How Successful is Refractive Lens Exchange? Expert Insights from an Eye Surgeon at Swagel Wootton Eye Institute.

With the expanded availability of equipment, innovations in phacoemulsification techniques and artificial lenses, and a growing aging population, the popularity of refractive lens exchange (RLE) has significantly increased in recent years. At Swagel Wootton Eye Institute in Arizona, we often recommend it for patients who meet specific criteria and may not be well-suited for laser refractive surgery such as LASIK or photorefractive keratectomy (PRK). RLE offers a reliable path to long-term vision correction with considerable advantages, a low risk of complications, and high success rates.

What is RLE?

RLE, also known as clear lens exchange (CLE), aims to improve vision and reduce or eliminate reliance on corrective eyewear. It’s often an ideal procedure for individuals who wish to correct presbyopia or moderate to severe degrees of refractive errors such as myopia, hyperopia, or astigmatism. Similarly to cataract surgery, RLE involves an eye surgeon removing the eye’s natural lens and replacing it with an artificial intraocular lens (IOL); however, no cataracts are present with RLE.

Contributing Factors to RLE’s Success

Most studies show an average RLE success rate of more than 90% with substantial improvement in visual acuity, especially in people with high degrees of farsightedness or presbyopia. Millions of people achieve 20/20 vision after RLE. However, results may vary based on patient candidacy, accuracy of IOL selection, post-operative care, and eye surgeon skill. Generally speaking, a lens replacement surgery like RLE is a quick, safe, and comfortable procedure and an effective and reliable alternative to laser eye surgery. Our eye surgeons at Swagel Wootton Eye Institute believe several benefits contribute to RLE’s high success and satisfaction rates.

Tailored Results for Reduced Dependence on Corrective Eyewear

One of the biggest draws of RLE is the freedom from glasses or contact lenses. With lens technology advancements, IOLs can now address astigmatism with toric lenses or allow for greater visual independence across a range of distances with multifocal lenses, reducing or eliminating the need for reading glasses or bifocals.

Minimal Risk of Regression and Permanent Results

Unlike other refractive surgeries where vision quality may diminish over time, such as LASIK or PRK, the effects of RLE are largely permanent. RLE involves the removal of the eye’s natural lens, so the possibility of regression — the return of vision impairment over time — is minimal. Because of this, RLE greatly reduces the need for future eye surgeries.

Importantly, although IOL exchange procedures are uncommon, they are possible if a patient is experiencing complications with their initial IOL or dissatisfaction with their visual outcomes.

Future Cataract Prevention

RLE replaces the eye’s natural lens with a synthetic IOL and effectively eliminates the risk of cataract development. The dual benefits of immediate vision improvement and future cataract prevention add tremendous value and present a significant advantage for patients.

Risks and Considerations of RLE

Risks associated with RLE are relatively minor in most instances, but as with any surgical procedure, they are possible. Although uncommon, retinal detachment is the most serious of these risks. Other complications can include:

• Posterior capsular rupture
• Posterior capsular opacification, or secondary cataracts
• Infection and inflammation
• Visual disturbances, such as glares and halos
• Temporary or persistent dry eye

While these risks are relatively minor in most instances and can typically be treated with medications or additional surgeries, they must be carefully considered. Understanding that there may be an adaptation period and the importance of appropriate post-operative eye care are critical considerations as well.

As refractive surgeons, we take critical precautions to minimize these risks, including properly sterilizing and using appropriate and advanced equipment, providing essential pre- and post-operative education and guidance, and closely monitoring the patient’s eye health and recovery following surgery.

Request an RLE Consultation at Swagel Wootton Eye Institute

At Swagel Wootton Eye Institute, our entire team – from our front desk teammates and consultation counselors to optometrists and eye surgeons – takes extreme pride in our commitment to patient safety, comfort, and results. We understand the key factors supporting patient-centered care and successful CLE outcomes, including patient selection and education, surgical precision and techniques, and post-operative care and support. Request an appointment today to learn more about CLE, LASIK, PRK, or other refractive surgery options that may be right for you.

About Dr. Loan Ramsey, F.A.C.S.

Loan Ramsey, MD, is the Medical Director and lead surgeon of Swagel Wootton Eye Institute and specializes in advanced cataract surgery, laser-assisted cataract surgery, and premium IOLs. She has performed more than 10,000 surgical procedures and has been nominated for the Best Cataract Surgeons in America organization.