What is Refractive Lens Exchange?
Refractive Lens Exchange (RLE) is a surgical vision correction procedure that removes the natural lens from the eye and replaces it with a clear plastic intraocular lens (IOL). It is an alternative to LASIK, which uses a laser to create a thin flap on your eye to then reshape your cornea. An IOL is an implant which replaces your natural lens, allowing your eye to better focus on objects, and reducing your need for glasses or contacts. It is identical to a cataract procedure, the most common eye procedure in the world.
Why have Refractive Lens Exchange?
- It’s a preemptive solution for people over 40 who are beginning to develop cataracts, as RLE removes the need for future cataract surgery.
- It provides an ideal solution to those with presbyopia, a vision disorder that affects a person’s ability to focus close up, as it can help with near vision activities such as reading, computer, and smart phones.
- It’s a great choice for people with hyperopia (farsightedness), myopia (nearsightedness), or astigmatism who have a significant refractive error or abnormal cornea that would otherwise disqualify them for LASIK.
What kind of Intraocular Lens (IOL) is right for me?
After reviewing the overall health of your eyes, your surgeon will discuss your options and help you choose the IOL that best fits your individual needs and lifestyle. There are two general types of RLE lens implants:
Standard Intraocular Lens Implants
A standard mono-focal IOL has one point of focus, which is usually distance vision. If you choose a standard IOL, you will generally need glasses for near activities like reading. On the other hand, if your mono-focal IOLs are focused on near vision, you will typically need glasses to see distant objects clearly. This is the case even if you didn’t need glasses before surgery.
Custom Intraocular Lens Implants
Custom IOLs are more advanced lens implants that not only treat cataracts, but also improve distance vision, reading vision, and everything in between. Your doctor will help determine which implant is best for you.
Custom IOL Options Include:
Multi-focal Intraocular Lens Implants
A multi-focal IOL contains multiple zones that focus light at a variety of distances, allowing you to see a continuous range of vision without glasses. This results in excellent visual acuity of close up and far away objects. Many patients report the ability to read small print and see distances, both without glasses. At Medical Eye Center, we utilize the first and only FDA-approved tri-focal lens for our patients. However, if you frequently drive at night, keep in mind that this lens can produce rings or halos around bright lights, which may make driving at night disorienting at first. Most patients adjust to this effect given time.
Extended Depth of Focus Intraocular Lenses (EDOF IOL)
EDOF IOLs enhance the sharpness of your vision at far, intermediate, and near distances. They are often called “Next-Generation Trifocals” because the lens is designed to provide correction at all three distances. EDOF IOLs provide good vision in most day-to-day situations without the need for glasses, especially for computer and tablet users. Some patients find that intense near tasks (e.g. reading small print) can be optimized further by wearing glasses which is common to all intraocular lenses.
Toric Intraocular Lens Implants
If you have astigmatism, your surgeon may recommend a Toric IOL which helps restore clarity to distance vision. Correcting astigmatism once required that tiny limbal relaxing incisions (LRIs) be made in the cornea to change its shape. Now Toric IOLs can replace the need for these incisions in patients with mild to moderate astigmatism. For those with higher levels of astigmatism, a combination of technologies may be used. Generally, these procedures reduce the thickness of your glasses at all distances and may also reduce your reliance on glasses for distance vision.
What to Expect:
- A minimally invasive surgery.
- During the actual procedure, a very tiny incision is made in the eye so the natural lens can be removed and the new intraocular lens (IOL) can be positioned. Stitches are not required in most cases.
- A comfortable procedure.
- For RLE, anesthesia typically consists of relaxing medication and a local anesthetic. A Certified Nurse Anesthetist will be monitoring your anesthesia to help ensure a pleasant and comfortable experience.
- A short recovery time.
- Typical recovery time after RLE is around one week, during which your eye doctor may ask you to limit certain physical activities, such as bending and lifting.
- Fast results.
- Many patients experience improved eyesight almost immediately following RLE surgery. For some, vision may be blurry at first as your eye heals, and there may be some mild discomfort and itching for a couple of days after the procedure, but within a few days, your discomfort should disappear.
FAQs About RLE:
A very tiny incision is made in the eye so the natural lens can be removed and the new intraocular lens (IOL) can be positioned. Stitches are not required in most cases.
No. RLE is performed on one eye at a time. Your second eye surgery will take place 1-2 weeks after the first.
For RLE, anesthesia typically consists of relaxing medication and a local anesthetic. A Certified Nurse Anesthetist will be monitoring your anesthesia to help ensure a pleasant and comfortable experience.
Unlike LASIK surgery, in which a laser is used to change the shape of your cornea, RLE works by replacing the lens in your eye. This procedure is much like cataract surgery, one of the most commonly performed eye surgeries in the world.
We attempt to achieve the best vision possible. However, everyone heals differently, and we cannot guarantee perfect vision in 100% of patients. Many of our patients do achieve 20/20 vision, but somewhere between 20/20 and 20/40 is a more realistic expectation. At 20/40 or better you can drive legally without corrective lenses. Most people function extremely well at this correction.
You may or may not still need reading glasses following RLE. Whether or not you need glasses depends on your laser vision correction needs and the type of IOL your doctor recommends for you. When your doctor examines your eyes and recommends a specific IOL, he’ll be able to give you a realistic prognosis.
After reviewing your overall eye health, your surgeon will discuss your options and help you choose the IOL that best fits your individual needs and lifestyle. While no lens implant can re-create the vision of a 20-year-old eye, many patients report being able to read the newspaper, restaurant menus, and food labels without glasses after receiving Custom IOL implants—all in addition to the clearer distance vision.
Because RLE is considered elective surgery, most health insurance plans do not cover it. Affordable monthly payment plans are available and you can learn more about our financing options.