An Overview of Refractive Lens Exchange Surgery


 Lasik pic

A graduate of the University of Maryland School of Medicine, Dr. Anthony Roberts has worked as an ophthalmologist and surgeon for over two decades. At Shady Grove Ophthalmology in Rockville, Maryland, Dr. Anthony Roberts provides comprehensive eye exams and performs a variety of refractive procedures, including Lasik, laser cataract extraction, and refractive lens exchange.

Also called “clear lens exchange” or “clear lens extraction,” refractive lens exchange (RLE) is a vision-correction procedure that is typically reserved for older patients with refractive errors that cannot be adequately corrected with Lasik. During the procedure, which is very similar to cataract surgery, a surgeon removes the clear natural lens of the eye and replaces it with an artificial intraocular lens that improves the eye’s ability to focus.

RLE can provide rapid vision recovery without affecting the natural shape or thickness of the cornea. It also promotes stable vision and can greatly reduce a patient’s dependence on eyeglasses or contact lenses. Those who are candidates for the procedure include both farsighted and nearsighted adult patients with otherwise healthy eyes. Although major complications are rare, RLE risks include infection, increased eye pressure, and retinal detachment.


How Cataract Surgery is Performed

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Cataract Surgery

Dr. Anthony Roberts, founder and eye physician at Shady Grove Ophthalmology in Maryland, performs such procedures as refractive lens exchange, PRK, and Lasik. A member of the American Academy of Ophthalmology, Dr. Anthony Roberts possesses more than 20 years of experience and is familiar with treating a variety of conditions, including cataracts.

Cataract surgery is performed by an ophthalmic surgeon or ophthalmologist and is a fairly straightforward procedure. It is usually done while the patient is awake and takes around 30 to 45 minutes to complete. A local anesthetic is applied to the eye to ensure patients do not feel pain during the procedure and patients may also receive medication to help them relax.

Most cataract surgeries use a technique known as phacoemulsification. When using this technique, medical professionals begin the procedure by putting drops in the eye to dilate the pupil. A small cut is then made in the cornea, which is the transparent tissue in the front of the eye. Through this cut, surgeons place a small probe that uses ultrasound waves to break up the affected lens. The lens pieces are then removed and a small plastic lens is put in its place.

The lens may also be removed using an extracapsular cataract extraction technique. With this technique, a large incision is made in the cornea and surgeons remove the front capsule and cloudy portion of the lens using surgical tools. The back capsule of the lens is left intact and supports the artificial lens.

The Lens of the Eye

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Shady Grove Ophthalmology

Dr. Anthony Roberts, founder and chief of ophthalmology at Shady Grove Ophthalmology in Maryland, performs a variety of vision-related procedures including Lasik, cataract surgery, and refractive lens exchange. In doing this work, Dr. Anthony Roberts draws on a detailed knowledge of the lens and how it works within the eye.

In a healthy human eye, the lens serves to focus rays of light onto the retina, which transforms those light signals into visual images. The focusing ability of the lens stems largely from its ability to change shape, which it does thanks to its connection with the surrounding ciliary muscles. These muscles stretch and contract the lens so that it can focus clearly on objects at varying distances.

In its natural state, the lens is typically about 10 mm in width and 4 mm thick. It is curved in both the front and the back and is ellipsoid, meaning that it most closely resembles an elongated sphere. The outer boundary of this shape is created by the lens capsule, a smooth and transparent layer of cells.

Inside the capsule are the lens fibers, which are long and thin in shape and also transparent. These make up the functional structure of the lens. Between the lens fibers and the capsule is the lens epithelium, which provides stability to lens function and is responsible for creating more lens fibers as required to keep the lens working well over a person’s lifetime.

Refractive Lens Exchange

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Refractive Lens Exchange

Since 2002, Dr. Anthony Roberts has practiced as an eye physician and surgeon at Shady Grove Ophthalmology in Rockville, Maryland. Dr Anthony Roberts draws on experience in LASIK and other vision-correction surgeries, including refractive lens exchange.

Refractive lens exchange, also known as clear lens exchange, replaces the lens of the eye as one would do for a patient with cataracts. In the case of refractive lens exchange, however, the patient has no clouding of the lens and is seeking the procedure primarily to achieve permanent vision correction. An option for nearsighted or farsighted patients who cannot tolerate contact lenses, refractive lens exchange can significantly improve an individual’s quality of life.

Refractive lens exchange has become possible thanks largely to the clinical advancements that have made cataract surgery safer. Many clinicians now recommend the procedure for older individuals with hyperopia, or farsightedness, who have severe symptoms or moderate symptoms with evidence of incipient cataracts. Nearsighted individuals may need more careful assessment, as these individuals carry a greater risk of retinal detachment, though innovative technology has made elective refractive lens exchange a newly viable option.

What to Expect after Cataract Surgery FAQ

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Cataract Surgery

The official ophthalmologist for the Washington Redskins football team, Dr. Anthony Roberts is the founder of Maryland-based Shady Grove Ophthalmology. An eye physician, he provides his patients with a number of treatment options, ranging from comprehensive eye exams to various forms of eye surgery, including LASIK. Among the procedures that Dr. Anthony Roberts provides is cataract surgery.

Cataract surgery is the most commonly performed ophthalmologic procedure in the world, with around 20 million of these surgeries completed each year. Following are three frequently asked questions and answers about what to expect after undergoing cataract surgery.

Q: How long will it take for my vision to be restored after the procedure?

A: Full recovery time varies from one person to another. Some patients will regain their sight the next day, and for others, recovery may take several days, a week, or even a month.

Q: Can patients drive themselves home after cataract surgery?

A: Most professionals recommend that patients arrange to have another person drive them home after the procedure, especially if vision in the unaltered eye is poor. At some ophthalmologic practices, patients are required to have another person transport them home after the procedure.

Q: Do patients have to wear any protective covering over the treated eye?

A: Yes, most doctors will provide patients with a plastic protective shield or patch to wear over their eye after surgery. They will protect the eye from being accidentally bumped or rubbed, which can cause enough pressure to open the surgical incision.

Determining Suitability for Lasik Surgery

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Lasik Surgery

Dr. Anthony Roberts, an eye health specialist, provides a variety of treatments for common eye conditions. Additionally, for patients who qualify for the procedure, Dr. Anthony Roberts performs Lasik surgery.

For many individuals, Lasik surgery, a type of surgery that uses a laser to correct vision, can provide good results. However, certain individuals are not good candidates. Doctors look at a number of factors when determining a person’s suitability.

To start, the person should be over 18 years of age and in good health overall. This includes eye health, as having conditions such as glaucoma, herpes zoster, and others can disqualify a person. People who have ongoing issues with eye dryness and whose vision is unstable should not get the procedure, and pregnant and nursing women should wait for a period of time as advised by their doctor. This is because hormones during this time can affect vision.

Other factors doctors evaluate include the thickness of the patient’s corneas, as people who have corneas less than around 0.5 millimeters thick shouldn’t get the surgery. The doctor must deem the person’s farsightedness, nearsightedness, or astigmatism to be treatable through the procedure as well. An eye doctor can check for these and other important factors during a consultative visit.

Femtosecond Lasers and Corneal Refractive Surgery

Dr  Anthony Roberts pic
Dr Anthony Roberts

Dr. Anthony Roberts is a Rockville, Maryland, physician who leads Shady Grove Ophthalmology and offers LASIK treatments. Experienced in employing advanced technologies in vision correction, Dr. Anthony Roberts undertakes the majority of LASIK procedures using the femtosecond laser, which offers a host of distinct advantages over other techniques.

Femtosecond laser systems are infrared and were first developed for ophthalmic use in the 1990s. They employ an ultrashort pulse of light that is achieved through passive mode locking. Finely tuned application of these ultrashort pulses results in a quickly expanding cloud of ionized molecules and free electrons, like an acoustic shock wave.

This is used to perform a variety of procedures, including corneal refractive surgery, particularly for correcting presbyopia and implanting intrastromal corneal ring segments. Femtosecond lasers are also used in LASIK procedures to cleave the cornea over the pupil and create what is known as the “LASIK flap.” Advantages include the reduced incidence of flap complications and greater physician control in determining variables such as flap thickness and diameter.