Lens Replacement

Bij een clear lens extraction of ook wel refractive lens extraction wordt er net als bij een staaroperatie een kunstlens in het lenszakje geplaatst. De inhoud van het lenszakje dat verwijderd wordt, is in dit geval nog niet troebel. Mensen boven de 50 jaar die graag minder bril- of contactlensafhankelijk willen zijn, kunnen voor deze ingreep in aanmerking komen.

Een clear lens extraction of refractive lens extraction kan ook een optie zijn voor jongere mensen die graag minder bril- of contactlensafhankelijk willen zijn wanneer de kamerhoek te nauw is om een Artisan of Artiflex of ICL implantlens te plaatsen.

iris-scan-search

Voor de behandeling

Preparation
  • Your eyes should not be made up during the treatment. Small particles of makeup can get into the surgical area and cause inflammation. We recommend that you do not wear makeup one day prior to treatment and that you thoroughly clean the eyelid edges.
    You may have your eyelashes dyed or fake eyelashes placed, but there must be at least one week and preferably two weeks between the dyeing/placement and the treatment.
    Please come to the treatment well rested.
    You may eat and drink before and after treatment.
    Do not use perfume, aftershave and/or day cream on the day of treatment.
    Wear comfortable clothing during the treatment. Avoid wool and clothing with loose fibers, because they can contaminate the operation area. The room has a constant temperature of 18 degrees, keep this in mind when choosing your clothes.
    Take your sunglasses with you. After the treatment you may be extra sensitive to light.
    Sunglasses also protect your eyes from UVA and UVB radiation. The light sensitivity can be quite intense the first few days, wear sunglasses as needed (even indoors).
    You should carefully read the informed consent (the treatment agreement). On the day of treatment you will sign this document at the desk.

    You cannot go home on your own. We advise you to arrange for an attendant to pick you up. The treatment always takes place in Rotterdam.

Treatment step by step

Here you can read step by step how the lens replacement procedure works. The treatment takes place under local anesthesia on an outpatient basis. Usually 1 eye is treated at a time and we start with the dominant eye.

Step 1
You will be given eye drops (an anesthetic drop and a drop to make the pupil larger) by the assistants or the ophthalmologist himself before you enter the operating room.

The assistant will also ask if you would like a Valium tablet. Valium is a sedative and relaxes the muscles. This is not mandatory. Just before you enter the operating room, you will be given an overcoat, a cap and you will have to put on slippers over your shoes.

Step 2
In the operating room, you will be given another anesthetic drip.

Step 3
You will lie down on a flat chair. The skin around your eyes will be cleaned and a sterile drape will be taped over the face.

Step 4
After placing the eyelid spreader, the ophthalmologist will first make a small incision, about 2.5 a mm, at the edge of the cornea. This is the entrance used to remove the lens. Gel is injected into the anterior chamber of the eye and then the lens is removed.

Step 5
The artificial lens is rolled up in a holder (cartridge) and inserted into the eye. This is still done through the original 2.5 to 3 mm opening. The lens slowly unfolds and molds to the capsular bag. Once the small lens is securely in place, the rounding process begins. The gel is sucked out of the anterior chamber of the eye. The procedure is complete.

Step 6
You will be taken to a special room where you can recover.

Step 7
You will be told about the drops/medications to be used after the procedure.
After the procedure, the eye will be covered with an eye cup.
During the follow-up examinations we will discuss when the other eye can be treated.

How long does the procedure take?
The actual treatment takes about half an hour, in total you will be present for about 1,5-2 hours. Visus eye clinic works with high quality standards. It is possible that the doctor in charge cancels the procedure on or just before the day of treatment. It will be explained to you why the treatment cannot take place.

iris-scan-approved-1

Na de behandeling

Post-treatment requirements

After the treatment, you do not have to keep your eyes closed, but you may.

The first hours after the treatment your eyes will tear, you may have a burning sensation or a headache. You may also feel that you cannot keep your eyes open. You may feel that there is something in the eye. These are normal symptoms that usually disappear after about 4 hours. If necessary, you can take a light painkiller like paracetamol.

What you see the first few days is not decisive for the result of the treatment.

It is important for a quick recovery of the eye after the treatment that a number of rules are followed:

The first 24 hours you should not shower (the head and hair must remain dry) or bathe. The following days in such a way that no water enters the eye.
Rubbing the eyes should be avoided for at least 6 weeks. Even after that you should be careful not to rub the eyes.
You may bend over, but try to avoid excessive lifting and pressing for the first 2 weeks.
After 2 weeks, you may use makeup again. Be careful with the use of mascara and eye shadow: these should also be removed without rubbing too hard or too much.

You should take the following into account when doing sports:

Do not do strength training for the first 2 weeks.
Do not swim in chlorinated water or seawater for the first two weeks.
Do not use a sunbed for the first 2 weeks, after that it is better to protect your eyes with special glasses.
Avoid hard blows to your eyes. So for ball sports or contact sports protect your eyes for the first two months.
For specific sports or when in doubt, consult your doctor or clinic.

When is the result reached

Within a few weeks the intended result of the procedure is achieved, in the meantime you can usually function as normal. With tri/multifocal lenses, habituation often needs to occur, sometimes you may also need to do exercises to get your brain used to the new vision. A positive attitude and awareness that your vision will improve will help you adapt more quickly.

Letter of discharge from your family doctor
On the day of treatment you will receive a letter of discharge for your family doctor, together with your medication. You should give this letter to your family doctor.

color-picker-2

Nazorg

Medication

After the treatment you will use drops to speed up the recovery. We will give you a number of medicines. These medications are prescribed by the ophthalmologist and declared to your health insurance company by the clinic’s home pharmacy. Any co-payment is borne by the patient. If you are insured abroad, you must pay the cost of the medication to Visus Eye Clinic. You can ask for a quote at the front desk.

For repeat prescriptions you can request your prescription online via the website www.visusoogkliniek.nl under the heading “contact” at the top right. It is important that you know the fax number of your pharmacy.

Attention!

If your doctor differs from the standard medication described on this page, follow your doctor's advice and ignore this page.


Artelac

The Artelac eye drops are eye moistening drops that combat dry eyes and increase comfort in the eyes. These drops can be administered in case of burning and irritation, as needed.


Diamox (Acetazolamide)

For pain, you may take one paracetamol (2x 500 mg) in the first day/night. If after one and a half days no improvement is experienced, you may take one Diamox tablet.  Thanks to the Diamox tablet the eye pressure will be lowered and if there is any oedema (fluid) present it will be drained more easily. You will receive 2 tablets on the day of treatment, the second Diamox should only be taken on the doctor’s advice.


Nevanac (Niet steroïde ontstekingsremmer NSAID)

You use the Nevanac drop after the first follow-up checkup. The drop has an anti-inflammatory effect. From the first follow-up, you should use this drop once a day for 28 days.

  • For 28 days 2 x 1 drop per eye/per day

Tobrex BID (antibioticum)

The Tobrex eye drops are used for the prevention of inflammatory symptoms. On day 1 through day 7, use the Tobrex drops twice a day.

  • Day 01 to day 07 after treatment 2 x 1 drop per eye/per day

Dexamethason (corticosteroïd)

Dexamethasone inhibits inflammation and hypersensitivity reactions. You use Dexamethasone on day 1 through day 28 in a tapering schedule.

  • Day 01 to day 07 after treatment 4 x 1 drop per eye/per day
  • Day 08 to day 14 after treatment 3 x 1 drop per eye/per day
  • Day 15 to day 21 after treatment 2 x 1 drop per eye/per day
  • Day 22 to day 28 after treatment 1 x 1 drop per eye/per day
Tips voor oogdruppelen
Tips for eyedropping
How to drip another?

Follow the next steps:

  1. Wash your hands with soap and dry them well with a clean towel or with paper.
    Sit down and take the bottle of eye drops in your writing hand.
    With the tips of your fingers from your other hand, pull the lower eyelid down to create a gutter.
    Bend your head back and look up (towards your eyebrow). If you cannot tilt your head back properly, lie down.
    Put your hand with the vial on top of the hand making the channel. Bring the bottle above your eye. When doing so, avoid touching the bottle to the eye, eyelids, and eyelashes.
    Squeeze the bottle and let one drop fall into the flume.
    Close your eye (do not squeeze). You can sit up again.
    Next, press your tear duct closed for 1 minute, by gently pressing just below the small hard bump in the inner corner of your eye (on the nose side). This ensures that as little of the eye drop as possible gets into your nose and throat.
    Wash your hands with soap and dry them with a clean towel or paper towel