Refractive Lens Exchange (RLE) is essentially cataract surgery on an eye without a cataract. for the purpose of correcting a refractive error, usually severe myopia or hyperopia. In RLE the clear (rather than cloudy with a cataract) lens of the eye is removed and replaced with a plastic intraocular lens. With severe levels of myopia or hyperopia, the quality of vision and results are often better with RLE than with LASIK, and because an IOL can be ordered in almost any strength, RLE can correct almost any refractive error, no matter how severe. RLE may be one of the few options left for a patient with an extremely high refractive error.

The disadvantage of RLE over LASIK is that it is more “invasive” – it is surgery inside the eye rather than on the surface, as in LASIK.  For extremely nearsighted patients, RLE and even normal cataract surgery carry a higher risk of retinal detachment than in patients with lower degrees of myopia. And for patients younger than 40 or 45 who would normally not need reading glasses after LASIK, RLE also weakens focusing, making reading glasses necessary. This may be an acceptable trade-off for a severely nearsighted patient.