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Refractive lens exchange surgery

Understanding refractive lens exchange surgery

Many people with a weakness or deficiency in their eyes are able to adequately improve the quality of their vision through the use of glasses or contact lenses, or by choosing to have laser eye treatment if appropriate.

Glasses, contact lenses and laser eye treatment all have their own specific advantages in helping to correct vision, but they also have their limitations:

  • Glasses can be expensive and may be impractical for certain activities such as contact sports,
  • Contact lenses are often a better choice for an active lifestyle, but not being able to wear them when swimming or sleeping can be challenging, 
  • Laser eye surgery can be an inappropriate option for people with a very high eye prescription or a severe case of astigmatism. 

To help correct your vision, you may be advised by a specialist eye doctor (ophthalmologist) to undergo eye surgery. Surgery to improve your eyesight is known as ‘vision correction’ or ‘refractive surgery’, and there are two main types of lens surgery; phakic intraocular lens (PIOL) implantation and refractive lens exchange (RLE) surgery.

This page explains RLE surgery but if you would like to learn about PIOL implantation at St Joseph’s Hospital please click here.

What is refractive lens exchange surgery?

RLE is a surgical procedure to correct vision by removing the natural lens and replacing it with an artificial lens. RLE surgery is the same as cataract surgery, although RLE surgery is carried out to reduce or remove the need for glasses or contact lenses instead of to treat cataracts.

RLE surgery is the primary method of vision correction surgery in people aged over 65.

There are a few different types of lens implant that can be used for RLE surgery and your surgeon will discuss which one is best for you during your consultation.  

Before your surgery, you will be given an eye drop to enlarge your pupils. You will also be given an anaesthetic eye drop to numb your eye, which will help to stop you feeling pain during the procedure.

If you are feeling nervous, you may also be given an injection of a relaxant into your hand or arm to help you remain calm.

Once the anaesthetic has been administered, your surgeon will make a small incision in the surface of your eye.

The lens will then carefully be removed from the lens capsule and the new artificial lens placed in through this gap and positioned correctly using a special gel.

As the incision made is extremely small, often no stitches are needed. The surgeon will be looking at your eye through a microscope while performing the procedure, 

Your eye will then be thoroughly washed with sterile water and antibiotics, to rinse out the gel used for the procedure and to help promote healing and reduce the risk of infection.  

RLE surgery is a short procedure, ordinarily taking around 20 minutes per eye. You will be able to return home the same day as your surgery and you are able to wash and shower as normal.

While you will usually be able to resume regular non-contact sporting activities shortly after surgery, swimming and contact sports are not recommended until your surgeon says they are okay to do.

Your surgeon will tell you when you can start driving again, and this will normally be a few days after surgery.  

You will be given some eyedrops to administer for a period of time after surgery. It is important you use these as advised by your consultant, as they have antibiotic and anti-inflammatory properties, helping to reduce the risk of pain and infection.

You will have scheduled follow-up appointments to assess your recovery and healing, and these will be explained to you by your consultant at St Joseph’s.

Recovering from RLE surgery implantation may take some time, but if you have any queries or concerns at any stage of your recovery, you can contact the ophthalmology team at any time for expert advice.

Any surgical procedure carries risks and the potential for complications, including:

  • Infection,
  • Pain,
  • Reaction to the anaesthetic,
  • Formation of blood clots.

Complications and risks specific to RLE surgery include:

  • Discomfort in the eye,
  • Disturbances in your vision, although these usually settle down over time,
  • Potential loss of vision,
  • Detachment of retina, although this is very uncommon.

The above risks are intended as guidelines only and are not exhaustive. We always recommend that you talk with your consultant about potential risks and complications before you decide to have any surgery.

Should you choose to have RLE, the consultant-led ophthalmology team at St Joseph’s Hospital is at the forefront of ophthalmic care in the UK and will ensure you receive the very finest care and treatment.

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