45-plus? You don’t want to wear reading glasses any more?
Get rid of the hassle of reading glasses with lens replacement treatment. Lens replacement (PRELEX) is a great solution to help you restore your close-up reading vision and distance vision.
The Prelex, laser presbyopia surgery
PRELEX/RLE suitability criteria
Presbyopia is an inevitable phenomenon. No-one can avoid presbyopia; it starts developing from the age of 50 and results in a progressive loss of near vision. As the lens ages, it starts gradually losing elasticity. It thickens, hardens, losing its suppleness until it can no longer function properly. Accommodation (the lens changing focus) becomes insufficient.
PRELEX is a controlled, effective and life-lasting solution which stops this natural and inevitable phenomenon. PRELEX (PREsbyopic Lens EXchange) is for you whatever your age and your visual defects, if you don’t want to wear reading glasses anymore:
- Presbyopia Myopia+/- astigmatism and presbyopia
- Hyperopia +/- astigmatism and presbyopia
- Astigmatism and presbyopia
How does PRELEX/RLE work?
PRELEX (Presbyopic Lens Exchange) is a presbyopia surgery procedure that replaces the eye's natural crystalline lens with a multifocal intraocular lens (IOL) to correct presbyopia. The procedure is based on the same principles as cataract surgery, but it is performed before a cataract develops, when the natural lens gradually loses its ability to focus due to the aging process.
During the procedure, the surgeon removes the natural crystalline lens using a technique called phacoemulsification, which uses ultrasound energy to break up and remove the lens through a micro-incision. The lens is then replaced with a multifocal intraocular lens, which is carefully positioned within the capsular bag.
Multifocal intraocular lenses have been used successfully for more than 20 years and are a well-established solution for presbyopia correction, providing functional vision at multiple distances.
What are the advantages of PRELEX/RLE?
PRELEX (Presbyopic Lens Exchange) is a presbyopia surgery procedure designed to provide a long-lasting correction of near, intermediate, and distance vision by replacing the eye's natural lens with a multifocal intraocular lens (IOL). In most cases, the procedure significantly reduces or even eliminates the need for glasses or contact lenses for everyday activities.
PRELEX is based on the same well-established technique used in cataract surgery. Performed as an outpatient procedure, it is minimally invasive and typically allows for a rapid visual recovery. Most patients are able to resume their normal daily activities the following day, in accordance with their surgeon's recommendations.
The intraocular lens is permanently positioned inside the eye and cannot be felt after surgery. It is designed to last a lifetime and does not require replacement.
PRELEX provides a long-term solution for presbyopia. Because the natural crystalline lens is replaced with an artificial intraocular lens, a cataract cannot subsequently develop in the treated eye. When patients are carefully selected, the procedure delivers excellent visual outcomes and high levels of patient satisfaction. A thorough pre-operative assessment combined with the expertise of an experienced surgeon is key to achieving the best possible results.
What are the limitations of PRELEX/RLE?
Like any refractive surgery procedure, PRELEX has certain limitations that should be understood before treatment.
During the first few weeks after surgery, some patients may notice that reading very small print is more difficult in low-light conditions. Halos around lights, particularly when driving at night, may also occur.
The intensity of these visual phenomena depends on several factors, including the type of intraocular lens implanted and each patient's individual visual characteristics. With the latest-generation multifocal intraocular lenses selected by our clinic, these effects are generally mild and gradually diminish as the brain naturally adapts to the new visual system. In the vast majority of cases, they become barely noticeable after a few months.
What are the PRELEX/RLE risks?
Like any eye surgery, PRELEX carries potential risks and side effects, although serious complications are uncommon when patients are appropriately selected and the procedure is performed under optimal conditions.
Minimizing these risks relies on several essential steps: a comprehensive pre-operative assessment to confirm your suitability for the procedure, meticulous surgical technique, careful post-operative follow-up, and close adherence to your surgeon's recommendations.
At Bellecour Vision Clinic, we place particular emphasis on every stage of your care to provide the highest standards of safety and achieve the best possible visual outcomes. During your pre-operative consultation, your surgeon will answer all your questions and explain the benefits, limitations, and potential risks of PRELEX presbyopia surgery clearly, transparently, and in a way that is tailored to your individual needs.
With this surgery, the main risks are:
An infection
If you use your eye drops as prescribed and respect the postoperative hygiene instructions, this risk is nearly zero.
The impossibility to position the expected implant
In France, it usually happens to 1/100 patients. At Bellecour Vision Clinic, 1/2000 patients. If this should happen, there would be another surgery where we would use another implant, the patient would need glasses again. To be completely reassured, do not hesitate to ask all your questions during the consultations.
What are the PRELEX/RLE alternatives?
The patients can wear glasses or contact lenses. But usually, people are not satisfied with the way contacts correct presbyopia. In some cases, the alternative to PRELEX can be PRESBYOND.
How is a PRELEX/RLE procedure performed?
PRELEX (Presbyopic Lens Exchange) is a surgical procedure designed to correct presbyopia by replacing the eye’s natural crystalline lens with a multifocal intraocular lens (IOL). It is performed as an outpatient procedure. On the day of surgery, your total time at the clinic is usually around one hour.
Upon arrival, a pre-medication may be administered to help you relax and ensure your comfort. After being welcomed into a private recovery area and prepared for surgery, you will be taken to the operating room. In the vast majority of cases, the procedure is performed under local anaesthesia using eye drops. General anaesthesia may be considered in specific situations.
The procedure takes approximately 30 minutes and consists of two main steps:
- The natural crystalline lens is removed using a technique called phacoemulsification, which uses ultrasound energy to break up the lens before it is gently extracted.
- A multifocal intraocular lens is then placed inside the capsular bag to replace the natural lens.
Throughout the procedure, your surgeon will guide you step by step to ensure your comfort and confidence. The surgery is performed in an environment that follows strict sterile protocols and uses advanced high-precision technology, including the ZEISS OPMI LUMERA 700 surgical microscope.
After the procedure, you will return to the recovery area before leaving the clinic. You will need to arrange for someone to accompany you home.
Post-operative Care After PRELEX®
During the first few hours following surgery, it is recommended to rest your eyes. A transparent protective eye shield should be worn at night during the first week to prevent accidental rubbing while sleeping.
Antibiotic and anti-inflammatory eye drops are started on the evening of surgery, according to your surgeon’s prescription. During the first few days, it is essential to follow strict hygiene measures, including carefully washing your hands before applying eye drops and avoiding environments that could increase the risk of infection.
You should also avoid rubbing your eyes and protect them from any impact during the healing period.
Post-operative follow-up includes a check-up appointment the day after surgery, followed by further visits at one week and one month to monitor your recovery and ensure that your visual rehabilitation is progressing well.
What are the PRELEX/RLE results?
PRELEX generally delivers excellent visual outcomes and allows the majority of patients to regain a high level of visual independence in their daily lives.
In our clinical experience, most patients who undergo PRELEX surgery achieve functional vision without glasses for their main daily activities, including reading, using a computer, driving, participating in sports activities, and enjoying their leisure time.
Our results show that approximately 90% of daily activities can be performed without glasses after PRELEX surgery. In certain situations requiring very close vision, such as reading very small print in low-light conditions, a pair of reading glasses may occasionally still be helpful.
Visual adaptation after the implantation of a multifocal intraocular lens is gradual. Over the following weeks and months, the brain learns to adapt to and make the most of this new optical system, allowing patients to fully benefit from this long-lasting correction of presbyopia.
PRELEX therefore provides a significant improvement in quality of life, offering greater freedom in everyday activities and a substantial reduction in dependence on glasses.