Other Procedures and Services Available at our Manchester Clinic – Refractive Lens Exchange, Phakic Implants, ICL, Cataract Surgery, and More
- Refractive Lens Exchange
- Accommodating Implants
- Multifocal and other Premium Implants
- Implantable Contact Lens (ICL)
- Anterior Phakic Refractive Lens (APRL)
- Permavision Intracorneal Lens
- Cataract Surgery
- Corneal Transplant Surgery
- Reading Implants
- Intracorneal Ring Segments (Intacs)
- Eye Exams
- Which is the best Procedure for my eyes?
Refractive Lens Exchange
"I can honestly say that this operation has changed my life. Prior to surgery, I had a restricted pilot's license. A few months after the operation, the civil aviation authority, awarded me a full license without the need for me to carry spare spectacles. I am a keen amateur musician, and I can read music unaided in most lighting conditions. It is very useful appeal to read music, and watch the conductor at the same time. This is always difficult, wearing reading glasses."
Michael C, Consultant Surgeon had RLE
"I had refractive lens exchange surgery on 16 November 2007. I say that date so clearly as it is a date I shall never forget and my life was totally changed. I am still thrilled each morning when I first peep open my eyes and can SEE. No more bumbling about looking for specs to use until I got up properly and put in my contact lens. For over 37 years these contact lens had been my "eyes" and cannot tell you what a release it is not to have to deal with them or consider them. But best of all, is the fantastic vision that I now have. I am still surprised with the new intensity of colours - that was a totally unexpected bonus. My sight is superb with details apparent to me that I never noticed before. All of this was through the efforts of Mr Deepak Chitkara at Viewpoint Vision. He is totally professional but was also very good at giving me the necessary information to give me the confidence to undergo this operation. Great job, Deepak, thank you very much!"
Barbara B, Wiltshire (had RLE)
For patients who are presbyopic (aged over 45-50 years) and/or unsuitable for other refractive procedures, refractive lens exchange with accommodating lens implants is a revolutionary breakthrough. The aim of refractive lens exchange is to reduce your refractive error (long or short sight) so that you can enjoy clearer vision without spectacles or contact lenses. The technique is similar to that used in modern cataract surgery. Your own natural lens is removed, and a lens implant is put in its place.
With the advent of newer Accommodating Implants, the procedure not only corrects long sight and short sight but also provides useful accommodation, enabling some reading ability as well as better distance vision without the need for glasses.
"I opted for local anaesthetic and must admit nerves kicked in on the day of operation. I should not have worried. …… No pain, No long drawn out operation, No problem. My vision now feels better than with contact lenses However as explained I will need glasses for very close work. I have worn glasses since I was 11 years old. Why did I wait so long (now 56) for refractive surgery?"
– Jim G from Yorkshire had RLE
This short procedure takes only five to 10 minutes and is done under local anaesthetic. We use numbing eye drops not needles to completely anaesthetize then eye. The surgery is completely painless. Through a small opening (microincision) the natural lens is removed and a replacement lens is slid into its place. The recovery is almost instantaneous with most patients able to watch TV immediately upon return to their rooms.
"It all happens very quickly, perhaps 5 -10 minutes per eye and then you are back in your room. There is absolutely no pain at all as the eyes are under topical anesthetic…. I just wish I hadn't worried so much before the operation as it was such a simple procedure. I think I worried so much because it was my eyes and they are so precious…..Mr. Chitkara came to my room about 1 hour after surgery and lifted my eye pads. I was asked if I could see anything. There was a clock on the wall and I was asked if I could tell the time. I was able to tell him that it was 11 am. I honestly could not believe that I could see so soon."
– Lesley G from Isle of Man
"I was very surprised to see the television on the wall of my bedroom. I was allowed home the next day, and it was all my wife could do to prevent me from driving home. The following day, I did undertake a motorway journey with her by my side….. I lost only one day from my office."
– Michael C, Consultant Surgeon
Small Incision Surgery
Since Refractive Lens Exchange is small incision surgery, it offers many quality-of-life benefits to the patient:
- Early return of good vision (within a few hours in most cases)
- Normal or near normal vision within days of surgery
- Large degree of long sight or short sight can be eliminated
- Astigmatism can be addressed during the surgery
- No postoperative padding of the eye
- Very few restrictions after surgery – i.e., normal household, recreational, and even occupational activities may be resumed within a few days
- Significantly reduced need for aftercare and follow-up visits compared with conventional surgery
- Both eyes can be treated on the same occasion
- Removal of your natural lens means you will not develop cataracts as you get older
- Permanent solution to your focusing problem!
Intraocular Lenses
Following removal of your natural lens, an intraocular lens is placed in the same position as your natural lens. It remains there permanently. The intraocular lens offers significant advantages:
- Magnification is at the natural level
- Full peripheral (side to side) vision is retained
- The lens is placed inside the eye during surgery and does not need to be adjusted
Posterior Capsule Opacification
When you have your surgery, the capsule that held your own natural lens is left in place. With time, this can thicken and become cloudy, impairing your vision. All that is required is a few seconds of YAG laser treatment in the clinic to ‘polish’ away the cloudy capsule. This usually restores clear vision within a few hours.
Accomodating Implants
These new lenses are now available which promise some degree of focusing for near and far distance – so called ACCOMMODATING lenses. Surgeons at Viewpoint were one of the first in UK to offer these lenses to certain suitable individuals.
Mr Chitkara was the first Surgeon in the world to use the Tetraflex accommodating lens and in fact helped to design the lens. The Tetraflex lens is 
now the most popular accommodating lens in use in UK.
The consultant will discuss with you in detail, the choice of lens used and the technique which will be most appropriate for your needs during consultation.
"I would like to thank everyone at viewpoint for the wonderful treatment I have had over the past 2 years. A special thank you to Deepak for giving me perfect sight for the first time in my life. It is a wonderful feeling to wake up in the morning and be able to see. I just wish this would have happened years ago. Once again thank you and I salute you Deepak for your wonderful skills."
– Bernadette S from Manchester had RLE
"Cannot speak too highly of my treatment or the results I don’t need specs anymore. Thanks."
– Roland B from Isle of Man had RLE
Multifocal and other Premium Implants
Newer implants such as the ReSTOR and the ReZoom are designed to correct near vision like a bifocal or Varifocal lens in your glasses. Other implants such as the Tecnis implant are designed to correct the distortions in your vision to improve the quality of your vision.
The consultant will discuss with you in detail, the choice of lens used and the technique which will be most appropriate for your needs during consultation.
The Implantable Contact Lens (Visian ICL)
Implantable lenses are one of the most exciting new breakthroughs in the field of enhanced vision care. The quick and easy outpatient procedure can be performed in 10 to 15 minutes, and results in immediate improvement to the patient's vision.
"I am over the moon with the results from my implantable contact lenses (on my complicated eyes). I now have better than 20/20 vision. I was so upset when told two years ago that I was unsuitable for Laser Eye Surgery. My only regret is not finding out about Viewpoint Vision sooner. Viewpoint Vision were unbelievable helpful before, during and after the operation. They worked around my flights to and from Dublin, and arranged a taxi service when required. The service provided was over and above what I was expecting. I will be recommending them to all my friends and family who are interested in eye surgery."
– Ms Ruth B from Dublin, Ireland
A tiny opening is made into eye and the insertable lens is simply slid into the eye. Once inside the eye the lens becomes part of the eye and cannot be felt. Insertable lenses can also be updated easily with a new prescription should vision change in the future.
This device has been available since 1996 as a means of correcting higher degrees of both myopia and hyperopia in the range -20.00 to +8.00D. This implantable lens is surgically inserted inside the eye in front of the crystalline lens and stays in place permanently. It is not truly a ‘contact’ lens as it is not in contact with the crystalline lens. Rather, it ‘floats’ in front of the crystalline lens and is only anchored in place at its edges. 
- The ICL offers a more predictable and accurate form of refractive surgery for high myopia and hyperopia.
- The procedure can be reversed if necessary.
- Corrects nearsightedness and astigmatism in patients whose corneas are too thin for LASIK
- The surgical method is ‘tried and tested’ and similar to that used for small incision cataract surgery.
- Less dry eye risk than LASIK as the procedure does not affect the cornea.
- The effect is almost immediate and rehabilitation is very rapid.
"Fantastic! Had apprehension about op being completely successful. Nothing to worry about. Everyone was friendly, caring and professional. Do not need glasses at all. Thank you to everyone involved."
– Wendy H from Bolton had ICL surgery
As with any procedure, there are potential complications. However, these are rare. One potential complication is the formation of cataract. Should this happen, the ICL implant and your own lens will be removed and replaced by another implant. Another very rare complication is development of acute glaucoma. This is normally prevented by making a small drainage hole through the coloured iris during surgery to allow the fluid to flow normally around the ICL.
Anterior Phakic Refractive Lens (APRL)
APRL combines the latest intraocular lens technology with implantation techniques that have been in use for over 40 years. This time tested method of vision correction may be your answer to a new lifestyle and a whole new outlook on your future.
"Deepak has changed my life. I have just turned 40 and having new sight was my husband's birthday present [to me]. For the first time in 40 years I have fantastic vision. I had lens implants in both eyes and after the initial three weeks with the stitches in where my vision was better, When the stitches were removed it was like a miracle. Both reading and distance is 20/20. Thank you Mr. Chitkara."
– Tanya C from Paris, France
The precision designed APRL is a flexible plastic intraocular lens. It is placed in side the human eye in front of the natural lens between the coloured iris and the back of the cornea or front window of the eye. It becomes part of the eye, and is not visible to the naked eye except on close inspection and does not affect the function of the structures within the eye. The natural lens is not removed and so enables excellent distance and reading vision without the need to remove any tissue from the eye.
- The procedure is used to correct high myopia or hyperopia and astigmatism in patients who are not yet presbyopic or under 45–50 years of age.
- The surgical method is similar to that used for small incision cataract surgery and is therefore ‘tried and tested’ technique.
- The procedure does not affect the cornea or lens thus avoiding haze or scarring or cataracts that can occur with other techniques.
- The effect is almost immediate and visual rehabilitation is very rapid.
- The lens can be removed should the need arise i.e. the procedure is reversible.
Permavision Intracorneal Lens
To implant this type of lens, the surgeon creates a flap in the cornea, just as in LASIK surgery. The lens is then placed under the flap and the flap is put back in place. The lens is made from a very biocompatible hydrogel material, which is extremely thin and porous. This prevents wound healing, growth of blood vessels or scarring and is invisible to the naked eye. When the lens is placed under a flap they reshape the cornea to correct long sight up to +6D.
The procedure is quick and performed with known tools and techniques. No sutures are required. Should it be desirable to change the lens, it is easy to lift the flap and the lens can be repositioned, replaced or removed, i.e. a truly reversible technique. The technique can be used in one eye only to correct presbyopia by achieving a monovision.
Cataract Surgery
About half of the population over age 65 has a cataract, or cloudiness of the eye’s natural lens. If you are suffering from this vision problem, we can perform cataract surgery at our Manchester centre. The surgery is an outpatient procedure that is quick, painless, and often very effective. Before you receive cataract surgery at our Manchester practice, we will determine the strength of the lens that will be placed in your eye. On the day of surgery, we will give you a local anaesthetic and make a small incision in your eye with the aid of an operating microscope. The surgeon will remove the cloudy lens from your eye and replace it with a permanent intraocular lens (IOL) implant. The incision will be closed, and a shield will be placed over your eye. You will then be allowed to return home, provided you have someone to drive you.
Occasionally, the capsule that once contained your natural lens may become cloudy and you may experience reduced vision in the weeks or months following cataract surgery. This is called an after-cataract. If you experience this, you will need to return to our Manchester clinic to undergo a fairly common procedure called a YAG laser capsulotomy. During this procedure, the surgeon will use a laser to cut a hole in the capsule so that light can once again pass through to the retina unobstructed.
Corneal Transplant Surgery
For patients with a damaged cornea, the surgeon at our Manchester practice can perform corneal transplant surgery. This surgery involves removing the central area of the cornea and replacing it with a donor cornea. Before surgery, you will be given a sedative and your eye will be anesthetized. Then, the doctor will remove the damaged cornea and stitch the transplanted cornea in place. You will be asked to wear an eye patch and shield to protect your eye until the day after surgery. Although this surgery has a higher success rate than other transplant surgeries, the recovery time can still be quite long. For more details about corneal transplant surgery, please set up a consultation with the surgeon at our Manchester clinic.
Reading Implants
Reading implants are plastic implants about the size of small grains of rice, which are inserted in the white (sclera) portion of the eye within a small tunnel. They are used to correct presbyopia, or the deterioration of close vision that occurs with natural aging of the lens. When four reading implants are placed around the eye, they help to compress the muscles within the eye, allowing them to contract more efficiently. This improves a patient’s ability to focus at close objects.
The operation is an outpatient procedure performed under local anaesthetic. Only one eye requires surgery, but both eyes gain the ability to focus at close objects.
The main advantages of this procedure are:
- The implants are placed outside the line of vision – this is safer than surgery that involves operating on the line of vision.
- The implants are made from PMMA, a material that is highly biocompatible and remains stable within the eye for over 50 years.
- The surgery does not involve cutting inside the eye.
- The implants can be removed and/or replaced if necessary.
- It is the first procedure that actually corrects the underlying pathology of presbyopia.
Intrastromal Corneal Ring Segments - Intacs
For patients with Keratoconus Intacs may be an option to correct astigmatism. Intacs are small, clear, crescent-shaped pieces of plastic polymer that are inserted into the cornea through a tiny incision. The pieces of plastic alter the shape of the cornea, thereby correcting the refractive error.
Since Intacs are inserted in the outer edge of the cornea, the centre of the cornea remains untouched. The advantage of Intacs is that they can be surgically removed or replaced by the surgeon at our Manchester practice if necessary. When Intacs are removed, the cornea returns to its pre-operative state.
Intacs cannot be used to correct higher levels of myopia or astigmatism. Some patients with Intacs experience a feeling of discomfort in the eye, while others can experience halos, difficulty with night vision, or an increase in astigmatism.
Please contact our clinic in Manchester for more information about Intacs.
Eye Exams
We offer a wide variety of eye exams at our practice, from simple eye chart exams to tests using very complex equipment. When you visit our practice, our doctors will decide which eye exams are necessary for you.
Which is the Best Procedure for my Eyes?
This is decided by some of the following criteria:
- Age of the patient
- Nature and degree of the refractive error
- Thickness of the cornea
- Size of pupil
- Thickness of the natural lens
- Size and shape of the structures within the eye
- Timescale of treatment effect
- Patient inconvenience e.g. post-operative pain, healing process, method of anaesthesia, etc.
- Time between treatment for first and second eye.
No single technique is suitable for all types of refractive error. All forms of correction have their benefits and drawbacks. Practice of refractive surgery involves many techniques, which are interdependent. One technique may not be used in isolation to achieve a successful outcome. Refractive surgery is a process not a single operation. As such almost any refractive error is capable of adjustment in a healthy eye. The process needs to be specific for each eye. After consultation and depending on your situation, we will be able to advise you on the technique(s) which is(are) most suitable for you.
Surgical experience, time scales, staging, predictability, stability, safety, adjustability and reversibility are some of the considerations in choosing an application, whilst patient motivation, needs and attitude/expectations govern choice as well.
Refractive surgery is not just laser surgery to the cornea. Practice of refractive surgery may involve corneal or lens surgery or a combination of both to achieve optimal result. Surgery may have to be staged or sequential. Success depends on the surgical know how as well as the diagnostic facilities to assess your eye needs accurately. Every effort is made to make use of the latest technology in the understanding of your visual problem.