Refractive Lens Exchange

Until relatively recently, spectacles and contact lenses were the only thing we could use to correct some issues with our vision.

Now, thanks to huge advances in implant techniques and technology, you can say goodbye to both with Refractive Lens Exchage. RLE is a safe, cost-efficient and practical solution for long-term vision correction. It may also be a good option if your age or prescription means that laser treatment isn’t appropriate for you.

Refractive Lens Exchange (RLE), also known as clear lens extraction or PRELEX, is a form of vision correction for short-sight, long-sight, astigmatism or presbyopia. It relies on removing the eye’s natural lens and replacing it with an artificial implant lens.

To understand how our vision changes under certain circumstances, it helps to know a little more about the inner workings of the eyes. In simple terms, the lens of the eye lies just behind the iris. Its function is to focus light rays onto the retina, the light-sensitive layer of nerves at the back of our eyes.

Light passing through a healthy iris and lens to the retina

The way the eye focuses light depends on three main factors:

  • the power of the cornea, which is the part of the eye that acts as a clear window,
  • the power of the lens inside the eye,
  • the length of the eye.

The cornea and lens work together to create a focused image on the retina. The length of the eye remains fixed.

In short-sight (also known as myopia), the eye is “too big” and the clear image falls in front of the retina.


In long-sight (also known as hyperopia or hypermetropia) the eye is “too small” and the clear image falls (theoretically) behind the retina.

In a normally-sighted eye, a healthy young lens has the ability to adjust the eye’s focus, allowing us to see things clearly both near and far away. Many people begin to lose this ability, however, when they reach middle age. Around this time they begin to discover that they need a spectacle correction for reading. This is called presbyopia.

Refractive Lens Exchange works by altering the focus of the eye. It provides clear vision by changing the optical power of the lens. This allows the image to be focused onto the retina, rather than in front of or behind it. A multifocal or accommodating lens can then help to provide near and distance focusing.

There are no hard and fast rules about when to have Refractive Lens Exchange surgery. But if you find that wearing glasses or contact lenses is interfering with your daily life, it’s definitely worth considering the treatment.

Refractive Lens Exchange is technically very similar to modern cataract surgery. Thanks to major developments in surgical technique, the very low risk of complications and the huge visual benefits of modern implant lenses, it has become very popular.

During surgery we remove your natural lens and replace it with a clear, plastic lens implant. It remains permanently in your eye, but you won’t be able to feel it.

If both your eyes require Refractive Lens Exchange surgery, we can help you to decide which eye should be dealt with first. Surgery will be carried out on only one eye at a time. There is usually an interval of one or two weeks between the two procedures, but occasionally we recommend both surgeries on the same day.

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