EyeWorld India December 2021 Issue

REFRACTIVE 28 EWAP DECEMBER 2021 Contact information Nehls: nehls@wisc.edu Williamson: blakewilliamson@weceye.com R efractive lens exchange (RLE), clear lens extraction, custom lens replacement—the removal of a dysfunctional crystalline lens that doesn’t have a visually significant cataract goes by different names, depending on who you talk to. Regardless of what the procedure is called, improvements in IOL technologies have increased interest in these procedures, and there is more confidence among surgeons in its ability to deliver expected outcomes. Blake Williamson, MD, said he does this procedure routinely each week. Thanks to a local The who, what, when of refractive lens exchange by Liz Hillman Editorial Co-Director marketing campaign in his area, Dr. Williamson said he has patients coming in asking for a procedure that can address presbyopia. “They walk in saying ‘I’m 45 years old and I hate my reading glasses, what can I do?’” he said. “If someone does come in for LASIK, if they’re hyperopic and 45 or above, they’re automatically getting switched to a [custom lens replacement] evaluation instead of a LASIK evaluation.” Sarah Nehls, MD, said she often has patients in their 50s and 60s coming in for a LASIK consult that she usually ends up shifting to a lens-based discussion. Dr. Nehls said the most common patient is someone who has had great vision most of their life, but as they aged, they experienced a hyperopic shift along with presbyopia. Sometimes they also have early lenticular changes. Patients in this age group, she said, are going to benefit from correction of their distance vision and presbyopia. In addition, it’s a one-time procedure; they won’t develop cataracts. “To be able to use lenses to capture the distance and reading vision is amazing,” Dr. Nehls said. “I tell patients that this lens is going to last your lifetime. … There are things that can happen as you age that might affect your vision like glaucoma This article originally appeared in the September 2021 issue of EyeWorld . It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp.