Refractive lens exchange (RLE)

Also known as lens replacement surgery, a refractive lens exchange is a common vision correction procedure which involves replacing the natural lens inside the eye with a synthetic implant.


Refractive lens exchange (RLE), also known as lens replacement surgery, is a common procedure which involves replacing the natural lens inside the eye with a synthetic implant called an intraocular lens. It is performed to correct short-sightedness, long-sightedness and astigmatism to reduce the need for glasses or contact lenses. The eye lens replacement procedure can also improve vision for those suffering from cataracts.

Refractive lens surgery and cataract surgery are exactly the same operation. When cataract surgery is performed primarily to correct the need for glasses, it is called RLE or lens replacement surgery.

Who is suitable for refractive lens exchange surgery?

RLE is suitable for patients aged 50 or over, though younger patients can be considered in some cases, and with a glasses prescription higher than the normal range for laser eye surgery.

Lens clarity and flexibility diminish with age, and many older patients who would like their sight corrected actually have the beginnings of a cataract. Replacing the natural lens is often therefore the best option for sight correction, even for patients with a lower prescription, particularly if they are long-sighted.

Other candidates for RLE include those with astigmatism, and glaucoma (as long as the condition is stable)

Your surgeon will scan and test your eyes during your initial consultation to assess your suitability.

What happens during lens replacement surgery?

During your initial consultation, your specialist consultant eye surgeon will scan and test your eyes to determine your suitability for lens replacement surgery. They will also discuss the procedure’s benefits and potential risks, as well as agreeing on a personalised plan with you. Eye lens replacement surgery is usually performed on one eye at a time. If you require surgery on both eyes, the operations will typically be carried out one week apart.

On the day of the surgery, anaesthetising eye drops and a mild sedative will be administered to ensure the procedure is painless. Your surgeon will soften your existing lens using an ultrasound. This is then emulsified, removed and replaced with an intraocular lens implant (a clear artificial lens), which is held in place by the back membrane of the lens. The latest multifocal lens implant options are available at Moorfields Private to aid reading vision and provide greater freedom from glasses and contact lenses.

The procedure takes between 30 to 60 minutes and you will be able to go home the same day.

RLE/ Lens replacement surgery recovery times and aftercare

Recovery times for this type of surgery vary but typically take between three to four days. It is normal for you to experience blurred vision and glare during this time, along with sensitivity and discomfort in your eye, but this will only last a few days. You will be given antibiotic and anti-inflammatory drops to help with this.

You should be able to return to work a few days after the lens replacement operation and will be able to drive after your consultant has confirmed your vision meets the standard in your follow-up appointment. Following recovery, you will benefit from improved focus, reduced glare and clearer distinction between colours.

Frequently asked questions about RLE

How safe is lens replacement surgery?

Lens replacement surgery is one of the safest and most common procedures in the world, with more than 3 million surgeries being carried out each year in Europe alone.

As is the case with all operations, there are risks involved. Complications are rare and most can be successfully treated with medication or a follow-up procedure. Your specialist consultant eye surgeon will discuss the risks with you during your initial consultation. However, your chances of having problems are significantly reduced when you put yourself in expert hands and an approved clinical environment.


How successful is lens replacement surgery?

There is a high success rate with lens replacement surgery, with 95% of patients achieving vision of driving standard or better following the procedure.

How much does RLE/lens replacement surgery cost?

Initial consultation


The initial consultation fee is £195. The full cost of your onward treatment will be confirmed once you have agreed your personalised plan with your consultant.


Approximately between £3,600 and £4,600 per eye

Once you have agreed a personalised plan with your consultant, the full costs of onward treatment will be between approximately £3,600 and £4,600 per eye which includes take-home medication and one post-operative appointment. This price is approximate as the price of lenses varies depending on your individual needs.

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