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What is PRELEX/Presbyopic Lens Exchange?

PRELEX stands for presbyopic lens exchange. It is a surgical procedure for the treatment of presbyopia: the loss of flexibility of the eye lens resulting in blurred vision. In this procedure, your doctor removes your natural lens and replaces it with a multifocal intraocular lens (IOL). PRELEX helps people lead a better life with improved vision and reduced to no dependency on glasses. PRELEX/presbyopic lens exchange works by improving the refractive errors in your eyes. Refractive error is an eye abnormality wherein the eyes are unable to focus properly and cause blurred vision.

The difference between PRELEX and cataract surgery is that cataract surgery is performed to remove the cloudy lens while in PRELEX the natural lens is replaced with a multifocal intraocular lens of an appropriate power to reduce a person's dependence on contact lenses or glasses.

What is Presbyopia?

Presbyopia is the gradual loss of the eye’s ability to focus on close objects. It occurs due to ageing as the eye lens becomes hard and loses flexibility to change its shape for viewing far and near distances. 

Symptoms of presbyopia appear gradually and usually manifest after 40. People with presbyopia may hold newspapers or books at arm's length to be able to read them. Presbyopia is diagnosed with the help of eye tests. Treatment for presbyopia begins with conservative approaches such as glasses and lenses. Your doctor may recommend refractive surgery which helps to alter the shape of the cornea if you don’t like wearing glasses or contact lenses. Other treatment options may include:

Corneal inlay: A small plastic ring with a central opening is inserted into the cornea of one eye.
Lens implant: An intraocular lens is an artificial lens implant that is used in place of the natural lens.

What are the Indications for PRELEX/Presbyopic Lens Exchange?

PRELEX/presbyopic lens exchange is recommended for the treatment of presbyopia. 

What is the Pre-Surgical Preparation for PRELEX/Presbyopic Lens Exchange?

Before your eye surgery, your ophthalmologist will:

  • Test your vision and perform a detailed eye exam
  • Select an appropriate implant for you
  • Prescribe medicated eye drops to be used a few days before your eye surgery
  • Give you specific instructions pertaining to your surgery

Procedure for PRELEX/Presbyopic Lens Exchange

PRELEX/presbyopic lens exchange is similar to a conventional small-incision cataract surgery. It is an outpatient procedure in which usually one eye is treated at a time and the other eye is treated a week after the first procedure. 

  • PRELEX/presbyopic lens exchange is performed under topical anaesthesia. This means that an eye numbing medication, usually in the form of eye drops, is administered in your eye. 
  • You may also be given anti-anxiety medication to keep you relaxed.
  • With guidance from an ophthalmic surgical microscope, a tiny incision is made through the cornea to reach the lens.
  • The lens is cut carefully and removed piece by piece through gentle suction. 
  • It is then replaced by a foldable IOL implant which is unfolded after placing inside the incision and positioned properly.
  • There are no stitches as the incision tends to heal naturally.

During the procedure, you may see some light but will usually feel nothing or only some slight pressure. PRELEX may be completed within 15-30 minutes. 

Recovery and Post-surgical Care after PRELEX/Presbyopic Lens Exchange

You can return home the same day after PRELEX. 

  • You should arrange for someone to drive you back home.
  • You can resume your regular activities as per your eye specialist’s instructions, usually within a day or two. 
  • Avoid straining your eyes by limiting excessive screen time. 
  • Take the medicated eye drops as prescribed by your doctor.

It may take a few weeks to around 2-3 months for the new lens to become fully functional post-presbyopic lens exchange.

What are the Risks and Complications of PRELEX/Presbyopic Lens Exchange? 

PRELEX/presbyopic lens exchange is relatively safe. However, it may have the following risks and complications:

  • Dry eyes
  • Haloes around lights, glares, or appearance of rings or floaters
  • Uveitis: eye inflammation

What are the Advantages of PRELEX/Presbyopic Lens Exchange?

PRELEX/presbyopic lens exchange is a vision correction procedure. It gives impressive results for people with presbyopia. Usually, they experience improved vision almost immediately.

Prognosis for PRELEX/Presbyopic Lens Exchange

PRELEX/presbyopic lens exchange is a safe and effective vision correcting procedure. It helps people perform activities like driving and reading with greater ease without the need for glasses.

The success of a PRELEX/presbyopic lens exchange depends on your eye surgeon’s expertise and accurate IOL calculations.

Make sure to go for regular follow-ups with your eye specialist to ensure timely diagnosis of any unwanted side-effects.

Eye Specialists

54 Hughes St
Cabramatta, NSW 2166


  • the university of sydney
  • the royal australian and new zealand college orthopaedic
  • UNSW
  • South Western Eye Care