Refractive lens exchange (RLE) is a refractive surgery procedure in which the crystalline lens of the eye is removed and replaced with an artificial lens implant in order to correct refractive error. RLE surgery is the same as that used during cataract surgery. However, in RLE, the procedure is performed primarily to change the refractive properties of the eye rather than to remove a cataract that has developed in the lens of the eye.
How Does RLE Work?
In hyperopic (farsighted) or myopic (nearsighted) patients, the light coming into the eye is not focused properly on the retina. This poor focus may be due to the eye’s crystalline lens being either too weak or too strong to help focus light appropriately. By removing the eye’s crystalline lens and replacing it with an artificial lens, the light can be better focused on the retina, reducing the person’s dependence on glasses and contact lenses to see clearly. The artificial lens that is placed in the eye, called an intraocular lens (IOL), can be chosen depending on the refractive needs of the patient’s eye.
Who are candidates for RLE?
RLE is most commonly used for middle aged and older hyperopic(farsighted) people with higher levels of farsightedness than can effectively be corrected with LASIK or PRK. These individuals usually are also presbyopic and may be also having to rely on reading glasses to see near items clearly. Additionally, they may, but not always, have a mild degree of cataract in their crystalline lenses which, though not causing symptoms currently, will probably progress and cause decreased vision in the future. In these patients, exchanging the natural crystalline lens of the eye for a multifocal lens may help correct both the farsightedness and presbyopia symptoms. Monofocal lens implants can also be used for these patients. RLE can also be used for myopic (nearsightedness) people who otherwise are not candidates for LASIK or PRK as well as patients with astigmatism.
In general, candidates for RLE should be:
•21 years of age or older: younger people may still have eyes that are growing.
•Dissatisfied with wearing glasses or contact lenses.
•Have had no change in glasses or contact lens prescription for at least a year.
•Have otherwise healthy eyes.
•Be willing to accept a small amount of risk associated with surgery.
•Understand that glasses and/or contacts are occasionally still needed for some activities after surgery.
These conditions may prevent you from undergoing RLE or other refractive surgeries. You should alert your eye surgeon if you have one or more of these conditions so that he or she can help you make the best choice about undergoing refractive surgery.