Lens Replacement Surgery

Lens Replacement Surgery or Refractive Lens Exchange is a straightforward procedure that is becoming increasingly popular. We explore what the procedure involves and who would benefit from it.

What is Refractive Lens Exchange?


‘Refractive Lens Exchange’ or ‘Lens Replacement Surgery’ is a procedure that is performed by a specialist consultant Ophthalmologist.  It is virtually identical in nature to traditional cataract surgery, however the lens that is being replaced is clear, as opposed to clouded by a cataract.


The procedure takes between 15–30 minutes per eye (usually under local anaesthetic dependent on each specific case), and each eye is done separately with at least a week’s gap between.


What happens during the procedure?


The eye is numbed with drops beforehand and the ophthalmic surgeon will use a fine blade to create a micro-incision in the cornea or front of the eye. A probe is then inserted to break up and remove the patient’s existing lens with ultrasonic waves. A folded Intraocular Lens (IOL) is then inserted through the same incision where it unfolds and is positioned by the surgeon. It is a little like having a permanent internal contact lens which replaces the focusing power of the natural lens.


Discomfort is minimal although patients are advised not to overstrain their eyes for a short time, particularly with screen work / TV. They may also be more sensitive to bright light for a few weeks. The good news is that most patients will have instant vision improvement post-surgery.


Who would benefit from Refractive Lens Exchange?


RLE is generally recommended for the following eye conditions:


  • Extreme long-sightedness (presbyopia) caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.

  • Astigmatism.

  • People who have difficulty with both near and distance vision (hyperopia).


Also, if you have a thin cornea, corneal problems, a developing cataract or dry eyes, Refractive Lens Exchange can be a much better alternative to laser vision correction.


It can also be used to correct near-sightedness (myopia) but is generally not recommended when laser surgery is a good option for the patient.


Long term results of RLE

While the standard intraocular lens that replaces your own lens cannot change focus in the same way as a youthful, natural lens, the introduction of multifocal intraocular lenses can enhance both near and distance vision. Ophthalmic surgeons can calculate the precise power of a new lens by taking accurate measurements of the eye using the latest laser measurement techniques prior to surgery, and will discuss all options in full.

Whether you suffer from long or short sightedness, the implanted inter ocular lens (IOL) will optimise vision so you no longer need spectacles for normal distance vision.

 Although glasses may still be required for some visual tasks, such as reading, many patients rarely require spectacles after this form of surgery

Another major benefit of Refractive Lens Exchange is that patients cannot develop cataracts as they age.


For further information please visit The Royal College of Ophthalmologists.

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