Abstract
Refractive lens exchange (RLE) still has a role in young age with anisometropia, or in an eye that is anatomically not suitable for phakic intraocular lens (IOL) implantation or in high hypermetropia. Furthermore, in the presence of water vacuoles in the crystalline lens above the age of 40, it is recommended to perform RLE rather than phakic IOL implantation. Multifocal refractive IOLs are designed with several optical zones on the IOL. Apodised diffractive multifocal IOL has gradual diffractive steps on the IOL implant that create a smooth transition between focal points. RLE is a surgery with the same risks of a cataract surgery. Complications do occur in RLE. The mean incidence of retinal detachment is 1 % while the mean incidence of cystoid macular oedema is 0.1 %. Contraindications include unstable refraction, amblyopia and the presence of certain eye pathologies as age-related macular degeneration, glaucoma, diabetic retinopathy and a high risk of retinal detachment.
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