Refractive lens exchange in modern practice: when and when not to do it?

Area of Science:

• Ophthalmology
• Refractive Surgery

Background:

• Cataract surgery has evolved from lens removal to optimizing refractive outcomes.
• Lens surgery is gaining popularity for refractive correction in non-cataract patients.

Purpose of the Study:

• To explore refractive lens exchange (RLE) as a refractive modality.
• To compare RLE advantages over corneal refractive surgery.
• To assess RLE's potential for correcting refractive errors and presbyopia.

Main Methods:

• Review of refractive lens exchange (RLE) principles and outcomes.
• Comparison of RLE with corneal refractive surgery for various refractive errors.
• Consideration of intraocular lens (IOL) technologies and adjunctive procedures.

Main Results:

• RLE is advantageous for high myopia, hyperopia, and astigmatism, unsuitable for laser surgery.
• Presbyopia correction remains a challenge, often requiring monovision or reading glasses.
• Combined RLE with advanced IOLs and corneal procedures may address all refractive errors, including presbyopia.

Conclusions:

• Refractive lens exchange (RLE) presents a viable alternative to corneal refractive surgery.
• RLE, particularly with advanced IOLs, offers a comprehensive solution for refractive errors and presbyopia.
• This approach may eliminate the need for future cataract surgery.