If you’re over 45 and you’re constantly reaching for your reading glasses, you’re not alone. Almost everyone experiences presbyopia at some point in their lives. Presbyopia is the loss of the ability to focus up close with age. But what if there was a way to fix it for good, no glasses or contacts? Refractive Lens Exchange (RLE) is gaining recognition as one of the most effective long-term solutions for presbyopia. In this blog, we take a look at how RLE works, who it is suitable for, and whether it can really cure presbyopia for good.
What is Presbyopia, and how does it occur?
Presbyopia is a natural result of the aging process when the natural lens of the eye slowly loses flexibility. The lens, which normally changes shape to focus on objects at different distances, becomes hard over time. This is why a lot of people in their 40s and 50s start needing reading glasses, because it becomes harder to focus on close-up text or objects close to you.
Presbyopia is not a simple case of the shape of the eye, like short-sightedness or long-sightedness – it is a progressive stiffening of the lens itself. That’s also why LASIK and other kinds of laser eye surgery that reshape the cornea can’t directly treat presbyopia in the same permanent way that RLE can.
What is RLE (Refractive Lens Exchange)?
Refractive Lens Exchange (also known as Clear Lens Extraction (CLE)) is a surgical procedure in which the eye’s natural lens is removed and replaced with an artificial intraocular lens (IOL) of a precisely calculated power. This corrects for refractive errors such as myopia (short-sightedness), hypermetropia (long-sightedness), astigmatism, and presbyopia.
The procedure is basically the same as modern cataract surgery, except that in RLE the natural lens is clear, not cloudy. The surgical technique, called phacoemulsification, uses microsurgical instruments to break up and suction out the natural lens. The plastic IOL is then inserted in its place. The tiny incision seals itself, so it doesn’t need stitches.
RLE is ideal for people aged over 50 years who want independence from glasses and contact lenses. It is performed on an outpatient basis and takes 20 to 30 minutes per eye, and people can usually resume normal daily activities within two days.
Is RLE The Cure For Presbyopia?
Short answer: Yes, RLE is a permanent solution for presbyopia. So, the procedure removes the aging natural lens and replaces it with an artificial lens, thus effectively eliminating the root cause of presbyopia. The artificial lens does not age, stiffen, or degrade in the same manner as the natural lens does.
With a multifocal IOL or monovision approach, patients can have functional vision at multiple distances, near, intermediate and distance, without glasses. Multifocal lenses are lenses that have multiple focal zones on a single lens. Monovision is when one eye is corrected for distance and one eye is corrected for near. Your eye doctor can help you decide what option is best for you, based on your lifestyle and vision goals.
The big thing is, in RLE, the natural lens is removed completely, so patients who undergo the procedure will also never get cataracts, a long-term bonus benefit that many people find very appealing.
Who is the right candidate for RLE?
RLE is ideal for people who:
- Are above 50 years old and are presbyopic
- Present with significant refractive errors (Myopia, Hypermetropia or Astigmatism) with presbyopia
- Not suitable for laser eye surgery, as they have thin corneas or high prescriptions
- Reaching an age where you might naturally develop cataracts
- Desire a long-term, glasses-free fix
What to Expect Before, During, and After RLE Before Surgery
Before Surgery
Your surgeon will conduct a thorough eye exam to determine your prescription and assess your eye health. From these measurements, the power of your custom IOL will be calculated accurately.
During Surgery
The procedure is carried out under local anaesthetic with a mild sedative to help you relax. Eye drops are given, the area around the eye is sterilised, and the whole process takes about 20 to 30 minutes. You will need someone to drive you home and should expect to be at the surgery centre for approximately 2.5 to 3 hours in total.
Post-surgery
RLE is easily recovered from by most people. You will be given eye drops and instructed on how to use them. Try not to rub or put pressure on the eye. Most people are back to work in two days, and strenuous activity should be avoided for a short time. Your surgeon will give you clear instructions about when you can resume driving and other activities.
RLE and Other Treatments for Presbyopia
Contact lenses and reading glasses treat the symptoms of presbyopia, but not the cause. Another surgical option is laser blended vision (a form of LASIK for presbyopia) but again there are limitations particularly in patients with large refractive errors. RLE is unique in that it removes the lens and so the cause of presbyopia is removed forever. It is a complete solution and other refractive errors can also be corrected simultaneously.
RLE is often the most sensible choice in patients in their 50s and older, because it corrects presbyopia today and eliminates the risk of cataracts in the future. It provides long-term clarity of vision at all distances.
Conclusions
Refractive Lens Exchange is a real, permanent solution for presbyopia. RLE (Refractive Lens Exchange) is a procedure replacing the eye’s natural lens with a complex artificial IOL to correct presbyopia and related refractive errors, and to eliminate the risk of cataracts for life. One of the most complete and effective options available today for those over 50 who are tired of wearing reading glasses and want to enjoy lasting visual freedom is RLE.
If you are considering RLE, the most important next step is a thorough consultation with a specialist ophthalmologist to see if the procedure is right for you. The right lenses and expert surgical care give many patients clear, comfortable, glasses-free vision at all distances for the rest of their lives.
Ready to see what you can?
Consult a qualified eye doctor about whether Refractive Lens Exchange is the right solution for your presbyopia. The first step to a life of visual freedom is a thorough eye assessment.
Frequently Asked Questions (FAQs)
1. Is Refractive Lens Exchange permanent?
Yes. Once the natural lens is removed and replaced with an artificial intra-ocular lens the correction is permanent. Under normal conditions the IOL does not break down or need to be replaced. Since the natural lens is removed, presbyopia can not return. Patients will also be immune to cataracts in the future.
2. Refractive Lens Exchange, am I too old?
RLE is especially well suited to patients older than 50 years of age. There is no upper age limit in principle but your ophthalmologist will look at your overall eye health and medical history to see whether you are a good candidate. Great results have been seen with RLE performed on patients in their 50s, 60s and beyond.
3. Will I need reading glasses after RLE?
It depends on the type of IOL selected. With multifocal or extended-depth-of-focus (EDOF) lenses, most patients have good functional vision at near, intermediate and distance without glasses. The monovision approach corrects one eye for near and the other eye for distance. Your surgeon will help you decide which lens option is best for your vision needs and lifestyle.
4. Is lens exchange for refractive purposes safe?
The surgical technique used in RLE is identical to that used in cataract surgery, which is the most common eye surgery in Australia and has an excellent safety record. The rate of complications is low. The pre-operative assessment is comprehensive and ensures that the procedure is appropriate for each individual patient.
5. How long does it take to recover from RLE?
It usually recovers quickly. The majority of patients are able to return to work within two days and resume normal daily activities and moderate exercise shortly thereafter. You will be asked to use eye drops as prescribed, to not rub the eye, and to avoid very strenuous activity during the initial healing period. Your surgeon will let you know when you can drive and do other specific activities.