By our 40s, it’s common to notice that reading or focusing up close takes more effort. Glasses and multifocal contacts can provide temporary relief, but they often fall short for individuals with active, on-the-go lifestyles. That’s why so many are now choosing Refractive Lens Exchange (RLE)—a modern, lens-based procedure that restores clear vision at all distances and prevents cataracts before they ever form.
At Coastal Eye, we perform RLE with the same advanced technology and precision used in laser cataract surgery, replacing the eye’s aging natural lens with a customized intraocular lens for crisp, lasting clarity.
In this post, we’ll explain why RLE has become the preferred vision correction option for adults over 40, how it compares to multifocal contacts, and what to expect before and after treatment. You’ll also see why patients across Greenwich and beyond trust Dr. Omar Shakir, MD, MBA—Yale-trained, board-certified, and nationally recognized for innovation in lens-based surgery—to help them experience life in focus again.
The Case for RLE vs. Multifocal Contacts: How RLE Addresses Presbyopia and Cataract Concerns Early
Long-term clarity without lens maintenance
- Multifocal contact lenses can be an excellent option for getting clear near vision, but many people face challenges like comfort, dryness, reduced contrast at night, and the costs involved.
- These issues can sometimes lead to dissatisfaction, especially as presbyopia develops.
- It's worth noting that many people tend to stop wearing contact lenses around the age of 50 due to these vision and comfort concerns.
Spectacle independence—day and night
- Refractive lens exchange (RLE) using lenses that correct presbyopia, like multifocal or extended-depth-of-focus lenses, has resulted in many patients no longer needing glasses and experiencing high satisfaction rates.
- For example, a study involving 17,603 eyes across several centers used trifocal lenses and showed that these presbyopia-correcting lenses performed very well for seeing at near and intermediate distances (BJO multicenter series, JAMA Ophthalmology network meta-analysis).
Cataract prevention
- Because RLE replaces the crystalline lens now, you won’t develop a cataract later—a meaningful benefit for active adults planning decades ahead.
- This mechanism is foundational in lens-based surgery guidance and patient resources from professional societies (AAO overview, RCOphth patient info).
Dysphotopsia trade-offs are known and manageable
- Both multifocal contacts and multifocal IOLs can produce halos and glare because light is split across focal points.
- Evidence syntheses show more halos with multifocal IOLs than monofocals, but most patients adapt, and careful lens selection mitigates symptoms.
How Lifestyle and Occupation Influence Whether RLE Is Right for You
- Night driving & low-light precision: If you frequently drive at night or work in dim environments, we balance the desire for glasses independence with the potential for halos/contrast trade-offs. EDOF IOLs or targeted monovision can reduce photic phenomena compared to some multifocal designs.
- Screens & sustained near work: Editors, coders, and clinicians often prefer EDOF optics for smoother intermediate vision; avid readers may still choose a trifocal to maximize near vision. Evidence supports the use of strong intermediate/near vision with modern presbyopia-correcting IOLs when matched to task demands.
- Outdoor/active lifestyles: Swimmers, travelers, and those tired of lens care favor RLE’s permanence and freedom from contact-lens dryness and maintenance; presbyopic contact lens dropout is typical due to comfort and visual compromises.
- Risk tolerance & medical nuance: Like cataract surgery, RLE carries risks (infection, retinal detachment, IOL issues). Proper candidacy, retinal evaluation, and surgeon experience are key—especially for high myopes.
Recovery After Refractive Lens Exchange: What Patients in Greenwich Should Expect
Most RLE procedures take minutes per eye in a calm, office-based surgical suite. Vision typically sharpens quickly; many patients resume light activities within days, with full neuroadaptation to new optics over weeks. These timelines mirror modern cataract surgery recovery, with additional steps (like dry-eye optimization and YAG capsulotomy when needed later for posterior capsule opacification) managed in routine follow-up.
Why More Over-40 Patients Are Choosing RLE Over Multifocal Contacts
- A permanent solution that corrects both distance and near vision while also preventing cataracts
- There is documented high independence from spectacles in large cohorts and meta-analyses of Refractive Lens Exchange (RLE)
- Unlike multifocal contact lenses, which can lead to dryness-related issues and frequent lens care—particularly for those in midlife—this solution eliminates those concerns
- The optics can be tailored to fit your lifestyle, including options such as Extended Depth of Focus (EDOF), trifocal, and toric lenses, all chosen by a surgeon who performs these procedures daily
Coastal Eye in Greenwich: The Clear Choice for Life After 40
Your vision deserves more than temporary fixes. With Refractive Lens Exchange, you can enjoy long-term clarity, freedom from contacts and reading glasses, and peace of mind knowing cataracts will never cloud your sight.
At our practice, every RLE procedure is performed by Dr. Omar Shakir, MD, MBA—a Yale fellowship-trained, board-certified ophthalmologist, Clinical Instructor at Yale, and multi-year “Best Cataract Surgeons in America” honoree. A recognized innovator and pioneer of office-based retina surgery, Dr. Shakir pairs advanced ZEISS and Alcon advanced technology with meticulous precision and compassionate care to achieve elegant, natural results.
If you’re over 40 and ready to see the world with confidence again, we invite you to take the next step. Contact us today to book a consultation for your personalized vision correction plan at Coastal Eye.
