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Here’s Your Guide to Lasik (iLasik) and RLE (Refractive Lens Exchange)

Posted on March 31, 2022
Close up of a Blue Eye with Concepts of Laser Eye Surgery.

Are you looking for a surgical procedure that can help with your eyesight? While many people are only familiar with laser eye surgery (or LASIK), you have another option as well. 

RLE (or refractive lens exchange) is a lesser-known procedure that’s great for certain conditions. If you’ve never heard of it before, you’re not alone.

Many people don’t seek out RLE unless it’s recommended by a doctor. If your physician hasn’t recommended eye surgery to you but you still want to get all of the information that you can, we’re here to help.

Keep reading for our guide to LASIK eye surgery and RLE so you can make an informed decision about your health.

Guide to RLE

Refractive lens exchange is the lesser-known procedure between the two. It’s another advanced vision correction procedure. It’s similar to cataract surgery, but the people who elect to get it don’t yet have cataracts. 

While it solves many of the same problems as LASIK, there are features that make it more appealing for certain eye conditions. 

Here are a few details about RLE

Conditions Treated

There are several conditions that can benefit from refractive lens exchange. It can address astigmatism, nearsightedness, farsightedness, and vision that declines due to age known as presbyopia. 

For the best results from RLE, you should be over forty years of age. You should have already had a consultation to see which procedure you are the best candidate for. RLE is often good for people who aren’t good LASIK candidates.

If you have significant near or farsightedness, you might be a better candidate for RLE than LASIK, as well as if you’re someone who uses reading glasses.

There are several different kinds of lenses and each type works for different conditions. They’re similar to the different types of contact lenses but even more advanced in their design.

Toric intraolcular lenses are great for people who have astigmatism. Monofocal lenses are a good lens for giving improved vision at near or far while multifocal lenses have multiple points of focus that allow improved near and distance vision.

Extended depth of focus lenses can help prevent things like glare and halos. They’re often good for people who use bifocal lenses


The procedure itself isn’t very complicated. Once it’s been determined that RLE is the best choice for you, the procedure takes about just a few minutes. You generally do one eye at a time with a few days in-between, though this may vary. 

The person doing the procedure will measure your eye for length and curvature. After this, they prepare and protect your eye by gently holding it open with an instrument and administering eye drops to hydrate and numb them. You will also receive a sedative from the anesthesiologist in the room.

They use a tiny instrument to enter the eye where they can break down and remove the current lens. After this, they replace that lens with a new intraocular lens. 

While this may sound frightening, the numbing drops and medication make it painless.  

Healing Process and Results

The results should be permanent. You won’t be at risk for cataracts in the future and you should have improved vision right away, though it won’t reach its full potential for several weeks.

The recovery process is quick. Some people return to their normal tasks within a day, but you can expect to be back to your normal activities within a week. 

Guide to LASIK

LASIK eye surgery is more popular than RLE, but that doesn’t mean that it’s better for everyone. It’s simply good for different types of conditions. LASIK reshapes your cornea to change the way that light refracts onto your retina. 

Here’s a quick guide to see if LASIK could be right for you. 

Conditions Treated 

LASIK is a great choice for people with mild to moderate nearsightedness, farsightedness, and astigmatism

Ideal patients for this procedure are over the age of eighteen, don’t have any specific eye conditions (aside from astigmatism) unless cleared by their doctor, and have had a consistent eye prescription for at least two years. 


Similar to RLE, LASIK is a relatively painless procedure. It’s outpatient, so you don’t have to worry about a hospital stay.

Like with RLE, you get numbing eye drops and a mild sedative (if you want one). A laser makes a small flap on the front surface of your cornea. The skin cell layer of your cornea will be moved out of the way so that another laser is able to treat your prescription on the stromal layer of your cornea.The doctor will replace the flap and your surgery is over. 

You’ll have some sensitivity once you’re done, so you’ll need someone to drive you home. Otherwise, the procedure is painless. 

Healing Process 

After your procedure, the doctor will prescribe you special eye drops. These drops will hydrate your eyes and reduce the risk of infection and inflamation. You shouldn’t use any over-the-counter eye drops during your healing period without contacting your doctor first. 

You should avoid bacteria-rich water (like swimming pools) and try to protect your eyes while you’re bathing.

Your vision should be noticeably better after several days.

Like RLE, the results of LASIK are permanent. However with LASIK, as your eyes age you may still need reading glasses. 

Do You Need LASIK or RLE?

If you’re looking for better vision and you’re tired of wearing glasses or contact lenses, you may want to consider surgical options. If you’re under the age of forty, LASIK may be your solution. If you’re forty or older (and especially if you’re worried about cataracts) RLE may be preferable. 

As this guide to LASIK and RLE describes, both procedures have their pros and cons. While LASIK is more accessible and less invasive, you will likely still need reading glasses in your 40s. Meanwhile, RLE should have permanent results, but there are more limitations. 

Talk to a doctor today about which procedure is right for you. 

If you’re looking for an eye doctor in Austin, we want to help. Contact us so we can talk about your options.

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