Refractive Lens Exchange (RLE)

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What is Refractive Lens Exchange?

Refractive lens exchange is also known as lens replacement surgery or clear lens exchange is a vision correction surgery aimed to permanently correct the focus of one’s vision. The main aim is to keep the patient spectacle free and is a form of presbyopic correction.

How Does RLE Work?

During RLE, the natural lens of the eye is removed and replaced with an artificial lens implanted during a surgery which is very similar to cataract surgery. The artificial lens implant is designed to allow multiple focusses of your vision so that one can see both in the distance, intermediate and reading or close distances with minimal or no glasses.

The difference between RLE and cataract surgery is that this is performed before cataract develops , with the sole aim of reducing the person’s need for glasses.

How is RLE Performed?

The procedure is very similar to cataract surgery, commonly phacoemulsification. It is performed as a day procedure, lasting between 15-30 minutes per eye.

Who are Candidates of RLE?

RLE is best considered for individuals usually over 45 years of age and would like to be glasses free. Patients considered may also be those with high refractive errors or who are not candidates for LASIK. If you have early cataracts or are at higher risk of developing them, then RLE may be a procedure to consider as these can be treated simultaneously.

Pros and Cons of RLE

Pros

Cons

To correct presbyopia and refractive errors including high degrees of myopia, hyperopia and astigmatism simultaneously
Need for minimal spectacle correction or be spectacle free
Address early cataracts and negate need for future cataract surgery
Long lasting results- permanent solution for vision correction

Risks of surgery, whilst rare, significant complications can result in vision loss, infection or retina detachment.
Down time or adjustment period of a week. Full recovery may take few weeks to couple of months
Glare and halos (but this should gradually get better)
Dry eyes
Posterior capsular opacity (PCO)- a cloudy film behind implanted lens- but can be treated with a quick, painless laser procedure known as yag. capsulotomy.

What Type of Lenses are Available?

When we talk about vision, we can divide into the following:

• Distance Vision – approximately 4 metres away and mainly for driving
• Intermediate Vision – examples include using a computer screen, reading using gadgets such as iPad or kindle, looking at a menu, gardening or cooking
• Near Vision - reading newspapers or book, usually around 40cm away

We can optimise refractive outcomes in accordance to your needs for vision through several artificial or intraocular lenses implanted during the surgery.

Multifocal/ Trifocal lenses: These lenses correct for distance, intermediate and near vision- negating the need for glasses. If glasses are needed, it is often a very weak prescription. The main drawback or cons for these lenses is that it may induce glare or halos. This is worse in dim light conditions and is exaggerated for some individuals especially those with ocular surface or ocular problems.
Extended Depth of Focus (EDOF)lenses: These lenses correct for distance and intermediate vision but reading glasses are likely required for close or reading work.

This is an increasingly popular option for patients with modern gadgets such as the iPad. Most of our daily living now involves mainly intermediate distances. Thus, having distance and intermediate vision may cover the vast majority of needs for many patients, particularly those with mild underlying ocular disease. This lens induced minimal glare as compared to the latter.

Advanced Technology and Techniques

Our clinic is equipped with state-of-the-art technology and employs advanced surgical techniques to deliver safe, precise, and effective Refractive lens exchange

Customised Treatment Planning

RLE is meticulously planned and customised to address the unique visual needs and ocular characteristics of the patient. By integrating advanced diagnostic imaging, intraoperative guidance systems, and patient-specific data, surgeons can tailor the surgical approach, lens selection, and incision placement to optimise visual outcomes and patient satisfaction.

Contact us today to schedule a comprehensive consultation and take the first step towards achieving clearer vision and a brighter future. With our advanced technology, personalised care, and experienced surgical team, clear vision awaits you!

Frequently Asked Questions

What conditions can be treated with retina laser therapy?

Retina lasers such as panretina photocoagulation remains the gold standard treatment for proliferative retina vascular disease such as diabetic retinopathy and retina vein occlusion. Lasers targeted at the macular , macular laser therapy is often used to treat conditions such as diabetic macular oedema, macular oedema from vein occlusion and certain cases of central serous retinopathy.
Is retina laser therapy painful?

Patients will be given topical anaesthetic drops and will have a contact lens on the eye to keep the eye open during the procedure. You can feel slight discomfort during the procedure and immediately after. Usually paracetamol or NSAID tables over the counter will help to ease the discomfort from the procedure. You should not be experiencing pain beyond a day or two. If not, please seek urgent assistance.
How long does a retina laser therapy session typically last?

Depending on the area to be treated, a session will take from 15 mins to 30 min per eye.
Are there any side effects or risks associated with retina laser therapy?

Whilst laser photocoagulation is effective, there are risks involved , such as: Vision loss: It may cause a blind spot in the area where a scar forms. If the fovea is lasered, this may cause visual loss but this is incredibly rare. Damage to the retina caused by the scar that formed from treatment: This damage may occur right after surgery or years later. Blood vessels that grow again: Retina specialists can remedy this by repeating the laser treatment. Bleeding in the eye Reduced colour vision Lowered night vision
What is the recovery process like after retina laser therapy?

The procedure is a day procedure and you will usually go home after the procedure. You can continue with normal activity following the laser therapy. You might feel slight discomfort for a day or two. The true impact of the laser on the retina vasculature or fluid may take up to 2 weeks or 3-4 months in the case of macular oedema. A follow up appointment will be scheduled to monitor on the status of the retina following the procedure
Will I need multiple sessions of retina laser therapy?

In certain indications of retina laser such as proliferative diabetic retinopathy, several sessions of retina laser therapy will be planned
Is retina laser therapy covered by insurance?

Most indications of retina laser therapy are covered by insurance, please contact your insurance to confirm your eligibility depending on your personal insurance plans.