Refractive Lens Exchange

Freedom From Glasses…Over 45!

Refractive Lens Exchange (RLE) enhances your eye’s focusing power by replacing your natural lens with an artificial one. RLE offers the ability to correct both distance and near vision problems.

Tired of Reading Glasses?

RLE is a treatment option for presbyopia, which is the condition that necessitates reading glasses as you age. It is caused by lens stiffening, inhibiting the ability to focus up-close.

In addition, RLE offers an alternative for individuals who are not candidates for laser eye surgery. RLE is best for:

  • moderate to high degrees of myopia/hyperopia.
  • aging individuals experiencing farsightedness due to presbyopia.
  • eliminates the need for future cataract surgery.

Refractive Lens Exchange (RLE) FAQ

Q: What is Refractive Lens Exchange?

A: Refractive Lens Exchange (RLE) is a surgical procedure that replaces your eye’s clear natural lens with an artificial intraocular lens (IOL). The lens changes the eye’s focusing power, thus inserting an artificial lens corrects refractive error, including both nearsightedness and farsightedness. RLE also provides the dual advantage of preventing the need for future cataract surgery, as an artificial lens is not susceptible to cataracts.

Q: How does RLE differ from Cataract Surgery?

A: Both RLE and cataract surgery, replace the eye’s natural lens, with a permanent man-made one instead. The difference is that RLE is an elective procedure, simply decreasing the need for glasses, while removing a formed cataract is medically necessary, as adequate vision cannot be achieved otherwise.

Q: Who is a candidate for RLE?

A: You may be a candidate for RLE surgery if you:

  • are forty-five or older with farsighted vision.
  • do not qualify as a candidate for laser eye surgery, due to acute nearsightedness or farsightedness.
  • wear bifocals or progressives lenses for both reading and distance vision.

Q: What complications may occur with RLE?

A: One percent of patients experience postoperative complications. Despite efforts to avoid such complications, the following may occur:

  • Eye infection (1 in 10,000 cases), usually requires emergency surgery, additional antibiotics and may result in vision loss. Dr. Conlon has not had a case of an intraocular infection in over twenty years.
  • Posterior ocular swelling (1 in 500 cases), is usually resolved with antibiotic drops.
  • Failed removal of the crystalline lens after one operation (1 in 1,000 cases), thus necessitating a second operation.
  • Retinal detachment, occurs when the thin tissue at the back of the eye pulls away from its normal position (1 in 1,000 cases). Requires surgical retinal reattachment.

Q: What testing is required prior to RLE?

A: The Conlon Eye Institute carries out the following tests and measurements prior to surgery:

Computerized Topography images the cornea’s both sides, to determine the degree of corneal astigmatism and orientation, and thus reduce astigmatism. Forms of treatment include laser arcuate incisions, limbal relaxing incisions, and/or a toric implant.

The IOL Master 700 determines intraocular lens power. This device measures the front of the eye’s curvature and its length. This information is used to calculate the lens’ power.

Macular Optical Coherence Tomography (OCT) is used to examine the macula, prior to RLE, to confirm the macular health, and thus eliminating any contraindication for RLE.

Q: Will RLE surgery increase my chances of getting a cataract?

A: Cataracts are a clouding of the eye’s natural lens. As RLE surgery removes the natural lenses, RLE eliminates the possibility of cataract development.

Q: What are the different lenses?

A: Saskatchewan’s Medical Services Branch (MSB) does not cover RLE implants but they are available for private purchase. These include:

  • toric implant besides reducing spherical aberration and enhancing the quality of vision, also reduces astigmatism, making it the best choice for higher degree astigmatism patients. Astigmatism correction is actually built directly into a toric  implant and then rotated to a specific orientation in the eye.
  • multifocal implant can improve both distance and near vision without glasses. This type of implant may cause glare and/or halos but these symptoms tend to diminish with time.

Q: Does insurance pay for RLE?

A: RLE is an elective procedure, and thus is left uncovered by insurance. MSB will cover cataract surgery, so for those experiencing visual impairment due to cataract,the surgery will be covered, minus the costs of upgrades from monofocal lenses. RLE is more expensive than laser vision correction as it must be performed in an accredited non-hospital surgical center.

Q: What technology does Dr. Conlon use to perform RLE?

A: The Conlon Eye Institute uses only the latest technologies to ensure optimal patient outcomes are achieved. For RLE, the LenSX Femtosecond Laser, and the ORA with VerifEye+ Systems, are combined to produce such results:

LenSX Femtosecond Laser performs surgical maneuvers previously undertaken with hand-held surgical tools. This blade-free laser technology completes corneal incisions, anterior capsulotomy and lens fragmentation with a newfound level of precision, consistently ensuring the best refractive outcomes.

The ORA with VerifEye+ System predicts whether a chosen implant will optimize your refractive outcome. Using this information, Dr. Conlon can adjust the implant as needed. The ORA system guides Dr. Conlon during IOL placement, providing real-time micro-measurements mid-surgery, allowing Dr. Conlon to adjust accordingly.