Refractive Lens Exchange

Advanced lens replacement surgery for completely personalised vision correction.

What results should I expect from ReLEx Smile surgery?
Expected Results
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Fully customised, clearer vision
ReLEx Smile Surgery Length
Surgery Duration
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10-15 minutes
ReLEx SMILE recovery time
Recovery Time
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Comfortable eyes within a few hours and good vision within 48 hours
Am I suitable for ReLEx SMILE surgery?
Suitable Candidates
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Difficulty focusing at different distances
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Early signs of cataracts
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Turning back the clock by rejuvenating your vision

Refractive Lens Exchange (RLE) is an excellent approach for older people to get rid of their spectacles and contact lenses for distance vision and increase their range of focus so that they hardly ever need to use reading glasses.

Many patients achieve complete independence from glasses. It is the crystalline lens inside the eye which causes the aging of our vision – the need for varifocal glasses, reading glasses or longer arms.

With Refractive Lens Exchange (RLE) we are replacing the natural lens which has become rigid. We use all the technology at our disposal at Custom Vision Clinic to work out whether our patients will be best served by RLE or by Presbyond blended vision LASIK laser eye surgery.

For patients who are showing signs of cataract change in the natural lens, the best option is usually refractive lens exchange. This is essentially early cataract surgery with the aim of removing the early cataract lens change and replacing the natural lens with technology which provides improved focus at all distances.

There are different lens designs to help us achieve this for our patients:

  • Multifocal lenses
  • Extended Depth of Focus (EDOF) lenses
  • Lens implants which control spherical aberration (bluriness at the edge of your vision)

There have been lens designs in the past which attempted to mimic the movement of the natural lens in order to create a range of focus (accommodative lenses such as the Crystalens) but the long term results which these lenses could achieve were inconsistent, so they are no longer used.

Read on for more about the lens replacement procedures, and the different types of lens we use.

What conditions can be treated using lens replacement surgery?

What refractive lens exchange treats:

How does the refractive lens exchange (also known as lens replacement) procedure work?

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The best way to figure out your treatment options is to request a call back by filling in the form below:

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Eyesight Guide - Private Eye Surgery in Leeds & York

Eye Surgery Pricing

All of our treatment packages include everything you need from first assessment to complete aftercare. In your free consultation your surgeon will discuss with you which package(s) are the most suitable for your eyes.

Standard Cataract Surgery

£2200 per eye
  • Excellent cataract surgery
    We use state-of-the-art lenses and have no waiting lists

  • Includes:
  • • Initial consultation
  • • Full ophthalmic exam
  • • Comprehensive imaging
  • • Surgeon’s fee
  • • Medications and supplies for 2 months post-op
  • • Standard monofocal lens implant
  • • Surgeon’s mobile number

Premium Cataract Surgery

£3000 per eye
  • Superb comprehensive treatment
    Specialised lens options and two types of laser treatment included

  • Includes everything from our standard Cataract Surgery package, plus:
  • • Medications and supplies for 6 months post-op
  • • Toric lens to correct astigmatism*
  • • YAG Capsulotomy within 2 years of treatment*
  • • Laser enhancement procedure within 2 years of treatment*
  • • All follow-up care for 2 years after treatment

  • * Included wherever clinically beneficial

Refractive Lens Exchange

£3800 per eye
  • Completely customised vision
    World-class highly personalised lens replacement surgery

  • Includes:
  • • Initial consultation
  • • Full ophthalmic exam
  • • Comprehensive imaging
  • • Surgeon’s fee
  • • Medications and supplies for 6 months post-op
  • • Multifocal/EDOF lens implant
  • • Toric lens to correct astigmatism*
  • • YAG Capsulotomy within 2 years of treatment*
  • • Laser enhancement within 2 years of treatment*
  • • All follow-up care for 2 years after treatment
  • • Surgeon's mobile number

  • * Included wherever clinically beneficial

Implantable Contact Lenses

£3000 per eye
  • For long- and short-sightedness
    Permanent contact lenses which can be removed surgically

  • Includes:
  • • Initial consultation
  • • Full ophthalmic exam
  • • Comprehensive imaging
  • • Surgeon’s fee
  • • Medications and supplies for 6 months post-op
  • • Any enhancement required within 2 years of treatment
  • • All follow-up care for 2 years after treatment
  • • Surgeon’s mobile number

Payment Plans Available

Spread the cost of your treatment over 24 or 36 months.

How successful is lens replacement?

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Multifocal lenses

Multifocal lenses present both the distance focus and near focus at the same time onto the retina at the back of the eye.

Processing of the images by the brain begins in the retina and in the vast majority of patients is able to provide comfortable distance vision without glasses and comfortable reading vision without glasses.

Approximately 1% of patients find difficulty with having both distance and near images in focus at the same time in the eye and for these patients we use blended vision (outlined below). Multifocal lenses provides a very high level of independence from spectacles (90% of patients do not require glasses for any activity).

Multifocal lenses create a range of focus with rings on the optic of the lens. These fine rings create a halo effect around point sources of light but this effect gradually reduces with time. A small percentage of patients have difficulty with the halo effect and for these patients we can again use a blended vision approach with extended depth of focus (EDOF) lenses instead.

The images below illustrate how the multifocal lens (Panoptix) splits the light into a distance and a near focus whereas the extended depth of focus lens (EDOF) (IQ Vivity) extends the range of focus from distance to intermediate.

Multifocal lense exchange surgery Leeds
Multifocal lens replacement surgery Leeds

Extended Depth of Focus Lenses (EDOF)

The concept of extended depth of focus lenses has been around for quite some time.

The latest EDOF lens design provides very high-quality vision in all light environments including when driving at night. If the lens is set for clear distance focus then the extended range provides good intermediate vision without spectacles also.

Intermediate vision typically includes being able to see the dashboard of the car, read text on a desktop computer and see what you are eating when seated at a dining table. We can increase this range of focus by asking each eye to do a slightly different job.

We set the dominant eye to provide distance through to intermediate vision and the non-dominant eye to provide intermediate through to near vision. The extended range of focus in each eye provides an overlap which helps the brain blend the eyes together to provide a seamless range of focus.

This set-up provides social independence from glasses with many patients achieving complete independence from spectacles.

Extended depth of focus lens replacement surgery Leeds

Spherical aberration modulation lenses

Spherical aberration modulation can be achieved by carefully measuring the shape of the cornea (the window at the front of the eye) and selecting a monofocal lens implant with a shape which compliments the cornea.

Spherical aberration is actually an imperfection in the sharpness of focus achieved by a lens, but like so many things in life, the imperfection actually has a benefit. The spherical aberration slightly increases the depth of focus provided by the lens and we can use this to increase the range of focus of the eye.

This approach is particularly beneficial for our patients who have had laser eye surgery when they were younger.

In the majority of cases the corneal shape created by the laser eye surgery provides a beneficial increase in depth of focus which we can further improve with appropriate choice of monofocal lens implant technology.

Frequently asked questions about refractive lens exchange

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Results at a glance

Laser procedures
Cataract procedures
Better than the national average of complication rates

My eyesight following the operation is brilliant and better than I thought possible, and this is all down to your excellent surgeon Mr James Ball and not to forget all the very dedicated people around him who make these operations possible.

Keith Garlick

Two of the best decisions I ever made in my life were firstly to have lens exchange and secondly to have Mr James Ball carry out my operation.

Patricia Walton

Within minutes I could tell there was a difference. But now, only a couple of months later, my sight is better than it was seven years ago! I can even read the really tiny print on the car sales ads! If you want that confidence you probably felt when you were younger, this is the ideal solution. Thanks to the treatment, I feel rejuvenated, independent and much younger!

John Hazelgreave

Many thanks for all your care and kindness. To me it appears a miracle that I can see so well. I feel very grateful. It is impossible to fully express my thanks.

Grace C.

May I offer grateful thanks for your expertise in operating on my eyes. It was intimated to me that you were the best, and from the results I am now enjoying, I am convinced that this is correct.

Jean D.

You are truly innovative. Thank you very much for curing the problems I have been having with my reading and near vision.

Sala M.

My work was becoming almost impossible. I had refractive lens exchange to both eyes with multifocal lens implants last July. I can now see better than 20/20 for distance and can read the tiniest print in newspapers - all without glasses! I have started reading for pleasure again, and I feel that my performance both at work and on the golf course has improved.


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I felt I was treated as an individual and all my questions were answered. From my experiences – I can highly recommend Mr Ball.

Janet Howden

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Further information about eye conditions

Discover your eye treatment options

Give us a call on: 0345 643 0466
Or request a call back:

More Useful Information

Read more about lens replacement

About our surgeons

Mr James Ball | Consultant Ophthalmic Surgeon

MA (Cantab) MB BChir FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic. My major interest is in refractive surgery and finding the best treatment suitable for each patient.

Mr Jack Gormley | Consultant Ophthalmic Surgeon

MB ChB (Hons) FRCOphth CertLRS

I am a Consultant Ophthalmic Surgeon at Custom Vision Clinic and York Teaching Hospital, where I lead the Corneal and Refractive service. I have completed over 2,000 surgical and laser eye procedures.