Refractive lens exchange, also known as refractive lens surgery or phaco-refractive surgery, corrects refractive errors and reducing or eliminating the need for glasses or contact lenses . It consists of removing the eye natural lens, which is the structure responsible for focusing images on the retina, and replacing it with a customized transparent artificial lens. It may be considered for people with myopia, hyperopia, astigmatism, and also presbyopia, that is, the progressive difficulty in seeing up close that occurs with aging. It is a particularly suitable option when the refractive error is important and there are age-related changes in the lens, such as reduced focusing ability and loss of transparency. Although it is technically similar to cataract surgery (lens replacement) the goal of refractive lens exchange is to correct vision and reduce the need for glasses or contact lenses in daily life. Who can benefit from refractive lens exchange? This procedure may be recommended for people with: Presbyopia; Myopia; Hyperopia or hypermetropia; Astigmatism; Early-stage cataract; High dependence on glasses. The procedure success depends on a highly detailed preoperative assessment, including a personalized analysis of the patient’s lifestyle and several tests, such as: Ocular biometry; Corneal topography; Retinal evaluation. Types of lenses used in refractive lens exchange Intraocular lenses used in refractive lens exchange are not all the same. The choice is always individualized, taking into account eye health, lifestyle, visual needs, and each person’s expectations . The aim is to achieve a balance between quality of vision, daily needs, and the specific characteristics of each eye, determined after a comprehensive ophthalmological assessment. Monofocal lenses Correct vision at a single focal distance, meaning they can optimize distance, near, or intermediate vision, but not all simultaneously. Therefore, when selected for distance vision, it is common to still require glasses for reading or other near tasks. Multifocal lenses Correct vision at more than one distance, allowing simultaneous improvement of distance and near vision and, therefore, reducing dependence on glasses. Toric lenses Correct astigmatism at the same time as any other existing refractive error. Main benefits of refractive lens exchange The main advantage of this surgery is the possibility of significantly reducing dependence on glasses or contact lenses . After refractive lens exchange, most people gain greater freedom in daily activities, for example, not needing glasses or contact lenses to : Read; Watch television; Go to the cinema; Drive; Practice sports. In addition, it eliminates the possibility of developing cataracts in the future. However, it is important to understand that the intraocular lenses used in this type of surgery, although highly advanced, do not guarantee perfect vision in all situations . Some people may notice night halos, glare, or may occasionally need glasses in specific situations. When correctly indicated, this surgery represents one of the major advances in modern ophthalmology, allowing greater visual independence and a significant improvement in quality of life. An assessment by an ophthalmologist is essential to determine whether refractive lens exchange is the most suitable solution . Learn more about the ophthalmology clinical team at Hospital da Luz network and book your consultation. Author : Tiago Martins Silva (ophthalmology) The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
