Refractive Lens Exchange (RLE)

Refractive Lens Exchange (RLE) is the exchange of the natural crystalline lens for an artificial one. It is the same as cataract surgery, but is often used to correct presbyopia or extreme degrees of refractive errors.

Extreme degrees of refractive errors are those that are out of the range recommended for laser eye surgery.

RLE is permanent. The procedure can’t be reversed. Your natural lens is removed and replaced with the artificial lens. It is, however, possible to replace the lens should that ever become necessary.

Distance or Multifocal intraocular Lenses

You do have a choice of single vision or multifocal intraocular lenses. Single vision lenses usually focus on distance vision. This means you will still need glasses for reading and computer work.

The newer multifocal lenses are designed with a series of concentric focal zones that allow you to focus for near, intermediate and distance vision. These patients may not need reading glasses at all. Those who do may only need them infrequently.

Cost of RLE

RLE can be expensive. Depending upon which lens your eye surgeon chooses for you, you should plan to spend at least $2,500 per eye. More expensive lenses can boost the costs to over $4,500 per eye.

While insurance and Medicare will not cover the elective RLE procedure for correcting refractive errors, Medicare and some insurance policies will cover the same surgery to correct cataracts.

All surgery has risks. No one can guarantee success or that no problems will occur. Statistics show that refractive lens exchange is associated with a higher risk of retinal detachment.

Other risks are about the same as that for cataract surgery. These include the possibility of:

  • Glaucoma, increased intraocular pressure
  • Decentered lens. This would require lens repositioning or replacement.
  • Endophthalmitis, inflammation or infection of the eye.
  • Corneal swelling
  • Retinal swelling
  • Ptosis, eyelids that droop
  • Safety of Refractive Lens Exchange

    Although the risks seem intimidating, the occurrence of serious complications is less than two percent with cataract surgery, the same surgery as RLE.

    The procedure statistically produces nearly 96% success in achieving 20/40 or better uncorrected vision. 20/40 vision is legal for driving in most stated without glasses or contacts.

    Younger patients have also had successful results from RLE, but it should be noted that these patients either had early development of cataracts, or very extreme refractive error, for example more than +6.00 diopters of hyperopia (farsightedness).


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