Refractive lens exchange surgery: your questions answered

Written in association with: Mr Prateek Agarwal
Published:
Edited by: Conor Dunworth

Refractive lens exchange surgery is a procedure that is similar to cataract surgery, with a number of key differences. In his latest online article, renowned consultant ophthalmic surgeon Mr Prateek Agarwal explains this procedure in detail.  

 

What is refractive lens exchange surgery? What does it involve?

A refractive lens exchange surgery is a premium refractive procedure wherein the natural lens which has early/minimal cataractous changes is replaced by an artificial lens. This lens can be a Toric/Multifocal/EDOF lens, thereby reducing the dependency on glasses completely or significantly, unlike the standard lenses used in cataract surgery.

 

How does it compare to cataract surgery/other procedures of this type?

Normal cataract surgery involves the implantation of a standard mono-focal lens. In contrast, refractive lens exchange involves dedicated calculations, using cornea topography, modern formulas, more sophisticated pre-operative testing to measure the eye’s optics, and more sophisticated lens implants such as multifocal and Toric lens implants. It is aimed at addressing the astigmatism and arriving at the best possible scenario to reduce dependency on glasses for both distance and near.

 

Who is a good candidate for refractive lens exchange treatment?

Usually, patients in their mid-50s to any age are good candidates for this procedure.

 

What are the success rates of refractive lens exchange? Is it safe?

A refractive lens exchange is very much similar to cataract surgery except that more sophisticated pre-operative testing to measure the eye’s optics, and more sophisticated lens implants such as multifocal and toric lens implants are involved. The success rates, risks and complications are similar to cataract surgery, of which thousands are performed every week in the UK. 

 

How long do the results last?

The results are expected to last a lifetime unless some other pathologies in other components of the eye develop as a part of the normal ageing process. As an example, age-related macular degeneration /glaucoma/diabetic retinopathy may occur independently, but not due to the surgery procedure itself.

 

Mr Prateek Agarwal is a highly respected consultant ophthalmic surgeon who is based in Manchester. If you would like to book a consultation with Mr Prateek Agarwal, you can do so today via his Top Doctors profile.

By Mr Prateek Agarwal
Ophthalmology

Mr Prateek Agarwal is a highly respected consultant ophthalmic surgeon who is based at Manchester. He is renowned for his expertise in laser eye surgery, refractive cataract surgery (premium intraocular lenses) LASIK, SMILE procedures, and also specialises in keratoconus and cornea transplantation.

Mr Agarwal is one of the few surgeons to have received qualifications from all three Royal Colleges of United Kingdom and is on specialist register for ophthalmology. He is one of the few to perform more than 1500 surgeries every year. Mr Agarwal received the Best Surgical Video Award at the 2022 United Kingdom & Ireland Society of Cataract and Refractive Surgery for his excellent surgical technique in the management of a complex case.

His main fields of interest are refractive cataract surgery with premium IOLs, PRK, LASIK, SMILE, ICL’s, and cornea transplantation. At Optegra, Mr Agarwal offers refractive lens exchange as well as small incision cataract surgery with torics, trifocals and extended depth of focus intraocular lenses, as well as the full range of modern refractive procedures including SMILE, LASIK, advanced surface ablation and implantable contact lenses (ICL).

After qualifying in medicine in 2006, Mr Agarwal completed a master of surgery residency programme based at India’s highly esteemed Aravind Eye Hospital and Post-Graduate Institute of Ophthalmology in 2009. He later undertook a fellowship at University Hospital Bern, Switzerland, specialising in cornea and external diseases followed by further training in laser eye surgery at the Barraquer Eye Institute in Barcelona. Mr Agarwal joined as a cornea, cataract and refractive surgeon at the prestigious Cleveland Clinic with further training on SMILE in 2017. He then relocated to the UK where he was appointed as a fellow of the Royal College of Ophthalmologists and began a consultancy position within the NHS. Mr Agarwal currently sees private patients at the Optegra Eye Hospital in Manchester.

Mr Agarwal is the examiner for Royal College of Ophthalmologists Fellowship Exam (FRCOphth) and the Certification in Laser Refractive Surgery (CertLRS) Royal College Examination. He received an Honourable Mention Award in 2019 for his work on pinhole implants at the Annual Congress of the American Society of Cataract and Refractive Surgeries in San Diego.

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