Refractive Lens Exchange or RLE is a common refractive procedure designed to improve vision without glasses or contact lenses. It is typically offered to people who are not candidates for LASIK or ICL based on age or extent of refractive error.
The procedure for a refractive lens exchange is a 10-15 minute eye surgery where the natural lens of the eye is removed and then replaced with a plastic artificial lens or IOL. The power of the new lens can be chosen to restore clear vision without the need for glasses or contact lenses. RLE uses the same technology as cataract surgery, a safe and effective eye surgery performed over 4,000,000 times each year in the United States.
Caption: Refractive Lens Exchange removes the natural lens inside the eye and replaces it with a thin plastic lens. The new lens is chosen to correct the vision without glasses or contact lenses.
People over 50 generally are not good candidates for LASIK or ICL surgery. The reason is due to aging changes that develop in the human eye. In the 50’s the eye begins to lose the natural focusing mechanism, and many people start to need reading glasses. Cataract also begins to develop in the 60’s and 70’s which leads to changes in the vision and the strength of glasses or contact lenses. With these changes LASIK or ICL are not very helpful. Once these changes start to develop, the best refractive procedure is to remove the aging lens and replace it with an IOL that fully corrects the vision.
LASIK can treat hyperopia (known as farsightedness) but these treatments are not long lasting and are limited to lower amounts of hyperopia. ICL is not available to treat hyperopia in the US. Therefore, people with hyperopia of more than +3.00 diopters are great candidates for a refractive lens exchange procedure. The new IOL placed in the eye can be tuned to focus the light accurately and restore the vision without glasses or contact lenses. RLE is best for people over 50, but some people with high hyperopia (+4.00 or more) can consider the procedure at a younger age.
LASIK and ICL can both treat myopia and are usually the best procedures for young people. Once a person is older than 50, LASIK and ICL are not as beneficial and RLE becomes the recommended treatment.
RLE is a safe and proven procedure. Rare risks include infection, retinal detachment, significant swelling in the cornea or retina, or IOL power problems. Most of these issues can be improved with treatment. Severe or permanent vision loss with RLE would be very rare, less than 1-in-1,000. Retinal detachment is more common in people who are very nearsighted (-6.00 and higher).
When the natural lens is replaced with an artificial lens, there are several options available with different models of lenses to choose from. Our goal is to match the best lens to your daily activities.
There are three main categories of lenses; Monofocal, Extended Depth of Focus, and Multifocal. The best chance at seeing well without glasses with a full range of vision is a multifocal lens. Extended depth of focus lenses give clear vision with a good range but do not focus on near images as well as the multifocal lens. Monofocal lenses will give good clear vision but have a limited range of focus. A monofocal lens is a bit cheaper than the newer technology lenses.
The Panoptix lens is a multifocal IOL and the first full trifocal lens approved by the FDA. The Panoptix IOL gives good vision for reading, computer, and distance tasks such as driving. All multifocal lenses have a slight decrease in contrast which might be noticed when the lighting is poor such as driving on a foggy evening. The Panoptix lens will also have some glare or halos around bright lights. This is particularly noticeable when driving at night with oncoming headlights. For most people this is a minor issue.
The Vivity IOL is considered an extended depth of focus lens. This lens has better contrast than a multifocal lens but also has less focus for near work such as reading small print. People who want the sharpest vision and good contrast but don’t mind wearing reading glasses are good candidates for a Vivity lens.
A monofocal lens will give great clarity and sharp focus for your vision. If both eyes are set for the distance you can drive and watch TV without glasses. You can wake up in the morning and have a shower and eat breakfast without needing glasses or contact lenses. However, you will need glasses for computer or reading books or magazines. Some people don’t mind wearing glasses for these activities.
One problem with both eyes set for distance with a monofocal lens is trouble with near and intermediate tasks without glasses. Some people mentioned that they can drive easily and see street signs well, but when they eat dinner they needed to get reading glasses to see the food on their plate. To help give a better range of vision and help with some of these issues Blended Vision was developed. With Blended Vision the dominant eye is set for clear distance vision and the other eye is set for 2-3 feet. This covers the computer screen and dashboard of the car for most people.
Monovision is a great way to avoid reading glasses. It is mainly recommended for people who have worn contact lenses in the past and did monovision with contact lenses. Monovision allows you to read and watch TV without glasses but does cause a loss of depth perception. In general, a multifocal lens is a better choice than monovision for most people.
NV Eye Surgery is a regional leader in Refractive Lens Exchange procedures. Our in-office surgery suite allows for a quick and comfortable procedure with almost instant results. Our prices are lower due to the opportunity to have surgery done in our office-based operating room compared to other surgeons in Las Vegas who operate in the hospital or ASC. Dr. DeBry has done more RLE procedures than any other surgeon in Las Vegas. We are uniquely qualified to help provide RLE surgery for clients in the Las Vegas area.
