Opens in a new tab
Evergreen Eye Center — Refractive Lens Exchange (RLE)

Refractive Lens Exchange

Refractive Lens Exchange is a procedure that can correct refractive errors and reduce your dependence on visual aids, tailored to each person's unique vision needs.

  • Replaces your natural lens with an artificial lens
  • Patients who have RLE will never develop cataracts
  • Self-sealing incision, typically no stitches
Is This Right for You?

Am I a Candidate for Refractive Lens Exchange (RLE)?

If any of the following sound familiar, it may be time for an evaluation.
High Refractive Error
Significant nearsightedness, farsightedness, or astigmatism outside the range LASIK typically treats
Not a LASIK Candidate
Some patients aren't suited to LASIK or PRK but are good candidates for RLE
Want Less Dependence on Correction
Patients who simply want to rely less on glasses or contact lenses
Want to Avoid Future Cataracts
Because RLE permanently replaces the eye's natural lens, patients who have the procedure will never develop cataracts

RLE is also a good option for those who simply prefer to reduce their dependence on glasses or contact lenses. Your doctor will review your prescription and eye health to confirm candidacy.

The Procedure

What Is Refractive Lens Exchange?

Refractive lens exchange, also known as RLE, is a procedure designed to reduce your dependence on glasses or contact lenses. It involves replacing your eye’s natural lens with an artificial lens to correct your refractive error. Your surgeon numbs your eye, then makes a small incision in the cornea to reach your natural lens. Ultrasound is used to break up and carefully remove the natural lens, and an artificial intraocular lens (IOL) is inserted in its place. The corneal incision is self-sealing and typically does not require stitches. Patients who have RLE surgery will never develop cataracts, and depending on your lens choice, many patients permanently have good near and distance vision without glasses.

Is RLE the Same as Cataract Surgery?

Refractive lens exchange uses the same basic technique as cataract surgery: your natural lens is removed and replaced with an artificial intraocular lens. The key difference is why the procedure is done. Cataract surgery is performed when the natural lens has become cloudy, while RLE is performed on a clear lens, purely to correct a refractive error and reduce dependence on glasses or contacts.

What If I Already Have Cataracts?

If a consultation reveals visually significant cataracts rather than just a refractive error, you may be a candidate for cataract surgery instead, which can achieve similar results by replacing the cloudy lens with an artificial one. Your doctor will evaluate your eyes and recommend the option that fits your specific situation.

Patient Reviews

Monika F.

So far everything has been very positive and friendly, both staff and doctors.

Catalina R.

All the staff were friendly. Dr. Tester was saying each step out loud during the surgery and that calmed me down a lot.

William L.

Been with Evergreen for a number of years and have always been very happy with their services.

Rene S.

Evergreen Eye Care in Auburn, WA is awesome. I see Dr. Freckles and he is great. Very professional, caring and compassionate. He answers all me questions in a way that is very understandable. The staff is also very nice and friendly.
I highly recommend Evergreen Eye Care, especially the Auburn office.

Denise K.

Love Evergreen Eye Center! Dr Frankel is so warm and friendly! I receive excellent care and that is so important to me. I would not go anywhere else for my eye health. Everyone excels in their particular job before you see the doc.

Read more patient reviews
Your Options

LASIK/PRK vs. Refractive Lens Exchange: Which Is Right for You?

Evergreen Eye Center offers several ways to reduce your dependence on glasses or contacts. Which one fits best depends largely on the degree of your refractive error and your candidacy for corneal reshaping.

LASIK & PRK

Corneal reshaping procedures

  • Reshape the cornea to correct nearsightedness, farsightedness, and astigmatism
  • Best suited for moderate refractive errors and adequate corneal thickness
  • Not recommended for very high prescriptions or thin corneas
For Moderate Refractive Errors

Refractive Lens Exchange

Replaces the eye's natural lens

  • Recommended for high degrees of nearsightedness, farsightedness, or astigmatism
  • An option for patients who aren't suitable candidates for LASIK or PRK
  • Patients who have RLE will never develop cataracts
  • Involves replacing the eye's natural lens rather than reshaping the cornea
For High Refractive Errors

Your surgeon will recommend the option that best fits your prescription, corneal health, and vision goals.

Step by Step

Your Refractive Lens Exchange Journey

From consultation to clear vision, here's what to expect.
1
Consultation
  • Prescription and eye health reviewed
  • IOL options discussed
  • Candidacy for RLE confirmed
2
Procedure Day
    • Eye numbed for comfort
    • Small self-sealing incision made in the cornea
    • Natural lens removed with ultrasound
3
Lens Replacement
    • Artificial IOL inserted into the eye
    • No stitches typically required
    • Procedure completed same day
4
Recovery
    • Scratchy sensation and blurry vision common for the first hours
    • Vision improves daily over 1-2 weeks
    • Eye drops used to prevent infection and control inflammation
What to Expect

Expected Refractive Lens Exchange (RLE) Outcomes & Recovery

For the first few hours after the procedure, you may experience a scratchy or gritty sensation and blurry or hazy vision. Scratchiness typically improves by bedtime, and vision improves each day over the next 1-2 weeks.
No More Cataracts
Because the natural lens is replaced, patients who have RLE will never develop cataracts.
Reduced Dependence on Glasses
Depending on your lens choice, many patients permanently have good near and distance vision without glasses.
Short Recovery
Vision typically improves each day over the first one to two weeks after surgery.
A Self-Sealing Incision
The small corneal incision used in RLE is self-sealing and typically does not require stitches.

What Patients Can Expect in the First 30 Days

  • A scratchy or gritty sensation and blurry vision are common for the first few hours
  • Scratchiness typically improves by bedtime
  • Vision improves each day over the next one to two weeks
  • Eye drops are used to prevent infection and control inflammation
  • Avoid heavy lifting or contact sports during the first week
Informed Care

Safety & Risk Considerations

During the first week after RLE, it's important to avoid activities such as heavy lifting or contact sports. You'll be prescribed eye drops to help prevent infection and control inflammation, and you'll need follow-up appointments with your eye doctor.

Safety Profile

  • The corneal incision made during RLE is self-sealing and typically does not require stitches
  • Patients who have RLE surgery will never develop cataracts
  • RLE has a relatively short recovery period

Possible Side Effects

  • A scratchy or gritty sensation and blurry or hazy vision are common for the first few hours after the procedure
  • Vision improves each day over the next one to two weeks
  • You'll be prescribed eye drops to help prevent infection and control inflammation

How We Minimize Risk

Individual Consultation

Your surgeon reviews your prescription, eye health, and goals before recommending RLE.

Prescribed Eye Drops

Post-operative drops help prevent infection and control inflammation as your eye heals.

Scheduled Follow-Up Visits

Regular check-ins let your doctor confirm your eye is healing as expected.

Why Evergreen Eye Center

Refractive Lens Exchange: Why Choose Evergreen Eye Center

Here's what sets RLE care at Evergreen Eye Center apart.
A Comprehensive Approach
We tailor refractive lens exchange to each person's unique vision needs rather than a one-size-fits-all approach.
A Range of IOL Options
Multiple intraocular lens options are available so you and your doctor can choose the best fit for your goals.
An Option When LASIK Isn't Right
RLE gives patients who aren't candidates for LASIK or PRK another path to reduced dependence on glasses.
Our Team

Our Refractive Lens Exchange Surgeons

Our experienced ophthalmologists tailor refractive lens exchange to each patient's unique vision goals.
Find Us

Refractive Lens Exchange (RLE) in Seattle

RLE consultations are available across our Federal Way, Federal Way – Maplewood, Auburn, Seattle, Burien, and Tacoma locations.
Coverage & Financing

Cost & Insurance

Evergreen Eye Center accepts most major insurance plans and offers flexible payment options for refractive lens exchange consultations and surgery.

Insurance We Accept

28+ plans accepted

    • Accepted plans include Aetna, Blue Cross Blue Shield, Cigna, Kaiser Foundation Health Plan, Medicare, Premera Blue Cross, Regence, TriWest/Tricare, and United Healthcare, among 28+ carriers
    • Different carriers and plans have different requirements, so coverage can vary
    • Contact your insurance provider directly to confirm your specific benefits

Coverage requirements vary by carrier and plan, contact your insurer to confirm your specific benefits.

Payment & Financing Options

Ways to pay for your care

    • Cash, check, and major credit cards (Visa, MasterCard, American Express, Discover) are accepted
    • Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) can be used
    • Limited CareCredit financing is available for qualifying procedures of $200 or more, subject to credit approval

    Our billing team can answer payment questions at 800-340-3595.

Flexible financing available. We work with CareCredit to offer low- and no-interest payment plans for premium lens upgrades and elective procedures. Ask about your options at your consultation.

locations
Common Questions

Frequently Asked Questions

Answers to common questions about refractive lens exchange (rle).
Ready When You Are

Schedule Your Free Consultation

Most patients see results within 24 hours. Consultations are available at all four locations, online scheduling takes less than two minutes.