What is Refractive Lens Exchange

As people age the lens within their eye becomes less flexible, making sight hazy or blurry. As a result, an individual might have to undergo a Refractive Lens Exchange (RLE) or also known as Refractive Eye Surgery. An RLE or Lensectomy is just like cataract surgery, except with the intention of changing the refractive error in eyes. With the purpose of eliminating your need for a prescription, a RLE is usually undergone to correct hyperopia (far-sightedness) and presbyopia.

An RLE doesn’t involve the use of lasers and instead replaces the eye’s lens with an artificial intraocular lens (IOL) that changes the focusing power of the cornea. A refractive lens exchange from Perfect Vision will provide better focus and remove the need for glasses.

This procedure is most suitable for patients suffering from hyperopia or presbyopia that are over the age of 45. Perfect Vision recommends the surgery for people who use several pairs of glasses to see objects both up close and at a distance.  After a Refractive Lens Exchange you will also never develop cataracts.

What is the Refractive Lens Exchange procedure?

A RLE is a non-laser refractive treatment meaning that no lasers will be used in the operation, instead implementing a process known as phacoemulsification. This process provides better vision by replacing the existing lens with a clear artificial IOL. Each artificial lens is chosen based on the type of visual aid required and which IOL’s will provide the most efficient outcomes.

Our surgeons will make a micro-corneal incision in order to access the affected lens in the eye. From there they will proceed to break up the lens in the eye into fragments using an ultrasonic probe, gently sucking out the pieces of the lens. The process leaves the capsule the lens was originally within, unharmed. The artificial lens is then folded and placed through the same incision. It unfolds naturally in the existing lens capsule taking its original shape. No stitches are required for the incision as it self-heals over time.

If there is still signs of refractive problems, laser surgery may be used to correct or even ‘fine tune’ the patient’s vision.


Am I suitable for Refractive Lens Exchange?

An RLE is commonly performed to correct presbyopia or severe hyperopia. A RLE is also an option for patients with lower prescriptions, whose natural lens is developing a cataract. This treatment will help to correct reduced vision and to provide a greater quality of vision for sufferers. Because the crystallisation of the natural lens diminishes with age, some patients are better suited for a RLE instead of laser surgery. After a certain stage in life, generally after the age of 50 years, laser surgery cannot offer the same longevity as a RLE procedure.

How long does my procedure take?

It usually takes about 15-20 minutes per eye. You will be at our day theatre for approximately 3 hours in total, as it requires time to prepare you for the procedure as well as to ensure that you are fit to leave once the procedure is complete.

When can I go home?

Your procedure is performed in an accredited day theatre; it does not require an overnight stay. You may return home once you feel fit to leave and our team think you are safe to leave.    

Is it painful?

The majority of patients feel no pain. A local anaesthetic is used to relax patients without putting them to sleep, and a guard is used to help keep the eyelids open during the procedure.

Can I have both eyes done at the same time?

It is common that we perform a RLE procedure on both eyes at the same time; however, this will need to be confirmed once you have seen our doctors.   

Are there risks involved with the procedure?

No medical procedure is without risk. However, at Perfect Vision Laser Correction, we implement the highest grades of aseptic technique, and we have never had a case of infection with any of our procedures. The benefits and risks are discussed upon your consultation.   

Can I drive after the procedure?

You will be required not to drive for a minimum of 24 hours after the procedure. We advise that you arrange for someone to drive you home after your procedure. Upon examination the day after your treatment, you will be given a better indication as to when it will be safe to drive. Most patients find they are okay to drive after the first 24 hours have passed.  

How will I feel after the procedure?

Due to the local anaesthetic, you will feel drowsy. This is normal for the following few hours after your procedure. We keep you rested on recliners until you feel ready to make your way home. You will be given some food and our nurses will check your medical status to ensure that you are fit to leave the theatre. It is advised that you go home and rest until we see you the following day.

Is there anything that I will not be able to do after the procedure?

  • You will not be able to drive for a minimum of 24 hours after your procedure.
  • We advise that you do not swim for 2 weeks and do not use eye make-up for a week post-operatively.
  • You will be required to wear clear plastic eye shields post-operatively for 3 nights as you sleep. You will be able to see through the shields.
  • Sunglasses are suggested outdoors for the first week post-operatively.  Windy, dusty or dirty environments should be avoided for the first week.
  • No contact sport for 4 weeks.
  • There are no restrictions regarding heavy lifting or exercise after the first 24 hours have passed.
  • You may watch television or read after the procedure. Although you may find vision initially blurred, watching television or reading will not harm the eyes.
  • You will be able to bath or shower as normal, just avoid soap and water from entering your eyes.
  • Initially after the procedure, you may experience some haloes around lights at night and glare. This effect is normal and can take some time to resolve.
  • It is not advisable to fly on a plane for a minimum of 24 hours following your procedure. It is preferable that you stay in the country within the first 2 weeks post-operatively.

Will I need glasses after the procedure?

Generally speaking, for most common day to day tasks you will not require any glasses correction. We commonly use multifocal lenses which correct well for far distance vision as well as for close reading vision. Some patients may still need a weak pair of magnifying glasses for some computer work. This can be discussed further upon your consultation and will also depend on the actual type of IOL which will be used for your eyes. Some prescriptions including higher degrees of short-sightedness, long-sightedness or astigmatism may require laser correction secondarily (after your RLE procedure). This will be discussed with the Perfect Vision surgeons if necessary.

Commitment Program

Here at Perfect Vision we have an immense amount of faith in our surgeons to provide excellent results. We believe that our surgeons provide treatment that lasts long-term, resulting in patients maintaining excellent eyesight for years to come. We want our patients to be as happy as possible with the results and intend to help them maintain the best possible vision for as long as possible through our commitment program.

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With over 40,000 successful procedures, Perfect Vision is the only laser vision correction clinic in Australia to truly combine expert surgeons, world-leading technology and personalised service for your treatment.