Refractive Lens Exchange (RLE) – (Clear Lens Extraction)
Refractive lens exchange (RLE) is a type of vision correction surgery in which the eye’s natural lens is removed and replaced with a man-made intraocular lens (IOL). Alternative names occasionally used for RLE are clear lens exchange, clear lens extraction or CLE. Refractive lens exchange is essentially the same surgical procedure as cataract surgery, which is performed on approximately three million Americans each year. But in RLE, the eye’s natural lens is not clouded—the clear lens is removed and replaced with an IOL simply to change the focusing power of the eye. Refractive lens exchange can reduce or eliminate large amounts of nearsightedness and farsightedness and therefore may be a better surgical solution than laser vision correction for high prescriptions. RLE can correct a wide range of refractive error, from +8.00 diopters (D) of farsightedness to -20.0 D of nearsightedness. It can also correct up to 3.50 D of astigmatism if an astigmatism-correcting toric IOL is used. The same refractive intraocular lenses used for cataract surgery are used for RLE.
Advantages of RLE
- Rapid visual recovery
- The normal shape and thickness of the cornea remains unchanged
- The need for cataract surgery in the future is eliminated
- It provides stable vision with no risk of regression (loss of corrective effect)
- It enables people with mild cataracts to have refractive surgery
- It may reduce prismatic requirements and/or make them easier to correct
RLE Risks and Complications
The risks and potential complications of refractive lens exchange are virtually the same as those for cataract surgery. If you are considering RLE, you must be willing to accept these risks though rare, which can occur even when RLE is performed flawlessly by a skilled and experienced surgeon. RLE risks and potential complications include:
- Retinal detachment (more common in highly near-sighted people)
- Infection
- Overcorrection or undercorrection
RLE Candidates
Candidates for RLE should meet these criteria:
- At least 21 years of age
- Be willing to accept the risks associated with RLE (the same as cataract surgery)
Refractive Lens Exchange Cost
Refractive lens exchange costs significantly more than LASIK, ELASA or other laser vision correction procedures, and vision insurance typically does not cover any of the cost. This should be discussed with your eye care professional.