Refractive Lens Exchange (LASIK Alternative)

As much as you might not want to admit it, the vision and health of your eyes will worsen as you get older. While changes in your vision may be manageable with contact lenses and glasses, you may want to ditch these eye accessories for the convenience of a more permanent solution.

The most common procedure that comes to mind for many is often LASIK, but (depending on a variety of health factors) you may or may not be a suitable candidate for it. For those that are not a good fit for LASIK, there are a variety of procedures that may be a better fit. Refractive Lens Exchange (RLE) surgery is a compelling alternative for those that do not qualify.

What Is the Difference Between LASIK and RLE?

LASIK modifies the cornea to reshape the eye. The end result allows the cornea to once again properly bend and focus light onto the retina, offsetting a patient’s previous nearsightedness, farsightedness, or astigmatism. Prime candidates for LASIK are typically between the ages of 20 and 40, but are determined eligible or not based on a variety of factors such as one’s eye condition and overall health.

Unlike LASIK, which re-works the natural material of the eye, RLE completely removes the natural lens of the eye and replaces it with an artificial intraocular lens. This is essentially the same procedure one would go through for cataract surgery, and the end result is very similar to LASIK both in quality of vision and recovery time. Another key difference of RLE is that patients will lose all natural accommodation (the ability to change focus from distant to near), however new lens technology is able to replace accommodation and provide sharp eyesight at all distances.

Advantages & Disadvantages of RLE

While the outcome is very similar for both LASIK and RLE, choosing between the two often comes down to your personal situation (age, eye health, etc.) rather than preferences. However, RLE does have some distinct advantages and disadvantages in comparison to LASIK.

Advantages

  • Removes reliance on glasses and contact lenses
  • Longevity of effectiveness, providing stable vision without risk of regression
  • The cornea is relatively untouched during the procedure
  • Ocular dryness is less affected by RLE than LASIK
  • No possibility for developing cataracts later in life (because your natural lens is gone)
  • Can treat more severe nearsightedness, farsightedness, and astigmatism than LASIK
  • Can be done with multifocal lenses, which corrects vision for varying distances

Disadvantages

  • More expensive than LASIK
  • More invasive and significant procedure than LASIK
  • More restrictive post op healing period ( no heavy lifting, or straining for 2 weeks )
  • Extremely nearsighted patients may be at a higher risk of retina problems after RLE

What Makes a Good Candidate for RLE?

A good candidate for RLE is commonly a patient who was not a good candidate for LASIK. The key factors for a good RLE candidate are age and the related health of their existing lenses. Patients in their mid-50s and beyond are often better candidates for RLE than LASIK, as their natural lens has become more stiff, dysfunctional, and lacking the ability to autofocus at high levels. When this becomes the case, it makes much more sense to fully replace a lens rather than attempt to reshape what has become more-or-less defective lens material. LASIK, on the other hand, is more suited for patients who are typically younger than 50 and still have healthy, natural lenses with enough flexibility and clarity left to make the procedure worthwhile. The good news for RLE candidates though, is you likely will not need any further vision corrections moving forward!

How Much Does RLE Cost?

Given that RLE is a more involved and complex procedure than LASIK, the cost is higher as well. The lenses themselves are often customized to the specific needs of a patient, adding a notable expense to the procedure. The cost for RLE can range anywhere from $2,500 to $4,500 per eye, depending on the region, surgeon, and specific needs of any given patient. In 2019, the average cost of RLE with a standard monofocal implant was $3,783 per eye (according to a large survey of U.S. cataract and refractive surgeons). That number can increase for patients with astigmatism or farsightedness as the corrective lenses have more complexity.

Typically, RLE is considered to be an elective procedure, so insurance generally does not cover any portion of the cost. However, many clinics do provide financing options for patients to help make the costs more manageable and attainable.

Conclusion

RLE is an effective, long-term solution for vision correction, and is often ideal for those who are not viable candidates for LASIK. Millions of these procedures are done in the United States each year, making it a trusted and common operation with many qualified surgeons across the country. While it is more expensive than LASIK, RLE provides a similar outcome and can provide the same quality-of-life benefits.

If you are interested in finding out what corrective approach may be best for your eyes, you can schedule a free consultation with our doctors. We will be able to provide a recommendation for correcting your vision in the best way for your personal needs, and determine if you are a suitable candidate for LASIK, RLE, or something else altogether. The most important thing is that you find a solution that is right for you and helps you live your best life for many years to come.