+91-22-23623937 Menu


Replacing the Natural Lens to Correct A Range Of Vision.

Refractive Lens Exchange (RLE), also called clear lens extraction (CLE) or Presbyopic Lens Exchange (PreLEx), is a popular option for patients who want to decrease or eliminate their dependence on glasses or contacts but are not suitable candidates for laser vision correction. RLE is typically for patients with moderate to severe farsightedness or those over the age of 40 who have become dependent on bifocals or reading glasses. During RLE, the eye’s natural lens is replaced with an artificial lens to correct a range of vision (nearsightedness, farsightedness, astigmatism and/or presbyopia).

When we are young, the natural lens allows us to see far and focus up close, without the need for reading glasses or bifocals due to accommodation. As we age, the accommodation progressively declines resulting in loss of near vision (presbyopia) that requires the use of reading glasses or bifocals. With aging the lens also progressively becomes hard, yellow and cloudy (cataract), which blocks and scatters light reducing visual quality, quantity and colour perception.

The lens continually ages throughout life, resulting in the need for reading glasses or bifocals in your 40s and cataract surgery in your 60s, or 70s. Occasionally, it can occur at a much younger age. Lens changes cause progressive deterioration in our vision and the progression is unpredictable and varies from person to person.

With the advancement in technology and the safety of the procedure, patients are choosing to have their natural lenses replaced at an earlier age. Because of their active lifestyles, many patients do not want to have to tolerate the years of progressive decline in their vision as they develop cataracts; they want it fixed permanently now.

Refractive Lens Exchange has many benefits, primarily the improvement in both near and distance vision.
Since the natural lens has been replaced, cataract surgery will never be needed and the artificial lens will not age, providing visual stability to the eye.
For patients with moderate to severe far sightedness it can also reduce the risk of developing angle closure glaucoma in the future.

FREQUENTLY ASKED Refractive Lens Exchange

RLE means removing your natural lens which has the wrong power for your vision and putting in a new lens which has the correct power and gives your great vision. Essentially, it is the same operation as cataract surgery, but, we are giving it a different name RLE as the surgery is done to correct your vision instead of correcting your cataract. It is a good choice as cataract surgery has been around since decades. It is the most commonly performed eye surgery the world over, it is very safe and we have a lot of experience with it.

RLE is done under “eye drop” anesthesia. You may be aware that something is happening, but, it doesn’t hurt. The whole procedure takes about 15 mins and then your home feeling comfortable within an hour or two.

RLE is an excellent option for patients who are in their 40’s or above, have a high myopia or astigmatism, are not suitable for correction with LASIK or SMILE, have early cataract changes in their natural lens or are noticing glare at night. RLE is also the right procedure for patients with a high level of farsightedness. In such patients, PRK and LASIK do not give the best quality of vision. RLE improves the clarity of vision and also reduces the risk of glaucoma in the future.

RLE gives you permanent excellent results :
It also takes away the need of cataract surgery in the future so the effects are lifelong.

With RLE we have a few options to address both near and distance vision. We can treat both eyes for distance vision and then you would require reading glasses. We could also use multifocal, trifocal or EDOF lenses to give good distance and reading vision. So in all there are a variety of options that you can choose to make your distance or reading vision better.

RLE is very safe but it’s not 100 percent safe. Like all surgeries there is a risk of something that doesn’t go right like retinal detachment or swelling in the back or the front of the eye. These are really very rare. One of the better things about the risks is that everyone would eventually get cataracts if they live long enough so everyone eventually will have cataract surgery done which is like RLE. Essentially we are not exposing you to any additional risk as much as we are moving that risk up earlier in your life. Generally that is a good trade off for getting better quality vision for additional 10 or 20 or 30 years before cataract surgery.

One of the nice things about RLE is that the recovery is very fast. You can go back to work the next day, you are more comfortable, you are seeing well and driving your car. We ask you to stay out of swimming pools for a week otherwise there are no limitations on your activities.

With any type of lens exchange surgery whether it is cataract surgery or RLE because lens implant is placed in the eye to correct the vision some patients wonder if they can feel that lens. In fact you don’t, you cannot feel it or see it. Sometimes though if the light hits it and if you are facing the opposite person at the right angle they may see a glimmer in your eye. This has been minimized with newer lens implants.

You don’t want to decide on a Refractive Lens Exchange treatment without learning all of the facts. Your eyes are as unique as your fingerprints, and you’ll want to consult a specialist to help you decide on the best way to preserve your vision.

At Samyak Drishti, we will give you a thorough examination and explain all of your options, so that you can make an informed decision about the right solution for you.


RLE is performed as a short out-patient procedure. After numbing drops are put in the eye, Dr Shah will make a small incision (approximately 2-3 mm) to remove the natural lens from the eye and replace this with the a premium lens of your choice. The entire process takes about 10 minutes and you can return home shortly after.


Multi focal (Bifocal): A Multifocal IOL has a special optical design to provide good vision for distance and near activities. However, there is a compromise for intermediate vision. Also, many patients experienced glare and halos at night, especially for night driving. As a result, these initial lens designs are less popular nowadays.

Trifocal: A Trifocal IOL has a special optical design to provide good distance, intermediate and near vision, thus minimizing the need for glasses for almost all activities. These were designed to overcome the optical limitations of bifocal IOLs. Patients with trifocal IOL's experience fewer haloes at night than bifocal IOL's.

Extended depth of focus (EDOF): Trifocal IOL’s are superior in design to Bifocal IOL’s with good intermediate vision, but they have three principle ranges-distance, intermediate and near. Over the years, our visual needs have changed and we often require a more continuous range of vision, like our natural youthful lens. Though Trifocal IOL’s give less glare and halos at night, but, they do persist to some extent. EDOF IOL's give a more continuous range of vision from far to intermediate to near, with significantly less glare and haloes than Trifocal IOL’s. Also, the quality of vision may be superior to Trifocal IOLs both during day time and night time. But, this superior quality of vision comes at a trade-off- the near vision is not as good as a Trifocal IOL and glasses may be needed for reading fine print. They are more suitable for patients who frequently drive at night and are willing to wear glasses for near vision.

An EDOF IOL in the dominant eye can be combined with a Bifocal or Trifocal IOL in the other eye to optimise the benefits both i.e. less glare and haloes at night and also superior near vision

Toric: Toric IOL's have an additional "cylindrical" power in a single axis to compensate for corneal astigmatism and improve distance vision. Toric models are available for Bifocal, Trifocal and EDOF IOL's.

Customized IOL:For patients with complex vision conditions, if the desired IOL power is beyond the range that is routinely available, an IOL can be customized according to the patient's needs. It can take approximately 10 days to 3 months to order a customized IOL depending on the complexity of the prescription.

Schedule Your Consultation & Comprehensive Exam

Find out if you are a candidate from the Vision Correction Specialist.

  • Samyak Drishti was established in South Mumbai in 2005 by Dr. Sujal Shah, the first surgeon in India to perform Wavefront Optimized LASIK, Presbyond LASIK and SMILE.
  • 101, 1st Floor, Sukh Sagar, N S Patkar Marg, Girgaon Chowpatty, Mumbai- 400007

Schedule a Consultation