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Refractive Lens Exchange (RLE) is essentially cataract surgery, but exclusively for refractive purposes. SuperSight Surgery is probably the most advance RLE, Clear Lens Extraction (CLE), and Refractive Lens Replacement (RLR). RLE is often an appropriate alternative to conventional or Wavefront LASIK, All-Laser LASIK, iLASIK,SuperLASIK,PRK, LASEK, Epilasik if the patient is Presbyopic.
Exchange The Natural Lens
In RLE the natural lens of the eye is removed and replaced with a silicone or plastic intraocular lens (IOL). The replacement IOL is of a power to correct most, if not all, of the patient's hyperopia or myopia. RLE alone is not very successful at correcting astigmatism. To correct astigmatism, conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, CK, or Epi-Lasik may be required in addition to RLE.
Advantages of RLE
There are several advantages to RLE over other forms of refractive surgery. Some of the most obvious are that the surgery has years of successful history and the cornea is relatively untouched. If you have a thin cornea, dry eyes, or other minor cornea problems, RLE may be a better alternative. RLE may be the only option for people with high refractive error. Also, if the exact desired refractive change is not achieved, the IOL may be exchanged for one of a different power, or a cornea-based refractive surgery technique such as conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, CK, or Epi-Lasik may be used in combination with RLE to "fine tune" the correction. Because RLE removes the natural lens, there is no possibiliy of developing a cataract in the future.
Disadvantages of RLE
A big disadvantage with RLE is that it is a significantly more invasive surgery than any cornea-based refractive surgery.
See Distant and Near
Most IOLs cannot accommodate by changing focus from distance to near like a young and healthy natural lens. Your eye will be set to either near vision or far vision. New accommodating IOL designs such as the Crstalens do have the ability to provide a limited range of accommodation. You may also have multifocal IOLs such as the ReSTOR, Tecnis, ReZOOM and the Acri.LISA implanted that help with near and distance vision. You will need to discuss with your doctor if a multifocal or accommodating IOL is appropriate for your circumstances.
If you already have cataracts starting to form, RLE may make a lot of sense. If you are already presbyopic, RLE may be a better alternative. There is little need to have surgery affecting the cornea if within a short period of time you will be having cataract surgery anyway or you already cannot change focus from distance to near.
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REFRACTIVE SURGERY
Single Surgery, Permanent Solution