What is refractive lensectomy?

This is a surgical procedure to reduce dependence on glasses. It is an alternative to Lasik and PRK.

What is the actual surgical procedure?

The lens in the eye is surgically removed and replaced with an artificial lens. The procedure is similar to a cataract operation and takes 10-15 minutes to perform if there are no complications.

Who is a candidate for refractive lensectomy?

Patients 45 or older who wish to longer be dependent on glasses for their distance vision. In general, younger patients will not be happy with the procedure because they will need glasses to read afterwards. Lasik or PRK are the preferred procedures in these patients.

Why are reading glasses necessary after the procedure?

The implanted lens does not focus for near, only for the distance.

But aren’t there implanted lenses that can focus for both distance and near?

Yes there are, but Dr. Bentivegna does not feel comfortable using them at this point. These lenses can cause permanent glare and must be centered perfectly. Even if they are centered perfectly, the can decenter later in life, causing poor vision. There are doctors who are comfortable implanting these lenses and Dr. Bentivegna will be happy to refer you to doctors who do so.

Is the procedure covered by insurance and if not, what is the price?

Some patients wishing refractive lensectomy actually have small cataracts, meaning that insurance will cover the procedure. However, this depends on individual plans. Without insurance, the fee will vary from $2,500 - $3,500 per eye. This includes the Dr. Bentivegna’s and surgery center’s fee. The vast majority of patients will need refractive lensectomy in both eyes, meaning a total expense of $5,000 to $7,000. There may also be pharmacy charges for the necessary eye drops. Incidentally, many patients will recoup these costs over the years, because they no longer have to purchase expensive glasses and/or contact lenses.

Are both eyes done at once?

No. One eye is done and after 3-4 weeks, if there are no problems, the other eye is done.

What are the risks of the procedure?

With any eye procedure, there is always a risk of blindness. This is slim but it can happen. Other risks include retinal detachments and infection.

Will my vision be 20/20 in the distance without glasses after refractive lensectomy?

The goal of refractive lensectomy is to reduce dependence on glasses and most patients will see 20/20 in the distance; however, this is not guaranteed. There is a reasonable chance that you may need glasses to give you a crisp 20/20 vision. These glasses may be necessary for night driving or watching the small print on a television screen.

Can a cataract form in my eye after refractive lensectomy?

Once the lens is removed, you cannot develop the cataracts of normal aging; however, it is possible that the area behind the artificial lens can become cloudy (what is called a recurrent cataract). This requires a laser procedure that takes less than a minute. Most insurance plans will cover this procedure; however, if they do not, Dr. Bentivegna will not charge you.