If you're an aging Baby Boomer or someone with a very high amount of nearsightedness or farsightedness, the best vision correction surgery for you may be one you haven't heard of: Refractive Lens Exchange (RLE).

In RLE, the surgeon removes the natural lens inside the eye and replaces it with an artificial lens of a different power for clear vision without glasses. The RLE procedure is very similar to cataract surgery. The artificial lens (called an intraocular lens, or IOL) used in both procedures is the same.

Advantages of RLE

RLE can effectively correct high degrees of nearsightedness and farsightedness that may not be adequately corrected by LASIK. It also is a viable alternative to LASIK for eyes with corneas that may be too thin for laser vision correction.

Other advantages of RLE include:

• Rapid visual recovery.
• Preservation of the cornea's normal shape and thickness.
• Eliminates the need for future cataract surgery.
• Stable visual outcome with no regression (return of nearsightedness or farsightedness) over time.
• With the use of multifocal IOLs, RLE can correct presbyopia and reduce the need for reading glasses.
• The ability to have refractive surgery even if you have mild cataracts.

Disadvantages of RLE

Disadvantages of RLE include:

• RLE cannot correct astigmatism. If you have astigmatism, you may need to have LASIK, PRK or some other refractive procedure after RLE to eliminate vision problems caused by astigmatism.
• Higher risks of complications. Internal eye procedures like RLE have higher risks for complications than corneal procedures like LASIK, including the risk of surgically-induced glaucoma and retinal detachment.
• Higher cost. The surgical fees for RLE on both eyes is typically between $7,000 and $9,000 (about twice the cost of LASIK or higher).

Where to find an RLE surgeon

During your LASIK pre-operative consultation, your eye doctor can discuss the pros and cons of RLE vs. LASIK. If you are not a good candidate for LASIK or you prefer refractive lens exchange, your doctor can give you the names of eye surgeons in your area who perform RLE.

Many refractive surgeons who offer LASIK or cataract surgery also perform the RLE procedure.