Refractive Lens Exchange (RLE)
Regain your vision with premium multifocal intraocular lenses for absolute freedom from glasses for life!
Age related changes - Presbyopia
In our youth, the crystalline lens of your eye is soft and flexible with the ability to change its shape easily. Your focus could move from distance to close up with ease.
Between the ages of 40 and 50 years, we all start to struggle with near vision due a condition called Presbyopia. Presbyopia literally means “aging eye” – the lens thickens and becomes more rigid, losing the ability to focus up close, particularly in low light. Headaches, eyestrain, squinting and tiredness can be symptoms of Presbyopia. You may have also noticed the need to hold reading material at arm’s length to achieve good focus.
The most common way to treat presbyopia is to wear glasses or contact lenses. Many people in this age bracket require bifocal or multifocal lenses that make them feel old. The ever-increasing reliance on glasses can be intensely frustrating.
Treating Presbyopia with premium multifocal lenses
Independence from glasses can be achieved through a refractive lens exchange (RLE) with premium multifocal lenses.
Premium multifocal lenses can provide crisp vision at all distances – far, near and at intermediate range. Depth perception is maintained, with both eyes working together as nature intended.
The RLE procedure is very similar to cataract surgery. While the lens has aged and is rigid, it has not yet become cloudy. By exchanging the component deteriorating with time, you will never develop cataracts and the exceptional visual results will last for life.
Refractive Lens Exchange is a 15-minute procedure with no pain and next day recovery.
Freedom Eye Laser patients report a regained sense of independence leading to enormous improvements in their enjoyment and quality of life.
Can you imagine the freedom that would bring you?THE FREEDOM EYE LASER DIFFERENCE
At Freedom Eye Laser, we are one of the most highly experienced users of multifocal technology. We do not believe in a one size fits all mentality.
Dr Genge has extensively used the spectrum of available multifocal lens technology. He takes the time to assess your specific visual requirements such as near visual tasks that require fine detail, what form of computer you use, and the extent of activities such as night driving.
With this information, Dr Genge will select the most appropriate multifocal lens for your visual needs. This level of personal service is what sets freedom eye laser apart from other practices.
COMPARISON TO OTHER TREATMENTS
Freedom Eye Laser is committed to safe and effective procedures that achieve excellent visual results.
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| Refractive Lens Exchange | |
| Vision can be corrected for near, far and intermediate range | |
| Both eyes working together for near, intermediate and distance vision | |
| No future cataract development | |
| Lasts for life |
When choosing the best option for your needs and lifestyle, there are 3 key elements to consider:
We have summarised the key methods of addressing Presbyopia in the table above. The most common surgical procedures available to correct Presbyopia include Refractive Lens Exchange with a Multifocal Intraocular lens implant and monovision.
Refractive lens exchange with multifocal Intraocular Lenses is a superior method for correcting presbyopia and allows for a life without glasses. At Freedom Eye Laser, we do not perform monovision (either with laser eye surgery, lens surgery or corneal inlays) as the results are inferior for a multitude of reasons.
With monovision, one eye is corrected for distance, while the other eye is corrected for near vision. Monovision seriously compromises the quality of sight, as the eye seeing well for distance will be very blurred up close; the eye seeing well up close, will be very blurred when looking at objects in the distance. In addition, the bigger the difference in power of prescription between the eyes, the more they interfere with each other and you end up not seeing well at any distance.
Binocular vision is the natural way our eyes work together as a unit, blending the images from each eye to create a three-dimensional picture. If you separate the 2 eyes, then depth perception is lost. Without depth perception, we cannot accurately determine the relative size of objects or how far away they are. This can cause difficulty with everyday activities such as pouring a cup of tea, maneuvering to park your car, safely crossing the road or navigating downstairs.
In comparison, the endpoint for intraocular lenses is excellent vision in both eyes for distance, both eyes for computer and both eyes for reading. Depth perception is preserved and you are seeing the way your brain wants to see for optimal visual quality. As you have changed the component that is changing with time, the outcome is permanent.
Freedom Eye Laser is committed to the latest technology, only when it is safest and most effective. Given the Refractive Lens Exchange procedure is the same as in cataract surgery, there are two options to consider – traditional manual surgery versus laser-assisted surgery.
Traditional cataract surgery is the most common surgery performed worldwide and is recognised as being both safe and effective.
Femtosecond Laser-Assisted Cataract Surgery (FLACS) was introduced to Australia in 2009 as the latest technology. Many practices invested in these expensive machines with the hope it would be a safer and more effective option. Recent independent research indicates this information is misleading.
When comparing the efficacy and safety of Femtosecond laser-assisted cataract surgery (FLACS) to standard manual cataract surgery, Popovic and colleagues (2016) analysed thousands of procedures and concluded that in the hands of a surgeon who has mastered cataract surgery, the risk of tearing the capsule and complicating the procedure is 10x higher with laser cataract surgery. A Cochrane analysis (2016) of 13 studies found no significant differences in visual outcomes or complication rates for FLACS versus traditional surgery. 11 of the 13 studies were either funded by the manufacturer of the laser or had financial links with the manufacturer.
For further reading on the subject, see the review article in Eyeworld here.
While Dr Genge has trained and is accredited to use the femtosecond cataract laser, he chooses the manual surgical option with exceptional results. This decision is based on a large body of current, independent research suggesting that the additional cost of over $800 per eye to the patient, is in the very least unnecessary… and at worst, less safe.
Dr James Genge dedicates time to understand each patient’s visual goals so he can customise your treatment by selecting the procedure and most advanced optics available to achieve your desired result. He will thoroughly explain the process and allow time for questions to ensure you feel confident and well-informed.
Dr Genge’s involvement is maintained through the entire process – from assessment to post operative care and beyond. While this seems like a standard approach, we can assure you that it is the Freedom Eye Laser difference. We pride ourselves on personalised care and superb results.
What to expect
From the initial consultation through to post operative checks, Dr James Genge will see you through the entire journey.
Call us to discuss the best solution for you. We will lock in an assessment time to kick start your journey toward excellent vision and freedom from glasses.
You will be greeted warmly by our reception staff who will register your details and invite you to take a seat in our calm and comfy lounge area.
Our Orthoptic staff will lead you to the diagnostic rooms where they will take a medical history, determine your prescription and take precise measurements of your eyes in preparation for your consultation with Dr Genge.
During your consultation, Dr Genge will ask about your lifestyle and your visual goals. He will conduct a thorough eye examination and evaluate the results of tests performed.
Dr Genge will then offer an explanation of your vision, discuss the best treatment approach and allow time for you to ask questions.
Following your consultation with Dr Genge, our practice manager will explain the process for booking surgery. We can contact your private health insurer to check your cover and provide you with a transparent quote. You are welcome to book in at this time or take the information home to consider.
You are likely to be at the practice for approximately an hour and a half.
An information pack is provided outlining the process for surgery, with forms to complete and prescription eye drops to commence 3 days prior to surgery.
Patients are to attend the hospital approximately 1½ hours before surgery is scheduled and typically fast for 6 hours prior.
You will be admitted to the day hospital and assessed by the anaesthetist.
The operation itself takes just 15 minutes per eye and you are often leaving the hospital about an hour or so later.
Shields are placed over eye(s) for the remainder of the day.
Patients attend the practice in the morning for their day 1 postoperative appointment and the big reveal. Eye shields are removed and the vision is tested.
This is the most exciting part of all! Read more about ‘The Moment’ here. Any sport that causes perspiration, swimming and make-up worn on or around the eyes should be avoided for 2 weeks.
Drops continue for 4 weeks and a check up with Dr Genge happens at 3 months.
FAQs
Refractive lens exchange (RLE) is a procedure that replaces your eye’s natural lens with a premium multifocal intraocular lens, correcting the near-vision decline that comes with presbyopia. As we reach our 40s and 50s, the natural lens thickens and loses flexibility, making it harder to focus on close-up objects, especially in low light. Common signs include eyestrain, headaches, and holding reading material further away to bring it into focus.
RLE is generally suited to people aged 45 and over who are experiencing presbyopia and want lasting freedom from glasses or contact lenses. It’s a particularly good option for those who are frustrated with the ongoing cost and inconvenience of bifocal or multifocal glasses, or who are simply ready for a longer-term solution than repeatedly updating their prescription.
RLE is a quick procedure, typically taking around 15 minutes per eye, and most patients experience little to no discomfort. The process is very similar to modern cataract surgery, with your surgeon removing the rigid natural lens and replacing it with a premium multifocal intraocular lens tailored to your visual goals.
Premium multifocal lenses used in RLE are designed to restore clearer vision at near, intermediate, and far distances, all while preserving natural depth perception, since both eyes continue working together as they normally would. This sets RLE apart from approaches like monovision, where one eye is corrected for distance and the other for near vision, which can compromise depth perception and make everyday tasks like driving or navigating stairs more difficult.
As with any surgical procedure, it’s important to have a realistic understanding of potential risks before proceeding. Your surgeon will discuss your individual risk profile during your consultation, taking into account your eye health and medical history.
Points typically covered include:
- A short adjustment period as your eyes and brain adapt to the new multifocal lenses
- Temporary light sensitivity or visual fluctuations in the days following surgery
- Potential risks and their solutions
- The importance of avoiding activities like swimming, strenuous exercise, or wearing eye makeup for around two weeks post-surgery
Recovery from RLE is generally straightforward. Patients typically return to the clinic the morning after surgery for a post-operative check, when protective shields are removed and vision is tested for the first time. In the weeks following surgery, prescribed eye drops are used for around four weeks to support healing, and a follow-up appointment is usually scheduled at the three-month mark.
The cost of refractive lens exchange varies depending on the specific multifocal lens technology selected and your individual treatment plan. Because RLE is often eligible for private health insurance rebates, many practices will liaise directly with your insurer to check your cover and provide a transparent, itemised quote before you commit to surgery.
Before booking, consider the following:
- Ask for a full breakdown of costs, including consultation, surgery, and post-operative care
- Check whether your private health fund covers refractive lens exchange, and to what extent
- Request a written quote so you can compare costs with confidence before making a decision
- Ask whether the quoted price includes both eyes or is charged per eye
Booking a consultation is a straightforward first step. It typically begins with a phone call to arrange an assessment time, followed by an in-depth consultation where detailed measurements of your eyes are taken and your visual goals and lifestyle are discussed with your surgeon.