# Refractive Lens Exchange

> Citation bundle for Refractive Lens Exchange on The Treatment Registry.
> URL: https://thetreatmentregistry.com/procedures/refractive-lens-exchange
> Bundle URL: https://thetreatmentregistry.com/api/citations/procedures/refractive-lens-exchange

- Category: ophthalmology

## Description

Clear lens extraction, also known as refractive lensectomy, custom lens replacement or refractive lens exchange is a surgical procedure in which clear lens of the human eye is removed. Unlike cataract surgery, where the cloudy lens is removed to treat a cataract, clear lens extraction is done to surgically correct refractive errors such as high myopia.

## Overview

Refractive lens exchange (RLE), also called clear lens extraction, refractive lensectomy or custom lens replacement, is a refractive surgery in which the eye's clear natural lens is removed and, in the same way as cataract surgery, an artificial lens is implanted in its place. The key difference from cataract surgery is the reason for the operation: in a cataract procedure the lens being removed has become cloudy, whereas in RLE the lens is still clear and is exchanged specifically to correct a refractive error such as high myopia. Refractive surgery as a whole is elective surgery intended to improve the refractive state of the eye and reduce or eliminate a person's dependence on glasses or contact lenses, treating conditions such as myopia, hyperopia, presbyopia and astigmatism. Broadly, the field offers two routes: surgical remodelling of the cornea — most commonly reshaping its curvature with an excimer laser — or, as in RLE, lens implantation or lens replacement. Because it is not suitable for everyone, candidates need a full eye examination first. Refractive surgery is generally not recommended for people with certain corneal or retinal diseases, for pregnant women, or for those with conditions such as glaucoma, diabetes, uncontrolled vascular disease or autoimmune disease. Screening tests such as corneal topography and pachymetry are used to identify corneas that would make surgery inadvisable.

## Peer-reviewed outcome rates

- **Complication rate:** 7.67% (range 7.60–7.74%) — from 2 cited sources

## FAQs

### What is refractive lens exchange?

Refractive lens exchange, also called clear lens extraction or refractive lensectomy, is a refractive surgery in which the eye's clear natural lens is removed and replaced with an artificial lens to correct a refractive error. It follows the same broad approach as cataract surgery.

### How is it different from cataract surgery?

The technique is similar, but the reason differs. Cataract surgery removes a lens that has become cloudy, whereas refractive lens exchange removes a lens that is still clear, in order to correct a refractive error such as high myopia.

### What vision problems can refractive surgery correct?

Refractive surgery is used to reduce or eliminate dependence on glasses or contact lenses and can address common vision disorders including myopia (near-sightedness), hyperopia (far-sightedness), presbyopia and astigmatism.

### How does RLE differ from laser eye surgery?

Laser procedures such as LASIK reshape the curvature of the cornea with an excimer laser. Refractive lens exchange instead works by removing and replacing the eye's lens, which is one of the lens-based routes within refractive surgery.

### Who is not a good candidate?

Refractive surgery is not recommended for everyone. People with certain corneal or retinal diseases, pregnant women, and those with conditions such as glaucoma, diabetes, uncontrolled vascular disease or autoimmune disease may not be suitable, and a full eye examination with tests such as corneal topography is advised first.

## Cited authors

- Diana Carmen Dragnea — From the Department of Ophthalmology, Antwerp University Hospital, Wilrijk, Belgium (Dragnea, Goemaere, Tassignon, Dhubhghaill); Departme…
- Veshesh Patel — Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine, Miami, FL, USA.

## Sources

- [Intraocular bag-in-the-lens exchange: indications, outcomes, and complications.](https://doi.org/10.1097/j.jcrs.0000000000000787) — Journal of cataract and refractive surgery (accessed 2026-06-28)
- [Intraocular Lens Exchange: Indications, Comparative Outcomes by Technique, and Complications.](https://doi.org/10.2147/OPTH.S399857) — Clinical ophthalmology (Auckland, N.Z.) (accessed 2026-06-28)