There are instances when your refractive error is too high, or your cornea is too thin, that laser refractive surgery isn't a good choice. Individuals who do not qualify for refractive surgery and are intolerant of eyeglasses or contact lenses may benefit from Refractive Lens Exchange (RLE). This is also known as Clear Lens Extraction And Replacement (CLEAR). RLE/CLEAR is basically the same procedure as cataract surgery in an individual without cataracts, and possessing a high refractive error, with a desire to be spectacle independent. All the machines, and procedures used in cataract surgery are utilized and performed in RLE/CLEAR.
INTRAOCULAR LENS IMPLANT OPTIONS
An appropriate intraocular lens (IOL) for your specific visual requirements has been chosen preoperatively. This IOL may be an aspheric monofocal (Alcon IQ, Freedom Fold, HumanOptics Aspira, J&J Tecnis, Medicontur Bi-Flex T, Ocuflex, PhysIOL microAY123, Rayner Aspheric, VSY Acriva, Zeiss CT Asphina) aspheric monofocal toric (Alcon IQ Toric, HumanOptics Toric A, Medicontur Toric, Rayner Toric, Zeiss TORBI), aspheric multifocal (Alcon ReStor, Alcon Panoptix, HumanOptics Diffractiva, Medicontur Liberty, Oculentis Lentis MplusX, PhysIOL FineVision microF, Rayner Trifocal, VSY RevIOL, Zeiss AT Lisa, Zeiss AT Lisa Tri), aspheric multifocal toric (Alcon ReStor Toric, Alcon Panoptix Toric, Medicontur Liberty Toric, Oculentis Lentis MplusX Toric, PhysIOL PodFT, Rayner Trifocal Toric, Zeiss AT Lisa Toric). The IOL you chose to correct your vision will be inserted into the same location that your natural lens occupied. Once the IOL is locked into position, the micro-incision seals itself, typically without the need for sutures. It remains tightly closed by the outward pressure within the eye and provides a fast and much more comfortable recovery.
- IOL Comparison Table
- Video | IOL Options
- Animation | IOL Options
- Zeiss Trifocal
- Zeiss EDoF
|MONOFOCAL||MONOFOCAL TORIC||MULTIFOCAL||MULTIFOCAL TORIC||EDOF VARIFOCAL POLYFOCAL||ADD ON|
|Intermediate Vision||No||No||Yes||Yes||Yes||Yes (Multifocal only)|
|Near Vision||No||No||Yes||Yes||Yes||Yes (Multifocal only)|
|Astigmatism Correction||No||Yes||No||Yes||Yes (Varifocal Toric only)||Yes (Toric only)|
|Preloaded||Yes (Hoya 251, Micro123, Aspira, Bi-Flex HL)||No||Yes (AT LISA Tri)||No||No||No|
|Brands||Alcon IQ, Freedom Fold, HumanOptics Aspira, J&J Tecnis, Medicontur Bi-Flex T, Ocuflex, PhysIOL microAY123, Rayner Aspheric, VSY Acriva, Zeiss CT Asphina||Alcon IQ Toric, HumanOptics Toric A, Medicontur Toric, Rayner Toric, Zeiss TORBI||Alcon ReStor, Alcon Panoptix, HumanOptics Diffractiva, Medicontur Liberty, Oculentis Lentis MplusX, PhysIOL FineVision microF, Rayner Trifocal, VSY RevIOL, Zeiss AT Lisa, Zeiss AT Lisa Tri||Alcon ReStor Toric, Alcon Panoptix Toric, Medicontur Liberty Toric, Oculentis Lentis MplusX Toric, PhysIOL PodFT, Rayner Trifocal Toric, Zeiss AT Lisa Toric||Symfony, MPlus Comfort, MPlus MF20, MPlusX, MPlus MF30, WIOL||Toric, Multifocal, SML|
|Average Cost (in Philippine Pesos)||10,000 - 25,000||40,000||60,000 - 75,000||75,000 - 90,000||75,000 - 90,000||75,000 - 90,000|
REFRACTIVE LENS EXCHANGE PACKAGES
Phacoemulsification Refractive Lens Exchange Package
Phacoemulsification Refractive Lens Exchange Surgery at JCI-accredited hospitals
- St. Luke's Medical Center Global City
- Asian Hospital Medical Center
Most insurance companies and HMOs provide coverage for phacoemulsification cataract surgery. Philhealth provides basic coverage subject to a 5-day pre-approval process. If bladeless femtosecond laser-assisted cataract surgery is desired, please choose the Platinum packages instead.
Femtosecond Laser-Assisted Refractive Lens Exchange Package
This is the latest premium state-of-the-art bladeless Femtosecond Laser-Assisted Refractive Lens Exchange Surgery
- St. Luke's Medical Center Global City (LenSx)
Most insurance companies and Health Maintenance Organizations (HMO) do not provide coverage for premium FLACS. Philhealth provides basic coverage subject to a 5-day pre-approval process. Choose this package if you wish to say goodbye to manual incisions and blades, and say hello to laser-precision, improved healing, faster visual recovery, and better visual outcomes.
REFRACTIVE LENS EXCHANGE PACKAGES
|IOL||CASH ONLY||CASH + PHILHEALTH||CASH + PHILHEALTH + HMO|
|IOL||CASH ONLY||CASH + PHILHEALTH||CASH + PHILHEALTH + HMO|
- IOL. Intraocular Lens implant. Implanted to improve vision after cataract surgery.
- PHILHEALTH. Philippine Health Insurance Corporation. First Payor. If cataract surgery is pre-approved, Philhealth provides coverage of 16,000 pesos.
- HMO. Health Maintenance Organization. Second Payor. Provides coverage, after Philhealth, for the rest of the hospital bill, and professional fees. If Philhealth is not available, the HMO usually requires the individual to shoulder the Philhealth coverage of 16,000 pesos. An IOL is usually not covered, and is paid out of pocket.
- MONOFOCAL. An intraocular lens which provides a correction for a single point of focus, usually far. It does not correct for astigmatism. If used for far correction, the individual must use reading glasses all the time
- TORIC. An intraocular lens used to correct for astigmatism. Astigmatism is a type of refractive error in which the eye does not focus light evenly on the retina, resulting in distorted or blurred vision at all distances.
- MULTIFOCAL. An intraocular lens which provides correction for all distances (far, intermediate, near). Provides around 90% spectacle independence in the real world setting. One may need to use prescription glasses for 10% of the time (small print, low light conditions, bright light conditions).
- PRESBYOPIA. Presbyopia is a condition associated with age. As people age, the lens becomes harder and less elastic, making it more difficult for the eye to focus on close objects. Presbyopia correcting IOLs, e.g. multifocal IOLs, provide correction for all distances. See MULTIFOCAL.
- ADDON. A second intraocular lens implant inserted in an anatomic space called the sulcus, in front of an existing intraocular lens placed in the capsular bag. It may correct for post-operative spherical refractive errors, astigmatism, and presbyopia. The SML, Scharioth Macula Lens, is a Low Vision implant useful for patients with age -related macular degeneration or other maculopathy (central vision problems).
- NON-ASPHERIC (SPHERICAL). A spherical intraocular lens can induce minor optical imperfections called higher-order aberrations (HOAs), which can affect quality of vision, particularly in low-light conditions such as driving at night.
- ASPHERIC. Premium aspheric IOLs approximate the shape and optical quality of the eye's natural lens, and provide sharper vision, especially in low light conditions and for people with large pupils.
HOW TO USE THE TABLE
- Choose the CASH column if you have no insurance and are paying 100% out of pocket.
- Choose the CASH + PHILHEALTH column if you have PHILHEALTH. This is your total bill minus 16,000 pesos paid by Philhealth.
- Choose the CASH + PHILHEALTH + HMO column if you have both PHILHEALTH and HMO/Insurance. The amount shown here is basically the cost of the intraocular lens implant, which is paid out of pocket.
- Choose the MONOFOCAL row if you would like far correction only. You are willing to wear reading glasses all the time.
- Choose NON-ASPHERIC if your astigmatism is less than -0.75D and you don't require excellent quality of vision at night.
- Choose ASPHERIC if your astigmatism is less than -0.75D and you require excellent quality of vision at night.
- Choose TORIC if you have astigmatism greater than -0.75D.
- Choose the PRESBYOPIA row if you would like to have correction for all distances (far, intermediate, near) in order to be less dependent on glasses. You understand that you will be spectacle free for 90% of the time in the real world setting. You are willing to wear prescription glasses for small print, low light conditions, and bright conditions.
- Choose MULTIFOCAL if your pre-operative astigmatism is less than -0.75D.
- Choose TORIC if your pre-operative astigmatism is greater than -0.75D.
- Choose the ADDON row, if you had previous cataract surgery, and have an unacceptable post-operative refraction.
- Choose SPHERICAL if you have a significant spherical error and would like to have clearer distance vision.
- Choose TORIC if you have significant astigmatism and would like to have clearer distance vision.
- Choose MULTIFOCAL if you have acceptable distance vision, but would like to say goodbye to reading glasses.
- Choose SML if you have low vision due to age-related macular degeneration, and would like to have magnification for your your near vision requirements in your non-dominant eye.
COLUMN + ROW
The intersection of the COLUMN and the ROW that you have chosen is the amount that you have to settle for your cataract surgery.
- Cataract Surgery with intraocular lens implantation under local anesthesia is performed:
- by Dr. Manolette Roque
- in St. Luke's Medical Center Global City daily except Sundays and holidays. Scheduled patients must arrive one (1) hour prior to surgery.
- in Asian Hospital Medical Center, in Alabang, Muntinlupa every Tuesday afternoon. Scheduled patients must arrive two (2) hours prior to surgery.
- with any of the following phacoemulsification units: Alcon Centurion/Infiniti or B+L Stellaris.
- with the Alcon LenSx Femtosecond laser for FLACS.
- Cataract screening and post-operative follow up examinations may be done in Asian Hospital MOB 509 or St. Luke's Medical Center Global City MAB 217.
- Phacoemulsification Cataract Surgery Packages are limited to surgeries performed under local anesthesia in either hospital. FLACS is only done in St. Luke’s. If sedation is requested, add 30,000 pesos to the Cataract Surgery Package.
- STOP the following medications, one (1) week prior to planned cataract surgery:
- All blood thinners (Aspirin, Aspilet, Clopidogrel, Heparin, Enoxaparin, Ardeparin, Danaparoid, Warfarin, Vitamin E, Gingko Biloba)
- All prostate medications (Harnal, Tamsulosin, Flomax, Hytrin, Avodart, Duodart, Proscar, among others)
- The Cataract Surgery Packages may only be used for routine cataract surgery. It may not be availed with cataract surgery combined with trauma, glaucoma, uveitis, cornea, or retina diseases. These combined surgeries are much longer and require more consumables, and are therefore associated with additional expenses.
- Package Inclusions:
- Professional fee
- Hospital bill (peri-operative services, operating room fee, phacoemulsification machine use, surgical microscope use, consumables needed for surgery, surgical instruments, sterilization, post-operative medications, post-operative services); femtosecond laser machine use for FLACS
- Intraocular lens implant, 3 free post-operative follow up visits (usually day 0 or 1, week 1, month 1).
- Package Exclusions:
- Pre-operative consultation
- pre-operative diagnostic tests
- pre-operative medications.
- All Cataract Surgery Packages are inclusive Senior Citizen Discount and exclusive of eVAT. It may not be combined with other promos and discounts.
- Additional charges will be billed for the use of Iris Hooks, Malyugin Rings, Triamcinolone Acetonide, Ozurdex Dexamethasone implant, and other devices.
- Philhealth pre-approval is required five (5) working days prior to the scheduled surgery. Please submit your Philhealth ID, MDR, and other documents 1 week prior to scheduled surgery.
- Only Philippine FDA-registered IOLs may be used when availing of Philhealth benefits. For premium IOLs which are not yet registered, Philhealth may not be filed.
- HMO letter of authorization (LOA) or Insurance guarantee of payment (GOP) needs to be requested three (3) days prior to scheduled surgery.
OUR REFRACTIVE LENS EXCHANGE SPECIALIST
MD, MBA, DPBO, FPAO, FPCS
Dr. Manolette Roque is a specialist in uveitis, cataract, and refractive surgery. His private practice began in 2000, after his post-graduate fellowship at the Massachusetts Eye and Ear Infirmary, Harvard Medical School, in Boston, Massachusetts, USA. His patients are mostly adults who desire spectacle independence. His advocacy includes taking care of individuals with ocular inflammatory diseases.
Everyone deserves the best eye care possible.