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PRELEX and refractive lens exchange are basically the same procedure. The name solely indicates the reasoning for performing the surgery. Some doctors refer to the procedure as PRELEX when it is performed on individuals (usually > 40 years old) who are wishing to decrease their dependence on reading glasses or bifocals. And some doctors refer to the same procedure as a refractive (or clear) lens exchange when it is performed on a younger individual who is not experiencing symptoms of presbyopia.


PRELEX corrects vision by replacing the eye’s natural lens with a multi-focal, intraocular lens (IOL). The new implant provides both distance and near focusing powers, with the patient ultimately having minimal dependence on reading glasses or bifocals. Sometimes, patients have early cataracts that are not considered severe enough to warrant cataract surgery. Other patients are either nearsighted, farsighted, or are experiencing presbyopia symptoms and wish to be as glasses or contacts free as possible. All are good candidates for PRELEX.

Refractive (Clear) Lens Exchange

As in PRELEX, a refractive lens exchange corrects vision by replacing the eye’s natural lens with a multi-focal IOL. The best candidates for RLE are patients with extreme farsightedness, or with farsightedness and corneas that are too thin for laser vision correction. Generally, patients with nearsightedness have other options, such as the Visian ICL.

Both of these procedures are actually exactly the same as cataract surgery. The surgery is performed in an outpatient setting. Your eye is anesthetized to ensure comfort. The surgeon will then remove your natural lens using a laser and ultrasonic vibrations through a micro-incision of 3mm or less. The natural lens is replaced with a clear foldable multi-focal intraocular lens, which is inserted through the micro-incision. Usually, no sutures are required because the micro-incision is so small that it is self-sealing. Your vision usually improves within a day to a few days. The procedure is then performed on the second eye one to two weeks later.