Lens Exchange – Quick Answers
- How does RLE differ from cataract surgery under NFZ? The surgical technique is very similar. The difference lies in the goal and technology. In RLE, we remove the lens before cataracts fully develop, to treat presbyopia.
- How do Trifocal and EDOF lenses differ? Trifocal lenses provide sharpness at three points: distance, computer, near reading. EDOF (Extended Depth of Focus) provides a smooth transition from distance to computer with a lower risk of halo effect at night (ideal for drivers).
- What about astigmatism? Will an RLE lens remove it? Yes. For patients with astigmatism, we use a variant of lenses called “Toric” lenses. This implant has a built-in cylinder axis that completely eliminates astigmatism during a single procedure.
- Can I still get cataracts after RLE? No, it’s physically impossible. Because the patient’s natural lens is permanently replaced with an artificial acrylic implant, the risk of cataracts is eliminated forever.
- Are both eyes operated on the same day? Yes – this is our standard. Each eye is operated on as a separate procedure: no instrument from the first eye touches the second. At the patient’s request, procedures can be performed on separate dates.
Refractive Lens Exchange (RLE): Freedom from Glasses, including Progressives
Warsaw · Krakow · Vienna · Zurich
Refractive Lens Exchange (RLE) is a lifelong reset of your vision. This procedure corrects refractive errors and presbyopia (the need for reading glasses) by replacing the natural, aging lens with a personalized Premium implant (Trifocal or EDOF). You gain seamless vision at every distance, and the removed lens can no longer become cloudy – cataracts will never occur. The microsurgical procedure takes 15 minutes, is painless, and we support your return to activity with sick leave (L4).
Refractive Lens Exchange in Brief
- What it is: removal of your own clear eye lens and implantation of a premium implant in its place – the same one used in cataract surgery. It corrects refractive error and presbyopia simultaneously; cataracts can no longer develop.
- For whom: usually after 45-50 years of age, when presbyopia joins refractive error, or when laser surgery is not an option (high hyperopia, initial lens changes). For younger patients with preserved accommodation, we offer laser surgery or ICL lenses.
- Price: PLN 11,000 per eye with a premium implant – spherical, toric, or Customized, with no extra charges for the model. Qualification examination PLN 400. Full price list.
- Procedure: approx. 15 minutes per eye, topical anesthesia, outpatient; both eyes typically during one session (separately upon request). Neuroadaptation to a multifocal lens takes from several weeks to 3-6 months.
- Where: Warsaw, ul. Kolejowa 1 and Krakow, ul. Kluczborska 15/U3 – operated by Dr. Victor Derhartunian.
Which Lens Do We Implant in RLE – Comparison
| Implant Type | How you see | For whom | Glasses after surgery |
|---|---|---|---|
| Monofocal | sharp at one distance, best contrast | people who don’t mind reading glasses; retinal diseases | for reading – yes |
| EDOF (Extended Depth of Focus) | smooth from distance to computer, very few night vision effects | drivers, screen work | for fine print – sometimes |
| Trifocal (multifocal) | distance, computer, and reading | people expecting full independence from glasses | usually no; possible night halos during adaptation period |
| Toric (any of the above) | additionally corrects astigmatism | astigmatism above approx. 0.75 D | as above, no extra charge |
We select the model during qualification based on biometry and lifestyle – the four-question selection tool indicates the direction, but we make the final decision together.
What RLE Is and Who It Makes Sense For – We Speak Openly
Around the age of 45, the lens in your eye loses elasticity (presbyopia), and over time it becomes cloudy (cataracts). Instead of masking this process with increasingly expensive progressive glasses, we propose replacing the “worn-out part” with a durable optical element.
At SwissLaser, we go a step further than other clinics. We openly discuss what the adaptation process truly entails:
1. The Miracle of Neuroadaptation (The Brain Learns Anew)
After trifocal lens implantation, you may notice a so-called halo effect (luminous glows) around lights at night. This is not a mistake – it’s the physics of light refraction on the multifocal rings of the lens. However, the human brain is ingenious. Through the process of neuroadaptation, the nervous system gradually learns to “filter out” these effects. With each passing month, your vision becomes more natural.
2. Posterior Capsular Opacification (Quick YAG Polishing)
In some patients (approx. 30%), several months or years after RLE, the capsule in which the new lens is seated may become slightly cloudy. This is a completely normal biological reaction. We resolve this in 60 seconds in the office using a YAG Laser – painlessly “polishing” the capsule, restoring 100% sharpness for the rest of your life.
3. MS39 Diagnostics (Digital Sizing)
To calculate the ideal implant power, we use optical biometry and the MS39 tomograph. We calculate your eye’s optics at a sub-micron level to select a lens perfectly suited to your lifestyle.
What premium lenses do we implant?
We work with the full portfolio of intraocular lenses from renowned manufacturers – we select the model individually based on biometry and your lifestyle, never “off the shelf”:
- Johnson&Johnson TECNIS Odyssey – new generation full-range lens (distance, intermediate, near)
- Johnson&Johnson TECNIS PureSee – EDoF with pure refractive optics, fewer light effects at night
- Bausch+Lomb LuxSmart – EDoF with extended focal range (distance and intermediate distances)
- Bausch+Lomb LuxLife – trifocal lens with full range of vision
- Bausch+Lomb enVista Envy – full-range lens with high tolerance for decentration
- Alcon Vivity – non-diffractive EDoF, good night vision
- Alcon PanOptix Pro – latest generation trifocal lens
- Teleon – European premium lenses, also in Customized variants
Toric variants (astigmatism correction) are available with us at no extra charge – a premium implant always costs 11,000 zł per eye.
How much does refractive lens exchange cost?
RLE with a Premium implant: PLN 11,000 per eye – spherical, toric, or Customized (Johnson&Johnson/Teleon lenses). One price regardless of implant type – no extra charges for astigmatism correction.
- 2 check-ups within the first month included in the package
- installment payment option (Santander Consumer Bank)
- qualification examination: 400 zł
- procedures performed in Warsaw and Krakow
How Lens Exchange Works – Step by Step
- Qualification: optical biometry and lens selection tailored to lifestyle (trifocal, EDOF, toric).
- Day of procedure (approx. 20 minutes): topical anesthesia; the natural lens is removed by phacoemulsification through a micro-incision.
- Implantation: the foldable premium lens unfolds in the eye; the incision heals without sutures.
- After the procedure: return home the same day; 2 follow-up appointments included.
Recovery Day by Day
- First days: vision improves quickly; we protect the eye from rubbing.
- 2 weeks: no intense exertion or sports.
- 4–6 weeks: complete healing of the eye – neuroadaptation of the brain to the new lens optics proceeds in parallel and takes longer.
- Weeks 2–12 – adjustment: the brain needs to get used to the new vision – this takes time and is completely normal. Vision improves gradually, day by day.
- Months 3–6 – full adaptation: neuroadaptation is complete. If necessary, precise fine-tuning is performed at this stage.
Think of hypertension therapy: we start with one tablet, measure blood pressure again – and adjust the dose until the result is right. It is the same with presbyopia correction: we correct, the brain adjusts to the new vision, and if necessary – we fine-tune. Enhancement is not a failure, but an element of precise treatment.
Dr. med. Victor Derhartunian, FEBO, FWCRS
Safety and Possible Side Effects – Honestly
With multifocal lenses, some patients experience night vision effects (halos) around light sources – these usually diminish during neuroadaptation; we discuss this openly before lens selection. Serious complications are rare. After years, posterior capsular opacification (secondary cataract) may occur, which is removed with a several-minute YAG laser procedure (PLN 800). Cataracts themselves will never develop after RLE.
Expert Commentary
“Lens selection is 80% of RLE’s success. That’s why we don’t sell the ‘most expensive’ lens, but rather choose optics tailored to the patient’s life – a night driver will receive a different lens from me than someone who reads all day. I operate according to the same standards I use in Vienna and Zurich.”
Dr. Victor Derhartunian, FEBO, FWCRS – refractive surgeon, SwissLaser and EyeLaser clinics
Frequently Asked Questions about RLE
Does RLE hurt and is general anesthesia used?
The procedure is painless. We use extremely precise topical anesthesia (drops). You are fully conscious, relaxed, only feel touch, and the procedure lasts approximately 15 minutes.
How many days of sick leave (L4) will I get after RLE?
We usually issue a medical certificate for sick leave (L4) for a period of 3 to 7 days per eye. This allows for safe healing before returning to work, especially if you work in front of a computer.
What is “Posterior Capsular Opacification” (YAG Laser)?
This is a natural, subtle clouding of the lens capsule that occurs in some patients months or years after the procedure. At SwissLaser, we quickly and painlessly resolve this problem with a YAG laser in the office (it takes a minute), restoring perfect vision.
What is the Bioptics procedure?
Even with very precise calculations, the biology of the human eye can be unpredictable. If a minimal residual refractive error remains after RLE, we offer the option of performing a Bioptics procedure – precise laser fine-tuning of the cornea with an excimer laser, to strive for absolute optical perfection. Cost of correction: PLN 3,700 per eye, first follow-up included.
Can an artificial lens wear out or expire?
No. Premium implants are made of stable, biocompatible acrylic materials. They remain in the eye for life, do not cloud, and do not lose their optical properties.
How do installments with Santander (MediRaty) work?
You can conveniently finance the cost of the procedure in installments. We handle the formalities on-site at the clinic in about 15 minutes. Instead of paying an optician for years to come, you invest in yourself.
Why do I see halos around lights at night after RLE?
This is a physical phenomenon resulting from the annular design of multifocal lenses. Your nervous system, through the process of neuroadaptation, gradually learns to ignore these reflections. For most patients, this process takes from several weeks to several months.
Does Dr. Victor Derhartunian personally perform surgeries?
Yes. Dr. Victor Derhartunian (FEBO, FWCRS), with extensive experience from Swiss clinics, personally qualifies patients, selects lenses, and performs microsurgical operations at SwissLaser Poland.
Can I play sports after the procedure?
Yes. After the initial healing period (approx. 3-4 weeks avoiding swimming pools and impact sports), the artificial lens is fully stable and allows for any activity – from diving to intensive training.
How to prepare for the qualification examination using MS39?
Soft contact lenses must be removed at least 7 days before the examination. We also recommend intensive eye hydration with preservative-free drops, as “dry eye” can impair the precision of biometric measurements.
Refunded Procedure vs. RLE – Two Different Goals
| Feature | Standard Surgery (NFZ) | RLE at SwissLaser (Premium) |
| Lens Type | Monofocal (sharp vision at one distance) | Trifocal or EDOF (Full Range) |
| Dependence on Glasses | Reading glasses mandatory | Independence from glasses |
| Astigmatism Management | Usually without astigmatism correction | Full correction (Toric lenses) |
| Bioptics Procedure | Unavailable | Availability of laser fine-tuning for refractive error |
| Waiting time for procedure | Date dependent on waiting list | Quick appointment, full comfort and support |
The Hidden Cost of Delay: How Much Do Progressive Glasses Really Cost?
Progressive glasses force an unnatural posture, narrow the field of vision, and are extremely expensive to maintain.
- Cost of delay: A good pair of progressive glasses costs PLN 3,000-5,000. As presbyopia progresses, you need to replace them every 2-3 years. Over 15 years, you will spend over PLN 25,000, and eventually, you will still need cataract surgery.
- SwissLaser Solution: RLE is a one-time, lifelong investment. Thanks to our cooperation with Santander Consumer Bank (MediRaty), we handle formalities on-site, and the cost of the procedure is converted into convenient monthly installments. You regain youthful vision without a single large impact on your budget.
Your Path to the Procedure – From First Visit to Follow-up
- Swiss MS39 Qualification: We analyze your lifestyle. If you are a night driver – we will select an EDOF lens. If you read a lot – a Trifocal. Always custom-tailored.
- Microsurgical Procedure (15 min): Under topical anesthesia, Dr. Derhartunian removes the old lens through a 2-millimeter, self-sealing incision and inserts the Premium implant.
- Rest (L4) and New Vision: You go home after a short rest. You receive sick leave (L4). The brain immediately begins the fascinating process of neuroadaptation to HD quality.
Related topics
- Refractive lens exchange in Warsaw – procedure and prices
- Phakic ICL lenses – when you want to keep your own lens
- Lens exchange for patients from Krakow
- Presbyopia – causes and all correction methods
- Price list for refractive lens exchange
- Which lens to choose – comparison of types and selection tool
- Premium lenses – compendium: types, brands, prices
- Cataracts – the same procedure when the lens has already clouded
- What is refractive lens exchange
- RLE qualification – step-by-step examinations
- Most frequently asked questions about intraocular lenses and RLE
- Multifocal lens – comfort at every distance
- Modern artificial intraocular lenses (IOL)
- Premium implants – advantages, disadvantages, prospects
- EDOF lenses – disadvantages, opinions, price
Refractive Lens Exchange Explained
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For the curious: Refractive lens exchange (RLE; also CLE, clear lens extraction in literature) is technically the same procedure as cataract surgery: phacoemulsification of the natural lens through a 2.2–2.4 mm incision and implantation of an intraocular lens (IOL) into the capsule. What differentiates it is the indication – refractive error and presbyopia (ICD-10 H52.1, H52.0, H52.2, H52.4) instead of lens opacification (H25/H26). The implant power is calculated from optical biometry (axial length, corneal curvature, anterior chamber depth) using all current formulas from the ESCRS calculator (Barrett Universal II, Cooke K6, EVO, Hill-RBF, Hoffer QST, Kane, PEARL-DGS); in highly myopic individuals, the risk of retinal detachment after lens exchange is higher than in the general population and requires assessment of the retinal periphery before the procedure.
Sources
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- Alió JL, Plaza-Puche AB, Férnandez-Buenaga R, Pikkel J, Maldonado M. Multifocal intraocular lenses: an overview. Surv Ophthalmol 2017;62(5):611–634. doi:10.1016/j.survophthal.2017.03.004
- de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev 2016;12:CD003169. doi:10.1002/14651858.CD003169.pub4
- Rampat R, Gatinel D. Multifocal and extended depth-of-focus intraocular lenses in 2020. Ophthalmology 2021;128(11):e164–e185. doi:10.1016/j.ophtha.2020.09.026
- Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg 2020;46(2):298–304. doi:10.1097/j.jcrs.0000000000000109
- Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J. Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology 2016;123(2):275–286. doi:10.1016/j.ophtha.2015.10.002
- Ripandelli G, Scassa C, Parisi V, Gazzaniga D, D’Amico DJ, Stirpe M. Cataract surgery as a risk factor for retinal detachment in very highly myopic eyes. Ophthalmology 2003;110(12):2355–2361. doi:10.1016/S0161-6420(03)00819-4
- Olsen T. Calculation of intraocular lens power: a review. Acta Ophthalmol Scand 2007;85(5):472–485. doi:10.1111/j.1600-0420.2007.00879.x
Not everyone needs a multifocal lens: for night drivers and those with retinal diseases, a monofocal or Monofocal Plus lens may be better: monofocal and Monofocal Plus lenses.
Where We Perform This Procedure
We perform the procedure in both our clinics – same surgeon, same technology, and same prices. Choose a location to see details, directions, and office hours:
Lens exchange in Warsaw
ul. Kolejowa 1, 01-217 Warsaw · tel. +48 22 120 16 90
Lens exchange in Krakow
ul. Kluczborska 15/U3, 31-271 Krakow · tel. +48 12 383 33 60
