Refractive Lens Exchange (RLE), previously known as Clear lens extraction (CLE), is a procedure in which the eye’s natural internal lens is removed and replaced with an intraocular lens implant, sometimes referred to as an “IOL”. In the past five years, it has become an acceptable alternative to other refractive procedures, and is performed by definition before there is any medically significant cataract presence that is interfering with vision that is corrected by glasses or contact lenses.
This refractive procedure has been around for nearly a century, and is occasionally used for patients with very high degrees of myopia (greater than 9 diopters), not easily managed by other refractive procedures, such as LASIK or PRK. However, it may be an even better choice for patients with high hyperopia (greater than 4 diopters) than for myopes, because of the smaller risk of postoperative retinal detachment and the availability of fewer alternative choices. Ideally, candidates for this procedure will be in their mid-50’s or older, as younger patients regardless of myopia/hyperopia may have increased risk for retinal detachment, a potentially vision-threatening complication.
Modern cataract surgery is a technically sophisticated procedure with an extremely high success rate. Since clear lens extraction is nearly identical to cataract surgery, it shares the same success rate and FDA approval.
Because the presently available lens implants are made of a material that cannot flex or focus like the natural human lens, they are usually implanted in patients who have already lost their ability to focus, as in those over the age of forty, or in younger patients with specific needs where the benefits outweigh the compromise.
See: Lens Implants and Cataract Surgery for more information.
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