Refractive Lens Exchange Surgery

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What is Refractive Lens Exchange (RLE) Surgery?

RLE is a vision correction surgical procedure intended to reduce or eliminate the need for glasses or contacts for people over the age of 45. RLE may be a better procedure for someone who is considering LASIK or PRK, but might be over the age of 45 years old.

Until RLE, people with presbyopia or moderate to severe hyperopia were generally out of options other than powerful prescription lenses. RLE can provide a dramatic improvement in even serious cases.

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Dysfunctional Lens Syndrome

The term “Dysfunctional Lens Syndrome” (DLS) has been around for 15 years or so. We at Ginsberg Eye, have adopted the topic as a way to improve both patient education and satisfaction.

DLS is a continuum of progression. The term describes the natural changes in the natural, crystalline lens after approximately age 42. It’s a continuum that begins the day a person is born. When patients understand the lens aging process, they better understand their options.

Dr. Ginsberg finds this especially true of patients who had keratorefractive surgery. They come to him complaining that “my LASIK has worn off,” unaware that their lens is changing. The cornea is not the culprit. This same scenario is common among patients who have had perfect vision their whole lives and now they begin to ease into distance glasses or reading glasses or both. It is the lens that is changing in these people as well.

DLS, as a condition, has become more popular since it was stratified into stages, which aids in patient education. The Stages are as follows:

DLS Stage 1


  • The lens starts to stiffen and loses focusing power
  • Loss of near vision and need for reading glasses
  • Development of higher-order aberrations

Treatment options
Potential candidates for refractive lens exchange surgery or LASIK & PRK with monovision variation

DLS Stage 2

50 years and older

  • Loss of accommodation
  • Light scatter formation degrading vision
  • Decreased contrast and night vision

Treatment options
Potential candidates for refractive lens exchange surgery or LASIK & PRK with monovision variation

DLS Stage 3

65 years and older

  • Full cataract
  • Poor visual quality
  • The nucleus of the lens yellows affects color perception
  • Opacity with degraded vision

Treatment options
Cataract surgery to improve overall vision and higher technology intraocular lens implant to achieve spectacle independence at all distances

Who should consider RLE?

RLE is designed for people 45 and older who want to eliminate their dependence on prescription lenses. RLE can correct nearsightedness, farsightedness, and astigmatism, and treat Dysfunctional Lens Syndrome, which is an early clouding of the lens, common in people ages 50+.

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How is RLE Performed?

For this office-based procedure, you will be given a mild sedative (usually Valium) and you will be given an anesthetic eye drop to numb your eye during the procedure, making the process pain-free. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your eye to keep the surgical area clean during the procedure. Dr. Ginsberg will place an eyelid speculum in your eye to keep you from blinking. Using an operating microscope, Dr. Ginsberg will use ultrasound and a femtosecond laser to carefully remove the natural lens and replace it with the chosen IOL-– view our lens implants.

Why Choose Ginsberg Eye for RLE in Southwest Florida?

An Ophthalmologist You Can Trust.

Barrett Ross Ginsberg, M.D., a board-certified and fellowship-trained ophthalmologist, spent 10 years practicing in Lee and Collier counties before opening a state-of-the-art boutique practice providing personalized eye care and surgery in Olde Naples. Ginsberg Eye offers a variety of vision correction options to serve our patients. Dr. Ginsberg personally handles all consultations and selects the procedure that will provide you with optimal results.

A Boutique Experience.

The beautiful, clean aesthetic of Ginsberg Eye will make you feel comfortable without the cold feeling of most other ophthalmology clinics and surgical facilities.


Dr. Ginsberg uses the latest laser assisted technology to perform RLE surgery.

Office Based Surgery.

Quality of care is a top priority of Dr. Ginsberg, which is why he is providing Office Based Surgery for RLE and Cataract Surgery. This means you can avoid a surgery center with patients from multiple clinics.

If you are over the age of 45 seeking vision correction surgery, RLE might be the right procedure for you!
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How is RLE different at Ginsberg Eye?

Ginsberg Eye is the only practice in Southwest Florida offering Office Based Surgery! RLE Surgery is performed in our in office-based iOR surgery suite with our specialized and caring staff. Each eye takes about 10 minutes and is painless. The benefit to Office Based Surgery includes no IV sedation, personalized patient care, reduced stress with a familiar environment, and complete management by the physician himself rather than a network.

How is RLE different from cataract surgery?

For individuals over 45 who are considering refractive surgery to decrease dependence on glasses and contact lenses, RLE is an excellent option worthy of serious consideration.

Like cataract surgery, this procedure involves removing the natural lens of the eye and replacing it with a custom-selected intraocular lens (IOL) implant; such as a monofocal IOL, a multifocal IOL, or an extended depth of focus IOL.

The main difference between RLE and Cataract Surgery is the cataracts that also need to be removed.

What are the advantages of RLE?

The advantages of RLE include a very fast recovery, excellent outcome predictability, and superior quality of vision.  Refractive Lens Exchange (RLE) Surgery is performed in our in-office iOR surgery suite.  Each eye is operated on one week apart. The surgical process typically takes about 10 minutes per eye. Vision usually improves immediately and continues to stabilize within a few days. Everyday activities like driving are usually resumed soon after.


The procedure itself takes approximately 10 minutes per eye.

No, Dr. Ginsberg and his team take the time to ensure you are comfortable and that your eyes are numb before getting started.

No, you will need to make arrangements for someone to drive you home.

RLE is an elective medical procedure with upfront costs however Ginsberg Eye offers CareCredit financing options to approved candidates. You can also take advantage of Health Savings and Flexible Spending Accounts offered by your employer.

No, the premium lens implant is designed to last the rest of your life!