refractive lens exchange case study

Refractive Lens Exchange Case Study

Here is a refractive lens exchange case study of Mrs R.M., a 58 year old woman. She went to one of our competitors three years prior and was advised she was not suitable for laser eye surgery. A friend recommended she see Advanced Vision Care and a consultation was arranged for June 2014. She was wearing varifocal spectacles and was not a contact lens wearer.

On the day the following results were found:

Refraction

Unaided Sph Cyl Axis VA Add VA
RE 6/60 -3.25 -0.75 80 6/7.5 +2.25 N5
LE >6/120 -4.00 -1.00 75 6/7.5 +2.25 N5

Ocular Examinations

Right                 Left
544 Corneal Pachymetry (µm) 548
6.5 Colvard Pupil Diameter (mm) 6.5
14 Goldmann Contact Tonometry (mmHg) 14
 43.0 @ 77, 42.7 @ 167 Orbscan keratometry (D) 44.1 @ 145, 43.8 @ 55
2.27 Anterior Chamber Depth (mm) 2.37
Pingeculae Anterior Segment Evaluation Normal
Clear Crystalline Lens Clear
Unremarkable Opthalmoscopy Unremarkable

Refractive Lens Exchange Case Study – Treatment

Our surgeon recommended the best procedure for the case study would be bilateral Refractive Lens Exchange surgery. The question was whether to have a Monofocal or Multifocal IOL. The concern was that RM is mildly amblyopic in both eyes. The multifocalswork best when optimum visual acuity is available. This was discussed with the patient and it was decided to go ahead with bilateral Refractive Lens Exchange surgery with Trifocal IOLs.

RM required in-depth counselling so she could understand the impact of her mild amblyopia and how Trifocal IOLs work. It is important to explain all matters carefully so the patient has realistic outcomes.

Bilateral Refractive Lens Exchange surgery went ahead in August 2014. Surgery on each eye was performed on consecutive days and without complications.

At the 1 Day check for the left eye, Mrs R.M. was happy with her distance vision but was finding the near vision a little tricky. Her vision was as follows:

RE 6/7.5 N6

LE 6/7.5 N6

BE 6/6 N8

Her eyes were healing well and she was reassured more time was needed for neuro-adaption for the near vision to become easier. As you can see, RM coped better at near vision with one eye than with both eyes together.

At the 3 month check Mrs R.M. was delighted with her vision but had noticed a new floater in her left eye. She was dilated and checked. It turned out to be a posterior vitreous detachment. This was explained and RM was advised appropriately.

Her vision was:

RE: 6/6-3 N6

LE: 6/6-3 N6

BE: 6/6 N5

At the 6 month and 12 month check-ups RM had no issues. Her vision was now even better at 6/6 and N6 in each eye. Binocularly, she could see 6/6 and N5.

Everything had settled and Mrs R.M. was extremely happy with her “new eyes”. Choosing to do bilateral Refractive Lens Exchange with Trifocal IOLs showed to be sound judgement with better prognosis than was originally thought possible.

Find Out How AVC Can Help You

If you would like to find out more about Refractive Lens Exchange at Advanced Vision Care and how it can completely change your life, then why not call AVC TODAY on 0800 652 4878 and request your free information pack or book your consultation to find out how we can help you.
 

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