Refractive IOLs RLE

There are two main scenarios in which refractive intraocular lenses (IOLs) might be the best option to correct your vision: first, if you were hoping to have LASIK or another laser vision correction procedure but discovered that your prescription is too high; and second, if you have cataracts and you’re interested in a treatment that both eliminates your cataracts and your need for glasses and contact lenses.

Sound familiar? If so, refractive IOLs may be right for you. Like LASIK and other modern eye surgeries, refractive IOLs have allowed millions of patients to achieve 20/20 vision or better without the need for corrective lenses. The procedure corrects your vision by removing your natural lens and replacing it with an artificial lens that fits your personalized vision needs.

Benefits of Refractive IOLs

Refractive IOLs may benefit you in a number of potentially life-changing ways.

If you don’t have cataracts…

First, if you don’t have cataracts but you do have severe myopia (nearsightedness) or hyperopia (farsightedness), your surgeon has probably informed you that you are not a good candidate for LASIK — but thanks to options such as refractive IOLs, you too can enjoy the transformative benefits of refractive surgery. The same is true if your surgeon has told you that your corneas are too thin.


Surgery to implant refractive IOLs also offers the following benefits:

  • Quick recovery
  • Doesn’t alter corneal thickness (unlike laser vision correction) and therefore eliminates some potential complications
  • No need for cataract surgery in the future
  • No risk of losing corrective effect (unlike laser vision correction)
  • Can correct presbyopia (age-related farsightedness)

If you have cataracts…

If you are considering refractive IOLs because you have cataracts, you, too, can expect a quick recovery. And unlike older cataract procedures, the procedures used today will allow you to see at multiple distances without the need for glasses or contacts. You will have a number of state-of-the-art lenses to choose from to personalize your vision; today, there are lenses that correct not only nearsightedness and farsightedness, but also astigmatism and presbyopia (age-related farsightedness).

Risks & Complications

All surgical procedures have some associated risk, including those involving refractive IOLs. Many of the risks differ from those associated with LASIK because refractive IOLs are implanted deeper in your eye than the area treated in LASIK.

There are more risks associated with refractive lens exchange than with LASIK. As a result, your surgeon is unlikely to recommend that you have RLE unless you have a high prescription for myopia or hyperopia.

Here are some of the risks of refractive IOL implantation:

  • Glaucoma
  • Infection
  • Retinal detachment
  • Over-correction
  • Under-correction
  • Bleeding
  • IOL dislocation
  • Posterior capsular occlusion (i.e., a new cataract forms)

Are You a Candidate?

You must be 21 years old or older to be considered a good candidate for a refractive IOL procedure. In addition, you must have stable vision for the six months leading up to your procedure, and you must have healthy eyes, with no history of eye disease. Finally, it is important that you understand and accept the risks associated with procedures involving the implantation of refractive IOLs.

Many experts believe that the best candidates for refractive lens exchange are people with moderate to high farsightedness, and those with farsightedness who are over age 45 and have presbyopia (the latter have a lower risk of retinal detachment than people with high myopia).


The cost of your procedure will vary depending on which procedure you are having.

Refractive lens exchange. This is considered an elective procedure, so it is not covered by insurance. It typically costs more than LASIK and other laser vision correction procedures. Expect to pay around $4,000 per eye, or more. If this sounds prohibitive, you likely still have options; look into whether your company offers a Flexible Spending Account (FSA) or Health Savings Account (HSA). These accounts allow you to use pre-tax dollars to pay for your procedure.

Refractive cataract surgery. While cataract surgery with a monofocal IOL is usually covered by Medicare, supplemental insurance for people with Medicare, and often by private health insurance or vision insurance, if you have refractive cataract surgery with a premium IOL — one that corrects astigmatism or presbyopia, or allows you see clearly at multiple distances without corrective lenses — you will pay the difference. Make sure you speak to your doctor and your insurance company about the cost before proceeding with surgery.