Refractive lens exchange or laser eye surgery – what’s best for me?

When you attend your initial consultation with our specialist team you will have a number of tests carried out on your eyes to see which procedure you are most suitable for. One main factor which influences which procedure you are most likely to be suitable for is age. Usually Refractive Lens Exchange (RLE) is carried out on patients who are over the age of 45, meanwhile patients younger than this are generally more suited to laser eye surgery.

The reason for this is that in the mid-40’s, a condition called presbyopia, a natural process of ageing set in. This causes the lens in our eyes to become stiffer and means that reading becomes a problem. It also explains why people start using reading glasses or have to use bifocal or varifocal glasses from their mid 40’s onwards.

Another reason which may sway your suitability is your prescription. RLE can be used for people whose prescriptions are too high to treat with the laser alone.

Laser vision correction can also be used for people in their mid 40’s upwards to help with reading vision correction in a technique called blended vision. Here, we set up the dominant eye to see distance and the non-dominant eye to see near. 80% of people get on with this arrangement but 20% do not and in these cases, refractive lens exchange would be the better option.

If you are more suited to RLE surgery you will then have a choice of lenses to choose from. There are monofocal lenses which improve either your shortsighted or longsighted vision, or multifocal lenses. Multifocal lenses allow you to see both near and far distances – offering complete independence from glasses. Multifocal lenses are the most common lenses used in RLE surgery.

Refractive lens exchange surgery is designed to last forever as the new replacement artificial lens does not change shape over time. Laser eye surgery results are long lasting; however the  natural aging process of the lens within the eye continues and there will come a point where the reading vision and / or the distance vision becomes a problem due to lens changes or cataract development. If you are in your mid-40’s, this may not happen until your 60’s and when the time comes, the vision can be corrected by having lens exchange surgery.