Understanding Refractive Cataract Surgery

Patients diagnosed with cataracts, or clouding of their natural crystalline lens, will benefit from Refractive Cataract Surgery (RCS) to both restore vision as well as correct refractive error (near-sightedness, far-sightedness, or astigmatism).

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Refractive Cataract Surgery

In RCS, the patient’s natural crystalline lens is removed via ultrasound (phacoemulsification) through a microscopic incision and replaced with a clear artificial intraocular lens (IOL) more suitable to the patient’s eye shape. Due to the extremely small size of the incisions and ample pain control, most patients will experience nearly no pain during the extremely short surgery. Having exclusive access to the most advanced IOL technology in the world, Lumea surgeons can correct BOTH patients’ distance AND reading vision with unprecedented satisfaction and accuracy.

Early side effects of RCS may include swelling, increased eye pressure, inflammation or rarely, infection. Patients may also experience temporary dry eye or temporary glaring around lights in the evening (depending on the IOL type that is chosen). Essentially all side effects can be successfully treated with medications and allowing the eye to fully heal from surgery.

Ideal candidates for RCS have:

  • Been diagnosed with cataracts
  • Any refractive error (near-sightedness, far-sightedness, astigmatism)
  • A desire for distance + / – near vision correction
Surgery Length
  • 30 minutes
Anesthesia
  • Local with IV sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or inflammation
  • Increased eye pressure
Recovery
  • Discomfort 12‑24 hours
  • Vision 3‑7 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 2‑4 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding RLE

Patients over the age of 45 and with severe near-sightedness, far-sightedness, or astigmatism may be more ideal candidates for RLE or “refractive lens exchange” rather than laser vision correction of the cornea.

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RLE icon

RLE

In RLE, the patient’s natural crystalline lens is removed via ultrasound (phacoemulsification) through a microscopic incision and replaced with a clear artificial intraocular lens (IOL) more suitable to the patient’s eye shape. Due to the extremely small size of the incisions and ample pain control, most patients will experience nearly no pain during the extremely short surgery. Having exclusive access to the most advanced IOL technology in the world, Lumea surgeons can correct BOTH patients’ distance AND reading vision with unprecedented satisfaction and accuracy.

Early side effects of RLE may include swelling, increased eye pressure, inflammation or rarely, infection. Patients may also experience temporary dry eye or temporary glaring around lights in the evening (depending on the IOL type that is chosen). Essentially all side effects can be successfully treated with medications and allowing the eye to fully heal from surgery.

Ideal candidates for RLE are:

  • Over 45
  • Severe myopia (near-sightedness)
  • Moderate hyperopia (far-sightedness)
  • Moderate astigmatism up to 5.0D
  • Desires distance + / – near vision correction
Surgery Length
  • 30 minutes
Anesthesia
  • Local with IV sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or inflammation
  • Increased eye pressure
Recovery
  • Discomfort 12‑24 hours
  • Vision 3‑7 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 2‑4 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding Presbyond LASIK

Over the last 20 years, lasik or “laser-assisted in-situ keratomileusis”, has become the most common refractive surgery in the world for treating most types of refractive errors (near-sightedness, far-sightedness, and astigmatism).

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Presbyond LASIK icon

Presbyond LASIK

A femtosecond laser creates a thin corneal flap which is then gently moved, like a page of a book. The resulting exposed cornea is then reshaped with a second laser (called an excimer) resulting in perfectly corrected vision within seconds. The flap is then gently replaced back to its original location and acts as a natural bandage. This is the major advantage of lasik over older types of refractive surgery (such as PRK) because the “bandage effect” of the flap allows for rapid healing (reduced pain and rapid visual recovery).

Until recently, LASIK laser technology allowed for the correction of only distance vision, meaning patients over 45 years of age still required glasses to read. Today, the surgeons at Lumea are proud to be one of the very few centres in Canada to have mastered the use of Presbyond LASIK to correct both distance AND reading vision in suitable patients over the age of 45. In Presbyond LASIK, a naturally occurring visual phenomenon called Spherical Aberration (SA) is optimized on the cornea to allow for the ideal blend of depth of focus and visual quality.

Side effects of Presbyond LASIK are identical to regular LASIK and include temporary dry eyes, and foreign body sensation. Patients may experience night time glare or halo for a few days, which quickly resolves with normal healing. Complications of Presbyond LASIK are extremely rare and are ALL treatable. These include infection, swelling or inflammation under the flap (diffuse lamellar keratitis).

Ideal candidates for Presbyond LASIK:

  • Are between 45 and 60
  • Have myopia (near-sightedness) up to -9.0D
  • Have hyperopia (far-sightedness) up to +2.0D
  • Have astigmatism up to 5.0D
  • Have suitable corneal thickness
Surgery Length
  • 15 minutes
Anesthesia
  • Local with oral sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or flap inflammation
  • Flap misalignment
Recovery
  • Discomfort 6‑12 hours
  • Vision 1‑2 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 1‑2 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding ICL

Patients under the age of 45 and with severe near-sightedness, far-sightedness, or astigmatism or have certain cornea conditions may be more ideal candidates for ICL surgery or “intraocular collamer lens” surgery rather than laser vision correction of the cornea.

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ICL icon

ICL

In ICL surgery, an ultra-thin and extremely soft lens is inserted into the patient’s eye order to correct a patient’s refractive error. ICL surgery is analogous to placing a contact lens permanently inside the eye, instead of daily practice of placing and removing a contact lens on top of the eye. The thin collamer lens is inserted into the through a microscopic incision and placed behind the iris and in front of the natural crystalline lens.

Due to the extremely small size of the incisions and ample pain control, most patients will experience nearly no pain during the extremely short surgery. ICL surgery is designed to decrease a patient’s dependence on glasses for both distance and reading vision.

Early side effects of ICL surgery may include swelling, increased eye pressure, inflammation or rarely, infection. Patients may also experience temporary dry eye or temporary glaring around lights in the evening. Essentially all side effects can be successfully treated with medications and allowing the eye to fully heal from surgery.

Ideal candidates for ICL surgery are those patients who:

  • Are under 45
  • Have severe myopia (near-sightedness)
  • Have moderate to severe hyperopia (far-sightedness)
  • Have moderate to severe astigmatism up to 5.0D
  • Have certain corneal conditions (too thin, or too “soft” for laser vision correction)
Surgery Length
  • 30 minutes
Anesthesia
  • Local with IV sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or inflammation
  • Increased eye pressure
Recovery
  • Discomfort 12‑24 hours
  • Vision 2‑4 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 1‑3 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding PRK

In PRK, the surface cells of the cornea are removed and the resulting exposed cornea is reshaped with a laser (called an excimer) within seconds.

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PRK icon

PRK

A clear contact lens is then placed on the eye to create a “bandage effect” while the surface cells regrow in 4 to 5 days.

Although the results of PRK are excellent, and comparable to SMILE and LASIK, patients do experience mild to moderate discomfort as the surface cells heal in the days following surgery. Because of this, PRK is usually reserved as the treatment of choice only for specific reasons (eg. unique eye shape, thin corneas).

Side effects of PRK include mild to moderate discomfort, dry eyes, and foreign body sensation. Patients may experience night time glare or halo for a several days, which resolves with normal healing. Complications of PRK are extremely rare and are ALL treatable. These include infection, swelling or haze to the cornea from healing.

Ideal candidates for PRK are:

  • Under 45
  • Myopia (near-sightedness) up to -9.0D
  • Astigmatism up to 5.0D
  • Corneas too thin for SMILE or LASIK
  • “Soft” corneas at risk for ectasia
Surgery length
  • 15 minutes
Anesthesia
  • Local with oral sedation
Side effects
  • Discomfort
  • Irritation
  • Dry eyes
  • Night glare
Risks
  • Infection
  • Swelling
  • Haze
Recovery
  • Discomfort 3‑4 days
  • Vision 1‑4 weeks
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 4‑12 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding LASIK

Over the last 20 years, lasik or “laser-assisted in-situ keratomileusis”, has become the most common refractive surgery in the world for treating most types of refractive errors (near-sightedness, far-sightedness, and astigmatism).

Watch video
LASIK icon

LASIK

A femtosecond laser creates a thin corneal flap which is then gently moved, like a page of a book. The resulting exposed cornea is then reshaped with a second laser (called an excimer) resulting in perfectly corrected vision within seconds. The flap is then gently replaced back to it’s original location and acts as a natural bandage. This is the major advantage of lasik over older types of refractive surgery (such as PRK) because the “bandage effect” of the flap allows for rapid healing (reduced pain and rapid visual recovery).

Side effects of lasik are mild and include temporary dry eyes, and foreign body sensation. Patients may experience night time glare or halo for a few days, which quickly resolves with normal healing.

Complications of lasik are extremely rare and are ALL treatable. These include infection, swelling or inflammation under the flap (diffuse lamellar keratitis). Very infrequently, the corneal flap may slightly shift immediately after surgery or later, from eye trauma.

Flap repositioning is an quick, easy, and painless option to restore excellence visual acuity in these uncommon situations.

Ideal candidates for lasik are:

  • Under 45
  • Myopia (near-sightedness) up to -9.0D
  • Hyperopia (far-sightedness) up to +3.0D
  • Astigmatism up to 5.0D
  • Suitable corneal thickness
Surgery Length
  • 15 minutes
Anesthesia
  • Local with oral sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or flap inflammation
  • Flap misalignment
Recovery
  • Discomfort 6‑12 hours
  • Vision 1‑2 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 1 to 2 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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Understanding SMILE.

The latest advancement in the laser vision correction or near-sightedness and astigmatism, SMall Incision Lenticule Extraction (SMILE) offers the same accurate outcomes and rapid recovery as LASIK, but with additional advantages.

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SMILE icon

SMILE

A femtosecond laser creates a thin corneal piece (lenticule) inside the cornea as well as a small incision. The surgeon removes the lenticule through the tiny opening which allows for the cornea to be reshaped. The major advantage of SMILE over LASIK is the lack of a flap. The least invasive refractive procedure in the world, SMILE leaves the surface of the cornea almost completely untouched allowing SMILE patients to benefit from less dry eye and more stable results over time.

Side effects of SMILE are mild and include temporary dry eyes, and foreign body sensation. Patients may experience nighttime glare or halo for a few days, which quickly resolves with normal healing. Complications of SMILE are extremely rare and are ALL treatable. These include infection, swelling or inflammation (diffuse lamellar keratitis).

Ideal candidates for SMILE are:

  • Under 45
  • Myopia (near-sightedness) up to -9.0D
  • Astigmatism up to 5.0D
  • Suitable corneal thickness
  • Contact sports
Surgery Length
  • 15 minutes
Anaesthesia
  • Local with oral sedation
Side Effects
  • Dry eyes
  • Irritation
  • Temporary night glare
Risks
  • Infection
  • Temporary swelling or inflammation
Recovery
  • Discomfort 6‑12 hours
  • Vision 1‑2 days
  • Exercise 5‑7 days
  • Make up 7‑14 days
Final Visual Outcome
  • 1‑2 weeks
  • Dry eyes typically resolve in 4‑8 weeks
Instructions
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