Refractive Lens Exchange

What is a refractive lens exchange (RLE)?

In a refractive lens exchange (RLE), your natural lens is removed in a technique very similar to cataract surgery and is replaced with an artificial lens to achieve a desired visual outcome, which is usually to free you of your distance and/or reading glasses.

When the operation is performed to remove a clear lens rather than a cloudy lens (i.e. a cataract) for the purpose of reducing your dependence on glasses, the procedure is referred to as a refractive lens exchange.

Who is suitable for a RLE?

RLE is usually recommended for patients over the age of 45 who:

  • Want freedom glasses and contact lenses but are either unsuitable or have a spectacle prescription that is too high for laser eye surgery.
  • Want freedom reading glasses.

RLE is able to treat a wide range of prescriptions for people with short-sightedness (myopia), long-sightedness (hyperopia) and astigmatism.

What type of replacement lens will I have after a RLE?

Dr Goh uses a range of premium intraocular lenses to provide you with the best option for your lifestyle and visual requirements. At your consultation, the health of your eyes will be fully assessed, and a recommendation will be made, tailored to your specific needs and personal preferences.

Spectacle independence after RLE can be achieved either by targeting monovision or using a multifocal lens that will enable you see well for distance and near.

How is a RLE performed?

RLE is performed as a day procedure similar to cataract surgery. Before the procedure, you will be given a light sedative to make you feel calm and relaxed. Anaesthetic eye drops will be used numb your eye.

A very small opening, less than 2.5mm wide, is created to access the lens. A circular opening in the front of the lens, known as a capsulorrhexis, is made in the capsular bag, which is a thin membrane that surrounds the lens. For further enhanced precision, you may elect to have the first three critical steps of the surgery performed with a femtosecond laser. Dr Goh uses the advanced LenSx® femtosecond laser cataract platform, which allows for image-guided, computer-controlled precision in making the corneal incisions, creating a perfectly sized capsulorhexis and performing segmentation of the lens in preparation for its removal via phacoemulsification.

Once the lens has been removed, an intraocular lens (IOL) is then folded and implanted into the capsular bag, through the same incision. This tiny incision is self-sealing and does not require any sutures.

This procedure takes approximately 20 minutes, but you should expect to be at the day surgery for at least 2 hours to allow for recovery from the sedation. We recommend that you have someone with you to drive you home.

How quickly will my vision improve after RLE?

Visual recovery is fast and most patients are able to see well by the next day. Your vision will continue to improve as the eye heals and settles down over the first few weeks following RLE. It is not uncommon for the eye to feel gritty and irritable for a few days after surgery. You will be given antibiotic and anti-inflammatory drops to prevent infection and assist with healing.

Booking a consultation

If you’d like to find out if you are suitable for a Refractive Lens Exchange (RLE), please contact us on (03) 9070 0955 to book a consultation in Melbourne, Victoria, or click on the button below to request a call back.

Refractive Lens Exchange FAQs

Cataract surgery is performed to remove the cloudy lens (cataract) in your eye and replace it with a clear, artificial intraocular lens to allow clear vision to be restored. In refractive lens exchange however, instead of removing a cloudy lens, your natural clear lens is removed for the purpose of correcting the refractive (focussing) power of your eye to achieve spectacle independence. This procedure is also known as a clear lens exchange.

The surgery itself is exactly the same; however, the terminology allows for distinction between removal of a cloudy versus a clear lens.

Cataract surgery is covered by Medicare and private health insurance but not refractive lens exchange surgery.

A referral from your GP or optometrist is required for you to claim a Medicare rebate for your consultation.

Dr Goh performs cataract and lens exchange surgery at the Manningham Private Hospital in Templestowe Lower.

Refractive lens exchange allows for correction of a wide range of prescriptions including myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism.

Vision typically improves by the next day but it may take up to 4 weeks for full recovery.

One eye is done at a time. The second eye is typically done anywhere between 2 to 4 weeks after the first eye. We recommend taking 2 to 3 days off work after surgery on each eye.

Most people are able to resume driving 1 to 2 days after surgery. Individual advice will be given by Dr Goh at your consultation if you are deemed unsuitable to drive whilst awaiting surgery on your second eye.