Explore refractive lens exchange in Adelaide

A new way to approach your changing vision

Lens replacement, also known as refractive lens exchange (RLE), is a procedure used to manage age-related changes in vision. The eye's natural lens is removed and replaced with a clear artificial lens, giving access to premium intraocular lens (IOL) technology that can support vision at a range of distances. As reading vision shifts with age, it is natural to look for solutions that feel right for you.

RLE suitability criteria

Lens replacement may be considered for people who:

• are 50 years or over (exceptions may be made based on individual circumstances)
• have a spectacle prescription for distance or near vision, or both
• wish to become less reliant on their glasses or contact lenses

How RLE works

The surgery is similar to cataract surgery. The eye's natural lens is removed and replaced with an artificial lens. This gives patients access to premium intraocular lens (IOL) technology, which can support spectacle independence at different distances.

The lens implant can be chosen from a variety of types, based on your requirements determined at your consultation at IVISION LASER. Dr Gupta takes the time to conduct a full assessment of your eyes and to help you make the decision that is suitable for your eyes.

Possible advantages of RLE

Refractive lens exchange uses an artificial intraocular lens (IOL) to replace the natural lens of the eye. Some people explore this option because it may:

• provide access to a range of lens designs that support different visual needs
• reduce how often they rely on glasses or contact lenses
• offer an option for people with higher prescriptions or age-related near-vision changes
• appeal to individuals who prefer not to wear contact lenses long-term
• replace the natural lens, meaning a cataract cannot develop in that eye later in life

Lens (IOL) options

Lens replacement allows for a choice of visual outcomes. IVISION LASER offers the following intraocular lens (IOL) types:

• Monofocal. You will see in the distance but need glasses for middle and near tasks.
• Blended vision (monovision). Your dominant eye is set for distance and your non-dominant eye for near. Together this allows for good vision at both distances. Glasses may still be needed in some instances, such as driving at night and reading fine print.
• Multifocal / trifocal. A trifocal lens design allows three focal points, so you can see in the distance, middle and near. There may be minor effects such as haloes at night, though most people adapt over the first three months after surgery.
• Extended depth of focus (EDOF). These lenses combine multifocal and EDOF technology to elongate your focus. Glasses may still be needed some of the time, such as for reading fine print, though there are fewer side effects. EDOF lenses are often known as a "social" lens.
• Toric (astigmatism correcting). Modern IOLs can correct even small levels of astigmatism. Dr Gupta uses the Callisto marking system to help ensure correct alignment of the IOL in your eye.

RLE risks

Lens replacement eye surgery is generally considered a safe procedure. However, like all types of surgery, it does carry some risk. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Minor risks include:

• Dry eye
• Posterior capsular opacification, which can require YAG laser
• Oedema or swelling of the eye

Major risks include:

• Infection (approximately 1 in 2000)
• Retinal detachment
• Loss of best corrected visual acuity

The RLE procedure and recovery, step by step

• The surgery is performed as a day procedure, so you can return home the same day.
• The procedure itself takes about 10 minutes per eye and is done under local anaesthesia with IV sedation to keep you comfortable.
• The surgery is performed through a very small 2 mm incision that is self-sealing.
• The natural lens is removed and replaced with a new artificial intraocular lens (IOL).
• Only one eye is operated on at a time. The second eye may be treated the following day or week, and usually the most affected eye is treated first. Increasingly, patients choose to have the second eye treated the day after the first.
• Recovery from surgery is about 1 to 3 days, and it is important not to drive during this time.

RLE options and alternatives

If lens replacement is not the right fit for your eyes, alternatives include:

• Laser correction with both eyes corrected for distance
• Laser correction with both eyes corrected for monovision
• Laser correction with a multifocal corneal ablation in both eyes, such as PRESBYOND laser blended vision

Where a natural lens has become cloudy, cataract surgery uses the same lens-replacement technique with premium lens options available.

RLE results

Lens replacement changes the way the eye focuses by replacing the natural lens with an artificial one. Each person's experience is different, and your clinician will explain what results may be realistic for your eyes.

Some people say they rely less on glasses after the procedure, while others may still use glasses for certain tasks. Your outcomes depend on your eye health, the lens selected and your visual needs.

How RLE compares to laser treatments

Laser treatments such as PRESBYOND, LASIK and TransPRK reshape the cornea and leave your natural lens in place. Lens replacement instead removes the natural lens and replaces it with a lens implant, which is why it can also prevent a future cataract in that eye. For people with presbyopia or stronger long-sightedness, RLE may be considered where corneal laser treatment is less suitable. The right option depends on your eyes, your age and your lifestyle, and is confirmed at your assessment.