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Seeing Clearly: A Comprehensive Guide to Refractive Lens Exchange (RLE) Surgery

Ms Laura de Benito-Llopis

Author

Ms Laura de Benito-Llopis

Specialist areas: Laser Vision Correction, Lens Replacement Surgery, Implantable Collamer Lens, Cataracts, Corneal Transplant, Keratoconus Surgery, Pterygium Surgery

10 Nov 2023

Refractive Lens Exchange

What is Refractive Lens Exchange?

If you’re one of the many individuals struggling with reading vision difficulties and find yourself squinting or reaching for reading glasses, refractive lens exchange (RLE) surgery might just be the solution you’ve been looking for. In this comprehensive guide, we’ll take you through everything you need to know about RLE surgery. From understanding what RLE is to the step-by-step process, aftercare, and the life-changing benefits it can offer, we’ve got you covered.

Refractive lens exchange, also known as PreLex (presbyopic lens exchange), clear lens extraction (CLE), or permanent lens replacement surgery, is a surgical procedure designed to alleviate reading vision difficulties. This revolutionary surgery offers a way to improve your vision and reduce your dependence on glasses, especially if you’re not a suitable candidate for laser vision correction.

Correcting Vision Problems with Refractive Lens Exchange Surgery

The core principle behind Refractive Lens Exchange surgery is the removal of your natural lens using ultrasound through microscopic keyhole incisions and its replacement with a high-definition intraocular lens. This innovative procedure allows skilled surgeons to correct a range of vision problems, including:

For those aged 50 and over who are experiencing reading vision difficulties, refractive lens exchange can be a game-changer. It’s essential to understand that RLE surgery shares its technique with cataract surgery, a well-established, safe, and sophisticated procedure that millions of patients worldwide have undergone.

One of the most significant advantages of RLE surgery is that it not only improves your vision but also eliminates the risk of developing cataracts later in life. We offer premium lens technology including multifocal/trifocal, extended depth of focus and premium monofocal lenses to grant you independence from spectacles for both near and distance vision.

Exploring Refractive Lens Exchange – Lens Types

Understanding the various lens options available is crucial in making an informed decision about Refractive Lens Exchange surgery. Let’s take a closer look at some of the options:

Multifocal and Trifocal IOLs

Multifocal or Trifocal IOLs have a specialised design with multiple rings or zones on their surface. These rings are responsible for directing light to different focal points, enabling clear vision at near, intermediate and distance. A detailed assessment is required to ascertain whether you are a suitable candidate for these lenses.

Extended depth of focus IOLs

These lenses include a variety of designs that work by extending the range of vision. They tend to be associated with less glare and haloes than multifocal IOLs and are a good option for the majority of eyes. In order to achieve more spectacle independence, we can target the dominant eye for distance and non-dominant eye for near and intermediate vision allowing the eyes to work well with a blended vision approach.

Premium monofocal IOLs

Premium monofocal IOLs provide excellent quality of vision, similar to a monofocal or ‘plain lens’ but use optical principles to extend the range of vision giving you more intermediate vision than a standard monofocal IOL. We can use the blended vision approach to give you even more near vision with this lens. These lenses are very forgiving being suitable for the majority of eyes.

Toric IOLs

Toric IOLs are designed to correct astigmatism, providing you with crisp and clear vision. If you have astigmatism we can implant the toric version of the above premium lens technology to ensure you achieve the best quality of vision.

Real Stories, Real Results

Before diving into the details of the Refractive Lens Exchange surgery, let’s hear from real patients who have experienced its life-changing benefits:

“I had cataract removal and interocular lens placement surgery performed on 20th January by Doctor Ali Mearza. The whole procedure was an astounding success. I went from cloudy vision and terrible myopia to perfect distance vision. Having worn glasses, hard contact lenses ever since I was a child, my life has completely changed for the better. So far, I have not experienced any adverse effects.

The surgery itself was approximately 30 minutes in total plus some prep and post op time. There was no pain during the procedure, and some pain within tolerable limits afterwards which subsidised after a few days. The facilities and staff were excellent.

I can without doubt recommend OCL Vision to anyone considering similar treatment. Again, this has dramatically improved my life and I am very grateful”. Samir Shah

“Had a prescription of -16 or so plus significant astigmatism and a left cataract. Had bilateral IOL surgery under Mark Wilkins. Have now got 20/20 vision in both eyes. A revelation for someone who was so short sighted. The treatment from start to finish was exemplary (including the surgery which I was really nervous about) and could not be happier. Would not hesitate to recommend”. Andrew Baker

“The quality and ultimately the results so far of my treatment carried out over the last month by Mr Romesh Angunawela (and his wonderful supporting and professional staff) have exceeded my expectations. I underwent refractive lens (multifocal) exchange surgery to address my myriad conditions which included cataract, severe short-sightedness, long-sightedness / presbyopia and astigmatism, and even after a retinal detachment! The quality of my vision is now incredible, and I would have to describe the operation as life changing. I am immensely grateful and cannot recommend OCL highly enough”. Ethan

The Refractive Lens Exchange Consultation

Before undergoing Refractive Lens Exchange surgery, you’ll have a consultation at one of our clinics in the UK. Our experienced surgeons including Allon Barsam, Masara Laginaf, Ali Mearza, Laura De Benito-Llopis, Mark Wilkins and Romesh Angunawela, conduct RLE surgery. Surgery is available at our central London, Kensington and Elstree (Hertfordshire) locations. This consultation serves several essential purposes:

Evaluating Suitability: The consultation allows us to determine if RLE surgery is the best solution for your specific vision needs. We aim to correct your vision accurately and comprehensively.

Vision Test: During the consultation, a specialist technician will conduct diagnostic tests on your eyes. You’ll also undergo a comprehensive eye test with one of our optometrists.

Meeting Your Surgeon: After the tests, you’ll meet your surgeon, who will discuss the test results with you. This is the time to explore treatment and lens options, ensuring that your care plan aligns perfectly with your needs.

Ordering Custom Lenses: After your consultation, custom lenses tailored to your eye measurements will be calculated and ordered as required.

Once you have decided to proceed with RLE surgery, a patient co-ordinator will schedule your surgery and discuss finance arrangements available. They will answer any questions you have and provide an email or by-post surgical pack including consent forms, post-operative eye drop information and a dos and don’ts summary. We remain at your disposal if you have any questions prior to your surgery.

Preparing for RLE Surgery

Before the big day arrives, there are a few essential preparations to keep in mind:

Contact Lenses – If you typically wear contact lenses, it’s important to note that you cannot wear them prior to your consultation. This advice is in place to ensure accurate measurements of your eyes. Specifically:

Soft lenses should not be worn for three days prior to your consultation.

Toric soft lenses should not be worn for at least 1 week prior to your consultation.

Gas permeable lenses should not be worn for four weeks before your consultation.

The RLE Surgery Process

Now that you’ve completed your consultation and made the necessary preparations, let’s delve into the step-by-step process of refractive lens exchange surgery:

Arrival at the Clinic: On the day of your surgery, you’ll arrive at the clinic typically 1 hour prior to surgery.

Consent Form: If you have signed a physical consent form at home this should be brought with you.

Preparation: The surgical team will prepare you for the procedure, making sure you’re comfortable and relaxed.

Surgery: The RLE surgery itself is a well-established, routine procedure that typically takes 15 to 20 minutes per eye.

Anaesthetic: We offer local anaethesia (drops to numb the eye) which usually keep the eye comfortable, along with the option of an oral sedation (tablet to relax you) or most commonly intravenous sedation. This a light sedation administered by an anaesthetist through a vein in your arm to make you feel more relaxed and at ease during the procedure.

Immediate Post-Surgery

After the surgery, you’ll leave the clinic wearing sunglasses, and we recommend having a friend accompany you on the journey home. Your eyes may feel tired and gritty for the rest of the day, so it’s advisable to stay home and rest. While you’ll be able to see, your vision may be slightly misty for the first 48 to 72 hours. Depending on your pre-surgery vision, you may notice a significant improvement almost immediately.

Refractive Lens Exchange Aftercare

The journey doesn’t end with the surgery; refractive lens exchange aftercare is vital for ensuring the best results and a smooth recovery process. Here’s what to expect:

Medication and Eye Shields

You’ll receive antibiotic and anti-inflammatory eye drops to use at home. Additionally, you’ll be provided with clear eye shields to wear at night during the first two nights after surgery. Clear instructions on their use will be provided, and our admin team is always available to answer any questions.

Taking It Easy

Although RLE surgery is a low-risk procedure, it’s crucial to remember that you’ve undergone surgery. You’ll need to take it easy for a few days afterwards. Light exercise can resume after three days, while your full exercise regime can be reintroduced after two weeks. Swimming should be avoided for the first two weeks, and when you do return to the pool, goggles should be worn for an additional four weeks.

You can start driving again once your vision clears and you feel comfortable. For most people, this takes just a few days, but it may vary. We recommend waiting at least a week after surgery before applying eye makeup, particularly mascara and eyeliner.

Life After RLE Surgery

A month after refractive lens exchange surgery, you should be able to resume all your usual activities. Many, including driving and returning to work, can be done in less than a week. The key difference now is that you can do these things without the need for glasses or contact lenses.

With RLE surgery, life quickly returns to normal, but it’s a better normal than before. Imagine waking up in the morning with clear vision and the freedom to enjoy your day without the constant search for your glasses. That’s the life-changing impact of RLE surgery.

Don’t let reading vision difficulties hold you back any longer. Refractive lens exchange surgery is here to provide a clear path to a brighter, glasses-free future. If you’re ready to see the world with new clarity, it’s time to explore RLE surgery as your solution.

If you have any questions or would like to learn more about refractive lens exchange or our services, please don’t hesitate to make an enquiry or call us at 0203 993 7210. Our dedicated team is here to assist you on your journey to improved vision and a glasses-free life. Say goodbye to reading glasses and hello to a world of clear, natural vision with RLE surgery in the UK.

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We’re here to answer your questions, talk through the process, and arrange a consultation with our caring team when you’re ready.

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