Featuring Dr. Baseer Khan, MD, FRCS(C), P.CEO, Ophthalmologist

Duration: 2 minutes, 52 seconds

A refractive lens exchange, sometimes referred to as a refractive lensectomy or a clear lensectomy, is the same surgery effectively as doing cataract surgery, except it’s in a patient who doesn’t have a cataract.

The natural lens of the eye is removed and replaced with an intraocular lens. Why would someone do this? Someone might do this for one of two reasons. Number one is they want to get rid of their glasses, and they’re not a candidate for ICLs or laser refractive surgery.

The other most common group are patients in their 50s and 60s who are now presbyopic, which is a fancy word for people who can’t see up close without glasses. Because of the intraocular lens technology that exists today, there are artificial lenses that we can implant that will give you vision in the distance and up close.

So for patients who don’t want to have reading glasses, they can undergo a refractive lens exchange, or RLE, to have one of these lenses in, so that they won’t need their glasses. Generally speaking, the right patient for a refractive lens exchange is somebody who’s motivated to get out of their glasses. Especially if they’re trying to get rid of their glasses for distance and reading, they should have a little bit of tolerance for glare and halos, which the lenses that will give them vision in the distance and up close will produce.

The recovery time for refractive lens exchange is very similar to cataract surgery. The day of surgery often patients will be a little bit blurry, their eye will be irritated. When they come the next day for their post-operative visit, they often see very good. Their vision will continue to improve for the first week.

Sometimes between the second and third month we get what’s called a secondary cataract. But it’s not really a cataract, it’s just a little bit of growth and debris on the back of the lens that we’re able to polish very easily using something called a YAG laser. We do a postura capsulotomy, or a polishing of the lens, and patients after that point will see even better.

Refractive lens exchange, or clear lensectomy, is generally a very successful surgery, however with any surgery there are always risks. We say that there’s a 1 in 1,000 chance of losing an eye to bleeding or infection based on literature. However, in reality it’s probably much lower than that. If you have any specific risks your surgeon will advise you.

When patients have refractive lens exchange, they can expect that their prescription will never change. There will never be any regression or drift, that this is the prescription and the vision that they will have for the rest of their life.

If you have any more questions on refractive lensectomy or any refractive surgery, please talk to your local optometrist or refractive surgeon, who will be more than happy to help give you some more information and options.

Presenter: Dr. Baseer Khan, Ophthalmologist, Vaughan, ON

Local Practitioners: Ophthalmologist