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Refractive Lens Exchange (RLE) Surgery


Most common vision correction methods:

The most common vision correction procedure today, is LASIK which can correct spectacle prescriptions of Myopia (up to -8D), Hyperopia (up to +5D) and Astigmatism (up to 4D) by reshaping the corneal tissues with the help of lasers.

If you're not found eligible for LASIK, the next preferred procedure is Implantation of ICLs which involves implanting an ultra-thin artificial phakic IOL lens just above the natural lens of the eye.

ICL can correct spectacle prescriptions of Myopia (up to -18D), Hyperopia ( up to +10D) and Astigmatism (up to 6D).  It is also recommended for patients with a thin cornea or eye dryness problem.

As we can see, LASIK and ICL can correct a wide range of spectacle power, therefore, these procedures are applicable for the majority of patients aspiring to get rid of their glasses.

Yet, there are a few eye conditions in which neither LASIK nor ICL procedures are suitable, that's when the RLE procedure comes in the picture. 



What is Refractive Lens Exchange (RLE)?


RLE stands for Refractive Lens Exchange, also called Lens Replacement Surgery or Clear Lens Extraction.
RLE replaces your eye’s clear natural lens with an artificial intraocular lens (IOL). 


Who is suitable for RLE?

This procedure is typically reserved for patients who experience a change in their vision due to the natural aging of the eye (Presbyopia). 


Presbyopia is a naturally occurring age-related condition where your eye's natural lens becomes more firm and inflexible, and you lose the ability to focus on near objects.

Presbyopia affects just about everyone and becomes noticeable sometime after age 40 in most cases.


Refractive surgery such as LASIK or ICL cannot directly address the presbyopia-induced loss of near vision. Therefore, RLE is considered as a viable option for correcting the Presbyopia.

RLE is also preferred for high hyperopic power (farsightedness) and for whom LASIK and ICL surgery generally are not suitable.


Is RLE and Cataract Surgery the same?

RLE surgery is identical to cataract surgery; Both operations involve replacing the natural lens with an IOL. 

The differences are:

  • RLE replaces a clear lens rather than a lens that has become cloudy due to a cataract. 

  • RLE is performed to reduce the need for glasses or contact lenses; whereas Cataract surgery is performed mainly to correct blur or light scatter caused by a misty natural lens due to cataract


As in cataract surgery, the types of artificial lenses available with lens replacement surgery are the same and depend on the health of your eyes.


There are two main IOL types: 

• Monofocal IOLs – Monofocal IOLs aim to reduce spectacle dependence for distance (driving) vision 

• Multifocal IOLs – multifocal IOLs aim to reduce spectacle dependence for a wider range of activities, including intermediate (computer screens) and near (reading) vision If you are suitable for RLE, your surgeon will discuss which IOL type is the best option for you



RLE Highlights


Corrective Uses:

  • Presbyopia

  • Moderate/severe hyperopia

  • Early Cataracts



It takes about 20-30 minutes per eye.

Just like cataract surgery, only one eye is operated at a time during the RLE procedure. The other eye can be operated after 3-4 weeks.



It takes 2-7 days to resume normal activities and up to 6-12 weeks for a complete adjustment.



Just like Cataract surgery, factors affecting the cost include the type of IOL used and the type of surgical operation opted. 




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