What to Know Before Refractive Lens Replacement Surgery

Refractive Lens Replacement Surgery - also called refractive lens exchange or clear lens exchange surgery - involves the replacement of your eye's natural lens with a lens implant.

It is a type of eye surgery that is carried out to correct short or long-sightedness as well as astigmatism. At the same time, it can also improve reading vision without the need for glasses. Everyone develops a condition called presbyopia during their 40s, which is where the natural lens in the eye loses its ability to change focus to see close up. This causes problems with reading and other near vision tasks, so the need for reading glasses increases.

Refractive lens exchange (RLE) is typically carried out to help correct issues with reading in those in their 50s or over. It is often a good choice for people who are not suited to laser vision correction. RLE follows the same procedure as cataract surgery - technically termed phacoemulsification and intraocular lens (IOL) implantation. It is, therefore, a very established technique with well-known outcomes and a strong safety profile.

Millions of lens replacement procedures are carried out around the world each year and it is one of the safest forms of surgery you can undergo. If you have been recommended this sort of procedure, then it is reassuring to know that it is reliably being carried out every day in the UK. What else should you know about lens replacement surgery before you have yours carried out?

In contrast to typical cataract surgery, where a standard monofocal lens is implanted, an advanced multifocal or enhanced depth of focus (EDoF) IOL is used. This allows a range of focus and so patients are largely spectacle independent after their RLE. It is important to understand that the aim of RLE is to maximise spectacle independence as glasses may still be preferred for certain visual tasks, such as prolonged night driving or fine near tasks.

RLE surgery is performed under local anaesthetic and typically takes 10-15 minutes per eye. Both eyes can be done on the same day if you meet the criteria for this following a surgeon’s assessment. Unlike laser vision correction, RLE is not reversible and since it is an operation inside the eye, the overall risks are higher. This is simply because laser vision correction is an operation on the surface of the eye.

Straight after surgery, the vision is soft focus and this resolves within a couple of days. Some, particularly those with high prescriptions, will notice a dramatic improvement in their vision almost immediately. Most people go back to work and are driving again within a week of surgery. Patients should always research their surgeon as the skill and experience of the surgeon is the biggest factor in the outcome of this type of surgery.

For more information please visit Mr Alex Day’s website.

About Dr Alex Day - Ophthalmologist

Mr Alex Day is a leading cataract and laser vision correction surgeon at Moorfields Eye Hospital, London, a world renowned centre of clinical excellence for eye care.

Mr Alex Day was ranked no.2 globally for top eye surgeons under the age of 40 by The Ophthalmologist

Private eye consultant & ophthalmologist London

MB BS (Distinction), BSc (1st Class Hons), PhD, FRCOphth, MRCOphth, DRCOphth, CertLRS, PgDipCRS (Distinction).

Mr Alex Day qualified as a doctor from St George’s Hospital Medical School, London with a double Distinction and 1st Class BSc (Hons). His ophthalmology training was initially in south London before moving to Moorfields Hospital, London in 2007 where he undertook 10 years of additional training.

During his Higher Surgical Training at Moorfields, he worked as a Specialist Registrar whilst completing a PhD at University College London. He later became an NIHR Academic Clinical Lecturer; and then fellow.

In 2020, Mr Alex Day was appointed as a full time Consultant Surgeon at Moorfields Eye Hospital, London.


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Last updated: Mar 8, 2021 at 4:21 AM

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