RLE vs LASIK - What Are The Differences?


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Refractive Lens Exchange (RLE) and Laser-assisted in situ keratomileusis (LASIK) are eye surgeries that promise a glasses-free life and short recovery time.

LASIK is a laser-based procedure, and RLE involves implanting a lens to replace the eye’s natural lens.

Comparing RLE and LASIK will help you decide which is best for you if you’re lucky enough to have a choice.

Both surgeries have their advantages and disadvantages. RLE and LASIK are quite different regarding the procedure’s difficulty and time required and which conditions they treat. While LASIK has a higher success rate, you need to weigh your opinion based on cost, the recovery process, and complications.

In the search for the best eye surgery for you, you’ll need a closer look into what RLE and LASIK entail to make an informed decision.

We’ll examine each option’s procedure, treatment conditions, recovery, possible complications, advantages, and disadvantages.

Not Sure Which Treatment Is Right For You?

We offer a number of vision correction treatments at our London Clinic.

We can give you a good idea of your suitability over the phone and schedule you for an initial consultation.

The Procedures

RLE and LASIK have different methods of fixing your eyesight to the point of being glasses-free and improving your quality of life. Eligibility and costs involved are also procedure considerations that could sway your decision.

RLE is a surgery where your eye’s natural lens is removed and replaced with an artificial intraocular lens (IOL). 

Most patients having RLE are middle-aged and require reading glasses, and some patients also need glasses for distance vision, for example, for short-sight, long-sight or astigmatism.

The kind of IOL you choose will depend on your prescription and the goal of the surgery.

If you want a fix for your distance vision but don’t mind wearing reading glasses, you’ll choose a monofocal IOL. These lenses are designed to give you the best distance vision possible and often have an advanced aspheric optical design.

A multifocal IOL will be your best choice if you want to permanently correct both distance and reading vision. These premium IOLs can correct far (e.g. TV and driving), intermediate (e.g. PC range) and close vision (seeing your phone). 

Your surgeon will advise on the best IOL for your needs.

The procedure takes around 15-20 minutes per eye, irrespective of the type of IOL you have selected.

LASIK, on the other hand, is a laser eye surgery where your eye surgeon creates a corneal flap and reshapes the tissue underneath so that refracted light passes through it correctly.

LASIK can treat short-sight, long-sight and astigmatism, as well as fixing both far and near vision through an option known as Blended Vision.

The laser is programmed to remove microscopic tissue from the cornea, after which the corneal flap is closed and heals naturally without stitches. LASIK surgery takes approximately 5-10 minutes.


Anyone over 21 with a stable visual impairment six months before the procedure is eligible for RLE, but it works best for those over 40. 

RLE best treats myopia, hyperopia, presbyopia, early cataracts, and astigmatism.

Patients should also have no history of eye diseases, and their eyes must be in good health. Patients with autoimmune problems, extreme corneal astigmatism, or retinal issues are discouraged from RLE.

LASIK surgery treats mild, moderate or high myopia (short-sight), hyperopia  (long-sight), and astigmatism. LASIK can also correct the need for reading glasses.

Like RLE, you need good autoimmune health to be eligible. Still, you will not be able to get LASIK surgery if you have cataracts, thin corneas, or very dry eyes.


Because of the differences in the treatments, the prices between the two can vary.

LASIK is the more cost-effective option, with complete LASIK treatment for both eyes at Focus Clinics costing between £4,400 and £5,600, depending on the prescription.

RLE at Focus Clinics costs between £6,500 and £7,500, depending on the prescription and lens implant required.


LASIK and RLE are very different surgeries, so the healing times also vary.

You will experience mild discomfort for a few days after RLE. Both eyes may be treated on the same day; patients find this a much more convenient option than splitting the surgeries across two visits.

The newer lens will take another ten days of initial healing, and you should be able to get back to everyday life with reasonably clear vision within one week. Multifocal implants can require several weeks of adjustment as your brain adapts to the new optics.

Your total visual adaptation to the new lens may take up to three months to see full results.

LASIK surgery, on the other hand, can be uncomfortable for only a short time, with your eyes itchy, sore, and watery for around four hours. 

Most people can return to work with clear vision just 1-2 days after treatment, but the full results are seen between three and six months.

Success Rate

Refractive lens exchange RLE is a popular and highly effective procedure, with a success rate of up to 99%. However, some patients may still require glasses for some tasks, around 10% or so.

However, it is essential to be aware that, as with any surgical procedure, there is a small chance of complications that may result in permanent vision loss. 

While these risks are rare, it is crucial to understand them before deciding to undergo surgery.

LASIK is a highly successful procedure, and complications are uncommon. For the past three years, 100% of Focus patients with typical short-sighted (myopic) prescriptions have achieved 20/20 vision with a single LASIK treatment, and it is one of the safest surgical procedures in the world.


All surgeries have their risks, but some are more than others. Eyes are delicate, and if you’re looking for the safer option between RLE and LASIK, the complications are something you need to look at.

Because LASIK is a highly evolved treatment, the procedure results lie predominantly in the quality of the screening process. Our surgeons are all highly experienced in performing LASIK; our lead surgeons have completed over 25,000 LASIK surgeries each.

With either procedure, the chances of complications are very low.

RLE Complications

  • Infection – Since your eyes must heal, infections are possible, but they are rare.
  • Retinal detachment – this is more common in very myopic patients, as they have an inherently thinner and weaker retina.
  • Over-correction – Occurs when the lens is too strong, e.g. a short-sighted patient can become somewhat long-sighted after surgery.
  • Under-correction – The IOL does not correct your vision as anticipated, and some prescription remains. A top-up LASIK procedure is usually the best remedy.
  • IOL dislocation – This happens when the IOL does not stay in place and requires your doctor to rectify the issue.

LASIK Complications

  • Under-correction – This happens when too little corneal tissue gets removed, so you don’t achieve the desired results, and it occurs in around 1% of patients. Laser re-treatment is highly effective at correcting any residual prescription
  • Over-correction – This happens when the laser removes too much tissue leaving your vision somewhat blurred, e.g. for close vision; this is rarer than under-correction and may correct itself in time.
  • Vision loss or changes – Sometimes complications can lead to loss of vision, leaving you with less than you had pre-LASIK, which is very rare.


RLE and LASIK are equally complex procedures that treat the same conditions but in different ways. However, not everyone is suitable for both treatments.

An optometrist or ophthalmologist can tell you which approach is most suitable for you based on your prescription and eye health.

If you’re unsure which treatment is right for you, schedule a free telephone consultation with our team, and they’ll be happy to discuss the options for your prescription.

About the Author

Mr David Allamby is the founder and medical director of Focus Clinic - the leading provider of laser eye surgery in London. Focus’ commitment is to be the #1 clinic for vision outcome results with 100% of patients achieving 20/20 vision or even better. He is one of a limited number of UK surgeons who work in laser refractive surgery full-time.


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