Lens replacement surgery offers a lasting, permanent solution to vision problems. The procedure replaces your natural lens with a high-quality artificial one, improving your vision and reducing the risk of future cataracts.
If you’re tired of wearing glasses or contact lenses, lens replacement surgery might be for you. But is it worth it?
In this article, we’ll discuss everything you need to know about the procedure to help you determine if it’s right for you.
What Does Lens Replacement Surgery Treat?
Lens replacement surgery removes your natural lens and implants an artificial intraocular lens (IOL) to correct vision.
It’s similar to cataract surgery but performed electively, often before cataracts cause significant vision changes. It’s generally used to enhance visual acuity and address refractive errors like:
- Myopia (nearsightedness)
- Hyperopia (farsightedness)
- Astigmatism
- Presbyopia (age-related farsightedness)
Types of Lens Replacement Surgeries
Refractive lens exchange (RLE) and cataract surgery are the most popular forms of lens replacement surgery.
These eye surgeries aim to improve vision and reduce the need for glasses and contact lenses. Another notable lens implant procedure is a phakic intraocular lens called the Implantable Collamer Lens (ICL).
Unlike other procedures, ICL doesn’t involve removing your natural lens. It provides long-term vision correction and is reversible.
What’s the Difference Between RLE and Cataract Surgery?
Both procedures similarly remove the natural lens of the eye. However, there are notable differences between the two surgeries.
Cataract surgery aims to correct vision issues caused by cloudy natural eye lenses. On the other hand, RLE aims to improve vision and reduce the need for glasses or contact lenses.
Those who undergo cataract surgery will likely notice improved but imperfect vision. They may need to continue using prescription glasses even after surgery.
What to Do Before the Procedure
Both RLE and cataract surgery will require a thorough eye exam before you undergo the procedure. They’ll review your medical history and determine which intraocular lens (IOL) is best for you.
Your surgeon may ask you to stop certain medications, avoid makeup, and refrain from alcohol before the procedure. You may need to stop wearing contact lenses for a week to allow accurate measurements.
Your doctor will explain the risks and benefits, often recommending antibiotic and steroid drops one to two days prior to surgery. If other options like LASIK or PRK are better suited, they may suggest those instead.
What to Expect During the Lens Replacement Surgery
RLE is a quick outpatient procedure that typically lasts about 15 minutes per eye. Anesthetic drops and mild sedatives keep you comfortable while your natural lens is removed and replaced with an artificial one.
The surgeon may use ultrasound or a femtosecond laser to break up the natural lens before removal. The artificial lens is placed into the capsule and remains there permanently.
In cataract surgery, the cloudy lens is removed and replaced with a clear artificial IOL. The entire process usually takes about 15 to 30 minutes per eye.
What Happens After the Procedure?
After lens replacement surgery, you may experience glare, halos, mild discomfort, and blurred vision. Your doctor will provide instructions to help with healing and recovery to reduce the risk of complications and side effects.
These include:
- Avoid rubbing your eyes for about 3 to 5 days
- Wear protective gear such as eyeshields or UV-blocking sunglasses
- Avoid makeup, creams, and lotions for some time
- Avoid water contact (e.g., in swimming pools, rivers, oceans, or hot tubs)
- Stay away from strenuous activities such as heavy lifting and contact sports
Most patients notice improvement quickly, and their vision usually improves within a few days. However, complete healing can take about 8 weeks. Be sure to attend a follow-up appointment within 24-48 hours to monitor your healing.
How Much Does Lens Replacement Surgery Cost?
RLE generally costs between $3,000 and $6,000 per eye. Meanwhile, cataract surgery costs about $3,500 to $7,000 per eye without insurance.
The cost of both procedures depends on the surgeon’s experience, the facility, and your location. Premium IOL choices or advanced techniques may increase the total cost.
Most insurance plans, including Medicare and Medicaid, cover standard cataract surgery. However, insurance and Medicare typically don’t cover RLE because it’s considered an elective procedure.
What is an Implantable Collamer Lens (ICL)?
Implantable Collamer Lens (ICL) or Visian ICL is the latest version of the phakic implants used to correct myopia (nearsightedness) and astigmatism. Instead of removing the eye’s natural lens, ICL lenses are placed behind the iris.
This enhances the focusing ability of the existing natural lens. The lens is also intended for permanent use, but the procedure is reversible. ICL lenses differ in shape, size, and consistency compared to standard contact lenses.
Visian ICL is ideal for people who don’t qualify for laser refractive surgery. It’s also a preference for those at risk of dry eyes.
This procedure takes about 20 to 30 minutes and costs about $4,000 to $5,000 or more per eye. Similar to RLE, it’s considered an elective surgery, so it’s not covered by insurance.
Types of Intraocular Lenses (IOLs)
There is no one-size-fits-all solution when it comes to artificial intraocular lenses. Your surgeon will choose the best option based on what will work best for your situation.
Listen In Q&A Format
Lens Replacement Surgery
Vision Center Podcast
If you need IOLs in both eyes, your surgeon will treat both eyes separately (one to two weeks apart). The different types of IOLs available for RLE or cataract surgery include:
- Multifocal IOLs. These are designed to provide near, intermediate, and distant focus simultaneously.
- Monofocal IOLs. These are designed for either medium-range or distance vision, but not all at the same time.
- Accommodating IOLs. These are monofocal lenses but provide clear focus at different distances through ciliary muscle contraction.
- Toric lenses or astigmatism correction IOLs. Premium monofocal lenses that help treat astigmatism; these cost more than standard monofocal lenses.
Who is A Good Candidate for Lens Replacement Surgery?
Qualifying for lens replacement surgery varies depending on the type of surgery you’re getting. Here’s a quick rundown on how to qualify for each type of surgery:
| Candidacy | Refractive Lens Exchange (RLE) | Cataract Surgery | Implantable Collamer Lens (ICL) |
| Age Range | Typically adults, often 40+ (especially with presbyopia) | Usually 50+ with cataract symptoms | 21 to 45 years old |
| Vision Conditions | Severe refractive errors (myopia, hyperopia), presbyopia | Vision-impairing cataracts; may reduce dependence on glasses/contacts | Moderate to severe myopia and up to ~4 diopters of astigmatism (with Toric ICL options) |
| Alternative Suitability | Not a good candidate for LASIK or PRK | Cataracts affecting vision or interfering with other treatments | Not a good LASIK candidate |
| Eye Health Requirements | Good overall eye health; no advanced retinal or corneal disease | Good overall eye health; cataract must be primary issue | Good overall eye health; no history of eye trauma |
| Other Requirements | Desire to prevent cataracts or eliminate eyewear; stable prescription preferred | Cataract must significantly impact vision; absence of advanced macular degeneration or detached retina | Stable vision correction prescription for 6 to 12 months |
| Medical Restrictions | None specific beyond general surgical safety | May be limited by advanced eye disease | Not pregnant or breastfeeding; not taking steroids that hinder healing; no allergy to anesthetic eye drops |
What Are the Complications of Lens Replacement Surgery?
While experiencing complications from lens replacement surgery is rare, the risk is still there. These complications include:
- Retinal detachment, especially in extremely nearsighted people
- Dislocated IOL
- Increased eye pressure (ocular hypertension)
- Severe reddening of the eyes
- Infection or bleeding inside the eye
In this article
