Richard Burns, M.D.

RLE - Refractive Lensectomy

Dr. Burns’ training and experience allow him to perform a variety of advanced vision correction procedures. He is especially proud to offer his San Diego, Temecula, Hemet, Murrieta, and Sun City patients the sophisticated Refractive Lens Exchange (RLE) treatment. During the RLE procedure, Dr. Burns exchanges patients’ natural lenses with sophisticated Intraocular Implants (IOLs). The IOLs allow patients to see clearly at various distances, greatly reducing their dependence on glasses.
Please peruse this page to learn more about refractive lens exchange offered by Dr. Burns.

Refractive Lensectomy (RLE)

During Cataract Surgery, the cloudy natural lens is removed and replaced with an artificial lens (IOL). Refractive Lensectomy (RLE) is different because during this treatment the clear lens is removed before it can become a cataract. Dr. Burns then replaces the removed lens with an IOL. The artificial lens becomes a permanent part of the treated eye and does not require any special care.

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Step 1.

First, a tiny (2.75mm) incision is made on the outside edge of the cornea.

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Step 2.

The next step of the RLE procedure involves delicately opening the capsule of the lens, which is located behind the pupil. Dr. Burns often tells his refractive IOLs patients to think of the natural lens as a grape with a thicker outer wall. This is the capsule. Dr. Burns makes a circular opening on the top surface of the capsule enabling him to gain access to the material of the lens itself.

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Step 3.

He then gently aspirates all of this material, leaving an empty bag (or a hollow grape). This empty capsular bag is still attached to the eye itself.

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Step 4.

During the next step of your RLE procedure, Dr. Burns places a new lens inside the empty bag and positions it depending on the type of the lens. Most often he recommends that his San Diego IOLs. In certain cases the best fit is the Toric or astigmatism correcting lens.

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Step 5.

After the lens is placed, the eye is sealed watertight.


The entire Refractive Lensectomy procedure usually takes around 5-8 minutes. However, the total amount of time most refractive IOLs patients spend in the operating room is 15-20 minutes.

Is Refractive Lensectomy for Me?

Most commonly Dr. Burns sees people who come to him for LASIK because they are tired of contacts or glasses. Many of these patients also require bifocals or special reading glasses. As Dr. Burns explains it, "If I performed LASIK for these patients, they would still need the reading glasses. If I do Refractive Lensectomy, they won’t."
RLE procedure is also the treatment of choice among patients with minor lens clouding (early cataract). If these patients underwent LASIK, the benefits would be only temporary. In contrast, vision correction results achieved through RLE are permanent.

Cataracts

Advantages of Refractive Lensectomy (RLE)

  • RLE can provide excellent bilateral distance and near vision without glasses or contact lenses. As opposed to monovision (one eye corrected for near, the other for distance vision), bilateral vision provides more natural vision experience.

  • Refractive Lensectomy significantly reduces patients’ dependence on glasses. While we cannot guarantee that you will never need glasses again, more than 95 percent of our refractive IOLs patients don’t. This is because IOLs have a multifocal component that allows you to see both near and far.

  • IOLs do not need to be replaced as they become a permanent part of the eye.

  • Patients who undergo RLE procedure do not need cataract surgery in the future. This is because during RLE the natural lens (which can become clouded forming a cataract) is removed.

  • Refractive lensectomy is a procedure with a proven track record of success. Dr. Burns has been performing RLE in San Diego for more than 15 years with excellent results.

  • RLE can be performed for many patients who do not qualify for LASIK due to their thin corneas, dry eyes, large pupils and/or keratoconus (abnormally bulging corneas).

  • Patients who receive refractive IOLs recover fairly quickly, often within a few days.

Refractive Lensectomy vs. LASIK

LASIK involves reshaping the surface of the cornea, while Refractive Lensectomy removes the eye’s natural lens and replaces it with an Artificial Lens (IOL). Generally, LASIK is less invasive and results in a quicker recovery. However, the drawback of LASIK is that it is not appropriate for certain patients. Disqualifying factors include thin corneas, large pupils and keratoconus. However, patients with these conditions can still undergo Refractive Lensectomy (RLE). In addition, RLE is also often recommended for patients with presbyopia (compromised near vision) and/or early cataract formation. By undergoing RLE earlier in life, many patients can avoid cataract surgery that is required by the vast majority of people over the age of seventy.

In comparison to LASIK Eye Surgery, the recovery time associated with RLE is somewhat longer. Most of our refractive IOLs patients experience some temporary blurring for a few days. It is normal to experience increased light sensitivity for a few weeks. Nighttime vision usually improves over the period of three weeks.