Refractive Lens Exchange or RLE is a common refractive procedure designed to improve vision without glasses or contact lenses. It is typically offered to people who are not candidates for LASIK or ICL based on age or extent of refractive error.
The procedure for a refractive lens exchange is a 10-15 minute eye surgery where the natural lens of the eye is removed and then replaced with a plastic artificial lens or IOL. The power of the new lens can be chosen to restore clear vision without the need for glasses or contact lenses. RLE uses the same technology as cataract surgery, a safe and effective eye surgery performed over 4,000,000 times each year in the United States.
Caption: Refractive Lens Exchange removes the natural lens inside the eye and replaces it with a thin plastic lens. The new lens is chosen to correct the vision without glasses or contact lenses.
Age greater than 50
People over 50 generally are not good candidates for LASIK or ICL surgery. The reason is due to aging changes that develop in the human eye. In the 50’s the eye begins to lose the natural focusing mechanism, and many people start to need reading glasses. Cataract also begins to develop in the 60’s and 70’s which leads to changes in the vision and the strength of glasses or contact lenses. With these changes LASIK or ICL are not very helpful. Once these changes start to develop, the best refractive procedure is to remove the aging lens and replace it with an IOL that fully corrects the vision.
LASIK can treat hyperopia (known as farsightedness) but these treatments are not long lasting and are limited to lower amounts of hyperopia. ICL is not available to treat hyperopia in the US. Therefore, people with hyperopia of more than +3.00 diopters are great candidates for a refractive lens exchange procedure. The new IOL placed in the eye can be tuned to focus the light accurately and restore the vision without glasses or contact lenses. RLE is best for people over 50, but some people with high hyperopia (+4.00 or more) can consider the procedure at a younger age.
LASIK and ICL can both treat myopia and are usually the best procedures for young people. Once a person is older than 50, LASIK and ICL are not as beneficial and RLE becomes the recommended treatment.
RLE is a safe and proven procedure. Rare risks include infection, retinal detachment, significant swelling in the cornea or retina, or IOL power problems. Most of these issues can be improved with treatment. Severe or permanent vision loss with RLE would be very rare, less than 1-in-1,000. Retinal detachment is more common in people who are very nearsighted (-6.00 and higher).