About Refractive Lens Exchange (RLE)

Refractive lens exchange (RLE), also known as clear lens extraction (CLE), is a surgical procedure for vision correction that replaces the natural lens of the eye with an intraocular lens (IOL). Using the same surgical techniques as cataract surgery, the clear lens of the eye is removed and replaced with an IOL to change the focusing power of the eye.

An alternative to laser vision correction, the RLE procedure avoids the need for a corneal modification that is used during the LASIK procedure and instead uses the same procedures performed in cataract surgery.

Patients who choose to undergo RLE have several options when it comes to the type of IOL that will be implanted into the eye. The RLE procedure uses the same IOLs used in cataract surgery and is able to treat all types of visual disorders, including farsightedness, nearsightedness, presbyopia, and astigmatism. Patients are provided with a choice of the most advanced premium IOLs, which will allow them to see clearly at all distances.

Candidates for Refractive Lens Exchange

Refractive lens exchange is ideal for patients who:

• Want to reduce or eliminate their dependence on glasses or contact lenses
• Are between the ages of 50 and 75 years of age
• Have high myopia, or nearsightedness; high hyperopia, or farsightedness; presbyopia, or astigmatism, with or without cataracts
• Have early symptoms of cataracts
• Are poor candidates for LASIK or PRK
• Have no health issues that affect the eyes

Patients with astigmatism can undergo additional correction during their procedure through relaxing incisions in the outer margins of the cornea, known as limbal relaxing incisions. These incisions create a symmetrical cornea and help reduce or even eliminate astigmatism in the eye. There are also IOLs that correct astigmatism to allow these patients to see clearly.

Benefits of a Refractive Lens Exchange

A refractive lens exchange is an option for those patients with corneas that are too thin for a laser vision correction procedure.

Some of the advantages of RLE include the following:

• Rapid recovery of vision
• Cornea remains untouched
• No need for cataract surgery in the future
• Vision is now stable
• Correction of near vision at the same time
• Most patients who have RLE will receive a multifocal IOL

Refractive Lens Exchange Procedure

The refractive lens exchange procedure is performed on an outpatient basis using the same techniques as those for cataract surgery.

A topical or local anesthesia is applied to the eyes to minimize discomfort during the procedure. Through a tiny incision of 3 mm or less, the natural lens of the eye is removed and replaced with an IOL that is inserted through the same opening. Once inserted, the lens is unfolded and moved into its permanent position in the eye. No stitches are needed because the incision will be able to seal on its own. The refractive lens exchange procedure takes just twenty minutes to perform and offers patients significant and immediate results.

After the Refractive Lens Exchange Procedure

After a refractive lens exchange, patients can return home the same day and can return to work and other regular activities after a day or two. Many report immediate improvements to their vision, and vision will continue to improve as the brain adapts to the new lens. Once vision has stabilized, it will likely stay the same over time, as the lenses correct vision and prevent the patient from developing cataracts in the future. The second eye is usually treated a few weeks after the first procedure.

The extent of the results of the RLE will depend upon the patients eye’s, lifestyle, and the IOL selected for the procedure. Many patients are able to eliminate their dependence on glasses or contacts after this procedure, while others may still need glasses for driving or reading.

Risks and Complications of a Refractive Lens Exchange

All surgeries carry some degree of risk. These concerns should be discussed, in detail, with the surgeon. The risks and complications of an RLE are the same as those of cataract surgery and may include:

• Retinal detachment
• Increased pressure in the eye
• Infection
• Bleeding
• Ptosis
• Sensitivity to light
• Dry eyes
• Glaucoma
• Distortion in vision
• Halos around lights

To find out if this treatment is right for you, please schedule an informative consultation with the doctor or call our office to find out if you are a candidate for this exciting procedure.