There is a limit to how much corneal tissue you can safely remove in refractive surgery. So lens implantation techniques are generally preferred for the correction of higher refractive errors.

Refractive Lens Exchange (RLE)

Cataract surgery involves replacement of the natural lens with an artificial lens implant. The power of this lens can be selected to suit your refractive requirements, and modern cataract surgery is about as accurate and as safe as LASIK for refractive correction. When the natural lens is not cloudy (a cloudy natural lens is a cataract), the operation is termed refractive lens exchange. It is commonly offered to people with high levels of long or short sight.

Early cataracts are common in patients over 45, and cataract surgery is commonly preferred to LASIK in this age group.

Refractive lens exchange is a day case procedure, and can be performed under general or local anaesthetic. The operation is not painful and good vision normally returns within 2 days of the surgery. Only one eye is operated on at a time, and typically the eyes are treated 7 days apart.

Phakic intraocular lens implantation/ Intraocular contact lens Surgery (ICL)

For younger patients with a clear natural lens and refractive errors outside the safe range for laser techniques, implantation of a second lens is often preferable to cataract surgery or CLE. The second lens is situated just in front of the natural lens, acting a little like a contact lens within the eye.

This surgery is also known as ICL or intraocular contact lens surgery. The key advantage for this technique in patients under 45 years old is that natural, unaided reading vision is preserved. As with CLE, only one eye is operated on at a time.

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Other treatments

• LASIK
• EpiLASEK, LASEK and PRK
• Non-corneal refractive surgery