Refractive Lens Exchange

Refractive lens exchange, also called “clear lens extraction”, may be a better option than LASIK or Implantable Contact Lenses refractive surgery for people with presbyopia and high hyperopia (farsightedness).

Refractive lens exchange (RLE) replaces your eye’s clear natural lens with an artificial intraocular lens (IOL) to correct your refractive error and achieve sharper focus, reducing your need for reading glasses, bifocals or multi-focals.

The procedure for RLE is virtually identical to cataract surgery. The difference is that in RLE, the lens being replaced is clear, rather than a cloudy lens due to a cataract. . There are no stitches or patches required during the surgery. Recovery is about 48 hours off work and a week of strenuous exercise.

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

  • Monofocal fixed-focus IOLs. Monofocal lenses provide clear vision at distance, intermediate or near ranges — but not all three at once. Toric IOLs to correct astigmatism also are classified as monofocal IOLs.
  • Multifocal IOLs. A multifocal lens provides clear vision at distance, intermediate and near simultaneously. They can also be used to correct astigmatism.

With RLE, there is no “one size fits all”, and Dr Apel will recommend an IOL that is most suitable for your individual needs.

RLE usually takes about 15 minutes and is performed on an inpatient day procedure basis. Each eye is done separately.

Numbing anaesthetic drops and twilight anaesthesia are used during RLE, so typically there is no discomfort, and most people report immediate vision improvement after surgery. Full vision recovery takes about 48 hours once the pupils have returned to a normal size again.

Final outcomes of RLE can take up to several weeks, and you may notice vision disturbances such as blurry vision, halos and glare, or a “scratchy” sensation as your eyes heal.

You should be able to return to work and resume driving within a week of surgery, dependent on Dr Apel’s instructions.

Normally, you won’t feel an IOL in your eye, in the same way that you don’t feel a dental filling for a cavity.

Also, since the IOL is situated inside your eye and not on the surface like a contact lens, it is not visible to the naked eye.

The artificial IOL is a permanent replacement for your natural lens and is designed to last the rest of your life.

And, because IOLs are not affected by age-related changes, there is minimal risk of regression (loss of corrective effect or deterioration of vision) over time.