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Refractive lens exchange can correct vision by removing the natural lens of the eye and replacing it with a high technology lens implant.

For patients that are wanting to reduce or eliminate the need for glasses or contact lenses and may not be a good candidate for refractive surgery like LASIK, a refractive lens exchange may be a great option for them. Refractive lens exchange (RLE) is used to correct refractive error such as near-sightedness, far-sightedness, and astigmatism by removing the natural lens of the eye and replacing it with a high technology lens implant. This procedure is a great option for those who desire great vision with minimal dependence on glasses or contacts but do not yet have cataracts.

The RLE procedure is identical to cataract surgery.  The only difference is the level of cloudiness of the lens, or cataract.

Lens Options

There are many new advanced intraocular lens implants that allow us to correct a multitude of refractive problems like near-sightedness, far-sightedness, and astigmatism.   By using the Acrysof Toric lens, astigmatism can be eliminated or significantly reduced.  The Vivity lens provides extended depth of focus giving distance and improved intermediate (computer) vision reducing glasses dependency.  We can restore distance, computer and near vision with the PanOptix multifocal lens further reducing your need for glasses.  You can even adjust your vision and customize it after surgery by changing the power of the intra-ocular lens in your eyes with the revolutionary Light Adjustable Lens.

The RLE procedure is identical to cataract surgery except for the fact that the patient has yet to develop a cataract. If you undergo an RLE, you will not later develop a cataract, thus you will never need to undergo cataract surgery as you grow older. Recovery from RLE is quick and your return to normal activities occurs within a few days.

Types of Lenses

Acrysof IQ Toric Lens

Some patients have astigmatism which is a focusing problem causing blur due to an irregularly shaped cornea and/or lens. Glasses and contact lenses can correct this but the standard monofocal lens does not. A Toric lens can be used to help correct astigmatism at the time of cataract surgery while also correcting myopia (near-sightedness) or hyperopia (far-sightedness). For those with astigmatism, the Toric lens provides about a 75% chance of not requiring a glasses prescription for distance vision.  25% of patients will likely need some distance correction and all will still require reading glasses or a bifocal.

  • Monofocal lens for those with astigmatism, which is an irregularly shaped cornea that requires glasses to correct.
  • 25% of patients will need distance glasses.
  • 100% of patients will need reading glasses.

AcrySof IQ Vivity IOL

The AcrySof IQ Vivity IOL has been engineered to deliver an extended depth of focus to patients wanting to lessen their need for computer glasses without the possible side effect of glare or halos around lights that are common with the PanOptix lens and other multifocal lenses. With this lens, the distance focus is as good as the other monofocal lenses but with the benefit of better computer distance vision without glasses. These patients have about an 85% chance of not needing glasses at arm-length and a 50% chance of functional vision at near with good light.

  • Designed to give an extended depth of focus to improve the computer or dashboard distance vision while giving great far distance vision.
  • Many can see their phone, watch, and tablet if held a little further from their eyes.
  • 85% of patients don’t need glasses for arm’s length and 50% of patients don’t need glasses for reading with good light.
  • This technology does not create any glare of halos at night.


Acrysof® IQ PanOptix® Lens

The Alcon PanOptix lens is the first and only trifocal lens that is designed in a way to correct the patient’s vision at all 3 visual planes: near, far, and intermediate (computer) distance. This lens works very well allowing about 80% of patients choosing this lens to be glasses free for everything. About 20% of these patients still need glasses for one of the 3 distance planes, most commonly the far distance. Because of the design and technology of the lens, many people will notice halos around lights, particularly at night, but most are not bothered by them. In fact, 99% of patients say they are very happy with this lens choice, and they would choose this lens again.

  • Multifocal lens giving vision at 3 distances: far, near, and computer distance.
  • Available in a toric lens option for those with astigmatism.
  • 80% of patients don’t need glasses for any distance when using this lens.
  • With this lens design, many patients notice halos around lights at night, but few are bothered by them.
  • Must be place in BOTH eyes for full multifocal benefit.
  • 99% of patients would choose this lens again when surveyed.


Light Adjustable Lens from RxSight®

With all of the above lenses, measurements are taken prior to surgery and lens calculations are performed using those measurements to predict what power of lens will function the best in the patient’s eye. Once the lens is implanted, no further changes can be made to the lens and any residual vision blur will need to be corrected with glasses or contact lenses.

The Light Adjustable Lens (LAL) offers customization to the patient and results that are unmatched by any other lens.

With the LAL, typical preoperative measurements and calculations are performed and routine cataract surgery is completed with the implantation of the LAL. After the eye has healed for 3-4 weeks, UV light treatments are performed to fine tune the focus of each eye. 1-3 treatments are performed on each eye after surgery to adjust the focus of the lens followed by 2 lock-in treatments that prevent any further change in the lens.

This gives the patient a chance to try out their vision while adjustments can still be made. Those patients who select the LAL are twice as likely to achieve 20/20 vision at 6 months without glasses as those who receive a standard monofocal lens.

Since we can alter the power of the lens AFTER surgery, many patients have great success using this monofocal lens to obtain a functional level of near vision in one eye without compromising the distance vision, thus freeing them from glasses use in most situations. By having the opportunity to try out your vision and adjust the focus, the LAL provides a level of customization that no other lens can provide.

  • This is the latest, most advanced intra-ocular lens (IOL).
  • Can be adjusted AFTER surgery to customize postoperative vision.
  • Can correct distance, computer distance, and near vision.
  • Can correct astigmatism.
  • Patients are 2x as likely to achieve 20/20 distance vision at six months compared to those using the conventional IOL.
  • Highly customizable and it gives the patient the ability to “try out” their vision and make changes up to 3x before locking in the final vision.
  • Can improve near vision without compromising distance or night vision.
  • Does require 3-5 additional postoperative, nonsurgical treatment visits to adjust the lens using a UV light.
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