Refractive Lens Exchange

Refractive Lens Exchange, or RLE, is an outpatient procedure whose goal is to change the way in which the eye focuses light rays on the retina. It is a non-laser procedure in which the natural lens of the eye is removed and replaced with an artificial intraocular lens, or IOL. Refractive lens exchange, also referred to as clear lensectomy, or as clear lens extraction, is actually the same surgical procedure as a cataract operation, except that the patient does not have a visually significant cataract, but instead is having the operation to alter the optical power of the eye. Refractive lens exchange is often recommended for a patient who is not a good candidate for LASIK or other laser vision correction procedures, or for a patient with a very large refractive error. The goal is to greatly reduce or completely eliminate the refractive lens exchange patient’s need for glasses or contact lenses.

Another consideration for refractive patients over the age of 40 is that as we age, the natural lens inside the eye begins to harden and lose its flexibility. As a result, the eye begins to gradually loose the ability to change focus, or “accommodate”, to see objects clearly at different distances. This condition, known as presbyopia, is especially obvious when trying to read small print. Presbyopia is a problem of the lens inside the eye, not of the shape of the cornea, on the surface of the eye. For this reason, for some patients who are presbyopic, refractive lens exchange with a multifocal or accommodating IOL may be offered as a choice to be considered along with laser vision correction procedures.

Dr. Violin performs refractive lens exchange at The Cataract and Laser Center, his state of the art surgical facility located in Dedham, Massachusetts. The procedure is performed on an outpatient basis under local or topical anesthesia, with light sedation. The entire procedure takes approximately 15-20 minutes.

Refractive lens exchange may be recommended for patients with high refractive errors, patients who are not candidates for corneal refractive procedures, patients with cataracts just beginning to form, or patients who are presbyopic or about to become presbyopic, are unable to tolerate monovision, and desire freedom from glasses at both distance and near.