Ocular Evidence
Procedures / RLE
Lens replacement

RLE outcomes

The natural crystalline lens is removed for refractive purposes and replaced with an intraocular lens.

Source: PubMed — PMID 26605356
Find overlapping cohorts
6studies represented
9study arms
53,518reported enrolled eyes*
7 yearslongest standardized follow-up

* Descriptive sum of reported arm counts. Missing eye counts are not treated as zero, and overlapping cohorts may not be additive.

How the operation changes the eye
Three-stage medical illustration showing the natural lens removed and replaced with an artificial intraocular lens during RLE
Original explanatory illustration. Simplified anatomy; exact devices and technique vary.
How the operation works

The natural lens is replaced with an artificial lens

RLE changes focus inside the eye rather than reshaping the cornea. It uses the same basic lens-replacement approach as cataract surgery.

  1. The surgeon makes a small opening at the edge of the cornea and accesses the natural lens.
  2. The natural lens is softened, broken up and removed while its supporting capsule is retained.
  3. An artificial intraocular lens is inserted into the capsule to provide the new focusing power.
Clinical reference: Moorfields Eye Hospital — refractive lens exchange

Study-specific outcomes

Percentages are displayed individually. They are not pooled or averaged.

LOW evidenceRETROSPECTIVEVerified evidence

Visual outcomes and patient satisfaction in refractive lens exchange with trifocal intraocular lens in presbyopic hyperopia, emmetropia, and myopia (2026)

Myopic presbyopiaEye count not reportedRayOne Trifocal
3 monthsFollow-up sample not reported
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.05 DSource
Mean postoperative spherical equivalent
LOW evidenceRETROSPECTIVEVerified evidence

Visual outcomes and patient satisfaction in refractive lens exchange with trifocal intraocular lens in presbyopic hyperopia, emmetropia, and myopia (2026)

Emmetropic presbyopiaEye count not reportedRayOne Trifocal
3 monthsFollow-up sample not reported
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.05 DSource
Mean postoperative spherical equivalent
LOW evidenceRETROSPECTIVEVerified evidence

Visual outcomes and patient satisfaction in refractive lens exchange with trifocal intraocular lens in presbyopic hyperopia, emmetropia, and myopia (2026)

Hyperopic presbyopiaEye count not reportedRayOne Trifocal
3 monthsFollow-up sample not reported
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.08 DSource
Mean postoperative spherical equivalent
MODERATE evidenceRETROSPECTIVEVerified evidence

Visual performance, safety and patient satisfaction after bilateral implantation of a trifocal intraocular lens in presbyopic patients without cataract (2022)

Bilateral AT LISA tri RLE72 enrolled eyesAT LISA tri 839MP
Postoperative assessment72 eyes observed
Not reportedUncorrected 20/20 or better
82.4%
72 eyes
Source
Refraction within ±0.50 D
97.1%
72 eyes
Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
-0.10 DSource
Mean postoperative spherical equivalent
87.5%
36 patients
Source
Distance spectacle independence
84.4%
36 patients
Source
Intermediate spectacle independence
78.1%
36 patients
Source
Near spectacle independence
78.1%
36 patients
Source
Patient satisfaction
LOW evidenceRETROSPECTIVEVerified evidence

Incidence of Intraoperative and Early Postoperative Adverse Events in a Large Cohort of Consecutive Refractive Lens Exchange Procedures (2019)

Consecutive primary RLE cohort18,689 enrolled eyesDevice not reported
Mean 8.9 months18689 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
0.005%
1/18689 eyes
Source · Table 2
Post-ICL endophthalmitis
LOW evidenceRETROSPECTIVEVerified evidence

Visual Outcomes and Patient Satisfaction After Presbyopic Lens Exchange With a Diffractive Multifocal Intraocular Lens (2012)

Presbyopic lens exchange with ZMA0045 enrolled eyesTECNIS Multifocal ZMA00
6 months45 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
Not reportedRefraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
78.0%
27 patients
Source · Abstract
Postoperative halos
26.0%
27 patients
Source · Abstract
Postoperative night glare
48.0%
27 patients
Source · Abstract
Postoperative starbursts
MODERATE evidencePROSPECTIVE COHORTVerified evidence

Retinal detachment after clear lens extraction for high myopia: seven-year follow-up (1999)

Clear lens extraction for high myopia52 enrolled eyesDevice not reported
7 years49 eyes observed
Not reportedUncorrected 20/20 or better
Not reportedRefraction within ±0.50 D
59.1%
29/49 eyes
Source
Refraction within ±1.00 D
Not reportedLost at least 2 lines of CDVA
Additional source-reported outcomes
85.7%
42/49 eyes
Source
MRSE within ±2.00 D of target
-1.01 DSource
Mean postoperative spherical equivalent
8.1%
4/49 eyes
Source
Retinal detachment rate
61.2%
30/49 eyes
Source
Nd:YAG capsulotomy rate