The Complete Guide On Lens Replacement Surgery

Feb 14, 2023
 – Besser Eye Care Team
  • Cataracts

Learn everything you need to know about the most common types of lens replacement surgeries.

Lens replacement surgery refers to an eye procedure where a surgeon replaces a patient's natural lens with an artificial intraocular lens (IOL).

The two most common lens replacement surgeries are cataract surgery and refractive lens exchange (RLE). While both procedures involve replacing the eye's natural lens, the reasons patients choose to undergo either of them and the outcomes they hope to achieve are different.

Learning about these two popular types of lens replacement surgery can assist patients in making an informed choice about their eye care.

Cataract surgery

Cataract surgery is the most common lens replacement surgery. The procedure treats cataracts that impair visual function.

A cataract is an ocular condition where the eye’s interior lens gradually becomes hard, cloudy, and yellowed over time — causing a patient's vision to dim and blur. Cataracts are a natural part of aging but may require surgery if they affect someone's daily life.

During cataract surgery, the doctor will remove the patient’s natural lens and replace it with an artificial lens. This new lens allows them to see better and prevents serious damage to the eye.

Who should consider cataract surgery?

While cataracts are a natural part of the aging process, in serious cases they can cause lasting damage to the eye. Patients should consider lens replacement surgery if they have a cataract that disturbs their job or daily activities.

Signs that a patient has a visually disruptive cataract include:

  • Blurry vision

  • Double or ghosted vision

  • Sensitivity to light

  • Difficulty seeing at night

  • Seeing bright colors as faded or yellow

Old couple smiling at eachother

What to expect after cataract surgery

Most patients will notice improvements in vision immediately after cataract surgery. A full recovery typically takes three to four weeks.

Patients may experience blurry vision after the procedure. This usually clears in the days following surgery, but for some patients, vision can take longer to return to normal.

Other mild side effects that can occur following surgery include light irritation, foreign body sensation, and heightened sensitivity to light.

Cost of cataract surgery

Visually disruptive cataracts are considered a medical necessity, therefore cataract surgery is covered by Medicare and most insurance companies.

Patients should note that this coverage typically applies to standard monofocal lenses. If patients select a specialty lens replacement, they will pay for some of the cost out of pocket.

Refractive lens exchange (RLE)

Refractive lens exchange (RLE) is another popular lens replacement surgery. RLE is recommended for people over 40 who wish to enjoy crisper vision, especially from a close distance, and freedom from glasses and contacts.

The procedure itself is the same as cataract surgery. A surgeon replaces the patient's natural lens with an artificial ocular lens. The implanted lens gives patients stable vision and helps correct eye conditions such as presbyopia, nearsightedness, farsightedness, and astigmatism.

Who should consider refractive lens exchange?

Refractive lens exchange treats age-related vision issues, in particular presbyopia — a condition where patients have difficulty focusing on close objects.

Eye doctors will typically recommend the surgery to patients over 40 who want clearer vision — and do not want to undergo other refractive surgeries like LASIK.

What to expect after RLE

Recovery from refractive lens exchange is nearly identical to cataract surgery. Patients will typically notice improvements in their vision immediately after surgery.

Blurred vision and fluctuations in vision can occur in the days following the procedure, but most patients’ vision stabilizes in the weeks following surgery, and they can begin to participate in work and day-to-day activities shortly after.

Cost of RLE

Unlike cataract surgery, refractive lens exchange is considered an elective surgery and is not covered by insurance.

However, there are financing options available that can make the procedure accessible. Patients can spread the cost into monthly payments with reasonable terms, or take advantage of pre-tax dollars through HSA and flex accounts.

Types of artificial lenses available

In both lens replacement surgeries, RLE, and cataract surgery, patients have a choice of artificial lenses.

At our clinic, there are three lenses patients can choose from:

  • Monofocal lenses: The standard lens type for RLE and cataract surgery.

  • Presbyopia-correcting IOLs: High-performance upgrades that correct vision at multiple visual ranges.

  • Toric lenses: Specialty lenses for patients with astigmatism.

Each lens type comes with distinct advantages and disadvantages. If patients are curious to find out which choice suits their lifestyle and needs, they should talk with their ophthalmologist before their lens replacement surgery.

Side effects of lens replacement surgery

Both cataract surgery and refractive lens exchange are considered safe and effective, with success rates of around 98%.

However, like any surgical procedure, there are side effects in certain cases. The most significant risk in lens replacement surgery is retinal detachment. This can happen in anywhere from 1.8% to 8% of cases, particularly with people trying to correct myopia.


If you’re in the Los Angeles area and would like more information about lens replacement surgeries like cataract surgery and refractive lens exchange, please contact Dr. Besser's office for a consultation.

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