Refractive Lens Exchange
(RLE)
Refractive Lens Exchange is a procedure becoming more popular in recent years.

For individuals whose prescription exceeds the range of the laser (which is usually considered to be between -10.00D of short sight to +5.00D of long sight), it is safer to perform surgery within the eye. Instead of using a laser to re-shape the cornea, the natural human lens can be replaced completely with an artificial lens of the right power to correct the vision (known as refractive lens exchange).

 

The Technique

The technique is very similar to cataract surgery. The natural lens is removed through a very small (2.4mm) incision using a sophisticated ultrasonic probe and the acrylic implant is inserted through the same incision. This can be done with the femtosecond laser. In most cases no stitches are required and visual recovery is rapid. The surgeon positions the lens to focus light clearly onto the retina.


Refractive Lens Exchange


The procedure is comfortable for patients as very little is felt during surgery. David Gartry will explain what is happening as he performs the surgery and the nursing staff will be there at all times to reassure you throughout. After the artificial lens is inserted the procedure is complete. The highest spectacle prescription that David Gartry has treated with this technique was -37.00D! The patient, an elderly lady who also had cataracts, was left with just -1D of short sight.

LENTIS Mplus lens

One of the disadvantages of refractive lens exchange is the need to wear reading glasses after treatment, unless multifocal implants are used (which also have their limitations). The procedure therefore tends to be reserved for patients (over the age of 40) who already need additional glasses for reading. A more recent procedure using phakic lens implants, can overcome the problem of reading glasses. Here, a secondary lens is inserted in front of the natural lens. The natural lens remains in place and can continue to adjust its focus for reading. Phakic implants are a relatively recent development and still the subject of evaluation.

“I am absolutely thrilled with the transformation in my sight. Like many people my sight had deteriorated with age causing me greater frustration and inconvenience. Professor Gartry replaced my natural lenses and thus liberated me from the constant use of specs.” Christine, Refractive Lens Exchange Patient at The David Gartry Eye Clinic