Text Size and Contrast

To improve your browsing experience select a different Text size or Contrast.

Select a Text Size

Select a Contrast

Moorfields Private Blog

    Share this article

    Vision correction surgery when laser is not the right option - RLE & PIOLs

    Written by Mr Tom Flynn, Consultant Ophthalmic Surgeon
    09 March 2021 | Categories: ICL, Laser Sight Correction, Vision Correction, RLE
    • When might laser eye surgery not be the right option?
    • What other vision correction surgery is available?
    • Refractive Lens Exchange (RLE)
    • Phakic Intraocular Lenses (PIOLs)
    • What works best for you?

    Vision correction surgery options – RLE, PIOLs & ICL (2)_Resize

    Not everyone is suitable for laser eye surgery, but there are plenty of options available that can help improve your vision.

    During your first consultation at Moorfields Private, we perform a number of scans and tests to determine how good your vision is and assess your general eye health. It’s important that we take the time to understand this as everyone’s eyes are different and it helps us to advise on what vision correction procedure best suits you.

    When might laser eye surgery not be the right option?

    Laser eye surgery (laser vision correction) works by reshaping the cornea – the clear window at the front of the eye – to improve focus. As the laser reshapes the cornea, its thickness is reduced.

    The natural thickness of the cornea before laser vision correction varies quite a lot from person to person. If it’s too thin your consultant may decide that you are not suitable for laser eye surgery. Some patients with high prescription glasses may also be outside the range for laser treatment. 

    What other vision correction surgery is available?

    When you are not suitable for laser vision correction, we normally recommend implantation of a corrective lens. These treatments are performed using keyhole surgery and an eye-drop anaesthetic, and typically take about 20 minutes. Patients can expect a quick, comfortable recovery.
    Different implants are available and the type that is most suitable depends on your age and the health of the natural lens in the eye.

    The lens implant procedures we offer at Moorfields Private are:

    • Refractive lens exchange (RLE)
    • Phakic intraocular lenses (PIOLs) 

    Unsuitable for laser eye surgery? Implantable contact lenses may be the answer. Read more here 

    Refractive lens exchange (RLE)

    Refractive lens exchange (RLE) involves removing the natural lens in the eye and replacing it with an artificial one with the main aim of increasing freedom from glasses or contact lenses.

    The procedure is identical to modern cataract surgery. For this reason, RLE is often preferred to laser vision correction for patients in the retirement age group in which the early stages of cataract are common.

    A variety of different implants are used including multifocal lenses designed to reduce reliance on glasses for near, intermediate and far vision.

    Vision correction surgery options – RLE, PIOLs & ICL resize

     Phakic intraocular lenses (PIOLs)

    In younger patients, artificial lenses called phakic intraocular lenses (PIOLs) are often a good alternative where the spectacle prescription is outside the range for laser vision correction.

    These are implanted in front of the natural lens without replacing it and are made from a soft natural material. The surgery is a bit like implanting a soft contact lens into the space behind your iris and in front of your natural lens.

    We use the market leading Visian implantable collamer lens (ICL) implants at Moorfields Private.

    You can’t feel these implants, you don’t have to clean them, and your eyes look the same after implantation. If there are problems after surgery – which is unusual – they can be removed. In fact, implantable contact lenses are so safe that some patients opt for them even if they are suitable for laser vision correction.

    What works best for you?

    At Moorfields Private, our surgeons will talk you through all of the options available and will be able to advise you on which would suit you best. Sometimes we use both laser and implant techniques to get the best results. These days, even the most extreme spectacle prescriptions can be corrected using a combination of the right techniques.

    Or speak to the New Patient Enquiry Team:

    0800 328 3421





    Mr Tom Flynn

    Written by Mr Tom Flynn

    Consultant Ophthalmic Surgeon