What Is A Refractive Lens Exchange?

Do you not qualify for LASIK or suffer from presbyopia? You may be a good candidate for a procedure called a refractive lens exchange. Keep reading to learn more and to see if it may be suited for you!

What is a refractive lens exchange?

Also known as lens replacement surgery, a refractive lens exchange is a procedure that’s almost identical to cataract surgery. The only difference?


During a refractive lens exchange, a clouded lens is not usually being replaced. Instead, during RLE, the lens replaced is likely still clear. After removing the clear natural lens, it is then replaced with an artificial lens, known as an intraocular lens.

For some patients, RLE is a procedure they undergo so they don’t have to deal with having cataracts later on in life. For others, it may be something that they have because they suffer from presbyopia.

Presbyopia occurs when the lens starts to lose its flexibility as a result of aging. When the lens is less flexible, it becomes much harder to focus on seeing objects that are up-close. This is something that affects almost everyone.

RLE is also good for those that don’t qualify for LASIK

Although LASIK is a life-changing procedure, that doesn’t mean that it’s right for everyone. For people that suffer from severe nearsightedness, LASIK may not be an option.

LASIK can only correct up to -11.00 diopters of nearsightedness. If your prescription is stronger, you’ll be told that LASIK is not a good fit.

For patients that still want to achieve clearer vision while relying less on glasses after having a refractive procedure, a refractive lens exchange may be the only way.

How do you choose the right IOL to replace your natural lens?

Patients commonly wonder how to choose the right IOL, whether they have cataract surgery or they undergo a refractive lens exchange. The first thing you should take into consideration when making this decision are your lifestyle needs.

intra ocular lens for refractive lens exchange

One kind of IOL is a monofocal IOL. With a monofocal IOL, you’ll have fixed focus at only one distance. That means you’ll need to use glasses to see either distance, intermediate, or up-close vision to compensate.

If you don’t mind continuing to wear glasses after having a refractive lens exchange, choosing monofocal IOLs may be the best option. But if you know that you would prefer not to wear glasses after your refractive lens exchange, you’d probably be happier with a premium IOL instead.

You may want to look at multifocal IOLs, which provide you with clear vision at multiple distances. If you spend a lot of time in front of computers or on your phone, this may be your best option.

Another premium lens option to consider are accommodating IOLs. These IOLs enable focus at several distances by shifting their position in the eye.

What can I expect when I have a refractive lens exchange?

It’s natural to be nervous before you have any kind of surgical procedure, but a refractive lens exchange is nothing to be afraid of! The procedure only takes about 15 minutes to complete.

Like cataract surgery, you’ll only have one eye done at a time. When you have a refractive lens exchange, the wait time is usually about a week apart.

This is to promote healing before performing the procedure on your second eye. Before the procedure begins, you’ll receive anesthetic numbing eye drops.

This will ensure that you won’t feel any pain during the refractive lens exchange. After the procedure is over, you’ll need to have someone drive you home.

husband and wife sitting on the beach

Once you get home, the best thing you can do is rest and relax. This will start your recovery off on the best possible foot.

Most patients start seeing visual improvements after RLE in as little as a week. Don’t be surprised if you see halos, glare, experience blurred vision, or have mild discomfort.

These are all normal side effects and are part of the healing and recovery process.

What are the risks of having a refractive lens exchange?

Although rare, there are risks and complications that can occur when you have a refractive lens exchange. Some risks include:

  • Your IOL dislocating
  • Glaucoma
  • Infection
  • Experiencing a retinal detachment
  • Over-correction
  • Undercorrection
  • Bleeding
  • A secondary cataract forms

If you suspect that something could be wrong after your refractive lens exchange, be sure to tell your eye doctor immediately! It’s much easier to treat a complication if it’s caught early on.

Can I have cataracts after having a refractive lens exchange?

No. One of the biggest advantages of having a refractive lens exchange is that you can have your natural lens removed and replaced before you have cataracts.

Because the natural lens is completely removed, you will never have to have cataracts or deal with the frustrating symptoms that come with having them. This is one of the things that can make a refractive lens exchange so desirable to patients considering having them.

Is a refractive lens exchange procedure permanent?

Yes, RLE is meant to be a permanent procedure. As the natural lens of the eye is completely removed and replaced with an artificial lens, it is permanent.

If you start to have symptoms that resemble a cataract, you could have a procedure called a YAG laser capsulotomy. During this procedure, your doctor uses a laser to create tiny holes in the membrane that holds your artificial lens in place.

Before a YAG laser capsulotomy, your vision may be blurry or cloudy. But after, you’ll be able to see clearly again!

Wondering if a refractive lens exchange could be right for you? Schedule an appointment at New England Eye Center in Boston, MA to discuss your vision correction options! If you don’t qualify for LASIK but you still want clear vision, RLE may be your best solution!

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