Refractive Lens Exchange

Refractive Lens Exchange (Clear Lens Extraction)

Refractive lens exchange, also called lens replacement surgery or clear lens extraction, may be a better option than SMILE, LASIK, PRK or ICL refractive surgery for people with presbyopia and high hyperopia (farsightedness).

Refractive lens exchange (RLE) replaces your eye's clear natural lens with an artificial intraocular lens (IOL) to correct your focusing error and achieve sharper focus, reducing your need for reading glasses or bifocals/graduated lenses.

The procedure for refractive lens exchange is virtually identical to cataract surgery. The difference is that in RLE, the lens being replaced is clear, rather than a cloudy lens due to a cataract.

There are different types of IOL’s available to replace your natural lens, depending on your vision needs and the health of your eyes.

They are:

• Monofocal fixed-focus IOLs: Monofocal lenses provide clear vision at distance, intermediate or near ranges — but not all three at once. Toric IOLs to correct astigmatism also are classified as monofocal IOLs.
• Multifocal IOLs: A multifocal lens provides clear vision at multiple distances.
• Accommodating IOLs: An accommodating IOL is a type of monofocal lens that enables focus at multiple distances by shifting its position in the eye.
• EDOF (Extended Depth Of Focus) IOL: These IOL’s spread focused light over a greater distance allowing patients to have a more continuous range of vision without the possibility of “gaps” in the vision. They are also less likely to induce night vision haloes or starburst effects than Multifocal IOL’s.

With intraocular lenses, there is no "one size fits all," and your eye surgeon will recommend an IOL that is most suitable for your individual needs.

The Procedure 

Lens replacement surgery usually takes about 20 minutes and is performed on an outpatient basis. Each eye is done separately, usually about a week apart. Numbing anaesthetic drops are used during the procedure, so typically there is no discomfort, and most people report immediate vision improvement after surgery.

Initial recovery from refractive lens exchange — when you can resume normal everyday activities — usually takes about a week. Final outcomes of refractive lens exchange can take up to several weeks, and you may notice vision disturbances such as blurry vision, halos and glare, or a "scratchy" sensation as your eyes heal. You should be able to return to work and resume driving within a week of surgery, dependent on your eye surgeon's instructions.

The artificial intraocular lens is a permanent replacement for your natural lens and is designed to last the rest of your life. And, because IOL’s are not affected by age-related changes, there is minimal risk of regression (loss of corrective effect or deterioration of vision) over time.