Refractive lens exchange surgery, also known as PreLex (presbyopic lens exchange), clear lens extraction (CLE) and permanent lens replacement surgery is a type of surgery performed to treat patients with reading vision difficulty. Refractive lens exchange offers a way of improving vision and reducing dependence on glasses for people who have problems with their reading vision and who aren’t suitable for laser vision correction.

What is refractive lens exchange surgery?

Refractive lens exchange eye surgery is the same as cataract surgery. It involves replacement of the natural lens and implantation of a high definition intraocular Lens. This allows surgeons to correct and therefore eliminate myopia (short-sightedness), far-sightedness, astigmatism and presbyopia (reading vision problems).

Refractive lens exchange is most commonly performed in the context of reading vision correction in people over 50. The surgery is exactly the same as cataract surgery in terms of technique. It is safe, sophisticated, and well established, as tens of millions of patients have had cataract surgery around the world. The purpose of lens exchange in a presbyopic patient is that it allows a trifocal or extended depth of focus intraocular lens to be placed within the eye. This allows the patient to be largely independent of spectacles for near and distance vision.

In older patients who have a spectacle prescription that is out of range for laser eye surgery (myopia > -10.00 D; hyperopia > +4.00 D), or those with severe dry eyes or thin corneas where laser surgery is not recommended, refractive lens exchange is the best option. Almost any level of long or short sight or astigmatism can be corrected with refractive lens exchange.

An added advantage of lens exchange surgery is that you won’t develop a cataract later in life.

Learn more about reading vision problems    

Learn more about short-sightedness    

Learn more about long-sightedness    

Premium Intraocular Lens for refractive lens exchange surgery

Refractive lens exchange surgery lenses

Monofocal lenses


Corrects distance vision only, providing that the patient does not suffer from astigmatism. Glasses may still be required for reading or distance vision.

Premium intraocular lenses


Can correct astigmatism and/or offer both distance and reading vision simultaneously, allowing patients to be free from wearing glasses entirely.

Customised aspheric IOLs


Lenses can be specially tailored and customised to the individual optical properties of a patient’s eye to provide the optimal quality of vision.

Toric IOLs


Correct astigmatism as well as myopia and hyperopia. Multifocal and trifocal IOLs can also be used in toric format to address astigmatism whilst addressing near and distance vision.

Multifocal and trifocal IOLs


Are divided into multiple zones which are focused for distance, intermediate and near vision, allowing most patients to be free from wearing glasses entirely.

Extended depth of focus IOLs


Enable patients to have better vision across a broad range of distances from distance to intermediate. They are most suitable for active individuals, allowing the performance of a range of daily tasks without the need for spectacles.

IOL blended vision


The dominant eye is corrected for perfect distance vision and the non-dominant eye is corrected for reading/intermediate vision. The result is independence from glasses for all activities except close reading.

IC-8 pinhole IOL


The new lens is inserted into your non-dominant eye and uses a pinhole design that allows only focused light to enter the eye, giving patients greater independence from glasses for far, near and intermediate distances.

All surgical procedures carry some risk. The information provided here is for general educational purposes only. Please contact Forest Eye Surgery to find out if refractive lens exchange surgery is appropriate for your individual situation.

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Phone: (02) 9452 6444
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