Lens replacement (RLE)2020-09-16T11:22:09+00:00

Lens Replacement (RLE)

See again without glasses or contact lenses if you’re 50-plus

For FAQs regarding Coronavirus please click here

What is lens replacement?

Lens replacement, also known as Refractive Lens Exchange, is a procedure that helps people 50-plus see clearly without glasses or contact lenses

Who can lens replacement help?

Can you see yourself below?

YOU’RE 50 TO 55

You might have become accustomed to wearing reading glasses, varifocals or multifocal contact lenses. If a combination of these solutions is not ideal for you, I can help you see clearly again without them.


You experience clouded, blurred or dim vision. You might have increasing difficulty seeing at night, or notice that colours are fading or yellowing. If that describes you, you might have a cataract. I can help you see clearly again – and often remove your need for glasses or contact lenses at the same time.

Live a richer life without reading glasses or varifocals

Lens replacement is an excellent solution if you want a safe and effective treatment for short-sightedness, long-sightedness, astigmatism and presbyopia


Imagine seeing the whole of the world without the need for glasses or contact lenses. You’ll have a freedom that some patients call “life-changing”.


Most patients say they wish they’d done it sooner. You may feel more confident and will certainly experience more convenience. Furthermore, you’ll not have to worry about ever getting a cataract.


Awaken ready to read the morning headlines on your mobile or tablet. Take a shower without the blurriness. Work and exercise without glasses or the dryness of contact lenses. Stop the constant need to put your glasses on and off. Don’t worry about where you’ve left your readers or needing to keep half a dozen pairs around the house.


We’re not getting any younger, but that doesn’t mean we have to pull out the granny glasses or varifocals every time we want to read the text on our phones.


You might feel as fit as you did in your 30s and 40s, so there’s no reason why your eyes shouldn’t be able to keep up. These days, we spend so much time switching between looking at things up close and seeing things far away – why allow your glasses to get in the way?

Affiliations and memberships

I am proud to be associated with these organisations as a member or consultant

Vision correction enables you to experience a richer life without spectacles or contacts

Take one of the first steps and find out if you are suitable

Supplementary information about Lens Replacement (RLE)

In my expert hands, you certainly don’t need to know all of the information I’ve included in the toggles below. If you’d like to know how it all works, however, open them and learn more.

Lens replacement or Refractive Lens Exchange (RLE) is an advanced form of vision correction surgery which we use to treat patients over 50 years of age who need glasses for both distance and for reading.

With this treatment, up to 95% of patients are entirely glasses free with the remaining 5% of patients needing to wear a weak pair of glasses for specific tasks such as reading very tiny print or reading in the very dim light.

RLE is similar to cataract surgery in many ways, but there are significant differences. In both cataract surgery and RLE surgery, I remove the natural lens of the eye and permanently replace it with an artificial intraocular lens (IOL).

RLE differs in that it requires:

  • more sophisticated pre-operative testing to measure the eye’s optics,
  • more sophisticated lens implants such as multifocal and toric lens implant, and
  • an experienced surgeon with very low complication rates.

Furthermore, you need a surgeon who is also experienced in laser eye surgery because up to 5% of patients who undergo refractive lens exchange require a minor laser eye surgery procedure to fine tune the vision and achieve the very best outcome.

The benefits of multifocal intraocular lenses are:

  • They will correct both distance and reading vision
  • No / minimal need for glasses

The compromises that are required when patients are considering this treatment:

  • All patients experience glare and halos in the first few days to weeks after surgery and especially at night. These side-effects slowly fade away but may initially prevent safe driving at night.
  • The period of adaptation can take anything between 1 week to 3 months. All patients will have a small number of residual halos around lights, but this is minor, and you’ll likely tolerate it.
  • For best vision, patients must have virtually no residual glasses prescription following treatment. Up to 5% of patients require a minor laser eye surgery procedure to correct any remaining glasses prescription and achieve best results.
  • While 95% of patients who have trifocal lens implants are entirely free of glasses, 5% of patients require occasional glasses use for specific tasks.
  • With short-sighted patients this is typically glasses for prolonged computer work but not for reading.
  • For long sighted patients this is typically a pair of weak reading glasses for reading in dim light or for reading tiny text.

If you are over 50 and have both distance glasses and are noticing symptoms of what we call presbyopia (difficulty reading close up without reading glasses), then RLE may provide you with an excellent solution.

Furthermore, many patients who never wore glasses in their life and who have worn reading glasses for several years find that eventually, they also start to develop deterioration in their distance vision.

This may be due to early cataract in short-sighted patients or to increasing long sightedness in other patients. If any of these sounds like you then refractive lens exchange may well be an excellent solution to give you glasses-free vision.

Multifocal lens implants are an advanced type of lens implant that is not available on the NHS. After RLE, the focused light from the distance, intermediate (computer/TV) and close up (reading) range fall onto the retina all at once. The human brain then learns to construct a three-dimensional world from all of this information. We can achieve the best results when a patient has multifocal lenses in both eyes.

The three leading types of multifocal lenses are:

  • Extended Depth of focus intraocular lenses
  • Trifocal intraocular lenses
  • Rotationally asymmetric intraocular lenses.

All of these lenses come in standard and in astigmatism correcting toric forms.

The steps involved in RLE and Lens Replacement are the same as those we take in cataract surgery.

RLE is an excellent treatment for patients who need a variety of different pairs of glasses for distance, intermediate and reading. It’s also suitable for patients who have early cataract and who want to be free of glasses.

It is necessary, however, that patients understand that no treatment can restore the same vision they had at age 18. If, however, they are willing to tolerate some minor compromises, RLE offers a 95% chance of being wholly spectacle-free. This procedure provides the added benefit that you’ll avoid any future cataract.

Take the first step

Find out if your eyes are suitable for vision correction

How it works

Enjoy a life free from glasses and contact lenses in 3 easy steps




Talk to us


Book a video appointment or give us a call on 020 3808 7758 and we’ll help guide you towards a free screening.


I’ll see you before treatment to ensure you’re a good candidate and treat you at one of my Harley Street London facilities.


I’ll supervise your aftercare as you begin to experience a life free of glasses and contact lenses.

Even more information about Lens Replacement (RLE)

I frequently write articles and publish videos to answer people’s most common questions and keep them updated on the latest developments in vision correction. Find out more below…

You don’t choose eye surgery from a menu

Some patients worry they will have to do a whole heap of work to choose the best eye surgery. Not on my watch. Below are some alternatives that you might have heard about, however, I believe it is my duty to choose which eye treatment is best for you after conducting a thorough examination


LASIK is the most common form of laser vision correction. It’s a safe and effective treatment for short-sightedness, long-sightedness and astigmatism. Unlike RLE or Lens Replacement, LASIK will only correct your distance vision.


SMILE works similarly to LASIK but is a less-invasive, keyhole treatment. It’s a safe and effective treatment for short-sightedness, long-sightedness and astigmatism. Unlike RLE or Lens Replacement, SMILE will only correct your distance vision.


PRESBYOND, also known as “laser blended vision” is a laser vision correction treatment aimed at treating presbyopia and other refractive errors.

The advantage of PRESBYOND surgery over refractive lens exchange surgery is that PRESBYOND is significantly less invasive and less expensive. However, the advantage of RLE over PRESBYOND is that the former permanently addresses your presbyopia and helps you avoid any chance of cataract in the future.


LASEK is a type of laser eye surgery, often used as an alternative treatment for those who are not suitable for LASIK eye surgery. LASEK may not be suitable for you if you have a high prescription, very high astigmatism or keratoconus.

Implantable Contact lenses (ICL)

If you are one of the rare patients for whom laser eye surgery is not suitable, ICL lens implants offer a safe and extremely accurate option to free you from needing glasses.

This option is particularly suitable for you if the shape/thickness of cornea makes you ineligible for laser eye surgery; or, if you are so short- or long-sighted that you are out of the treatable prescription range with laser eye surgery.

Lens Replacement (RLE)

Lens replacement or Refractive Lens Exchange (RLE) is an advanced form of vision correction surgery which we use to treat patients over 50 years of age who need glasses for both distance and for reading.

The advantage of ICL surgery over refractive lens exchange surgery is that the patients retain the natural focusing ability of the eye, called the accommodation.

Refractive cataract surgery

If you have a cataract, removing that cataract and replacing your natural lens with a multifocal artificial lens will negate the need to have an ICL. This is effectively the same procedure as RLE or Lens Replacement.

Complex cataract surgery

If you have a cataract and another complicating eye condition, removing that cataract and replacing your natural lens with an artificial lens is similar to RLE and Lens Replacement in technique. However, because of pre-existing conditions, we must take greater care when operating inside the eye.

About the author

Mr Alex J. Shortt | Consultant Ophthalmic Surgeon

MB BCh MSc PhD FRCOphth PGDipCatRef

I’m Alex Shortt, a highly trained academic researcher and Consultant Ophthalmic Surgeon based in London’s famous Harley Street medical district. I trained and worked as a consultant for 14 years at London’s Moorfields Eye Hospital. I specialise in advanced technologies for correcting vision, including cataract surgery, implantable contact lenses and laser vision correction.

Go to Top