So you want to get rid of reading glasses forever?
that’s the topic of today’s video Hello everyone, I am Dr. Audrey Tai, welcome
back to my channel - Eye channel by eye surgeon.
I am a board certified and fellowship trained refractive and cataract surgeon, ophthalmologist
and cornea specialist, I am here to bring you the latest information on eye health and
medicine.
The worsening of reading vision as we age is called presbyopia.
With the recent FDA approval of the Vuity eye drop, which is a temporary treatment for
presbyopia, a lot of my patients have been asking me about ways to eliminate reading
glasses permanently.
If you are interested in learning more about the vuity eyedrop, you can check out this
video.
In today's video I will discuss a surgical option that can treat presbyopia permanently.
This type of presbyopia eye surgery is known as refractive lens exchange surgery or RLE.
I will go over how RLE works, who are candidates for RLE surgery, what to expect before and
on the day of RLE surgery, the recovery process, and what are the risks of this type of surgery.
Make sure you watch the entire video to learn about both the benefits and risks of RLE surgery.
Ok, so how does RLE surgery work?
RLE surgery corrects presbyopia by replacing the stiff and aging natural lens in our eyes
with an advanced intraocular lens implant or IOL.
When we are young, we are able to see objects at different distances due to the flexibility
of our natural lens.
Our natural lens becomes more curved when the eye muscles contract, called ciliary body
muscles.
And our eyes become more nearsighted, and this enables us to see objects that are close
to us clearly.
In our early 40s, our lenses gradually lose their flexibility, and no longer change shape
as our eye muscles contract, causing presbyopia.
Although there is no currently available treatment to restore the elasticity of our natural lens,
refractive lens exchange surgery treats presbyopia by removing the rigid lens and replacing it
with an advanced IOL, to give us a clearer range of vision, including distance, intermediate,
and near vision.
So how do you know if you are a good candidate for RLE surgery?
In general people who are over the age of 40 and have developed significant presbyopia
or difficulty reading, may want to be evaluated by an eye surgeon for RLE surgery.
In order to be a candidate for RLE surgery, you need to have a healthy eye, free of significant
eye diseases.
For example, people who have glaucoma, macular degeneration, significant diabetic eye disease,
a history of retinal detachment, eye inflammation, or any significant disease of the cornea,
are not good candidates for RLE surgery.
People who are extremely nearsighted or farsighted, with abnormal length of the eye are also typically
not good candidates for RLE surgery.
For example, in people who are extremely nearsighted, with a glasses prescription over minus 15
diopters, the length of the eyeball is extremely long, and this increases the risk of developing
retinal detachment with any kind of intraocular surgery, including RLE surgery.
So what can you expect during your evaluation for RLE?
In order to determine if you are a candidate for RLE surgery, you will need to have a full
eye exam by your eye surgeon, and complete extensive testing and measurements of your
eyes.
Typically a full RLE surgery evaluation will involve measuring the curvature and length
of the eye, a full eye exam with pupil dilation, examining the health of the optic nerve and
retina inside of the eye.
Also the strength of the glasses prescription for both distance and near vision is recorded
during the exam.
After the examination and testing, if you are a candidate for RLE surgery, your eye
surgeon and you will pick the best advanced intraocular lens implant for your eye.
There are two main types of advanced IOLs that are currently available in the US for
presbyopia correction, multifocal IOLs and Extended depth of focus or EDOF IOLs.
The choice of IOL for each candidate is made based on that individual’s functional vision
needs, as well as any vision requirements for their profession and life style.
If you would like me to make a more in-depth video about the differences between different
types of IOLs, let me know in the comments below.
And if you are enjoying this video so far, don’t forget to hit the like button and
subscribe to my channel!
What should you expect on the day of RLE surgery and how do you care for your eyes after surgery?
RLE surgery is typically done for both eyes either separately or occasionally at the same
time.
It is an outpatient procedure that takes about 15 minutes for each eye, and you will go home
the same day.
During the surgery, patients are typically not under general anesthesia.
They will receive IV or local sedatives to stay conscious but in a very relaxed state.
The surgery itself is painless, and patients will be using different types of eye drops
with a tapered schedule in the weeks following surgery.
Strenuous activities should be avoided during the first week after surgery.
In general, your vision will be blurry on the day of surgery.
With a successful RLE surgery, your vision should be much clearer the day after surgery,
and you should be able to resume most of your vision tasks the day after surgery, such as
watching TV, or light reading.
You may feel very mild irritation or foreign body sensation in your eyes, and may have
some light sensitivity for about a week after surgery.
The majority of vision recovery occurs during the first week after surgery, but it is not
unusual for you to experience small fluctuations in your vision during the first month after
surgery.
Although mild irritation and vision fluctuation are expected shortly after surgery, significant
eye pain and sudden significant vision change are unusual and can be signs of potential
serious complications.
If you experience those or any other concerning symptoms, you should contact your eye surgeon
right away.
For most RLE patients, their vision stabilizes after about one month after surgery.
However, a small percentage of patients may take a few months to fully recover their vision
after RLE surgery.
Usually patients will be following up with their eyes surgeon or eye doctor a few times
during the postoperative period.
The surgical steps of RLE surgery are basically the same as cataract surgery, and it can be
done with a conventional manual method, or with assistance from a femtosecond laser.
To learn more about the steps of RLE and cataract surgery, and the differences between manual
RLE surgery versus femtosecond laser assisted RLE surgery, you can check out this video
- conventional cataract surgery versus laser assisted cataract surgery what are the differences?
If you have stayed with me this far, I hope you have found this video helpful, and if
so, please consider hitting the like button and subscribing to my channel.
it would really help me to bring you more videos about eye health and eye surgery.
Now remember, there are risks with any surgery, including RLE surgery.
With RLE surgery, there is a small chance of infection, bleeding, increased eye pressure,
glares at night and potentially other risks that you should discuss with your eye surgeon.
Most of the complications from RLE surgery are treatable with additional medications
or procedures.
Although it is rare, the risk of vision loss is not zero with RLE surgery, or any intraocular
surgery.
The goal of RLE surgery is to reduce the need for reading glasses, and to help you eliminate
reading glasses for most of your vision needs.
Most RLE patients do not need reading glasses after surgery.
However, people who spend a lot of time doing prolonged close up work, for example, threading
needles or reading very small print up close for hours at a time, may still want to wear
reading glasses for those tasks in order to reduce eye strain.
Therefore it is important for you to have an individualized exam and consultation with
your eye surgeon to determine if RLE surgery is the right treatment for you.
Let me know in the comments below if you need reading glasses now, and if so, have you heard
about RLE surgery as a treatment option for presbyopia?
And would you consider it?
I hope you find this video helpful, if you have learned anything new, please don’t
forget to hit the Like button, and subscribe to my channel, because if you click that subscribe
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I look forward to connecting with you there.
Thank you again for watching and I will see you in my next video.