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Refractive Lens Exchange (RLE)
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RLE (also called "Clear Lens Extraction" or CLE) is a surgical procedure that uses the same successful techniques of modern cataract surgery. These surgical techniques have evolved and improved dramatically over the last 20 years.
Cataract surgery is now the most common surgical procedure performed in medicine today.
The main difference between standard cataract surgery and RLE is that cataract surgery removes a patient's cloudy natural lens that is obstructing their vision, while RLE removes the clear natural lens of the eye to minimize a person's dependence on bifocal glasses or contact lenses.
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| RLE is for those who: |
- Want to be less dependent on bifocal glasses or contacts for far, near and intermediate vision.
- Are outside the corrective range of LASIK and other refractive procedures. .
- May be showing signs of clouding in their natural lens even though this clouding is not yet interfering with vision.
- Have no health issues affecting their eyes.
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Cataracts are a part of the normal aging process and if a person lives long enough, chances are they will develop cataracts. People who have RLE now will not ever need cataract surgery. RLE corrects vision by replacing the eye's natural lens, which has the wrong focusing power, with an artificial multifocal intra-ocular lens (IOL) such as the ReSTOR, ReZoom, and Crystalens lenses. These IOL's have the correct focusing power for the eye. Having this multifocal lens implant creates a new "visual system" inside the eye, one that can provide the focusing power to see near, intermediate and far images with little to no need for glasses. Monofocal lenses on the other hand, provide clear vision at only one point of focus.
 Here are two eye charts to help illustrate the range of focus between monofocal lenses and multifocal lenses. The image on the far left is what a person would see at about 16 inches. On the far right is what they would see at about 12 feet.
As you can see, looking through the monofocal lens, near vision is blurry but as you get farther away, it becomes clear. While looking through the multifocal lens, the close, intermediate and far images are clear.
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| What to expect on surgery day: |
 The RLE procedure is performed on an outpatient basis. Only one eye will be treated at a time and the procedures are typically separated by one to two weeks. After your eye is completely numbed with eye drops and mild sedation has been given, your eye's natural lens will be gently vacuumed out through a tiny incision, about one eighth of an inch wide. Next, the multifocal lens will be folded and inserted through the same micro-incision. It will then be unfolded and placed into the "capsular bag" that originally surrounded the natural lens. This incision is "self-sealing" and usually requires no stitches. This type of incision heals fast and provides a much more comfortable recuperation.
You will go home soon after the surgery and relax for the rest of the day. Everyone heals somewhat differently but many patients report improvement in their vision almost immediately after the procedure. Most patients return to their normal activities within a day or two.
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| Realistic expectations |
 It is extremely important to understand that with multifocal implants you are getting a new "visual system." You've spent years learning how to use your visual system. It will naturally take time for your brain to adjust to a new visual system. Following RLE, some patients initially notice halos around objects, especially at night. Over time this generally resolves. With RLE we typically use a multifocal IOL (Smart Lens such as ReSTOR, ReZoom, Technis Multifocal or Crystalens), but sometimes we implant a monofocal IOL or a toric IOL that corrects astigmatism.
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| Alternatives to RLE |
| RLE is not the only surgical procedure designed to reduce the need for bifocal and reading glasses. At the Alabama Vision Center, we are committed to offering the most current and comprehensive vision correction options available. Our experienced staff can customize a vision correction procedure for you. Call 800-841-EYES to set up a free consultation with one of our doctors. We look forward to "seeing" you! |