Refractive Lens Exchange (RLE)

Myopia, also known as nearsightedness, is a common type of refractive error where near objects appear clearly, but far objects appear blurry. This happens when the eyeball is too long or the cornea has too much curvature, causing light to focus in front of the retina instead of directly on it.

The medical term for farsightedness is hyperopia. Farsightedness is a common refractive error in the eye that affects the ability to see close-up objects. In farsighted individuals, light entering the eye focuses behind the retina instead of directly on it. This can result from an eyeball that is too short or a cornea that has too little curvature.

Astigmatism causes your vision to be blurred at both near and far distances. It occurs when your cornea is shaped more like a football than a basketball.

Key features of astigmatism include:

• Blurred or Distorted Vision: Individuals with astigmatism often experience blurred or distorted vision at both near and far distances.
• Eye Strain and Discomfort: Astigmatism can lead to eye strain, headaches, and discomfort, especially after prolonged periods of reading or computer use.
• Difficulty with Night Vision: Some people with astigmatism may notice challenges with night vision, including glare and halos around lights.
• Combination with Other Refractive Errors: Astigmatism can occur on its own or in combination with nearsightedness or farsightedness.

Presbyopia is a common age-related vision condition that affects a person’s ability to focus on near objects or read small print. It is often referred to as “aging eyes” or “age-related farsightedness”. Presbyopia typically becomes noticeable in the late 30s or early 40s and continues to progress with age.

People with early presbyopia often notice they need more light to read, and have to hold reading material at arm’s length to focus.

You should consider RLE if:

• You are dependent on reading glasses or bifocals for your near tasks
• You have a high level of farsightedness
• You have been diagnosed with early lens changes and feel that the quality of your vision has declined, but do not as yet have a significant cataract

Although you will need a ride home from the procedure, you will be able to resume most normal activities within a few days—with most patients able to resume driving as well.

Patients cannot feel the intraocular lens implants at all after the eye has healed, typically 8-12 weeks after surgery. Any initial discomfort or feeling at the edge of the lens is temporary and resolves as the eye adapts to the new IOL.

RLE and cataract surgery both replace the natural lens of the eye with an artificial intraocular lens. However, cataract surgery is performed to remove a cloudy, cataract-affected lens and restore clear vision. In contrast, RLE involves removing a lens with an early stage cataract (or no cataract at all) to correct refractive errors and improve overall visual acuity.

The choice between RLE and LASIK depends on your individual circumstances and visual needs. LASIK is generally recommended for individuals with mild to moderate refractive errors and a stable prescription. It is a corneal-based procedure that reshapes the cornea to correct vision.

On the other hand, RLE is often preferred for individuals with higher degrees of refractive errors, presbyopia, or those who may not be suitable candidates for LASIK due to factors such as thin corneas or dry eye conditions. RLE is an alternative to LASIK that offers a permanent solution by replacing the natural lens with an IOL.

Your ophthalmologist will evaluate your condition and provide personalized recommendations based on your age, refractive error, overall eye health, and lifestyle preferences.

Yes, it is possible to undergo RLE after having LASIK surgery. In some cases, individuals who have previously undergone LASIK may develop presbyopia or experience a shift in their refractive error over time. RLE can be performed to address these changes and further enhance visual acuity.

However, it’s important to note that a previous LASIK procedure may affect the calculations and considerations for RLE surgery. Your surgeon will consider the changes made to your cornea during LASIK when determining the appropriate IOL power and surgical approach.

Most health insurance plans do not cover RLE surgery as it is considered an elective procedure. However, some insurance providers may offer partial coverage or discounts for certain IOLs or specific medical conditions.

If you have a vision insurance plan,it is always advisable to consult with your insurance provider and discuss your specific coverage options before proceeding with RLE surgery.. Additionally, some employers may provide flexible spending accounts (FSAs) or health savings accounts (HSAs) that can be used to cover a portion of the RLE surgery costs.

RLE is a permanent solution for vision correction. The artificial IOL implanted during the procedure and the refractive correction it provides are designed to last a lifetime.

RLE is considered a safe and effective procedure when performed by a qualified and experienced eye surgeon. Like any surgical procedure, there are potential risks and complications associated with RLE, but they are typically rare and can be reduced by following your surgeon’s pre-and post-operative instructions carefully.

Potential risks and complications of RLE may include:

• Infection
• Retinal detachment
• Intraocular pressure issues
• Bleeding or inflammation
• Halos or glare around lights
• Dry eye symptoms
• Residual refractive error

Your ophthalmologist will thoroughly evaluate your medical history, eye health, and overall suitability for RLE to ensure the procedure is performed safely and with minimal risk.