Refractive Lens Exchange

What is refractive lens exchange (RLE)?

Refractive lens exchange (RLE) is a vision-correction procedure where the eye’s natural lens is replaced with an artificial intraocular lens to reduce or eliminate the need for glasses or contact lenses. It uses the same surgical technique as cataract surgery but is performed for refractive reasons rather than because the lens is cloudy. RLE can correct long-sightedness, short-sightedness, presbyopia and astigmatism, and may also improve near vision with multifocal or extended-depth-of-focus lenses. It is most suitable for people with high prescriptions or early lens changes who want a long-term solution to their vision problems. RLE is now available in Dunedin and Queenstown.

Is refractive lens exchange right for me?

An ideal candidate for refractive lens exchange is someone with presbyopia or significant refractive error who wants greater freedom from glasses and contact lenses, especially if they are over 45–50 years old. It is particularly suitable for people with early cataract changes, high long-sightedness (hyperopia), or those who are not good candidates for laser vision correction.

Candidates should have generally healthy eyes, realistic expectations, and a desire for improved distance, intermediate, and/or near vision using modern intraocular lenses.

Refractive lens exchange is early cataract surgery

Cataract surgery is a quick and gentle procedure where the cloudy natural lens inside the eye is removed and replaced with a clear artificial lens. It is usually done under local anaesthetic, so you are awake but comfortable and feel little to no pain. The surgeon makes a very small opening in the eye and uses ultrasound to break up and remove the cloudy lens before inserting the new lens in its place. Most people notice their vision becoming clearer within days, with full recovery over the following weeks.

The different types of intraocular lenses (IOL)

How to choose the right IOL

Choosing the right intraocular lens (IOL) is a personalised decision made with your eye surgeon, based on your eye health, lifestyle, and visual goals.

Certain eye conditions may limit which IOLs are suitable, and in these cases lenses that prioritise clarity and contrast are often recommended. Your daily activities—such as reading, computer use, driving, and hobbies—also influence which lens is best, as some focus on distance vision while others provide a broader range with possible trade-offs like glare or halos.

Premium lenses can reduce reliance on glasses but may cause visual side effects, especially at night, so your tolerance for these is important. Cost and insurance coverage also play a role, as some advanced lenses are not publicly funded. Your surgeon will help you weigh these factors and recommend the safest and most suitable option for your eyes.

Intraocular Lens (IOL) Simulator

This IOL visual simulator allows you to compare how different types of intraocular lenses (IOLs) may affect vision in everyday situations. Use the toggle buttons to select the scene (for example, day or night) and the type of IOL you want to view on each side of the image. Drag the slider left or right to directly compare the two visual simulations side by side. This tool is intended to help patients understand visual differences between lens options and support discussion with their eye care provider.

The simulator is optimized for use on laptop or desktop computer.

Frequently Asked Questions (FAQ)

Who is a good candidate for RLE?

RLE is often suitable for people over 45 years old, especially those with high prescriptions or early lens changes who are not ideal candidates for laser eye surgery. People seeking RLE are often people who have refractive errors or presbyopia but wishes to be glasses and contact lens independent.

What vision problems can RLE correct?

It can correct distance vision, near vision, and astigmatism, depending on the type of lens chosen.

Will I still need glasses after RLE?

Many people (>90%) reduce their dependence on glasses, but some may still need glasses for fine print or certain tasks, depending on the lens type.

Is the procedure painful?

No. It is performed with local anaesthetic drops, and most patients feel only mild pressure or light sensation.

How long does the surgery take?

The procedure usually takes about 20 - 30 minutes per eye. The surgery is done as a day surgery. You can go home on the same day.

Are both eyes done at the same time?

Yes, only if your eyes and social circumstances are deemed safe by the surgeon.

What are the risks?

As with any eye surgery, there are small risks such as infection, inflammation, retinal detachment, glare or halos, and the need for further treatment. The risk profile is similar to cataract surgery.

Will I ever get cataracts after RLE?

No. Because your natural lens is removed, you cannot develop a cataract in that eye again.

What is the cost of RLE?

The cost varies depending on the location of surgery (Queenstown vs Dunedin), type of anaesthesia (local vs general), and the type of intraocular lens. The full cost typically ranges from $4800 - $8000 per eye.

Where is the surgery done?

Surgery is carried out at either Southern Cross Central Lakes Hospital in Queenstown, or Mercy Hospital in Dunedin.

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