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Reduce dependence on glasses with RLE Surgery

Refractive Lens Exchange is a procedure virtually identical to cataract surgery (the most common operation in the Western World), only for a slightly different reason. Instead of a cloudy lens in the case of cataracts, this procedure replaces your eye’s clear, natural, but ‘focally challenged’ lens with an artificial intraocular lens (IOL) to reduce your dependence on those annoying glasses.

As your own pre-cataract lens is removed with Refractive Lens Exchange, there will never be the need for cataract surgery in the future. Double win. The Refractive Lens Exchange procedure is most suitable for people who suffer from presbyopia and hyperopia (longsightedness), over the age of 50 years. An added advantage of refractive lens exchange surgery is that you won’t develop a cataract later in life.

RLE surgery is a painless, quick, proven method of enhancing vision and can be completed by our specialist surgeons at Re:Vision Day-Case Theatre in Auckland.

  • No needle, no injection, no patch surgery
  • Same-day treatment for both eyes
  • Safe surgery and fast recovery

What is Glaucoma?

Glaucoma is a disease that damages the nerve at the back of your eye, called the optic nerve. The optic nerve sends the signals to the brain that enables you to see. Glaucoma is associated with increased sensitivity to pressure within the eye. The eye’s aqueous fluid is constantly produced and drained at a balanced rate and forms the intraocular pressure within the eye (IOP). When this drainage is reduced, or if there is too much fluid production, IOP increases and leads to damage of the optic nerve.

Image of the optic nerve showing loss of nerve cells in patients with glaucoma.

Glaucoma typically has no symptoms. Most patients do not experience any issues until they visit their eyecare provider. Untreated glaucoma can cause a gradual loss of vision, usually starting in the periphery which may go unnoticed for long periods of time.

Image showing the effect of loss of sight in patients with glaucoma.

Our Process :



Detailed measurements of the eyes are taken for safety and accuracy, and the team will discuss your options. If you wear contact lenses, please leave them out and wear glasses for two full days prior to the day of your assessment.

Meet your surgeon

Meet your surgeon

Usually, at the same visit, you will meet your surgeon who will thoroughly examine the front and back of the eye and discuss your eyesight problems and lens options. Our surgeons have also published widely on the safety of cataract surgery with various lens options.



The procedure is comfortable and quick, usually less than 20 minutes for each eye. IV sedation is provided by an anaesthetist for maximal comfort. Both eyes are typically done on the same day.



A follow-up appointment the next day will check how you are feeling and measure how much better your eyesight is. The vision recovers quickly, with the vast majoirty of patients regaining driving standard vision without glasses the next day but most people have 1 or 2 quiet days afterwards.


Saving money

The hidden costs: what could you save?

What could that money have done?

The $40,000 you'd potentially spend on glasses and contact lenses over the next 30 years could have given you 15 luxurious holidays.

Est- 15 Holidays

Est - 15 Holidays

Average holiday cost: $2600
Calculation: 40,000 / $2600 = 15

Saving time

The hidden cost of wearing glasses or contact lenses.

Did you know?

The time you'd spend handling glasses and contact lenses over the next 30 years is enough to have could have taken you around our planet over 30 times!

Est - 526 hours

Est- 526 hours

Cleaning: 3 minutes/day
Finding misplaced glasses: 2 minutes/day
Repair, shopping: 2 hours/year
Total: 526 hours (over 30 years)

Est- 526 hours

Inserting and Removing: 3 minutes/day
Cleaning: 2 minutes/day
Renewing & Check-ups: 2 hours/year
Total: 1,012 hours (over 30 years)

Saving planet

Reducing our carbon footprint

The environmental perspective

Over 30 years, using glasses and contact lenses contributes to 876lb of CO2 emissions. Opt for vision correction and take a stand for our planet!

Est - 876.6lb C02 emissions

Est- 876.6 CO2 emissions

Combined plastic waste:

0.525 kg (glasses)+65.7 kg (contact lenses)=66.225 kilograms over three decades.

Total: 66.225 kilograms of plastic×6=397.35 kilograms = 876Lb of CO2 emissions(over 30 years)

Benefits for RLE:


We use the newest lens removal technology available in New Zealand to provide unequaled safety, care, and quality of vision. Our surgeons have also published widely on the outcomes and safety of RLE surgery.

Short Surgery Time

It only takes 10-15 minutes to perform the surgery.

Simple Surgery

The surgery is performed with drops to number the eye without the need for an injection or stitches.

Good Visual Results

Most patients achieve better than driving standard vision the next day and many achieve freedom from their glasses.

Fast Recovery

Ther surgery is very comfortable and the recovery is quick, with many able to return to work within 1-2 days.

No more Cataracts

After RLE surgery, you can not develop cataracts.

Personalised Surgical Care

Some patients are not suitable for drops or laser therapy and require either cataract surgery, minimally invasive glaucoma surgery or complex glaucoma surgery.

Minimally invasive Glaucoma surgery (MIGS) marks a milestone in the advancement of glaucoma patient care. MIGS are a form of glaucoma surgery which is associated with minimal incisions, and are generally associated with lower risks in restoring normal eye pressure.

Prior to MIGS, treatment options were limited to medications, laser and major glaucoma tube and filtration surgery. Now, with MIGS, our team at Re:Vision have more treatment options which benefits a patient with faster recovery , less surgical risks and less dependence on medications following surgery.

Our surgeon is a leader in MIGS surgery in NZ, with a wealth of experience with iStent -W, Kahook Dual Blade, Hydrus, XEN, Preserflo, micropulse and cyclodiode laser.

MIGS management include:
1) Various treatment options and benefits which are patient centric and individualised
2) Evidence based therapy and
3) Promising outcomes for glaucoma patients.

MIGS can be performed as a standalone procedure or in conjunction with cataract surgery. There are different surgical approaches under the MIGS umbrella, but they generally are designed to allow more fluid to drain out of the eye and hence, reduce intraocular pressure.

a) iStent

The iStent is the smallest medical device ever implanted into humans. The iStent decreases eye pressure by creating a pathway into the eye’s drainage system. The iStent was the first trabecular micro-bypass device approved by the FDA and is the most thoroughly-studied glaucoma device on the market.

Click here to watch video on iStent

b) Kahook Dual Blade

The Kahook Dual Blade goniotomy procedure involves removing a section of the trabecular meshwork (the part which is associated with the greatest resistance in fluid outlflow) and hence increasing drainage out of the eye.

Click here for information on KDB

c) Micropulse Laser Treatment

This procedure decreases the amount of fluid produced by the eye and increases fluid outflow. A probe is placed on the surface of the eye and the surgeon applies laser energy to part of the eye which controls the production of fluid in the eye.

d) Preserflo Stent
The Preserflo drainage shunt is type of microshunt implant used to reduced intraocular pressure by creating a controlled pathway for the drainage of fluid out of the eye. It is made from a specialised biocompatible material called SIBS, which is known for its stability, flexibility and compatibility with the human body, hence minimising tissue inflammation.

Click here for information on Preserflo

Trabeculectomy surgery has been done for more than 50 years, and involves making a separate channel for fluid to filter out of the eye.

A drainage tube is a device inserted into the eye, which acts as straw where fluid can access to drain out of the eye onto the outer coat of the eye. There are several drainage tubes available in NZ which include Molteno drainage tube, Paul drainage tube and Baerveldt drainage tube.

Generally, these surgeries are done once all others have been exhausted and have failed to stop the progression of glaucoma.

Glaucoma is optic nerve damage due to increased pressure sensitivity within the eye while a cataract is a clouding of your natural lens within your eye.

In some patients, the hardening and change in the shape of the lens with the development of cataract, can potentiate the effects of glaucoma, such as angle closure glaucoma. In this situation, we may suggest having cataract surgery as a way to treat your glaucoma.

Some patients can combine glaucoma and cataract surgery (includes patients with open angle glaucoma). MIGS procedures in particular can be performed through the same incision as cataract surgery, providing an efficient way to address two problems at once.

Our Technology:

Sirius Tomographer

Combines Placido disk topography with Scheimpflug tomography of the front of the eye to allow the surgeon to perform the safest version of laser vision correction customised to your eyes. The device provides highly accurate measurements of corneal thickness, curvature, power as well as pupil size measurements and is commonly used for refractive surgery planning and follow-up.

Detailed Corneal Analysis

Custom Built Surgical Facility

Re:Vision Laser & Cataract was specifically designed and created by our surgeons to provide maximum safety for patients in need of eye surgery. We are fully accredited by the Designated Auditing Agency (DAA) with an excellent scoring.

Custom Built Facility

IOL master 700

The IOLMaster 700 provides highly repeatable and accurate measurements of the eye to allow the surgeon to customise the lens implant in your eye following cataract or RLE surgery. The device provides highly accurate lens thickness, anterior chamber depth, and corneal thickness measurements of the eye. The entire process is completed in about 50 seconds, with a total of 2,000 scans taken per second. During the process, the IOLMaster 700 also performs a 1-mm central retinal scan.

Highly Accurate Measurements

Zeiss Lumera operating microscope with Callisto virtual guidance system

The integral Callisto system in this microscope provides intelligent real time image guidance for incision and toric lens alignment for better management of astigmatism during surgery.

Intelligent Real Time Image Guidance

Centurion phacoemulsification machine

This is a highly advanced device utilises cutting edge technology to reduce ultrasound energy output, fluid volume used as well as surgical time to improve safety, consistency and control during cataract surgery.

Advanced Lens Removal System

woman and man having a glass of wine over a cheese board

Glaucoma Research at Re:Vision

Dr Perumal values the importance of research initiatives and technology in glaucoma. We may invite you to participate in the Save Sight Registry run by the Save Sight Institute, in collaboration with the University of Sydney and Sydney Eye Hospital to fight glaucoma blindness.

The Save Sight Registries is one of the most advanced ophthalmic registries in the world, and is a unique platform for tracking eye disease, interventions and patient outcomes. Its sophisticated design delivers real-world evidence on the risks and benefits of current and new treatments for ocular conditions. This information helps clinicians provide safe, cost-effective and evidence-based solutions for vision impairment and avoidable blindness.

The Save Sight Registries also promotes international scientific research aimed at developing strategies for reducing the incidence of blindness throughout the world.

How much does RLE surgery cost?

RLE surgery is more expensive that laser vision correction but exact costs depend on the type of lens that is most suitable for your prescription and needs.

By the time I turn 45, I will have spent on contact lenses/glasses :

At Re:Vision, all types of laser vision correction
(LASIK or PRK) cost : $3,599/eye

References :

  • Tavassoli S, Ziaei H, Yadegarfar ME, Evans J, Ziaei M. Trifocal versus extended depth of focus (EDOF) intraocular lenses for cataract extraction, Cochrane Database of Systematic Reviews, 2021
  • Evans JR, de Silva SR, Ziaei M, Kirthi V, Leyland MD. Outcomes in randomised controlled trials of multifocal lenses in cataract surgery: the case for development of a core outcome set. Br J Ophthalmol. 2020.
  • McGhee CNJ, Dean S, Freundlich SEN, Gokul A, Ziaei M, Patel DV, Niederer RL, Danesh-Meyer HV. Microdroplet and spatter contamination during phacoemulsification cataract surgery in the era of COVID-19. Clin Exp Ophthalmol. 2020 
  • De Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016 Dec.
  • Gray TB, Keenan JI, Clemett RS, Allardyce RA. Fusidic acid prophylaxis before cataract surgery: patient self-administration. Aust N Z J Ophthalmol. 1993 May;21(2):99-103.