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Refractive Lens Exchange (RLE)?

Refractive Lens Exchange (RLE) is an alternative option for individuals over the age of 50 who experience vision problems such as myopia, astigmatism, and presbyopia, but are not suitable candidates for LASIK due to high refractive errors, thin corneas, inability to undergo ICL (Implantable Collamer Lens), or early signs of cataract.

Refractive Lens Exchange (RLE)?

Refractive Lens Exchange (RLE) is a surgical procedure that involves removing the eye’s natural crystalline lens and replacing it with an artificial intraocular lens (IOL) specifically designed to correct refractive errors such as presbyopia, myopia, or astigmatism. This technique is similar to cataract surgery; however, RLE is performed electively to enhance visual quality rather than to treat cataracts.

There are several types of intraocular lenses available for RLE, including:

• Monofocal IOLs – designed to provide clear distance vision
• Multifocal or Trifocal IOLs – allowing for clear vision at near, intermediate, and far distances
• Extended Depth of Focus (EDOF) IOLs – designed to extend the range of vision

Patients can select the type of lens that best suits their lifestyle and visual needs based on thorough consultation and recommendations from their ophthalmologist.

Who is a suitable candidate for Refractive Lens Exchange (RLE)?

Individuals aged 50 and above who experience refractive errors such as myopia, astigmatism, or presbyopia, and are not suitable candidates for LASIK or ICL.
Individuals with early signs of lens clouding or cataract, which may present as blurred vision, reduced clarity even with glasses, or glare and halos. These conditions cannot be effectively corrected with LASIK or ICL.
Individuals who wish to reduce or eliminate dependence on glasses for all distances—near, intermediate, and far.

However, patients with conditions such as age-related macular degeneration or certain types of glaucoma may not be suitable candidates for RLE and should undergo a thorough evaluation by an ophthalmologist.

Additional Information: Vision correction through intraocular lens (IOL) implantation is suitable for individuals with cloudy natural lenses and coexisting refractive errors. Before undergoing refractive surgery, it is recommended to consult an ophthalmologist to evaluate the appropriate surgical approach, understand the indications, potential complications, available alternatives, and limitations of the treatment.

How many types of intraocular lenses (IOLs) are there?

Whether for cataract surgery or Refractive Lens Exchange (RLE), one of the most critical steps in the procedure is selecting the appropriate type of intraocular lens (IOL) to replace the natural lens. Each type of IOL has distinct features and limitations, which directly affect the quality of vision in daily life.

Today, a wide variety of intraocular lenses (IOLs) are available, which can be broadly categorized into three main types based on their visual performance:

1. Monofocal IOL – Single-focus lens

It is the most commonly used and basic type of intraocular lens.

It provides clear vision at a single fixed distance, typically for distance vision.
Patients will still require reading glasses or near-vision correction for close-up tasks after the surgery.

Advantages: Provides good quality distance vision with minimal glare. It is also cost-effective.

Limitations: Provides clear vision at only one distance; patients need to wear glasses for intermediate and near vision.

2. Multifocal / Trifocal IOL – Multifocal lenses

These lenses are designed to provide clear vision at near, intermediate, and distance ranges.

Helps reduce dependence on glasses in daily life.
Splits light to enable clear vision at multiple distances simultaneously.

Advantages: Suitable for individuals who desire clear vision at all distances.

Limitations: May cause issues with light dispersion, especially at night (such as glare and halos). It can reduce contrast sensitivity. Patients with corneal problems or those who have undergone LASIK may not be suitable candidates for this type of lens.

3. EDOF IOL (Extended Depth of Focus) – Extended Depth of Focus (EDOF) Lens

A new generation of lenses developed to provide continuous vision across multiple distances.

Provides clear focus from distance to intermediate ranges.
Reduces issues of glare and halos more than trifocal lenses.

Advantages: Provides natural vision and is suitable for individuals with outdoor lifestyles or frequent drivers. It can also be used by those who have undergone LASIK surgery.

Limitations: Monovision surgical techniques are required for multi-distance vision without the need for glasses. This necessitates precise eye measurements and the expertise of the operating surgeon.

Which type of lens should you choose?

Selecting the right lens depends on several factors, including:

• Your lifestyle and actual visual needs
• The physical characteristics of your eyes, such as pupil size and corneal curvature
• Your budget for the procedure
• Your expectations regarding visual quality after surgery

An ophthalmologist will provide recommendations based on a thorough diagnostic examination.*