Refractive Lens Exchange

New Vision

As we age, our vision tends to deteriorate. Those of us with normal eyesight begin to need reading glasses around our mid-40s.

If you are long-sighted, the need for reading glasses starts earlier and you later need glasses for distance too.

If you are short-sighted, distance vision is poor and glasses need updating to progressive lenses. If you wear contact lenses, reading glasses are needed to help with near vision. The natural lens in your eye is the problem.

Laser vision correction is usually a good solution for short and long sight for younger people. But, as we get older, our eyes’ natural lenses become both harder and hazier. Harder lenses aren’t able to focus for close vision – this is an unavoidable change for all of us. And hazy lenses start to scatter light, blurring vision and eventually becoming cataract, something we all develop if we live long enough.

What is refractive lens surgery?

Refractive lens exchange [RLE] replaces the problem lens in your eye with a new lens implant. 

It has the potential to improve your vision significantly, leaving you with less or even no reliance on glasses and contact lenses. The process replaces your eye's clear natural lens with an artificial intraocular lens (IOL) to correct your vision focusing and achieve sharper focus, reducing the need for glasses. The procedure is pretty much identical to cataract surgery. The difference is that the lens being replaced is clear, rather than cloudy due to a cataract.

Procedure time

The procedure takes about 20 minutes for one eye and is carried out as a day surgery procedure – you’re normally with us for about an hour and a half. You’re awake during the procedure but your eye is numb and comfortable with a choice of gel anaesthesia or a deeper anaesthesia around your eye with the option of light sedation as well.


Someone needs to drive you home and you return the following day for a check-up. Your vision is usually good at that stage and medicated drops are started that continue for about three weeks. Your second eye may be treated within the next week or two.

What are my different RLE options?

Distance vision monofocal lenses

Replacement of the lens in each eye with monofocal lens implants both focused on distance. Potentially a good option for those who require excellent distance vision (driving at night, pilots) and are happy with glasses for near and intermediate vision

Blended vision

Replacement of the lens in each eye with monofocal lens implants, one eye giving good distance vision and the other better near vision (a little nearsighted). The brain blends the vision from each eye to give an improved range of vision from distance to near, minimising the need for glasses in most day-to-day tasks. Glasses are still likely to be necessary for some tasks (detailed or prolonged near vision, possibly driving at night) and there is often a period of adjustment of a few weeks or more as you get used to the change in vision.

Extended range vision lenses

Replacement of the lens in each eye with a special implant that gives good distance vision as well as an extended range of vision good for intermediate but likely to still require reading glasses for fine near vision tasks.

Trifocal multifocal lenses

Replacement of the lens in each eye with a special implant that gives good distance, intermediate and near vision unlikely to need glasses for any tasks, particularly good for those who wish to have good near vision without glasses. There is often a period of adjustment of a few weeks or more as you get used to the change in vision. Some halo or glare may be noted with bright lights or lights at night.

Like all surgical procedures, there is some risk of an adverse outcome but this is small and risks are minimised by operating on one eye at a time. A detailed discussion of the details of the procedure with your surgeon is important. 

Since refractive lens exchange is an elective procedure, the main purpose of which is decreasing glasses and contact lens dependence, it is generally not covered by medical insurance. The cost of the procedure varies depending on the option chosen and will be discuss with you personally.

Refractive lens exchange has the potential to improve your vision markedly, with less or no reliance on glasses and contact lenses. We look forward to discussing this technique further with you so that we can optimise your vision.

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Call us on 0800 99 2020

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