What to Expect from the RLE Procedure -- A Step-by-Step Guide

The RLE process begins with a comprehensive consultation. This is not a brief appointment — it is a thorough evaluation typically spanning 60-90 minutes and including:

1. Complete review of medical and ocular history
2. Measurement of current glasses or contact lens prescription
3. Corneal topography — detailed mapping of the corneal surface
4. Biometry — precise optical measurements of the eye’s internal dimensions to calculate appropriate IOL power
5. Retinal assessment — examination of the retina and optic nerve
6. Tear film evaluation — assessing ocular surface health
7. Pupil measurements — relevant for IOL selection

Following the diagnostic component, Dr. Solomon reviews the findings and has a direct conversation about candidacy, lens options, expected outcomes, and the full risk profile. Patients leave with a clear understanding of whether RLE is appropriate and, if so, which lens is the right fit.

• Discontinuing contact lens wear before surgery — soft lenses: 3 days; rigid lenses: longer
• Beginning prescribed antibiotic eye drops the day of surgery
• Arranging transportation — a driver is required for surgery day and post-operative visits
• Arranging 2-3 days of reduced activity
• Fasting instructions, if sedation will be used
• No eye makeup or perfume on procedure day

The patient is registered and the surgical eye is marked. Dilating drops and anesthetic eye drops are administered. An intravenous line may be placed for mild sedation. Pre-surgical paperwork and consent are reviewed and finalized.

The procedure is performed with the patient lying down. Local anesthetic eye drops ensure the eye is fully numb. Mild intravenous sedation keeps the patient comfortable and relaxed — awake but calm.

1. Two self-sealing access points are placed at the edge of the cornea
2. A circular opening is made in the capsule holding the natural lens
3. The natural lens is emulsified using ultrasound energy and gently suctioned from the eye
4. The premium IOL is folded and inserted
5. The IOL unfolds and is positioned within the capsular bag
6. The incision is self-sealing and typically requires no sutures

Patients may see light and some movement during the procedure but do not see the surgical instruments. Pressure or mild discomfort is possible; pain is uncommon.

After the procedure, the patient rests in a recovery area while the anesthetic wears off. The eye is covered with protective glasses. Post-operative instructions are reviewed with the patient and any accompanying caregiver. The patient is then evaluated for early visual results, positioning of the IOL, and assessment of the intraocular pressure (IOP).

Eye drops are a critical part of RLE recovery:

• Antibiotic drops — to prevent infection, typically used for 1-2 weeks
• Anti-inflammatory drops — to reduce swelling and promote healing, typically used for 3-4 weeks
• Lubricating drops — artificial tears to manage temporary dryness, used as needed throughout recovery

Structured follow-up is essential to monitor healing and optimize outcomes:

For patients with the Light Adjustable Lens, additional appointments are required for UV adjustment treatments — typically 2-4 sessions — followed by a lock-in treatment that finalizes the prescription.

Following the active recovery period, patients are typically seen at 6 months and 1 year post-surgery to confirm long-term stability. After this, RLE patients return to the standard adult eye exam schedule — typically annually.

No special long-term maintenance of the IOL is required. The lens does not need to be adjusted, recharged, or replaced under normal circumstances.

The surgery takes approximately 15-20 minutes per eye. Patients should plan for a total appointment time of 1.5-2 hours on the day of surgery, including preparation, the procedure, and recovery room observation.

Yes. RLE is performed under local anesthesia with mild oral sedation. The eye is fully numb and the patient is awake but relaxed. Patients may notice light and some movement during the procedure but do not experience pain.

The practice will provide specific instructions based on the planned anesthetic approach.

No, but most patients choose to treat both eyes. Having one eye optimized by the IOL and the other with its original prescription can create a significant vision imbalance. Treatment of both eyes frequently produces the best overall outcome.