Refractive Lens Exchange (RLE) is essentially cataract surgery, but exclusively for refractive purposes. RLE is sometimes called Clear Lens Exchange (CLE), Clear Lens Extraction (CLE), and Refractive Lens Replacement (RLR). RLE is often an appropriate alternative to conventional or wavefront LASIK, All-Laser Lasik, PRK, LASEK, Epi-LASIK if the patient is presbyopic. In RLE the natural lens of the eye is removed and replaced with a silicone or plastic intraocular lens (IOL). The replacement IOL is of a power to correct most, if not all, of the patient’s hyperopia or myopia.
There are several advantages to RLE over other forms of refractive surgery. Some of the most obvious are that the surgery has years of successful history and the cornea is relatively untouched. If you have a thin cornea, dry eyes, or other minor cornea problems, RLE may be a better alternative. RLE may be the only option for people with a high refractive error. Also, if the exact desired refractive change is not achieved, the IOL may be exchanged for one of a different power. Because RLE removes the natural lens, there is no possibility of developing a cataract in the future.
A big disadvantage with RLE is that it is a significantly more invasive surgery than any cornea-based refractive surgery or even IOLs. An extremely myopic patient would have an elevated risk of vitreous or retina problems after RLE. If you have accommodation, you will loose some or all accommodation. If you are already fully presbyopic and need powerful reading glasses or bifocals, the reduction of accommodation with RLE may not be a problem because you already have a very limited range of accommodation.
Most IOLs cannot accommodate by changing focus from distance to near like a young and healthy natural lens. Your eye will be set to either near vision or far vision. New accommodating IOL designs such as the Crystalens HD do have the ability to provide a limited range of accommodation. You may also have multifocal IOLs such as the ReSTOR and the Tecnis multifocal implants that help with near and distance vision.
Call our office TODAY at 323-937-2269 to schedule consultation with Dr. Kagan to find out which procedure is best for you!