Refractive Lens Exchange FAQ


What is Refractive Lens Exchange?

Refractive Lens Exchange is a refractive procedure which enables patients to have more visual freedom from glasses or contact lenses.  When patients want to see more clearly without glasses or contact lenses, patients can choose either corneal-based surgery or lens-based surgery. Refractive lens exchange is lens-based surgery.

How is Refractive Lens Exchange Different from LASIK or PRK?

LASIK and PRK are types of corneal-based surgery, which uses a laser to sculpt or reshape the cornea so patients can see more clearly without glasses or contacts. However, sometimes patients are not good candidates for LASIK or PRK and an excellent alternative is refractive lens exchange.

When Would Someone Choose Refractive Lens Exchange?

Unfortunately, some LASIK surgeons will offer LASIK to patients when they really should have refractive-lens exchange. Patients in their 40s and 50s may have early lens changes or pre-cataract changes. If such a patient has LASIK, they may only have a few months or years of visual freedom from glasses or contacts. Because when the lens becomes more cloudy from cataract changes, the vision becomes blurry again. Unfortuately, when this happens the effects of seeing well without glasses from LASIK are lost, so patients should be careful and informed of all their options. Such LASIK patients will have paid a big investment on LASIK surgery with very little benefit.

Another consideration is presbyopia. When we reach our 40s and 50s, we become presbyopic and lose our close up vision. LASIK and PRK does NOT correct presbyopia except through a monovision approach (See Presbyopia FAQ). Patients can choose monovision with LASIK or PRK but then one eye will have to be focused for near and the other eye for far. This works well, but 30% of patients cannot adapt to it.

Refractive lens exchange takes advantage of removing the lens before the cataract forms and replacing it with a new intraocular lens implant. There are two benefits. First, refractive lens exchange means that patients will never have to undergo cataract surgery since the natural lens is already removed ahead of time. The lens never grows back thus a cataract cannot form. It's one less surgery to worry about in the future. Second, multifocal or pseudo-accomodative lens implants (See IOL FAQ) can be placed after the natural lens is removed (Lens Exchange) and these lenses can help patients see well at distance, intermediate, and near in both eyes and without glasses or contacts. This is superior to monovision for this reason. Patients can have the longest lasting visual freedom from glasses or contacts with refractive-lens exchange.

Is Refractive Lens Exchange Safe?

Like any surgery, there are risks involved, but refractive lens exchange involves the same steps of cataract surgery. And since cataract surgery is one of the most commonly performed and safest surgeries worldwide, refractive lens exchange is equally safe.  Your Professional Eye Associates eye surgeon will guide you and help you to make the best choice for your visual freedom.