Refractive Lens Exchange 2017-07-10T21:36:58+00:00

Refractive Lens Exchange

If you’ve never heard of refractive lens exchange (RLE), you might be missing out on remarkably improved vision without the use of glasses or contacts. The marvels of modern surgical techniques and the advanced technology of multifocal intraocular lenses (IOLs) have made this procedure increasingly popular among patients who could never have dreamed of being free of their glasses or contact lenses.

Refractive lens exchange represents a viable alternative for people with severe refractive errors. RLE is an outpatient procedure usually completed in under 20 minutes. So, who can benefit from refractive lens exchange surgery, and what can you expect during and after the procedure?


Clear lens extraction dates back to the 18th century when Abbé Desmonceaux became the first to perform the surgery in France in 1776 in a patient whose natural lens power was too strong to allow normal vision.

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What is Refractive Lens Exchange?

Refractive lens exchange, also referred to as clear lens exchange or refractive lensectomy, replaces the eye’s clear natural lens with an artificial intraocular lens (IOL) to correct refractive errors, such as blurred vision, difficulty reading, or crossing of the eyes in children.

Remarkably, clear lens extraction dates back to the 18th century, when Abbé Desmonceaux became the first to perform the surgery in France in 1776 in a patient whose natural lens power was too strong to allow normal vision. The procedure became more widespread in Europe in the 19th Century to treat severe near-sightedness but fell out of favor because of complications due to the techniques used during that era.

In particular, refractive lens exchange represents a viable alternative for people with severe refractive errors who are not candidates for laser-assisted in-situ keratomileusis (LASIK), allowing them to attain sharper focus and reduce the need for glasses for both distance vision and near vision.

Not A Candidate for LASIK?

Historically, lens replacement surgery was reserved for cataract patients in order to replace their cloudy lenses with a new, artificial one. But as the surgical techniques and technology have become safer and more sophisticated, more people with glasses and contact lenses are consulting with their eye care specialists to see if clear lens exchange might be the best way to correct their refractive errors.

Patients with abnormal corneas or significant myopia (nearsightedness), hyperopia (farsightedness) or astigmatism (asymmetric curvature of the cornea) are not good candidates for laser surgery (LASIK or PRK).

What About Near Vision?

Most people may not be aware that laser vision correction surgery such as LASIK only corrects distance vision and so does not address the issue of presbyopia.Presbyopia is a condition that affects most people but tends to become noticeable after the age of 40 and is associated with the lens of the eye becoming more rigid and less flexible, leading to a diminished ability to focus on objects nearby.

Until recently presbyopia could only be treated with monovision or reading glasses, with other refractive surgical techniques unable to directly address the loss of near vision. But refractive lens exchange is now allowing presbyopia sufferers to see the world much more clearly. And among patients having both presbyopia and significant hyperopia, clear lens exchange may be the sole surgical option for achieving clear vision.

Refractive Lens Exchange: A Treatment For Early Cataracts

Middle-aged or older individuals may start developing cataracts that could progressively deteriorate and require cataract surgery.

Symptoms of early or mild cataracts include:

  • Mild blurring
  • More pale vision in one eye, compared to the other
  • Poor night vision
  • Glare or halos around lights

If you experience the early signs of cataracts, clear lens exchange surgery could prove a viable option; instead of allowing cataracts to evolve to where they cause significant loss of vision and need to be removed, RLE can circumvent the process to restore vision right away.

Refractive Lens Exchange: The Procedure

RLE is an outpatient procedure that is usually completed in under 20 minutes. Each eye is done one at a time, with the surgeries spaced out over a week or two. Numbing anesthetic drops are employed before the procedure, so typically patients feel no discomfort. Recovery times are minimal: most people can return to work, resume driving and take up their normal activities within a week after surgery.

Results of Refractive Lens Exchange

It can take up to several weeks to observe the full benefits of refractive lens exchange. You may experience visual disturbances like blurred vision, halos, or scratchy sensations while your eyes heal. However, the majority of patients experience an immediate, rapid and progressive vision improvement after surgery.

The artificial intraocular lens (IOL) will actually be integrated into your eye (not on the surface of the eye like a contact lens) so it’s not visible to others. The artificial intraocular lens is a permanent replacement for your natural crystalline lens and is made to last the rest of your life, and the long-term risk of visual regression is minimal.

If you have any questions about the procedure or whether refractive lens exchange surgery is right for you, your eye care professional can help you make the right decision.

Consult an Ophthalmologist

Ocala Eye’s fellowship-trained ophthalmologists and medical staff are dedicated to helping your vision last a lifetime, which is why we offer comprehensive eye care for adults of all ages. From annual eye exams to advanced procedures like LASIK and cataract surgery, we can help you see your best at any phase of your life.

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