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RLE Refractive Lens Exchange

People over 40 years old gradually lose the ability to change focus from distance to near. This condition is called Presbyopia and comes from a loss of flexibility of the lens inside the eye, as well as other age-related changes. This is a gradual change throughout life but not usually noticeable until the mid-forties. Although we may call this reading vision. It is the vision we use for eating, putting on makeup, or reading a watch or computer.

This condition is not even correctable by laser vision correction but fortunately, a surgical option called Refractive Lens Exchange (RLE) can correct this issue. RLE is a surgical procedure that give patients a clear alternative to reading glasses and is capable of reducing or eliminating presbyopia by using an advanced multifocal intraocular lens implant. These lenses can provide clearer vision for patients suffering from nearsightedness, farsightedness, astigmatism, or presbyopia.

What is RLE?

Refractive Lens Exchange (RLE) is a refractive surgery procedure in which the crystalline lens of the eyes is removed and replaced with an artificial lens implant to correct refractive error. RLE surgery is essentially the same as cataract surgery. However, in RLE, the procedure is performed primarily to change the refractive properties of the eye rather than remove a cataract that has developed in the lens of the eye.

LASIK surgery accomplishes good vision by changing the shape of the cornea. However, RLE corrects vision by removing the natural lens in the eye and replacing it with a new artificial lens of a different focusing power that can provide good distance vision, good reading vision or both.



Types of IOLS

Types of IOLS

RLE is the same process as modern cataract surgery. In the first part of the procedure, using ultrasound, the surgeon removes the patient’s natural lens, leaving the capsule of the lens behind, Then, a prescription intraocular lens (IOL) is inserted into the capsule of the lens.

There are variety of intraocular lens available for implantation to help you enjoy improved vision. Before RLE surgery, your eyes are measured to determine your IOL prescription. We will them decide and recommend which IOL type is best for you.

Multifocal IOLs : These lenses have a variety of regions with different power that  allows some individuals to see at variety of distance, including distance, intermediate and near. Multifocal Lens cannot correct astigmatism and some patient still require spectacles for clear vision.

Multifocal Toric IOLs : If you have astigmatism, your surgeon may recommend a Toric IOL which helps restore nearsightedness or farsightedness in addition to astigmatism simultaneously.

The Benefit of Refractive Lens Exchange (RLE)

  • Enhanced vision in both eyes at all distances
  • Greatly decreased dependency on corrective lenses
  • Quick recovery
  • Elimination of the risk of cataracts Good Candidate for Refractive Lens Exchange (RLE) 

You could be Good Candidate for Refractive Lens Exchange (RLE) if :

  • You have presbyopia (loss of reading vision)
  • You are too nearsighted or farsighted for LASIK or PRK
  • Your corneas are too thin for safe LASIK or PRK
  • You have on other eye problems
  • You wish to eliminate your dependence on glass or contact while also showing early sighs of cataracts.

With advancements in technology happening at a rapid pace, the options for refractive vision correction have increased dramatically during the last few years. We are proud that LASER VISION physicians have been at forefront of many of these developments.

If your vision is affected by nearsightedness, farsightedness, astigmatism, or presbyopia, you can trust the physicians at LASER VISION to help you choose the right solution to achieve your vision goals.

Preoperative RLE Preparation

Diagnose any refractive error you have and measure both the curvature of your cornea and the length of your eye to help determine the type and power of lens you will need. Examine the external parts of the eye, such as the eyelids, cornea, pupil and lens. Place drops in your eye to dilate your pupils, so the doctor can look closely at the back of your eye. If you have had laser vision correction before, the doctor may conduct additional tests and may ask you to obtain your pre- and post-operative LASIK data for reference, if possible.

Your ophthalmologist will also ask for a full health history, including what medications you are currently taking and what medications you have taken in the past. Certain health conditions, including diabetes, diabetic retinopathy, autoimmune diseases, glaucoma, corneal disease and age-related macular degeneration may need special discussion. Some of these may hasten or delay when you’ll need to have cataract surgery and may make you more prone to some complications.

The preoperative examination includes

  • If you are a contact lens wearer, they should be removed at least 3 days for soft contact lens and at least 7 days for
  • hard, semi hard or rigid gas permeable lens prior to the appointment date.
  • Due to the blurry vision that results after the dilatation of the pupil, it is recommended that the patient be accompanied by a relative or close friend. Dilation causes the eyes to become extremely light sensitive and the patient might not be able to drive a vehicle after dilating the pupil.
  •  Bring all your current medications on the appointment. The doctor may recommend that you stop taking certain medications at least a few days prior to the operation. But it may be fine to continue other important medications.
  • Bring sunglasses is recommended.
  • It will take 2-3 hours for the complete eye examination.

Postoperative Care for the first day after the operation

  • In some cases, you may feel mild pain and the doctor may suggest you to take a mild pain reliever.
  • Take antibiotics as prescribed.
  •  Do not remove the bandage for the whole day until the next day of your check up.
  • Your eye may be sensitive to the touch and may be even scratchy for a few days.Be sure to avoid rubbing.
  • Get rest and try to keep the treated eye closed. We advise against watching TV or reading, since these activities will only irritate your treated eye.
  •  Do not carry any heavy stuff.
  • Consume light meals.

Postoperative Care for the first 2 weeks after the operation

There are a few precautions you need to know. For the first 2 weeks after cataract surgery, please follow these guidelines.


  • Do not rub or put pressure on the eye.
  • Avoid getting water and dust into your eye and do not rub your eye.
  • Avoid any smoky and dusty environments to prevent eye irritation.
  • Avoid sleeping on the side that has been operated on.
  • Do not bend your head down.
  • Avoid any eye make up. This includes mascara, eye shadow, eye liner, or any other type of makeup around the eyes. Lotions and lipsticks are allowed to be worn.
  • Avoid getting your hair into your eyes.
  • Avoid straining your eyes, especially at the time of constipation.
  • Avoid doing strenuous activity, especially bending and lifting heavy things.
  • Do not cough or vomit forcefully. Take some pills to control, if needed.


  • Wash your hands thoroughly before apply any eye drop and be careful with your treated eye.
  • Instill the medications as prescribed.
  • Cover your eye with the eyeshield nightly to prevent accidental contact.
  • Consume light meal or food that can be easily digested.
  • Resume light activities like reading, writing, watching TV and walking.
  • Wear sunglasses outside at all times to alleviate eye irritation.
  • Please come to check your eye as scheduled.

Post operative Check up

Every patient is asked to return one day after the surgery for your first follow-up visit, then one week after the surgery, one month, three months, and then one year. However as many eye and vision problems have no obvious signs or symptoms, therefore we recommend to have a yearly eye check up for maintaining your good vision and healthy eye always.