Refractive Lens Exchange – Is It Right For You

45 years old is a special age for visual loss. Our natural lens starts to become less pliable and we lose our ability to accommodate and see up close. This is why we need to either take off our glasses to see close (if you’re nearsighted) or get reading glasses through bifocals or progressive lenses.

If you are affected, you are in luck. There’s a relatively easy solution. To decrease your dependence on glasses and contacts, and see clearly like when you were younger, there is a safe, painless same-day procedure called RLE. 

What is RLE? 

RLE stands for “refractive lens exchange”; the eye’s natural lens is replaced with a custom IOL (intraocular lens). It is a procedure very similar to cataract surgery. The main difference is the lens replaced in cataract surgery is a cloudy and hazy lens to correct blur or light scatter as opposed to a clear crystalline lens in RLE.

RLE treats all ranges of visual errors including nearsightedness (myopia), farsightedness (hyperopia), presbyopia (problems with focusing up close), and astigmatism. Because RLE is nearly identical to cataract surgery, patients after RLE do not need cataract surgery anymore into their senior years.

What are the benefits of RLE? 


• makes you less dependent on glasses and contact lenses, and often glasses-free

• is particularly advantageous for age-related vision problems such as presbyopia (the need for reading glasses), as there are few other options (Lasik cannot correct for presbyopia)

• helps you to have a more active lifestyle with freedom from glasses and contacts

• eliminates the need for cataract surgery in later life

• corrects your vision if you are not a candidate for LASIK because of severe refractive errors or thin corneas or severe dry eyes

Am I suitable for RLE?

The patient’s prescription, corneal curvature and thickness, visual expectations, and age are important factors determining eligibility for RLE.

You are an ideal candidate if you:

• are over 45 years of age with moderate and severe refractive errors; nearsightedness, farsightedness, and/or astigmatism

• have presbyopia (it worsens between 45 years old and 60 years old) and want to reduce your dependency on reading glasses

• over 40 and not a candidate for LASIK; your glasses prescription higher than the normal range for Laser surgery, if you have severe Dry Eye Disease, or if you have thin corneas

• need vision correction and have early cataracts

How is RLE performed? 

RLE is a quick, painless day procedure that typically takes 15 minutes per eye. 

A tiny micro self-healing incision is made at the cornea’s edge (at the limbus) with a precise Femtosecond Laser or micro blades. The natural crystalline lens is removed with a micro ultrasound-based process, also known as phacoemulsification. The new replacement lens (IOL) is folded and inserted through the same incision into the same space (capsular bag) of the crystalline lens. The new lens stays in place permanently where the natural lens used to sit. This procedure is done without any sutures or needles.

What type of replacement lenses, IOLs, are implanted in RLE?

There are several types of IOLs to fulfill the needs and goals of the patient. IOLs available for lens replacement surgery include:

• Multifocal lenses – extended depth of focus to help at near and/or intermediate ranges, may still need reading glasses

• Monovision with monofocal lenses – correct one eye for distance and the other eye for short vision

• Monofocal lenses –provide clear vision at either a distance, intermediate, or near ranges — but not all three at once. Usually, these lenses are used to correct distance vision, however then patients will need to wear glasses for reading, or less often, vice versa

• Toric monofocal lenses – to correct astigmatism, and again it only corrects for one distance

How long does it take to recover from the RLE procedure?

Patients most likely notice better vision within hours to 48h. It may be a few weeks before the vision reaches its maximum improvement. 

How are the results of RLE? 

RLE surgery has had years of successful history. Approximately 95 % of patients are satisfied with the outcomes of RLE, and many describe it as life-changing (1)

In another study, 73% of the patients said the treatment exceeded their expectations. (2)

What are the risks and side effects of the RLE?

Overall, RLE is a safe procedure; the surgery is not different from cataract surgery, which is one of the world’s most common and safest surgeries. 

Like any other surgery, RLE is not a risk and complication-free procedure. However, if there any rare issues are either, they are self-limited or easily treated.

Some of the complications are:

• Dry eye symptoms (temporary)

• Retinal tear or detachment (rare)

• Halos, glare, shadow, or shimmering arc of light caused by the IOL (infrequent)

• Dislocation of the lens position (rare)

• Infection (rare)

• Bleeding inside the eye (rare)

Small targeting refractive errors (uncommon)

Most of the visual problems diminish with time, and patients are satisfied. But approximately 0.5% of patients can not adapt to a multifocal lens and undergo an IOL exchange.

0.1% of cases can end up in severe vision loss. 

Common eye care problems such as glaucoma, diabetic eye, and maculopathies can be easily monitored and treated as usual by your ophthalmologist or optometrist after RLE.

Are you wondering if refractive lens exchange is right for you? 

Please schedule a free virtual consultation from the comfort of your home or free in-person consultation with a specialist in one of our clinics at FVCL. There may be some in-office testing we have to do before any surgery.

RLE surgery at Fraser Valley Cataract and Laser

At FVCL, we pride ourselves on providing our patients with:

• Highly experienced Cataract/ RLE and LASIK surgeons 

• More than 20 years of experience in vision correction

• Leading-edge technology

• Affordability and Financing

Schedule your free consultation now at 

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