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What is Refractive Lens Exchange?

By WebMD Connect to Care Staff
Refractive lens exchange is a procedure to correct vision defects. Find out if you are a good candidate for this procedure.

Refractive lens exchange is a type of eye surgery used to correct nearsightedness and farsightedness. It’s often performed on older adults who wish to eliminate the need to wear glasses or lenses. If you have extreme farsightedness or nearsightedness and do not qualify for laser eye surgeries such as PRK or LASIK, your doctor may recommend refractive lens exchange as an alternative procedure. 

What is Refractive Lens Exchange?

“Refractive lens exchange is identical to cataract surgery but is performed in patients who do not have cataracts,” Yuna Rapoport, MD at Manhattan Eye in New York, tells WebMD Connect to Care. The procedures for both surgeries are similar. The only difference is that cataract surgery is performed to remove the cloudy eye lens that causes vision to become blurred, while refractive lens exchange is performed with the intention of removing the need to wear glasses or lenses.

According to the American Academy of Ophthalmology, refractive lens exchange replaces your natural lens with a clear artificial lens, also known as an implant. Before the surgery, you may be given a mild sedative along with a topical anesthesia that may be applied with eye drops. Your doctor will make a small cut at the edge of your cornea, remove your natural lens, and replace it with an artificial lens. The new lens helps you see better and reduces your dependency on glasses or contacts. According to the National Health Service, with post-refractive lens exchange, you may experience some side effects and pain for a few weeks or months.

Refractive Lens Exchange Pros

According to The Royal College of Ophthalmologists, refractive lens exchange is an option for anybody with a vision prescription. But it can be especially beneficial for those above 50 years of age who:

  • Have such a high prescription that they do not qualify for laser correction procedures like LASIK eye surgery or PRK, or
  • Are experiencing the preliminary stages of cataract development

According to The Royal College of Ophthalmologists, refractive lens exchange protects you from developing cataracts later on in your life, as your implants are synthetic and cannot get cataracts. It also reduces the potential glare or halo that may be associated with LASIK and PRK surgery.

Refractive Lens Exchange Cons

On the flip side, refractive lens exchange, done inside the eye, can result in more serious side effects than PRK and LASIK, which are procedures done to the outside of the eye. “Since refractive lens exchange is typically done for patients who are very nearsighted, those patients are already at higher risk for retinal tears or holes or detachments, and the procedure increases that risk further,” Rapoport says. “Additionally, it is entirely not covered by [most] insurance and is roughly double the cost of LASIK or PRK.”

Your surgeon will help you decide if refractive lens exchange is the best treatment option for you after evaluating your eye health. 

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