs. Although the simulator discusses cataract, the same principles apply to RLE surgery with the same lenses being available for both types of surgery.

Click here to visit the simulator now.


More information on Cataract Surgery

Although RLE and Cataract surgery are effectively the same operation, the reason for each is quite different. RLE is used in cases where laser surgery is not suitable or possible, while Cataract surgery is performed when the natural lens in the eye becomes cloudy.

Hover over and click the images below for more information about all the lens types that Mr Gore uses. Lots of information about life after Cataracts is available here, with more available in person at your consultation.

Toric lenses

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EDOF lenses

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Trifocal Lenses

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Private medical insurance

If you have health insurance, it is likely that not all fees (including premium lens implants) will be covered under your policy. Follow-up appointments are covered if you have outpatient cover. YAG laser capsulotomy is usually covered. For further details, please check with your insurer before your initial consultation if possible.
Additional information about RLE surgery is available from the Royal College of Ophthalmologists.
You can also get answers to some frequently asked questions about RLE surgery below.
FREQUENTLY ASKED QUESTIONS

How much does RLE / Cataract surgery cost?
Information on prices for all of our procedures can be found on our Prices pages.
How long does the operation take?
RLE / Cataract surgery is performed as a day-case procedure, typically lasting 15 minutes. You will go home with a protective shield over the eye which you can remove the following morning.
Does the procedure hurt?
No, there is no pain during the procedure. Anaesthetic drops are used to completely numb the eye before the beginning of the procedure. Sedation can additionally be given intravenously to help you stay relaxed during the operation. General anaesthetic is very rarely necessary.
What are the risks?
Overall, RLE/Cataract surgery is very safe. Complications rarely occur, with a serious problem such as an infection or bleeding in the eye affecting approximately 1 in 1000 patients. 1 in 100 patients may require a second operation - this could include repositioning or exchange of the lens, clearing lens fragments from the back of the eye or repairing a retinal detachment. 1 in 5 patients may develop posterior capsule opacification (PCO) - a thickened membrane behind the new lens that can develop months or years after the operation. This can cause the vision to become blurred again and may require a quick out-patient laser procedure (YAG laser capsulotomy) to restore clarity.

The experience and expertise of your surgeon is the most important factor in minimising the risk of complications during your treatment. Daniel Gore has an excellent safety record: His PCR (posterior capsular rupture) rate, the key index for safety in RLE & cataract surgery, is 0.5 %*, compared with 1.5% national average and the Royal College of Ophthalmologist's benchmark of 2.0%.

*(correct as of 2018)

How long does it take to recover from cataract or RLE surgery?
Your vision is likely to be better the following day, although it will continue to improve in the days following the operation. The eye may be sore and sensitive to light for the first 48 hours. Strict compliance with the drops typically ensures any discomfort settles early on. You may return to work when you feel able (often after the first few days). You may drive once you meet the DVLA standard - reading a number plate at 20.5 meters (approximately 26 paces).
Are RLE/Cataract lens implants permanent?
Lens implants are designed to be permanent. It is important to remember that regular eye health checks with your optician are recommended for all adults, regardless of lens implant surgery. Up to 1 in 5 patients may notice their vision deteriorating months or years after cataract/lens exchange surgery due to the natural thickening of a membrane behind the lens. This is called posterior capsule opacification (PCO), and is normally treated successfully with a simple laser procedure in the clinic.


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