Refractive lens exchange
What is refractive lens exchange (RLE)?
Refractive lens exchange (RLE) is surgery which is performed for people who wish to be less dependent on glasses or contact lenses. Whereas laser eye surgery is more commonly performed in those under the age of 50, refractive lens exchange is more commonly performed in those over the age of 50.
Everyone has a lens in their eye which is located behind our pupil. During refractive lens exchange surgery, this natural lens is removed and replaced with an artificial lens which improves vision.
Using a very small incision (approximately 2mm), your lens is broken up into small fragments and flushed out of the eye using fine instruments and special fluids.
A clear artificial lens made of a plastic-like material, is placed inside the eye.
The eye’s natural lens sits in a bag. The back part of this bag remains after lens replacement surgery and holds the artificial lens in place.
Everyone has a lens in their eye which is located behind our pupil. During refractive lens exchange surgery, this natural lens is removed and replaced with an artificial lens which improves vision.
Using a very small incision (approximately 2mm), your lens is broken up into small fragments and flushed out of the eye using fine instruments and special fluids.
A clear artificial lens made of a plastic-like material, is placed inside the eye.
The eye’s natural lens sits in a bag. The back part of this bag remains after lens replacement surgery and holds the artificial lens in place.
What lens implants are available?
Option 1: Multifocal lens implants.
Multifocal intraocular lenses provide excellent vision for objects at all distances. They provide excellent distance vision (driving, watching TV), intermediate vision (eg working with computers) and near vision (eg reading tablets, phones, books). They are the lens type which are most likely to result in spectacle independence. In some people multifocal lenses can result in haloes around lights which are most commonly noticed when driving at night. Usually these are very mild. However, in around 1 in 100 cases, haloes can be very troubling to the point where these lenses need to be removed and exchanged with a different type of lens.
Option 2: Extended depth of focus (EDOF) lens implants.
EDOF lenses provide not only excellent distance vision without glasses (eg driving, watching TV), they also provide excellent intermediate distance vision (eg working with computers). EDOF lenses also provide some degree of near vision (e.g. reading tablets, phones, books), although glasses are still required to read small print, particularly under low light conditions.Although the near vision provided by EDOF lenses is not quite as good as that provided by multifocal lenses, it is very rare for haloes to be noticed by patients.
Option 3: "Blended vision" or "monovision."
“Blended vision” or “monovision” refers to one eye seeing distance and the other seeing near. If you have previously had success with “monovision” or “blended vision” with contact lenses, then this setup can be replicated with lens replacement surgery. Artificial lens implants are inserted which result in one eye being focused for distance and the other eye being focused for near. If you have not experienced blended vision or monovision, multifocal lenses or extended depth of focus lenses are better options for you.
What will I experience during the operation?
Your Anaesthetist will apply local anaesthetic to your eye (usually drops but in some cases an anaesthetic injection around the eye may be required) so you don’t feel pain during the operation.
You will be given medication to relax you (sedation). The sedation will relax you but it is important you are still awake so that you can follow instructions during the surgery. This is very important for the safety of your operation.
You will be given medication to relax you (sedation). The sedation will relax you but it is important you are still awake so that you can follow instructions during the surgery. This is very important for the safety of your operation.
