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Refractive Lens Exchange

Refractive Lens Exchange (RLE), or Lens Replacement surgery, involves replacing the natural human lens with an artificial lens to correct nearsightedness, farsightedness, astigmatism and presbyopia. It is very similar to modern cataract surgery. With cataract surgery, the human lens is removed and replaced due to clouding of the lens with age. With RLE, the human lens is replaced, not due to cloudiness, but to  reduce dependency on glasses and contact lenses.

RLE can treat much higher levels of correction more accurately than LASIK. It is often a better choice for individuals in their 50s or older as many of these people can have the beginnings of a cataract. Once the human lens has been removed and replaced with an artificial lens implant, a cataract can never form. You have effectively addressed two problems with one, as the implant will last a lifetime. Our modern multifocal lens implants are able to correct both distance AND near vision, thereby also eliminating reading glasses or bifocals.

Like LASIK, drops are applied to “numb” the eye and a mild sedative is given. Through a small incision made on the side of the eye, a tiny ultrasound instrument is used to break up and remove the natural lens. The clear lens capsule is left behind in which to place the implant. The implant is placed through this small incision and unfolded to fill the space the natural lens occupied. The incision seals on its own without stitches. The entire procedure usually takes 10 to 15 minutes. Because the surgery is performed under local anesthesia, the patient is awake, but there is no discomfort. Some patients do, however, feel a mild pressure sensation during the surgery. Patients are asked to rest at home the day of surgery, but can usually resume normal activities the next day.


The Lens Replacement Procedure


Safety and Success Rate

Intraocular lenses have been on the market since 1949 for use in cataract patients. Lens implantation is performed on an outpatient basis and requires just a few hours of your time from start to finish. Your eye is treated with anesthetic drops prior to the procedure and you will feel little, if any, discomfort. A tiny incision is made in the eye to allow a small instrument to break up and remove the natural lens. Once the natural lens is removed, the new lens is inserted through the same incision and set into its permanent position. There are no stitches required.

After the procedure, Dr. Oursler will examine your eye within 24 hours and give eye drops to guard against infection. Most patients see well enough to return to their routine activities the next day. Complications are rare and the vast majority see well enough to pass a drivers test and read a newspaper without glasses.

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Frequently Asked Questions About Lens Replacement

Is iLASIK a better option?

Whether to go with lens replacement or iLASIK depends not only on the patient’s age, but the amount of correction they need. If the patient has a high amount of astigmatism, they are better served with iLASIK surgery. Also, individuals with low nearsightedness do quite well with iLASIK up until about age 60 if they have no signs of cataracts. Farsighted individuals do much better with lens replacement surgery starting at about age 45.

Is lens replacement an option for patients with previous LASIK or RK?

Yes, depending on the corneal topography and degree of astigmatism present.

How is astigmatism compensated for with lens replacement?

Dr. Oursler can address small amounts of astigmatism with relaxing incisions. Higher amounts of astigmatism may require an iLASIK touchup.

Does insurance or Medicare cover the cost for lens replacement?

Insurance or Medicare does not cover the cost of lens replacement for presbyopia patients. However, if a patient has developed visually significant cataracts, insurance or Medicare will cover the cost of surgery for a standard IOL. For an additional charge, patients may opt to upgrade to the newer presbyopia correcting lenses.

Can I use my Flex Spending Account?

Your company may offer a Flex Spending Account, which allows you to set aside pre-tax dollars to pay for your medical expenses. Use our FSA Savings Calculator to find out how much you can save by using your FSA to pay for iLASIK.

Where will I have my procedure done?

At Graystone Eye we have our own surgery center attached to our Hickory, NC, location. This feature allows us to ensure ease and convenience for our patients while keeping facility fees down.