Refractive Lens Exchange (RLE)

At Montgomery Eye Care, we know there’s no “one size fits all” solution when it comes to our patients’ vision correction goals. This is why we offer a range of vision correction options so that we can tailor each patient’s treatment plan to suit their unique needs and lifestyles. One option that is particularly appealing to our patients from the Denver, Northglenn, and Westminster, Colorado areas is refractive lens exchange.

senior couple camping by a lake and looking in the distance

What is Refractive Lens Exchange (RLE)?

You may hear refractive lens exchange referred to as RLE, clear lens extraction, or clear lens exchange. These are all common names for a vision correction procedure that involves replacing the natural lens of the eye with an artificial intraocular lens (IOL) to help a patient see the world more clearly.
The procedure for refractive lens exchange is the same procedure used during cataract surgery. The only difference is that RLE is not medically necessary and is solely performed to improve a patient’s vision by reducing dependency on glasses or contacts. In fact, since the natural lens of the eye is replaced during refractive lens exchange, patients who choose this option will never need to undergo cataract surgery in the future.

What Can be Treated with Refractive Lens Exchange?

A refractive error occurs when the lens and cornea of the eye improperly focuses light onto the retina. By replacing the natural lens of the eye with a customized intraocular lens implant, Dr. Montgomery is able to treat all common refractive errors:

Nearsightedness (myopia): Nearsightedness is the most common refractive error, affecting up to Trusetd Source Checkbox Trusted Source Myopia (nearsightedness) American Optometric Association Go to Source 30% of people in the U.S. When a person is nearsighted, they have difficulty seeing objects in the distance clearly.

Farsightedness (hyperopia): Farsightedness is the opposite of nearsightedness. It requires added focusing power to clear up distance vision and also helps with near vision depending on your age.

Astigmatism: When a person has astigmatism, vision may be blurry at all distances. The lens and cornea can develop with non-uniform curvatures creating the need for some type of vision correction.

Presbyopia: Age-related near vision loss, called presbyopia, happens to everybody. As the lens of the eye ages, it becomes less flexible and doesn’t bend as easily to help people focus on up-close objects. This is why people begin to need reading glasses or bifocals when they get older. The rigid lens of the eye is replaced during RLE, so reading and other activities that depend on near vision are no longer a challenge.

senior couple hiking on a trail and looking into the distance

Benefits of Refractive Lens Exchange

For patients who are good candidates, there are so many Trusetd Source Checkbox Trusted Source Refractive lens exchange in modern practice: when and when not to do it? Alió JL, Grzybowski A, Romaniuk D Go to Source benefits to refractive lens exchange :

  • RLE can improve vision at multiple ranges, so patients with nearsightedness, farsightedness, astigmatism, and presbyopia can all enjoy clearer vision
  • No need to worry about cataracts in the future
  • Little to no need for expensive and inconvenient glasses and contact lenses
  • The eye surgery is fast (15 minutes) and comfortable
  • Short recovery with little downtime
  • RLE may be an option for patients who don’t qualify for other vision correction procedures like LASIK and PRK

Who is a Candidate for Refractive Lens Exchange?

Even patients who aren’t candidates for LASIK and PRK laser vision correction may still be able to benefit from refractive lens exchange. A good candidate for refractive lens exchange has healthy eyes and is:

  • Over the age of 45
  • Already diagnosed with presbyopia
  • Not at risk for retinal detachment

Refractive Lens Exchange IOL Options

We offer a wide range of premium IOL options which makes it possible to customize each patient’s refractive lens exchange results for their specific lifestyle and goals. Options include:

Astigmatism-Correcting IOLs:
Toric IOLs are designed for patients with astigmatism, which causes vision problems due to an irregular shape of the cornea. Monofocal toric IOLs can correct astigmatism and vision at a single distance, and we also offer multifocal toric IOL options for patients who have presbyopia in addition to astigmatism.
Learn More About Astigmatism-Correcting IOLs
Presbyopia-Correcting IOLs:
For patients with presbyopia (age-related near vision loss), we offer multifocal and extended-depth-of-focus (EDOF) IOLs. We also feature the PanOptix® Trifocal Lens, which can improve vision at all distances.
Learn More About the PanOptix Trifocal Lens
Light Adjustable Lens™:
The Light Adjustable Lens (LAL) is the only FDA-approved IOL that can be adjusted after implantation. After refractive lens exchange, the patient returns so that Dr. Montgomery or Dr. Dugan can make minute adjustments to the power of the LAL. Once the patient’s ideal prescription is achieved, it is “locked in” so the patient can maintain their best possible vision.
Learn More About the Light Adjustable Lens

Preparing for Refractive Lens Exchange

The first thing you need to do to get ready for refractive lens exchange is to have a consultation at Montgomery Eye Care. After a brief eye exam and discussion about your vision correction options, you and your eye doctor will decide if refractive lens exchange is the right choice for you. Once your RLE procedure is scheduled, you’ll receive instructions about preparing for surgery as well as what to expect during the recovery period.

Refractive Lens Exchange: What to Expect

Refractive lens exchange takes only about 15 minutes per eye.

Before beginning your eye surgery, Dr. Montgomery will make sure you are comfortable. Anesthetic eye drops will be used to numb your eyes, and you will have the option for IV sedation to help you stay relaxed. A device will be used to hold your eyes open so you aren’t worried about blinking during the procedure.

To begin the refractive lens exchange procedure, Dr. Montgomery will make a very small incision. Through this, he will remove the natural lens of the eye and replace it with an intraocular lens implant. The incision is so small that you won’t even need sutures: your eye will heal on its own.

Recovery and Results After Refractive Lens Exchange

For the first few days after refractive lens exchange, you will need to wear a protective eye shield when sleeping. Your eyes may feel uncomfortable or itchy, but please try not to rub them.

Dr. Montgomery will prescribe eye drops to help with healing and preventing infection. You should closely follow his instructions for administering these drops.

You won’t need much downtime after your refractive lens exchange vision correction. In fact, most of our patients are able to get back to their normal routines within 24-48 hours.

One of the best things about refractive lens exchange is how quickly our patients see results. You should notice a vast improvement in your vision within a few weeks!

5-Star Rating!

They are a nice clean office on the inside. They got me an appointment within an hour of calling the morning I woke up and had a messed up eye. They accept Medicaid. I was here about 30 minutes.


Dr. Montgomery has been treating me for Macular [Degeneration] for 10 years. I’ve always been impressed by his expertise and thoroughness. He’s always willing to answer my questions to be sure that I understand. I highly recommend him. Thank you Dr Montgomery.

Jane G.

Very professional and caring physician, whom I feel very confident in. He is very current on the best treatment for whatever eye issue is going on. Also he has a very kind and helpful staff.

Annette T.

Refractive Lens Exchange FAQs

What are the risks of refractive lens exchange?

Refractive lens exchange is the same procedure as cataract surgery, which is one of the most common surgeries in the world. This procedure has a very high rate of safety, but even the simplest surgical procedure has some risks. Complications of RLE are rare and Trusetd Source Checkbox Trusted Source Cataract Surgery American Academy of Ophthalmology Go to Source may include :

  • Bleeding
  • Infection
  • Swelling
  • IOL dislocation
  • Retinal detachment

Is refractive lens exchange better than LASIK?

One vision correction surgery isn’t necessarily better than the others: each has distinct benefits and requirements. LASIK is a great option for many of our patients because it involves reshaping the cornea to treat vision problems. However, RLE is also a great option, and it’s often a good LASIK alternative for patients who aren’t good candidates for laser vision correction. Refractive lens exchange also allows Dr. Montgomery to correct a patient’s vision for a range of distances as well as treat presbyopia because it involves replacing the eye’s natural lens with a custom, artificial lens.

What is the cost of RLE?

The cost of RLE differs from patient to patient, as it depends on the type of IOL used. We’ll give you a detailed breakdown of the cost of your procedure when you come in for a consultation.

Is RLE Covered by Insurance?

Refractive lens exchange is performed to correct vision, but is not medically necessary. Because RLE is an elective procedure, it’s not covered by insurance. We can help you learn more about payment and financing options for refractive lens exchange.

Contact Montgomery Eye Care

One of the things that makes Montgomery Eye Care so special is that Dr. Montgomery and our entire team are committed to giving each of our patients the one-on-one, personalized attention they deserve. If you have questions about RLE or are ready to schedule your free consultation, please contact us. We are proud to serve patients from Denver, Northglenn, Westminster, and nearby Colorado communities.

We'd Love to See You!

Give us a call at: (303) 252-9981 or fill out the form below to request a consultation!

Contact Us

*Communications through our website or via email are not encrypted and are not necessarily secure. Use of the internet or email is for your convenience only, and by using them, you assume the risk of unauthorized use.

I agree to the

1 American Optometric Association. Myopia (nearsightedness). Available: Accessed December 12, 2022.
2 Alió JL, Grzybowski A, Romaniuk D. Refractive lens exchange in modern practice: when and when not to do it? Eye Vis (Lond). 2014 Dec 10;1:10. doi: 10.1186/s40662-014-0010-2. PMID: 26605356; PMCID: PMC4655463. Available: Accessed December 12, 2022.
3 American Academy of Ophthalmology. Cataract Surgery. Available: Accessed December 12, 2022.

The doctors at Montgomery Eye Care have authored or reviewed and approved this content. | Page Updated: