[The basics of refractive lens exchange]

Removal of the crystalline lens and its replacement by an intraocular lens (IOL) is known as refractive lens exchange (RLE). RLE is performed to correct high ametropia or aniseikonia. Crystalline lens removal always leads to a complete loss of accommodation; therefore, RLE should mainly be used for patients with beginning or existing presbyopia. RLE patients usually have a good best-corrected visual acuity, which is the default value for the postoperative uncorrected visual acuity. To reach this goal, microincisional and astigmatism-neutral implantation techniques as well as special IOL optic designs are available. These optic designs offer each patient individualized best visual performance. In spite of the high requirements for postoperative optical quality, RLE can lead to an effective, safe, predictable, and stable outcome with a low risk of complications.