What is RLE?
Refractive lens exchange, or RLE, is a procedure in which the natural lens of the eye is replaced by a surgically implanted artificial lens. It’s also known as clear lens exchange (CLE). The artificial lens refracts light differently, which can correct visual problems such as nearsightedness, farsightedness, or astigmatism. Many people no longer need glasses or contact lenses after having RLE.
If you’re choosing refractive surgery, make sure you’re choosing it because you really want it, not to please someone else or to fit an imagined ideal. No one else can make the choice for you; it’s your body, and you’re in charge of it. After you do your research and understand the procedure, if you believe that RLE are right for you, then proceed. To help you in your decision-making process, we have some information about the risks and benefits of RLE at Refractive Lens Exchange (RLE): Risks and Benefits.
Please note that this page is for informational purposes only, and is not a substitute for qualified, individualized medical advice. You should discuss your potential elective procedure with your own doctor(s), including your primary care physician and the doctor who will perform your procedure if you decide to proceed.
How it’s done
The RLE procedure is the same as cataract surgery, except that the lens being removed from your eye is not clouded by a cataract.
You will be reclining in a surgical chair during the procedure. You will receive several drops of numbing medication in your eye. Next, an eyelid holder will be placed that prevents you from blinking during the procedure. Drops are also placed in your eye to dilate your pupil. An incision is then made in your cornea.
In most cases, the natural lens is removed by a procedure called phacoemulsification. A tiny probe is inserted into the corneal incision, and placed near the lens. Ultrasound waves emitted by the probe break up the lens into small fragments, which are then suctioned out of the eye. The very back of the natural lens is left in place, to hold the artificial lens.
In some cases, a larger incision is made in the cornea, and the surgeon uses small surgical tools to remove the lens, also leaving the very back of the natural lens in place.
After removal of your natural lens, the artificial lens (IOL) is placed. Some IOLs require small incisions in the iris to allow the lens to fit into the space left by removal of the natural lens; in this case, the small incisions are closed by tiny dissolvable sutures. Other IOLs are folded up for placement; once behind the iris, the lens unfolds. In this case, no extra incisions are necessary.
The incision in the cornea is closed with tiny dissolvable sutures, and a protective shield is placed over the eye.
Preparing for the procedure
Choosing your surgeon
When choosing an eye surgeon for your refractive surgery, you want a highly-trained professional with experience in this type of surgery. A fellow of the American College of Surgeons has received training in surgery (look for the acronym FACS), and a member of the American Board of Ophthalmology has training and experience specifically in the surgical and nonsurgical care of eye diseases. Also, choose a surgeon with whom you feel comfortable and safe, and who listens to you and tries to understand your goals. If you have friends who’ve had refractive surgery, and you like their results, ask for a referral. While cost may be a consideration, don’t allow this to override more important factors in your decision. Your safety and the quality of your results are worth a little extra spending.
For more help in your search for a refractive surgeon, visit our How to Find the Best Refractive Surgeon page. At Doctor Review, you can also search providers for patient reviews to help you find the very best.
Getting ready for the procedure
For at least a few weeks before your refractive surgery, you’ll need to stop wearing contact lenses and switch to glasses. Contact lenses can distort your corneas by pressing on them, which could lead to inaccurate measurements, meaning that the outcome of your surgery won’t be ideal.
Also, in order to minimize the amount of debris that’s in your eye during your surgery, you should skip using any eye creams or makeup the day before and the day of your surgery. Otherwise, there could be buildup in your eye, leading to inaccuracies during your procedure.
After the procedure, you’ll need a family member or trusted friend to drive you home. You should plan to spend the rest of the day resting.
You will be given a transparent eye shield to wear over the treated eye(s). The shield is intended to remind you not to touch or bump your eyes, as any touching of the eye could damage the cornea and cause it to heal incorrectly. You will need to wear the shield full time for two days, and then should wear it at least at night for several more days, though wearing it during the day may provide extra safety for your eye. You will also be given eyedrops, which you will need to use several times a day; the drops keep your cornea moist as it heals, and help to prevent infection and inflammation.
It will take three to six months for healing of your eye(s) to occur. At this point, your vision will stabilize, and the side effects from the healing will resolve. You will then be able to decide whether you want an enhancement, which is a second refractive surgery designed to provide minor corrections and bring the vision closer to ideal.