Refractive Lens Exchange (RLE)

What is Refractive Lens Exchange (RLE)

Refractive Lens Exchange, also known as clear lens exchange is a highly precise surgical method of replacing the natural lens of the eye with an intraocular lens (IOL), this is not changing the lens of the eye but replacing it entirely. Conditions such as extreme farsightedness, nearsightedness, or presbyopia (blurred near vision due to the hardening of the lens due to age) can be corrected with this procedure while other surgeries such as LASIK cannot. Refractive lens exchange is an alternative to laser vision correction and is surgically very similar to cataract surgery.

The Benefits of Refractive Lens Exchange Include:

  • Quick Recovery
  • Can help you see both near and far
  • Major decrease of dependency on corrective lenses
  • Prevents any future development of cataracts
  • Enhanced vision
  • Permanent solution that lasts a lifetime

Patients who choose to undergo refractive lens exchange have several options when it comes to the IOL that will be implanted into the eye. This procedure uses the same IOLs as cataract surgery and can treat all visual disorders, including astigmatism. We offer patients the most advanced premium IOLs that allow patients to see clearly at a greater range of distances. Some of the most common IOLs include PanOptix®, Vivity®, Synergy® multifocal lenses, and Toric astigmatism correcting lenses.

Seek vision correction through refractive lens exchange.

Refractive Lens Exchange is Ideal for Patients Who

  • Want to reduce or eliminate their dependence on glasses or contact lenses
  • Are over 45 years old
  • Have high myopia (nearsightedness), high hyperopia (farsightedness) or presbyopia and/or astigmatism, with or without cataracts
  • Have early symptoms of cataracts

Many patients with extreme farsightedness or nearsightedness are not candidates for LASIK, and seek vision correction through refractive lens exchange.

Refractive lens exchange is performed on an outpatient basis and uses the same techniques as cataract surgery. Instead of removing a cloudy lens, the goal of this procedure is to reduce a patient’s dependence on glasses or contact lenses by replacing the natural lens with a corrective lens.

Learn More about Near Vision Decline

The Procedure

Local anesthesia is applied to the eyes to minimize discomfort during this procedure. The natural lens is removed through a tiny incision less than 3mm and replaced with an IOL that is inserted through the same incision. Once inserted, the lens unfolds and moves into its permanent position in the eye. There are usually no stitches needed as the incisions can heal themselves. The refractive lens exchange procedure takes less than 20 minutes to perform and offers patients significant results within days.

Refractive Lens Exchange Results & Recovery

After refractive lens exchange, patients can return home the same day and can return to work and other regular activities after a day or two. Many report immediate improvements to their vision, and vision will continue to improve as the brain adapts to the new lens. Once your vision has stabilized, it will likely stay the same over time as the lenses correct vision and also prevent the patient from developing cataracts in the future. The second eye is usually treated within a few weeks after the first procedure.

Refractive Lens Exchange is one of the most permanent and successful eye surgeries that can be performed. Dr. Bansal has offered Refractive Lens Exchange in the San Francisco Bay Area to many people who are now enjoying glasses and contact lens free lifestyles.

Many patients are able to eliminate their dependence on glasses or contacts after this procedure, while others may still need glasses for driving or reading.

Refractive Lens Exchange Risks & Complications

Since refractive lens exchange is a completely different procedure from laser vision correction, its associated risks are different as well. The risks are more similar to cataract surgery and include infection, hemorrhage, visual distortion, retinal detachment, and dryness. The doctor will discuss these risks with the patient, along with the benefits of the procedure, before deciding if refractive lens exchange is right for the patient. Patients can minimize these risks by choosing an experienced doctor to perform their procedure.


We know that cost is important to you. That’s why we want to provide you with all the information you need to make a decision about your eyesight.  You can save thousands of dollars by ditching your glasses and contacts.


2 Year Financing

RLE should be affordable for everyone. With 24-month financing, you can make payments that work for you.

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Flex Spending

If you have a Flexible Spending Account (FSA) through your employer, you can save hundreds on RLE.

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Cost vs. Risk

As with every surgery, the cost and the risks of RLE should be carefully considered beforehand.

Refractive Lens Exchange FAQs

I had LASIK years ago and now need reading glasses. Did my LASIK wear off?

LASIK is permanent and does not wear off. LASIK corrects your vision by changing the shape of your cornea, which is the outer layer of your eye, to help your eyes better focus light onto the retina (back of the eye). When you near your 40s, your up-close vision starts to become blurry, caused by the decreased flexibility of your eye’s lens. This condition is called Presbyopia, and is not related to or caused by LASIK. This can be treated with by Refractive Lens Exchange (RLE), where your natural lens is replaced with an intraocular lens (IOL).

I’ve had perfect vision for years. Now I am having a hard time seeing a menu, my cell phone, and reading other things up close. Why is my vision changing?

When you are young, the lens inside your eye is extremely flexible and allows you to easily focus on close objects. Over time, the lens gradually loses its flexibility, making it difficult to focus on close objects. This condition is called Presbyopia and is a normal, natural part of the aging process that happens to everyone, even those who have never needed glasses before.

Why do I need bifocals and reading glasses over age 40?

There are multiple elements within your eyes that contribute to your ability to see clearly. One of the most important is the actual lens that light passes through. In your 20s and 30s, the lens is clear and flexible, meaning that it can flex to focus on objects at different distances. As you enter your 40s, your lens begins to change. This is called Presbyopia results in near vision changes and the need for bifocals and reading glasses.

If I had vision correction, why do I still need to have annual eye exams?

Our commitment is to help you achieve the best vision possible at each stage of life. Early detection of eye conditions is the best way to preserve good quality vision throughout your life, so it is important for an eye doctor to monitor the health of your eyes on a regular basis.

If I choose to have RLE to fix my Near Vision, how do I know which Intraocular (IOL) is right for me?

At the time of your evaluation we will do a thorough assessment of your visual needs and the optics of your eye. Based on the evaluation, we will recommend the technology that will give you the best possible results.

If I need to, will I be able to wear contact lenses or reading glasses after RLE?

The goal of these treatments is to reduce your need for glasses and contact lenses in as many situations as possible. There may be some specific visual needs where you may benefit from glasses or contact lenses.

Can I have cataract surgery if I need it in the future?

One of the biggest benefits of RLE is that after you have had the procedure, you will never develop cataracts as your natural lens will be removed during the RLE procedure.

What is presbyopia?

When you are young, the lens inside your eye is extremely flexible and allows you to easily focus on close objects. Over time, the lens gradually loses its flexibility, making it difficult to focus on close objects. This condition is called Presbyopia (prez-bee-OH-pee-ah) and is a normal, natural part of the aging process that happens to everyone, even those who have never needed glasses before.

San Francisco

LaserVue LASIK and Laser Eye Surgery Center San Francisco
711 Van Ness Ave Suite 320,
San Francisco, CA 94102
Location & Map 1-800-527-3745 1-415-346-5500

Santa Rosa

Santa Rosa Business Location
3540 Mendocino Ave. #200,
Santa Rosa, CA 95403
Location & Map 1-800-527-3745 1-707-522-6200

Mountain View

Laservue LASIK Center in Mountain View
1174 Castro St., #112,
Mountain View, CA 94040
Location & Map 1-800-527-3745 1-650-966-0900

You can also Call 1-800-527-3745 to speak with our staff