Procedures
The same operation used for cataracts, performed to correct your prescription and presbyopia before a cataract ever forms. Your natural lens is replaced with an intraocular lens chosen for your vision — and that eye will never develop a cataract.
What it is
Behind the pupil sits the eye's natural lens. In our forties it stiffens and stops focusing up close, which is presbyopia; decades later it clouds, which is a cataract. Refractive lens exchange replaces that lens with a clear artificial one, an intraocular lens, whose power is calculated for your eye.
The operation is technically the same as modern cataract surgery. The difference is timing and purpose: it is done to correct the prescription, including prescriptions too high for laser surgery, rather than because the lens has clouded. Since the artificial lens cannot cloud, that eye will not develop a cataract later.
In 24 seconds
Illustrative schematic, no sound. Only the surgeon decides candidacy, after a full in-clinic evaluation.
The eye's length and corneal curve are measured to calculate the lens power. Monofocal, toric or extended-range options are explained and chosen with you before you book, never on the day.
Anaesthetic drops, outpatient. The incision is a few millimetres and usually needs no stitches.
Ultrasound breaks up the natural lens, which is removed, and the folded intraocular lens is placed in the same capsule and unfolds into position.
Dr. Serrano examines the eye himself the following day. Clearance to fly is given in writing at that visit, never before it.
A shield over the eye, mild scratchiness, blurred vision from the dilating drops. Someone should accompany you back to the hotel.
In-person check. Whether the second eye is done on this trip, and when, follows the plan Dr. Serrano set at your evaluation.
Drops for several weeks. No heavy lifting, swimming or rubbing the eye. Vision settles as the eye heals.
Final check of the prescription with your optometrist at home. Any glasses for fine tasks are prescribed then.
Every eye is different. Dr. Serrano goes through the risks that apply to yours at the evaluation, before you decide anything.
A summary to orient you. The evaluation decides, not the table.
| Feature | Lens exchange | LASIK | SMILE | Cataract surgery |
|---|---|---|---|---|
| Treats | Presbyopia and high prescriptions | Myopia, hyperopia, astigmatism | Myopia, astigmatism | A clouded natural lens |
| Works on | The lens, replaced | Cornea, under a flap | Cornea, no flap | The lens, replaced |
| Typical age | About 45 and over | 18 to mid-40s | 18 to mid-40s | Usually 60 and over |
| Helps with reading vision | Depends on the lens chosen | No | No | Depends on the lens chosen |
| Cataract later in that eye | No | Still possible | Still possible | No |
| Typical stay in Cabo | Set by your plan | 3 to 4 nights | 3 to 4 nights | Set by your plan |
How it's done
What each technique does, who it's for and what to expect. Anything that doesn't fit here gets answered at your evaluation.
The eye's natural lens is broken up with ultrasound and removed through an incision of a few millimetres that usually needs no stitches. It is today's standard technique for cataract surgery and for lens exchange.
The lens that replaces your natural one is chosen for your prescription and what you want from your vision: distance with reading glasses, or several distances with less dependence on glasses. Dr. Serrano works through it with you at the evaluation.
Frequently asked questions
Technically yes: the natural lens is removed and an intraocular lens is placed. The difference is the reason — here it's done to correct your prescription and presbyopia, not because the lens has clouded.
That depends on the plan Dr. Serrano sets for you. He explains it at your evaluation, along with how many days you'll need in Cabo.
Only after your in-person check and written clearance from Dr. Serrano. The trip is planned around that, not the other way round.
LASIK reshapes the cornea but leaves a lens that is already losing its focus and will later cloud. Lens exchange addresses the lens itself, so it can help with distance and near together and removes the future cataract. It is also surgery inside the eye, with different risks. The evaluation weighs both for your eyes.
A monofocal lens gives its best focus at one distance, usually far, with reading glasses for near. A toric lens also corrects astigmatism. Multifocal and extended-range lenses spread focus across distances and reduce the need for glasses, with a higher chance of halos at night. The choice changes the price and is made before you book.
Many people use glasses much less, but nobody can promise none at all. It depends on the lens chosen, on your eye's healing and on how demanding your near work is.
When there is no cataract it is an elective procedure, and U.S. insurers generally do not cover it at home or abroad. You receive an itemised receipt you can use for a health savings or flexible spending account if your plan allows it.
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