Refractive lens exchange (RLE) is a type of vision correction surgery in which the eye's natural lens is removed and replaced with an artificial intraocular lens (IOL). Alternative names occasionally used for RLE are clear lens exchange, clear lens extraction or CLE. This is not a type of corneal implant, inlay or phakic IOL.
Refractive lens exchange is essentially the same surgical procedure as cataract surgery, which is performed on approximately three million Americans each year. But in RLE, the eye's natural lens is not clouded—the clear lens is removed and replaced with an IOL simply to change the focusing power of the eye. Refractive lens exchange can reduce or eliminate large amounts of nearsightedness, farsightedness and astigmatism, therefore may be a better surgical solution than LASIK for high prescriptions, presbyopia or early cataract formation which is not significant.
While lens replacement surgery technically does not have FDA approval, many eye surgeons will perform the procedure off label in certain circumstances. This is legal and sometimes is the most effective way to correct particular vision problems.
Refractive lens exchange typically is for people with presbyopia or extreme farsightedness, for whom LASIK, PRK or phakic IOL surgery generally are not suitable. If you have both presbyopia and moderate to severe hyperopia, RLE may be the only viable option for clear vision and minimal reliance on glasses after refractive surgery.
Refractive lens exchange is an internal eye procedure with the potential for different risks and complications than laser vision correction surgery, RLE is generally reserved for people who are not good candidates for LASIK, PRK or other laser procedures or who have high amounts of nearsightedness, farsightedness, or astigmatism that are beyond the accepted treatment range for laser surgery.
The same refractive intraocular lenses used for cataract surgery can be used for RLE, including accommodating IOLs and multifocal IOLs to correct presbyopia as well as refractive errors.
Advantages of RLE
RLE can effectively correct high amounts of nearsightedness and farsightedness that may not be adequately corrected by LASIK. It also is a viable alternative to LASIK for eyes with corneas that may be too thin for laser vision correction.
Other advantages of RLE include:
RLE Risks and Complications
The risks and potential complications of Refractive Lens Exchange are virtually the same as those for cataract surgery. If you are considering RLE, you must be willing to accept these risks, which can occur even when RLE is performed flawlessly by a skilled and experienced refractive surgeon or cataract surgeon.
RLE risks and potential complications include:
RLE Candidates
Candidates for RLE should meet these criteria:
Refractive Lens Exchange Cost
Refractive lens exchange costs significantly more than LASIK, PRK or other laser vision correction procedures. Vision insurance typically does not cover any of the cost. Expect total surgical fees for RLE to be approximately twice that of LASIK.
You can lower your surgical costs for refractive lens exchange by setting up a Health Savings Account (HSA) at your bank or contributing to flexible health benefits program at work. Financing programs that allow you to pay for the procedure over time at an attractive interest rate or interest-free over a limited time frame are also available.
While lens replacement surgery technically does not have FDA approval, many eye surgeons will perform the procedure off label in certain circumstances. This is legal and sometimes is the most effective way to correct particular vision problems.
Refractive lens exchange typically is for people with presbyopia or extreme farsightedness, for whom LASIK, PRK or phakic IOL surgery generally are not suitable. If you have both presbyopia and moderate to severe hyperopia, RLE may be the only viable option for clear vision and minimal reliance on glasses after refractive surgery.
Refractive lens exchange is an internal eye procedure with the potential for different risks and complications than laser vision correction surgery, RLE is generally reserved for people who are not good candidates for LASIK, PRK or other laser procedures or who have high amounts of nearsightedness, farsightedness, or astigmatism that are beyond the accepted treatment range for laser surgery.
The same refractive intraocular lenses used for cataract surgery can be used for RLE, including accommodating IOLs and multifocal IOLs to correct presbyopia as well as refractive errors.
Advantages of RLE
RLE can effectively correct high amounts of nearsightedness and farsightedness that may not be adequately corrected by LASIK. It also is a viable alternative to LASIK for eyes with corneas that may be too thin for laser vision correction.
Other advantages of RLE include:
- Rapid visual recovery
- The normal shape and thickness of the cornea remains unchanged
- The need for cataract surgery in the future is eliminated
- It provides stable vision with no risk of regression (loss of corrective effect)
- With multifocal or accommodative IOLs, can correct presbyopia and reduce the need for reading glasses
- It enables people with mild cataracts to have refractive surgery.
RLE Risks and Complications
The risks and potential complications of Refractive Lens Exchange are virtually the same as those for cataract surgery. If you are considering RLE, you must be willing to accept these risks, which can occur even when RLE is performed flawlessly by a skilled and experienced refractive surgeon or cataract surgeon.
RLE risks and potential complications include:
- Retinal detachment
- Glaucoma
- Posterior capsular occlusion (PCO, or "secondary cataract")
- Infection
- Dislocation of the IOL
- Overcorrection or undercorrection
- Bleeding inside the eye
RLE Candidates
Candidates for RLE should meet these criteria:
- At least 21 years of age
- Stable vision (no change in eyeglasses prescription for at least six months)
- Healthy eyes with no history of eye disease
- Be willing to accept the risks associated with RLE
Refractive Lens Exchange Cost
Refractive lens exchange costs significantly more than LASIK, PRK or other laser vision correction procedures. Vision insurance typically does not cover any of the cost. Expect total surgical fees for RLE to be approximately twice that of LASIK.
You can lower your surgical costs for refractive lens exchange by setting up a Health Savings Account (HSA) at your bank or contributing to flexible health benefits program at work. Financing programs that allow you to pay for the procedure over time at an attractive interest rate or interest-free over a limited time frame are also available.