Lens Replacement Surgery

Lens Replacement Surgery, also known as Refractive Lens Exchange, is very similar to cataract surgery but performed before cataracts develop. Book a consultation today and find out if you’re suitable. 

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Refractive Lens Exchange

Refractive Lens Exchange (RLE) is the procedure of phacoemulsification performed before a cataract has formed so that a clear lens is removed, it is also called Clear lens Extraction (CLE). 

RLE may be performed when refractive errors are too high for laser vision correction e.g. high hyperopia or high myopia or the eye is unsuitable for ICL implantation. 

In some cases where the angle of the eye is narrow and there is a risk of angle closure glaucoma (see glaucoma section) RLE may be preferred over laser treatment to the iris or YAG laser iridotomy.

The process of RLE is very similar to cataract surgery but because the crystalline lens is clear, removal of the lens may result in loss of accommodation (the ability to change focus to look at near objects) that most people are able to achieve before the onset of presbyopia

This means that even if a high spectacle error is treated by RLE, you will still require spectacles for close visual tasks e.g. reading.

Refractive Lens Exchange Explained

What Lens Choices do I have?

Patient video from PanOptix: Deborah

At Anderson Eye Care, we are able to offer a wide selection of lens types to suit your needs and the type of eyes you have. All of our lenses are premium products, there are no lenses which are better or higher or lower quality, but different lenses have different functionality and will suit different eyes and different visual requirements.

Monofocal lenses will give the sharpest image quality but the shortest range of vision or depth of focus so that reading glasses are usually required for intermediate and close visual tasks e.g. reading a newspaper. The focus of each lens can be offset slightly so that a dominant eye is clearer for distance and non-dominant eye for near. This effect called monovision or micro-monovision and you may have tried this using contact lenses before.


Extended depth of focus lenses (EDoF) increase the depth of focus by ‘stretching’ the intermediate zone of focus as well as distance vision correction, low strength readers may be required for close work but most of the time glasses are not required.


The first of its kind and arguably the leading extended depth focus lens, AcrySof® IQ Vivity® IOL utilises non-diffractive wavefront-shaping elements to extend the range of vision of a traditional monofocal lens whilst maximising visual quality. Wavefront-shaping elements stretch and shift the wavefront of light entering the eye, creating a continuous extended focal range rather than multiple focal points. This may provide a smoother range of intermediate vision than traditional diffractive EDoF lenses. In conditions where optic nerve or macular function may be compromised, or when the eye has complex optics, this technology utilises all available light energy to focus on the retina and so may maximise the potential vision. Download the Brochure

Diffractive multifocal lenses will provide the greatest range of vision and therefore the greatest independence from spectacles but this will be balanced against optical quality so that you may experience some glare or halo around lights e.g. head or taillights when driving at night. You may already experience these symptoms because of refractive error or early cataract and most people will adapt to them but they are an important consideration when choosing this type of lens implant.


David Anderson has a wide experience using many different lens types over the last 25 years so depending on your clinical examination and optical preferences can help guide you to the best choice for your particular circumstances.

Can you correct astigmatism?

Yes, there are a number of different approaches to reducing astigmatism from the placement of the entry ports during surgery to the use of toric or astigmatism correcting lenses, or combining lens surgery with laser vision correction also known as Bioptics.

David Anderson has published some of the largest studies on astigmatism in cataract surgery which can be referenced here and can advise you on the best options for your particular circumstances.

  1. https://bjo.bmj.com/content/103/7/993.abstract
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846755/
Astigmatism Explained Animation


We are always on hand to answer any questions you may have about your proposed surgery or to provide you with further information. We have addressed some of the most frequently asked questions we receive below but of course, there are many others that you may have so please do contact us and ask!

Risks with surgery are low and David Anderson has performed many thousands of operations with excellent results. Surgical procedures do carry risks however and complications can include infection, macula oedema (or swelling), seeing small dots or floaters and retinal detachment. All risks and benefit of surgery will be discussed with you at your consultation, if you are anxious about potential complications please call us so we can help alleviate any concerns that you may have.


Your eye will feel slightly gritty and may ache a little for a day or two but should not be painful. Any mild ache should settle with simple analgesia e.g. paracetamol. In many cases, people do not experience any discomfort.

We usually suggest a week or so off work and can provide medical certification if required. There are no restriction on using screens so if you would like to work from home using screens you can do so as soon as you wish. You cannot ‘strain’ your eyes by using them to watch the television, read, use a screen or a smartphone. 

Our usual practice is to proceed with second eye surgery within a few days or a week of the first. Cataract surgery is very safe however, and there are circumstances in which surgery can be performed immediately sequentially on both eyes, particularly if a general anaesthetic is required. 

The IOL implants are designed to be left in place for life, they do not wear out so do not need to be replaced after a period of time. They are made from biologically inert acrylic polymers.

Yes. IOLs or artificial lenses can be replaced but rarely need to be as they do not wear out, are not load bearing and do not move within the eye.

You can fly on the day of surgery but it is advisable to remain local to the hospital for the first few weeks after surgery in case you need advice or additional treatment.

Please avoid wearing eye make-up, particularly mascara for a week following surgery. Any other face make-up can be worn after 48 hours. We ask that you be careful not to rub or apply pressure to your eyes during this time. 

We encourage you to be active but please avoid exercise for the first week after surgery and vigorous exercise for a second week. Taking walks can resume the next day and stretching or mobility within two or three days as long as it is gentle. Yoga and Pilates are fine to resume after a week but please avoid standing on your head!
If you have comfortable, well-fitting goggles you can swim after two weeks but ideally we would like you to avoid swimming pool water entering your eyes for a month following surgery. Many of our patients swim in the sea which is often cleaner and we recommend a two week period provided goggles are worn. After one month there are no limitations on swimming in freshwater or swimming pools.

5-Star Lens Replacement Surgery Reviews

Lens Replacement
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Extremely pleased with the result of having the multi focal lens replacement surgery. The procedure was carried out very professionally along with the aftercare.
Lens Replacement - Excellent results
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This operation has changed my life after many years of being unable to see or read without glasses. I can now read , drive and work without them. Mr Anderson delivered this procedure with courtesy, compassion and great skill. The results are wonderful and I would recommend it to anyone who is suitable.
Refractive Lens Exchange
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I was referred to Mr Anderson by my optician. I found him to be extremely personable and professional and was immediately reassured by his calm manner. He recommended refractive lens exchange, in both eyes. I was a little apprehensive pre op, but all the staff were reassuring, and the op itself was painless, and over very quickly. (probably around 15 minutes) I could see the results almost immediately. 4 weeks on and after 55 years of spectacle wearing the results are amazing. From a prescription of +9.5 I am now completely glasses free even for reading. Thank you
Ramesh - Optometrist
Trust to retore Gift of Sight
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Five Star experience from start to finish. Service provided was professional in every way and the whole Team involved during the Procedure were reassuring and exuded confidence. The end result was amazing and Mr Anderson called personally the day after surgery, to show concern and enquire if all was well. Of Course it was...Many thanks.
Top quality service from start to finish.
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I have been very short sighted {minus 9-minus 10} all my life and have needed to wear contact lenses or glasses all day. Amazingly now ,at the age of 55 , I do not need to wear glasses at all, not even for reading. My life {as well as my sight} has been changed completely. I would recommend David Anderson to anyone thinking of having treatment on their eyes. Everything was explained very clearly and everything happened exactly as he said it would. The care throughout was professional and thorough.
Professional and friendly service
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Brilliant results, wish I'd had the interocular lenses years ago for my shortsightedness, rather than wait till cataracts prompted me. Felt very confident in the treatment and advice given by Mr Anderson.

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