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Refractive Lens Exchange (RLE)

Lose your reading glasses and avoid cataract surgery with RLE

Refractive lens exchange (RLE) is a popular LASIK and early cataract surgery alternative for patients over the age of 45 who are noticing the effects of the common, age-related condition vision loss due to Dysfunctional Lens Syndrome (DLS).  DLS is the natural aging of the eye’s inner lens, causing a decrease in visual clarity and difficulty reading up close.

DLS describes the changes to the eye’s lens over time, as the lens begins to grow rigid, making it hard to focus on things up close (presbyopia), and begins to lose clarity, growing cloudy over time and leading to the development/diagnosis of cataracts usually after the age of 65.

Unfortunately, it’s no secret that as we age so do our eyes.  For the reasons explained above,  changes in close up vision typically occur around the age of 45 .  And of course for nearly everyone as we approach our senior years we experience the formation of cataracts.  At OCCR, we are able to offer an advanced technology procedure called Refractive Lens Exchange (RLE).  This procedure not only corrects the “over 45” vision changes but eliminates the formation of cataracts.

With RLE, the natural lens is removed and exchanged by way of the latest and most sophisticated version of laser-assisted, bladeless, incisionless refractive surgery. This procedure which is surgically performed exactly the same way as cataract surgery corrects and restores vision and eliminates the worry of cataracts developing in the future.  Through the use of advanced technology IOLs (Interocular Lenses) such as the Alcon Panoptyx trifocal lens,  RLE can offer patients a new reality of no more glasses, no future cataracts, and no more missing out on life’s beautiful moments.

During the RLE procedure, the aging lens of the eye is replaced with a new lens that gives patients the ability to see up close and far away with both eyes. RLE is a permanent solution to the vision problems associated with aging because the lens that ages in the eye is no longer present. This prevents the vision loss associated with cataract development and means you will no longer require cataract surgery later in life. As long as the eye remains healthy, long-term visual freedom can be expected.

About the Procedure

The procedure for refractive lens exchange is virtually identical to cataract surgery, the difference being that in RLE, the lens being replaced is clear rather than a cloudy lens due to a cataract.

The procedure itself takes about 10 minutes and is performed with local anesthesia to the eye so you won’t feel or see anything during the surgery. A mild sedative is also given to help you relax.

A small opening is made in the front of the eye (the cornea) to allow for the smooth removal of the lens material. An artificial Intraocular Lens (IOL) implant made of silicone or plastic is folded into itself and then inserted into a small incision made in the eye. After insertion, the lens opens and is placed in the proper position.

As in cataract surgery, multiple types of IOLs are available to replace your natural lens, depending on your vision needs and the health of your eyes:

  • A monofocal fixed-focus IOL provides clear vision at a single distance, either close up (near vision) or far away (distant vision).
  • multifocal IOL has several rings of different powers built into the lens. The part of the lens (ring) you look through will determine if you see clearly at a far, near, or intermediate distance.
  • An accommodative IOL is designed to work in coordination with the eye muscles. The design allows the accommodative lens to move forward as the eye focuses on near objects and move backward as it focuses on distant objects.
  • Toric IOLs are designed to correct both vision issues like presbyopia and astigmatism.

With intraocular lenses, there is no “one size fits all,” and your ophthalmologist will recommend an IOL that is right for you.

Lose your reading glasses and avoid cataract surgery with RLE


After the procedure, you’ll be given protective eyewear to keep on for the first 5 hours after surgery. The anesthesia will also be wearing off during this time, so taking a nap is recommended once you get home. You’ll need to have someone drive you home from the procedure as your vision will be hazy. You’ll be given post-operative instructions to follow, including the use of eye drops.

Most patients see clearly the day after surgery, with little or no discomfort. However, symptoms you may experience include mild pain in or around the eye, itchy and/ or gummy eye, blurred vision, feeling of grittiness in the eye, slight headache, bruising around the eye, and sensitivity and/or halos when looking at bright lights. These are normal symptoms that usually diminish within a few days.


RLE not only corrects presbyopia, allowing patients to see both far away and up close, but because it completely replaces the eye’s natural lens which can develop cataracts later in life, there is no need to worry about having to undergo cataract surgery down the road.

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