Refractive Lensectomy to Reduce Your Dependency on Glasses or Contact Lenses

I have many patients who ask me about Refractive Lensectomy. The most common refractive surgery procedure in the world is LASIK. The next most common refractive procedure is PRK where we use the laser to correct refractive errors without cutting a flap. Both of these procedures are very successful in allowing patients to reduce their dependency on glasses and contact lenses.

Another procedure, which is becoming more common, is Refractive Lensectomy. This procedure should be reserved for people who are not candidates for LASIK or PRK. Refractive Lensectomy is the same procedure we perform when we do cataract surgery. I tell my patients this is cataract surgery on lenses, which are not cataractous because we are removing the natural lens of the eye using the same technique, phacoemulsification. Refractive Lensectomy is intraocular surgery which means we have to open the eye and go inside as opposed to LASIK or PRK which is extraocular and we do not have to enter the inside of the eye.

Refractive Lensectomy is not as accurate as LASIK or PRK because the formulas and software we use in calculating the power of the intraocular lens to replace the natural lens is not as accurate as the formulas and normograms we use in LASIK and PRK to determine how much tissue to remove. So anyone considering refractive lensectomy should understand they might still need a "laser" treatment after to achieve their goal of good vision. Sometimes 3-5% of patients need a second procedure even after LASIK or PRK as well.

The risk of problems in refractive lensectomy are arguably slightly higher than with LASIK or PRK, because any complications from intraocular surgery such as infection can be more devastating and would be more likely to lead to loss of vision in some cases.

I have been performing refractive surgery of all kinds since 1986 and I personally will not perform Refractive Lensectomy for someone to be free of their glasses because I do not feel the risks are warranted. There are experienced refractive surgeons who agree with my position and those who disagree. I personally would recommend that anyone who is considering Refractive Lensectomy should have a thorough understanding of the indications and risks and complications.

Edgar M. Dapremont Jr. MD FACS, FAAO
Board Certified Ophthalmologist