Clear lens extraction or refractive lens exchange is a way to have clearer vision without having to wear bulky glasses or irritating contact lenses. This refractive correction procedure has been around for many decades. In the past ten years, it has been increasingly used as a practical alternative to other refractive surgical procedures such as LASIK for certain patients. RLE is vision correction surgery involving the removal of the natural lens of the eye. It is then replaced with a synthetic intraocular lens. The procedure for refractive lens exchange can be compared to that for cataract surgery. In cataract surgery, the cloudy lens of the eye is removed. It is then replaced with an artificial intraocular lens. However, for a refractive lens exchange the original, natural lens has not become cloudy. Instead it has become rigid. It is removed and replaced. A new artificial intraocular lens is used for the purpose of correcting the eye and its focusing power and give clearer vision. RLE can reduce or completely get rid of high levels of short sightedness and long sightedness. In the more common refractive surgeries such as LASIK, the lens of the eye is not removed but rather the cornea is reshaped to correct blurry near vision, far vision, or astigmatism. Because refractive lens exchange is considered more invasive than laser surgery, it is generally reserved for people with very high myopia or hyperopia that would not be suitable for laser surgery. People above the age of 50 are the ideal candidates for lens exchange. Since they commonly have the cataracts beginning to develop, it is sensible to change the natural lens of the eye along with the correction of refractive errors. When the natural lens is replaced with an intraocular lens, cataracts will never develop in the future since unlike the real lens of the eye, synthetic lenses will never get clouded with clumps of protein commonly associated with the ageing eye. For older adults with the signs of early cataracts and a refractive error such as myopia or hyperopia, there is an option to have refractive lens exchange instead of waiting for the cataracts to advance. Artificial lenses are very efficient in providing optimum vision and not having to worry about cataracts in the near future. Furthermore, a condition called presbyopia affects people from the age of 40 onwards. This is not a disease but rather a normal part of ageing wherein the natural lens of the eye slowly and progressively loses its elasticity. Over time the lens becomes more rigid. This means it cannot be refocused for varying distances, especially very close vision. This is noticeable as difficulty reading up close and having trouble looking at very near or very small objects. One would then need to have stronger prescription glasses to compensate for vision or would have to wear reading glasses for close work. RLE becomes very valuable in people with presbyopia because this would lessen the dependence on reading glasses. For people less than 45 years old with short sightedness, laser vision correction is still preferred. However, for severely hyperopic patients, a good choice for vision correction is RLE with a multifocal intraocular lens. These are implantable lenses that provide multiple focused visions at reading and far distance. Choosing the appropriate intraocular lens will depend on several factors such as pupil size and visual acuity. The eye doctor will give his recommendation based on complete assessment of the eye condition and visual acuity of the patient. Just like in Lasik surgery, dependence on glasses and contact lenses is reduced or even completely eliminated with lens exchange. The results are permanent and improved vision can be enjoyed almost immediately. After having refractive lens exchange, the need for cataract surgery in the future is eliminated and one would have better quality of life. It is best to take care of the eyes early on and regular eye checkups should be part of the routine since not all eye problems are easily noticeable. Some conditions common in the older age group such as glaucoma and macular degeneration can become far advanced before vision is significantly affected.
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