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Refractive Lens Exchange (RLE)

At Southern Eye Group, we offer a full range of vision correction procedures to our patients in Alabama, Florida, Mississippi and throughout the Gulf Coast region. One option we offer is refractive lens exchange, which can help patients achieve clearer vision even when they aren’t candidates for laser vision correction procedures like LASIK and PRK.

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What is Refractive Lens Exchange?

Refractive lens exchange (RLE) is sometimes referred to as clear lens exchange or clear lens extraction. This is a refractive surgery procedure that involves removing the eye’s natural lens and replacing it with an artificial intraocular lens (IOL). Refractive lens exchange is identical to the procedure for cataract surgery, except that it is performed on an elective basis to correct refractive errors. Refractive lens exchange is an ideal option for patients who aren’t good candidates for laser vision correction procedures like LASIK and PRK. Especially for patients with presbyopia (age-related near vision loss), refractive lens exchange is beneficial in that it treats vision at a range of distances, unlike LASIK.

What Does Refractive Lens Exchange Treat?

Refractive lens exchange can be used to treat common refractive errors, and we offer a variety of advanced IOL options to help patients achieve freedom from corrective eyewear. A refractive error is a problem with the way the eye bends (refracts) light onto the retina to produce clear images. Common refractive errors treatable with RLE include:

  • Nearsightedness (myopia): In people who are nearsighted, it is difficult to clearly see objects in the distance. At least Trusetd Source Checkbox Trusted Source Myopia (nearsightedness) American Optometric Association Go to Source 30% of the people in the United States are nearsighted.
  • Farsightedness (hyperopia): Hyperopia causes blurred vision when viewing close objects. In addition to blurry near vision, hyperopia can also cause eye strain, headaches, and a sensation of itching or burning Trusetd Source Checkbox Trusted Source Hyperopia (farsightedness) American Optometric Association Go to Source in the eyes.
  • Astigmatism: Astigmatism can affect near and distance vision and may also be accompanied by Trusetd Source Checkbox Trusted Source What is Astigmatism? American Academy of Ophthalmology Go to Source nearsightedness or farsightedness.
  • Presbyopia: Presbyopia is a natural part of the eye’s aging process that begins to affect everybody at around the age of 40. Presbyopia, or age-related near vision loss, is a result of the lens of the eye gradually becoming less flexible, and it makes it difficult to focus for up-close tasks like reading. Refractive lens exchange is an ideal vision correction solution for patients over the age of 40 who have presbyopia and wish to decrease or eliminate their dependence on reading glasses.

Benefits of Refractive Lens Exchange

Benefits of refractive lens exchange eye surgery include:

  • Significantly improved vision in patients with nearsightedness, farsightedness, astigmatism, or presbyopia
  • Reduced or even eliminated need for eyeglasses or contact lenses
  • By replacing the natural lens of the eye, patients who undergo RLE will not develop cataracts in the future

Who is a Candidate for Refractive Lens Exchange?

Patients who are not good candidates for LASIK surgery, PRK, or EVO ICL (implantable collamer lens) can still benefit from vision correction with refractive lens exchange. A good candidate for refractive lens exchange:

  • Is over the age of 40
  • Is not a candidate for other vision correction procedures
  • Has healthy eyes
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Refractive Lens Exchange: What to Expect

Preparing for Refractive Lens Exchange

Attending a consultation with an experienced ophthalmologist is the first step in preparing for refractive lens exchange. During this appointment, you will undergo vision tests and an eye examination and your eye doctor will evaluate your medical history to determine if you are a good candidate for RLE.

Once your eye surgery has been scheduled, a member of our team will give you detailed instructions about preparing for RLE as well as what to expect during the recovery process. Your follow-up appointment with your refractive surgeon will also be scheduled at this time. You won’t be able to drive yourself home after the refractive lens exchange procedure, so you should make arrangements for transportation.

The Refractive Lens Exchange Procedure

The refractive lens exchange procedure is identical to the procedure for cataract surgery. While RLE takes only 10-15 minutes to perform, you should expect to be at our eye care center for a few hours on the day of your refractive surgery.

Before beginning the refractive lens exchange procedure, your eye surgeon will apply anesthetic eye drops to help you stay comfortable. A device will gently hold your eye open so you won’t need to worry about blinking. To begin the surgical procedure, your eye surgeon will make a small incision in the cornea and break up the eye’s natural lens before removing it. This is followed by the implantation of the intraocular lens (IOL).

The corneal incision for refractive lens exchange is so small that no sutures are required: your eye will naturally heal itself. Once the procedure is complete, you will be fitted with a protective eye shield and recover briefly here before being released to be driven home by a friend or family member.

Refractive Lens Exchange Recovery and Results

When you get home after your refractive lens exchange surgical procedure, you will likely want to rest. Please be careful not to touch or rub your eye, and keep the protective shield in place when you sleep for the first day.

You will be sent home with anti-inflammatory and antibiotic eye drops that you’ll use for the first few days after RLE. You may feel some mild discomfort or itching, and this can be managed with over-the-counter medication. You will be able to resume most normal activities after 48 hours.

Your vision may be blurry immediately after refractive lens exchange. This will quickly resolve. You will quickly notice an improvement in your vision, and the full extent of your vision correction will be noticeable within a couple of weeks. Many of our patients are able to significantly reduce their dependence on eyeglasses or contact lenses after RLE, and some can eliminate corrective eyewear entirely.

Frequently Asked Questions About Refractive Lens Exchange

What are the risks of refractive lens exchange?

Refractive lens exchange is considered to be a safe procedure, especially when performed by an experienced ophthalmologist. Risks and complications of refractive lens exchange are the same as with cataract surgery and are rare. They may include:

  • Infection or bleeding
  • Retinal detachment
  • Dislocated IOL
  • Ocular hypertension (decreased pressure in the eye)
  • Ptosis (droopy eyelid)
  • Glare, blurry vision, and halos, especially at night

How much does refractive lens exchange cost?

The cost of refractive lens exchange varies according to the type of intraocular lens implant (IOL) used. Since RLE is an elective procedure, it is not covered by insurance. We offer a number of convenient payment options to help each of our patients achieve their dream of clearer vision.

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Contact Southern Eye Group

If you live in Alabama, Florida, Mississippi or the Gulf Coast region and wish to pursue clearer vision, refractive lens exchange at Southern Eye Group may be ideal for you. To learn more about this procedure, please contact us to schedule a consultation with an ophthalmologist.

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1 American Optometric Association. Myopia (nearsightedness). Available: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia. Accessed June 8, 2022.

2 American Optometric Association. Hyperopia (farsightedness). Available: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/hyperopia. Accessed June 8, 2022.

3 American Academy of Ophthalmology. What is Astigmatism? Available: https://www.aao.org/eye-health/diseases/what-is-astigmatism. Accessed June 8, 2022.

The doctors at Southern Eye Group have either authored or reviewed and approved this content.