Refractive lens exchange (also called clear lensectomy) is a procedure whereby the natural lens is removed and an artificial acrylic lens implant is placed inside the eye. This surgery is essentially the same procedure performed when somebody undergoes cataract surgery. However in cataract surgery the lens has already become cloudy or opaque.


Refractive lens exchange is considered for patients who have moderate to high degrees of nearsightedness and farsightedness which are beyond what is treatable by LASIK or PRK. Patients generally are over 40 years old and are beginning to lose some of their near vision. Refractive lens exchange is also considered in older adults who are seeking LASIK but may be showing the first signs of cataract and therefore are not good candidates for LASIK or Kamra inlay.


New technology lens implants can be combined with refractive lens exchange to correct not only nearsightedness farsightedness but also astigmatism and presbyopia. Presbyopia or loss of near vision with age is corrected with bifocal lens implants. We generally recommended to patients the Alcon restore bifocal lenses or the Symfony and Technis multifocal lenses by AMO.
Refractive lens exchange can be performed either with a femtosecond laser or more traditional techniques utilizing ultrasound and precision surgical blades.


The procedure

The procedure is performed in the office using topical anesthetics and light oral sedation. The procedure takes approximately 10 to 15 minutes. In most cases patients’ vision rapidly improves and within about 24 to 48 hours patients are often back to working and driving. Surgery is performed on just one eye at a time with an approximate 2 to 4 week lag time between eye. Your safety is our primary concern. The surgery is performed in our in-office surgical suite which is AAAASF certified.

As with any surgery, complications though rare can sometimes occur. This includes retinal tear or detachment, high or low pressure in the eye, hemorrhage, infection or in very rare cases, reduced or loss of vision. The decision to proceed with clear lensectomy should be made with your physician and only after a thorough eye exam to evaluate for any eye diseases which may need to be treated prior to refractive lens exchange.

Frequent Asked QuestionsWill insurance pay for my surgery?

No. Refractive lens exchange is performed at a time before any cataract development is considered “visually significant” by your insurance. This generally means that the vision is not impaired enough by cataract development to meet the insurance or Medicare requirements.

Is there any pain?

In most cases patients experience little to no pain either during or following the procedure. If necessary patient sometimes will take Tylenol or ibuprofen but in most patients that is all that is necessary. Some patients may experience a pressure like sensation during the surgery, may note a kaleidoscope pattern of lights or sometimes a general gray out of the vision.

How quickly may I return to work?

Depending on the type of work that you do in most cases you can return to work 1 to 3 days after the surgery. If your work involves heavy labor however you may wish to take up to a week off after the surgery.

What are my restrictions after surgery?

The first night after surgery it is recommend that patients sleep on an extra pillow and on their back. In the first week after surgery light exercise is allowable such as using a stationary bike an elliptical trainer or walking on a treadmill or walking outside. Heavy weightlifting and strenuous exercise are generally not recommended. No golf, tennis or bowling or activities with high impact or risk of injury to the eye is allowed in the first week. Swimming should be avoided for two weeks.