Lens Replacement Surgery or Refractive Lens Exchange (RLE)

Laser eye surgery can be considered at any age. For some patients over 55 however, laser surgery is not always the best option. Refractive Lens Exchange is a particularly good choice for patients over the age of 55 years. Often at this stage, the natural lens starts to lose its functionality and reading glasses are required as well as distance glasses.


What is Refractive Lens Exchange (RLE)?

RLE involves the replacement of the natural lens in the eye, with a new mono-focal, Toric or multi-focal intra-ocular lens implant (IOL). Accurate measurements of the eye taken prior to surgery allow for a bespoke, customised intra-ocular lens (IOL) to be implanted which can correct for any degree of long or short-sightedness and astigmatism so that clear distance vision without glasses is a reality. With the choice of premium lens implants, achieving excellent reading vision without glasses may be achieved allowing for true spectacle independence.

Benefits for you

The benefit of Refractive Lens Exchange (RLE) surgery is that it is either the only or the most appropriate procedure for treating certain eye conditions and vision problems. Specifically, it is the best way to fix presbyopia and extreme far sightedness, and in fact might also be the only way to get clearer vision without still relying on glasses post-surgery. It also has other benefits, such as:

  • Treats or prevents cataracts, astigmatism, presbyopia, long-sightedness, short-sightedness, corneal problems and dry eyes
  • Removes reliance on glasses and other corrective lenses and reduces the headaches and eye strain associated with their use
  • Acts as an alternative for people who are not able to have other corrective eye surgeries like Laser for whatever reason. It also generally improves the eye health and reduces the likelihood that you’ll develop an eye infection in long-term contact wearers.

Am I suitable?

Lens replacement surgery could be just what you need if you have any of the following:

  • Dependence on bifocal, varifocal or multifocal contact lenses or glasses
  • Presbyopia
  • Long-sightedness (hyperopia)
  • Short-sightedness (myopia)
  • Astigmatism
  • Cataracts


The lens exchange procedure takes between ten and fifteen minutes and is virtually painless. It is usually performed under local or topical anaesthetic. Patients return home the same day of their treatment and most see an immediate improvement in their vision.

Most patients will have their second eye treated within a couple of weeks and it is following this that the most dramatic results are seen.

If you are interested in finding out more about replacement lens exchange and your suitability, please contact us and we will be happy to arrange a consultation.

Your Journey

RLE is exactly the same operation as cataract surgery but performed for the purpose of correcting your sight and eliminates the need for cataract surgery in the future.

RLE is considered a relatively straightforward day surgery procedure, with patients returning home within several hours of the operation.

Before you leave the day surgery, you will be prescribed eye drops or other medication to prevent infection and reduce inflammation. You will need to have a family member or friend with you to take you home. Once you get home, it is recommended that you rest your eyes and nap. Several hours post surgery, most people are able to watch some television or look at a computer screen for a short period of time. Because RLE surgery is only performed on one eye at a time, you may notice an imbalance in your vision until the second eye is operated on (from 2–3 weeks later).

It is normal for vision to be blurry in the beginning – your eye needs to heal and adjust. Vision will normally begin to improve within a few days of the surgery. It’s also normal for your eye to feel itchy and to experience mild discomfort for a couple of days – you will be asked to wear an eye patch or protective shield at night to ensure you don’t rub your eye while you sleep. This discomfort should disappear after a few days.

While everyone is different, the average experience for the weeks following RLE surgery involves a gradual recovery of the eye. Adjustments in vision will occur for a few months after surgery.

Although most people can resume everyday activities 24 hours after surgery, there are a few instructions that you will be asked to follow. They include:

  • Don’t do any strenuous activities for a few weeks. Avoid rigorous exercise and heavy lifting
  • Don’t drive. The length of time after surgery before you can drive depends on a number of factors – your doctor will tell you when it is safe to resume driving
  • Follow your doctor’s orders regarding any antibiotic and anti-inflammatory eye drops. These are important to prevent infection and inflammation and ensure proper healing. If you have difficulty in administering them, get a friend or family member to help you out
  • Stay away from dusty areas. It’s a great idea to have your house vacuumed and cleaned before surgery, as your eyes will be sensitive to airborne allergens such as dust
  • Don’t rub your eye. Eye rubbing is a quick way to develop a nasty infection. It’s never a good idea, even when you aren’t recovering from surgery
  • Don’t swim. It’s best to avoid swimming or hot tubs for a week after surgery
  • Don’t wear make-up. Ask your doctor when you can resume doing so


There are several types of lens and these are namely; monofocal, multifocal (also called bifocal), EDoF (Extended Depth of Focus) and toric for the correction of astigmatism. Sometimes combining lenses is necessary and it may even be necessary to have lenses specially made. Accurate measurements and an in-depth consultation are needed prior to the procedure to ascertain which lenses or combination of lenses best suit you and your lifestyle.
Cost of the surgery can vary on the type of Lens chosen for your eyes needs.

Contact details

Nuffield direct on 0300 790 6190
Or Mr Anandan’s Secretary Sue Da Silva on 07900210191 or email manandan@derbyeyes.co.uk

Nuffield Health Derby Hospital. 
Rykneld Road, 
DE23 4SN

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