Refractive Lens Exchange

High and extreme diopters or presbyopia can be corrected with an artificial lens implant. This modern method is also known as RLE (refractive lens exchange) or CLE (clear lens extraction).

Refractive lens exchange

Troough this method, the eye’s lens, which is also called crystalline lens is replaced with a multifocal artificial lens with a diopter adjusted fit the parameters of the respective eye. Therefore, after the surgery, the patient no longer needs glasses. After implantation, the artificial lens remains functional for the rest of the patient’s life. The surgery is performed on different days for each of the eyes. The minimum time interval between the surgeries is 48 hours.

This technique is similar to cataract surgery, although in this case the natural crystalline lens is being replaced before the disorder occurs.
When the surgery is performed, crystalline lens is extracted, but its sac remains in place, and within a variable time interval, it might lose its transparency. The phenomenon is called secondary cataract. Secondary cataract treatment is non-surgical, and it is performed by laser in the medical room.

The operation is performed without hospitalization, by local anesthesia by injections or drops, different days being required in order to correct both eyes, and takes about 7 minutes. The success rate without complications is of 99%.

Refractive end implant


This type of intervention is recommended when the diopters exceed laser correction limit, when presbyopia is also involved and when there is a high possibility of cataract occurrence.

The role of the intervention is to correct the diopters, not to improve vision.

Therefore, after the intervention, the eye will be able to see without glasses or contact lenses as it saw before the intervention with the best optical correction (glasses/contact lenses).
If the diopters are very high or extreme or if they are combined with astigmatism, the implant of a customized multifocal artificial lens is required. This type of lens is manufactured upon request but the waiting time does not exceed 2 months usually.

We use multifocal artificial lenses manufactured by Carl Zeiss Meditec from Germany. These multifocal lenses are considered to be the most advanced worldwide.

When is it recommended?


Our clinic has the vastest and oldest experience in Refractive Lens Exchange from the entire country.

Complications are very rare and can be managed by treatment.

WARNING, in case complications occur, the cooperation of the patient in taking the treatment and following the surgeon’s recommendation is extremely important!

  • inflinflammations, infections or haemorrhage
  • artificial lens luxation
  • residual diopters
  • decreased contrast sensitivity (multifocal lens)
  • increased light sensitivity
  • cystoid macular oedema
  • retina detachment
  • red eye, lacrimation, foreign body sensation

The patient shall be informed by the physician on the complications, risks, results during the examination performed before the surgery.

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Indications before surgery

In order to benefit best from the surgery, the patient must be over 20, ocular refraction must be stable, (to make sure that the diopters do not further increase, particulary in myopic patients).
The operation is intended for those who want to get rid of glasses or contact lenses. The patients must not suffer from autoimmune systemic diseases (acute rheumatic fever, diabetes, LES, leukemias, lymphomas or other malignancies etc.)
Contact lenses wearers have to stop wearing them at least 5-7 days before the investigation, measurements and surgery. Before the surgery, certain measurements to be performed: auto-refractometry, keratometry, corneal topografie, pachymetry, visual field examination, visual nerve tomografie, retina tomografie.

WARNING, visual acuity obtained following the surgery will not exceed the visual acuity obtained with the best optical correction.

Indications before surgery

Indications after surgery

  • exposure to dust and strong wind is prohibited;
  • swimming in the pool, lake, sea is prohibited for 30 – 50 days;
  • during the first 2 weeks after surgery you will need help to wash your hair in order to avoid water entering your eyes;
  • eyes make up is prohibited for 4 weeks;
  • eyes rubbing is prohibited (it shall be avoided for 3-4 months);
  • local trauma, intense workout is prohibited, especially during the first 6 weeks.

Access postoperative instructions here

The patients can watch TV, work on the computer and read immediately after the surgery if the visual comfort allows such activities.
After the surgery, if the vision decreases, the eye becomes red or pain occurs, the patient should immediately contact one of the our nurses.
Our surgery room is equipped with the best quality equipment, provided by the most famous names of the specialized industry. In order to discover the range of state-of-the-art facilities within Ama Optimex Clinic, please visit the following page: Equipments