Refractive Lens Exchange (RLE) FAQs

Below are AVC’s refractive lens exchange (CLE) FAQs. Please click on the questions below to reveal the facts and answers:

RLE treatment is suitable for those over the age of 40 whose natural lens has started to age and will naturally deteriorate over time. There is no upper age limit and no prescription limitation. The only requirement is that your prescription has stabilised and that it is not currently in the midst of a decline.

CLE is suitable for patients who have very high and complicated prescriptions that cannot be treated by Laser Eye Surgery or Implantable Contact Lens treatment.

The RLE procedure is virtually identical to cataract surgery. The only difference is that a clear lens is removed in the CLE treatment and a cloudy lens is removed in cataract surgery.

Traditional intra-ocular implants are Monofocal lenses which focus light to only one point, meaning they correct distance vision only and glasses will be needed for near vision. This is the type of lens is typically used by the NHS.

A Trifocal intraocular lens has more than one point of focus, enabling clear distance, intermediate and near vision. It has revolutionised the results of treatment and allows for patients to be glasses free.

The optical design of intraocular lenses are completely different to varifocal spectacles. Instead of a patient needing to move their head to adjust the focus, they will be able to comfortably see distance, intermediate and near without having to make any movements. Layered concentric circles are used to correct each form of prescription issue allowing for simultaneous correction of all fields of vision.

AVC provide lenses from the following companies:

Patients who have cataract treatment with the NHS are solely given Monofocal lenses which will only correct distance vision. This leaves patients with a reading prescription or varifocal glasses. Piggy-back lenses can be used to treat these patients where a secondary lens (Trifocal) is implanted to correct reading vision.

Suitability for treatment and the type of lens is determined at your consultation.

If you are unsuitable for Trifocal intraocular lenses, Monofocal lenses are available. These can be used to either aim for monovision (one eye for distance, one eye for reading), or to correct your distance vision in both eyes and glasses will be needed for near vision. This will all be explained in detail during your consultation.

Once the natural lens has been removed and replaced with lens implants patients will never require surgery again. The materials from which the lenses are made from have been subject to accelerated ageing tests. Results have demonstrated that the lens material will last in excess of 150 years before showing signs of degradation.

No pain is felt as anaesthetic drops are used to numb the eye. However some discomfort or pressure can be felt during the procedure.

Most patients notice a difference to their vision immediately after the procedure. Distance vision is the first field of vision to settle, typically taking 24 to 48 hours. However, it can take slightly longer to adjust to the new reading vision.

Generally you will need 3-5 days off work (for most office jobs). Two for the treatment and one or two days afterwards to rest. Patients are able to perform most day to day tasks one day after surgery without any difficulty. Your working environment will also be taken into consideration and our surgeon will advise on what precautions should be taken at your consultation.

There will be a few restrictions after treatment. Examples include avoiding sports that may cause trauma to the eye, avoiding dusty environments and lifting heavy weights. At your consultation we will take into consideration your lifestyle and hobbies and advise you accordingly.

There is a small risk of infection with these types of procedures. To minimise the risk, each eye will be treated on a separate day.

All our treatments are carried out at our AVC clinic on 77 Harley Street. AVC are one of the very few clinics in the UK where everything from consultation to surgery and aftercare is conducted under one roof.

The Refractive Lens Exchange procedure involves removing the natural lens where a cataract would have developed. When a patient undergoes CLE treatment, it means that they will never develop a cataract in either eye at any point in the future.

Posterior capsular opacification (PCO) can sometimes occur after CLE. Sometimes you can develop a thickening of the back (posterior) of the lens capsule which holds your artificial lens in place. This thickening of the capsule causes your vision to become cloudy and can safely and easily be treated with a quick YAG laser procedure.

The lens implant is inside the eye where there are no nerves or sensation, so it cannot be felt. It will not feel like a contact lens and you will be completely unaware that it is there, apart from experiencing greatly improved vision.

Your consultation, treatment, one day post op, two week and the six week aftercare appointments are carried out at AVC’s Harley Street clinic. After this time, we can hand you over to the care of one of our nationwide independent optometrist partners, allowing you to stay closer to home for the remainder of the follow-up appointments.