Clear lens exchange surgery (refractive lens exchange)
When laser correction is not suitable — strong visual defects or established presbyopia — it may be proposed to replace the transparent lens with a custom implant. The principle is the same as cataract surgery, but performed before a cataract forms.
⬇ Download this fact sheet (PDF)
What is it?
The lens is the eye's natural focusing element. In this procedure, the still-transparent lens (with no cataract) is removed and replaced with an implant whose power is calculated to correct your vision. The technique is similar to cataract surgery.
Who is it for?
It is mainly considered for high hyperopia or high myopia beyond the limits of laser treatment, and for presbyopia after age 50–55, when the lens begins to lose its flexibility. It also has the advantage of eliminating the future risk of cataract, since the lens is replaced.
Which implants?
As with cataract surgery, several implants are available: monofocal (one sharp distance), toric (corrects astigmatism), and multifocal or extended depth of focus (EDOF) lenses, which aim to reduce dependence on glasses for both near and distance vision. The choice depends on your eye and your lifestyle.
Points to consider
This is intraocular surgery: the decision is individualized and takes into account age, eye anatomy, expectations, and the risks specific to any lens surgery. These points are explained in detail during the consultation.
Frequently asked questions
What is the difference with cataract surgery?
The technique is the same, but here the lens removed is still clear (no cataract). The goal is refractive: to correct a significant visual defect or presbyopia.
Does this prevent cataracts later on?
Yes: since the natural lens is replaced by an implant, a cataract can no longer form. The implant's capsule can still become cloudy over time, which is simply treated with a laser.
From what age?
It is mainly offered from around age fifty, when presbyopia sets in and the benefit/risk ratio becomes favorable. The decision is always made on an individual basis.
Before you decide
All questions →High refractive error or presbyopia?
A pre-operative assessment will determine whether lens exchange is right for you.
Book an appointmentThis page is for general information only and does not replace a medical consultation. The indication and technique are always individualized after a complete assessment. Pr Eric E. Gabison — cornea and refractive surgery, Fondation Adolphe de Rothschild, Paris.