What is refractive lens exchange? How does it work?


To understand refractive lens exchange, we must understand how the eye works. The eye focuses images from the front of the eye to the back of the eye. Here, the image is captured by the retina and transmitted to the brain. 

When we look at the focusing system of the eye, we see two components. The first is the cornea, which is the eye’s outer layer, and the second is the internal lens in the eye, which sits behind the pupil. 

Under 40

Before the age of 40, individuals need glasses or contact lenses due to the cornea’s inability to focus light on the retina. In this age group, we use corneal refractive procedures, such as LASIK, to change the shape of the cornea and allow images to focus clearly, without glasses or contact lenses. 

Over 40

As we age, the internal lens of the eye changes. When we are young, the lens is completely clear and flexible. This flexibility allows us to focus from distance to near. Unfortunately, due to the natural aging process, this ability doesn’t last forever, as people in their mid-40s or older can attest.

Over time, the lens hardens and becomes dysfunctional, interfering with its ability to focus from distance to near. A condition we call presbyopia. Presbyopia continues to worsen in our 50s and 60s, and we require more powerful reading glasses to see up close. Eventually, the lens becomes cloudy and affects the ability to see clearly. This cloudy lens is what we call a cataract.

Modern cataract surgery

When we remove a cataract, we replace the cloudy lens with a clear, intraocular lens implant. In the past, cataract and lens implant surgery’s goal was merely to replace the cloudy lens. Modern and interocular lens implant surgery, however, enables us to not only replace the cloudy lens with a clear one but also restore a patient’s ability to focus from distance to near. This provides a full range of vision without the need for glasses or contact lenses.

Over the past several years, modern intraocular lens implant surgery has become very safe and effective.

Refractive lens exchange

We now can perform what we term refractive lens exchange. Refractive lens exchange is basically intraocular lens implant surgery for patients in their mid to late forties and older who are presbyopic, but who have not yet developed visually significant cataracts. 

In suitable candidates, refractive lens exchange can help to restore the ability to focus from distance to near, and in many cases provide a full range of vision without glasses or contact lenses.

Find out if you’re clinically suitable for vision correction and book your free appointment using our online scheduler, or give us a call on (717) 996-3016. 

If you’re serious about clear vision and reducing or eliminating your dependence on corrective eyewear, this is the ideal next step. Not only will it give you the certainty you need regarding the best treatment for you, but it’s also free! Book now.

Share This Story

Home » Lens surgery » What is refractive lens exchange? How does it work?

Want to be glasses-free after cataract surgery?

Our cataract experts explain how to turn back the clock on your vision

Discover the steps to FREE yourself from glasses & contacts

Watch this video and start your journey towards clear vision today

Find us

What patients say about us

I was well taken care of. They took good care of my things. Dr. Erik Chotiner did an excellent job. I am so happy to see quite clearly with my eye that has macular degeneration.
Very happy with all the staff, from check in, check out and nursing in pre op. Amazing. Very clean facility. Dr. Chotiner is so efficient and fast. Would recommend him to everyone.
Vey Love
Excellent care and personal attention are provided at Memorial Eye. Hats off to Dr. E. Chotiner, nurses and staff for making my experience there so great!
Q. Bender
I had cataract surgery and correction of an astigmatism. In one word......excellent!
Ray Jaffev
Wonderful practice with kind and supportive employees. The doctors are top notch and excellent!
A. Hendrix
I am a first time patient at your practice. Everyone was so nice and knowledgeable. Overall it was a great experience. I did not realize how bad my vision was. I am amazed! The get well flowers were a nice touch!
Surgery was quick and easy. Staff was very pleasant. Would recommend Dr. Chotiner very highly.
Patricia Scheidler
Service is very complete and professional. Dr. Erik Chotiner was very friendly and able to answer all of my questions. I am very pleased with service and will recommend.
A. Lawrence
I would recommend Memorial Eye Institute and Dr. Erik Chotiner for their expertise. They are all very professional and caring for their patients. It was an excellent experience.
Joyce Keefer

Get a free appointment and find out if LASIK could help you

The first step to free yourself from the hassle of glasses and contact lenses is to book a free suitability appointment. Book below to discover your options and get an answer about whether LASIK is right for you.

Can you be free from glasses and contacts?

The best way to find out if laser eye surgery is right for you is to get a free appointment. You’ll get a clear answer from our experts on your suitability and treatment options

Recognized leaders in Harrisburg LASIK eye surgery


Dr. Erik A Chotiner
M.D., F.A.C.S.


Erik Chotiner, M.D. diagnoses and treats a wide range of medical eye conditions. He is a Phi Beta Kappa graduate of Franklin and Marshall College. Dr. Chotiner attended Jefferson Medical College in Philadelphia where he received multiple awards including the Physiology Prize for …

Learn more >