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Refractive Lens Exchange

In Refractive Lens Exchange (RLE) the natural lens of the eye is removed and replaced with an intraocular lens (IOL) to correct refractive errors (nearsightedness, farsightedness, need for reading glasses). RLE is sometimes called Clear Lens Exchange (CLE), Clear Lens Extraction (CLE), and Refractive Lens Replacement (RLR).

Refractive Lens ExchangeThe natural lens functions like a camera lens to focus images onto the retina (like the film in a camera). It is flexible in younger people under 40 years of age. However, it loses its ability to focus with age, leading to presbyopia and the need for bifocal or reading glasses. When the natural lens turns cloudy it is called cataracts. When this happens it impairs a person´s ability to see at all distances even with the best pair of glasses. Cataract extraction with intraocular lens is necessary to restore vision.

People who are nearsighted, farsighted, or presbyopic can see clearly as long as they wear glasses or contact lenses. Some people do not like the hassles of wearing glasses or contact lens, especially those who like water sports and outdoor activities. Refractive Lens Exchange can be a good option for them.

In RLE, the lens removal is done using a similar method as that for cataract removal. An intraocular lens(IOL) of pre-calculated power is then inserted to replace the natural lens. The surgery is done as an out-patient procedure. Currently, there are five options for IOLs: Monofocal IOL for distance, Monovision monofocal IOL, ReSTOR®, ReZoom TM, Crystalens TM.

Monofocal IOL for distance is similar to the IOL used in cataract removal for years with excellent track records. Both eyes are corrected for distance. The patient needs reading glasses.

Monovision monofocal IOL is a method where one IOL corrects for distance vision (dominant eye) and another IOL corrects for near vision. The patient´s brain adjusts to using the dominant eye for distance and the other for close up. This choice is best for patients who have worn monovision contact lenses.