Brinton Vision – Lasik St. Louis

Refractive Lens Exchange (RLE)

Refractive Lens Exchange St Louis

Brinton Vision Offers Cataract Surgery Alternative in Saint Louis

One of life’s great ironies is that, just as we begin to get comfortable enough in our finances and family life to enjoy the travel, outdoors, and hobbies that we’ve always wanted to try, our bodies — in particular, our eyes — start to have different ideas. Vision loss, whether from inability to read close-up (called presbyopia) or because of cataracts, can be devastating to our quality of life.

First, the bad news: As we age, so do our eyes. No matter how much we focus on living healthy lifestyles, the inner lenses in our eyes get older, eventually causing every one of us to lose at least some visual acuity.

The good news is that we don’t need to suffer. Thanks to incredible advances in technology and science, a procedure called Refractive Lens Exchange (RLE) can not only resolve age-related, “over 40” vision problems we develop over time, but also prevents the formation of cataracts. Of course, only a doctor can determine if you are ready for this procedure after your eyes are fully evaluated.

About Presbyopia

By the time most of us reach our early 40s, we begin to find ourselves holding books, menus, and newspapers away from our eyes in order to see them. We may sit farther from our computer screens or struggle with sewing projects. We simply can’t make out words or details when they are close to our eyes. This condition is called presbyopia, and is often confused with farsightedness.

Presbyopia is caused by natural thickening and loss of flexibility of the lens inside of our eyes. Much like a camera lens stuck in one place, our lenses become unable to fine-tune to see many of the details we were once able to see.

In years gone by, our parents and grandparents had to accept these changes as part of getting older. Thankfully, we don’t.

More and more people are choosing Refractive Lens Exchange (RLE) to not only correct and restore vision, but also to keep cataracts from developing or progressing, and to avoid future cataract surgery.

Through RLE, the eye’s natural lens is replaced with an artificial intraocular lens (IOL) to correct vision loss due to nearsightedness, farsightedness, astigmatism, presbyopia, or cataracts. Not only is vision greatly improved, but the positive changes are lasting.

What is a Cataract?

If uncorrected, the same changes in the lenses of our eyes that cause presbyopia eventually lead to the formation of cataracts. A cataract occurs when the lens becomes cloudy, blocking light from entering the eye. Cataracts become progressively worse and can result in significant vision loss, eventually necessitating cataract surgery.

In years gone by, cataract surgery in St. Louis and across the nation was limited by the lens implants available to even the best cataract surgeons. They could not correct a full range of vision. Still today, many St. Louis cataract surgery centers rely on these lenses because they work well for cataract correction, but they don’t offer the freedom from glasses that our patients seek.

RLE is a similar surgical process, but instead of suffering with declining vision while waiting years for cataract development, your natural lens is replaced with one that corrects vision and prevents cataracts. For many patients, that means no more glasses, no more cataracts, and no more missing out on life’s beautiful moments.

Considering Refractive Lens Exchange?

RLE may be an excellent solution if you have:

  • Difficulty reading without reading glasses or bifocals.
  • Difficulty seeing nearby objects.
  • Difficulty seeing to drive, especially at night.
  • Changing glasses prescriptions.
  • Being diagnosed with early cataract formation.
  • A high degree of farsightedness (hyperopia).
  • A strong prescription that cannot be corrected with LASIK.
  • A high degree of astigmatism.

The technology involved in RLE is safer and more effective than ever, and has been used successfully worldwide. Not only are people freed from the barriers of cataracts, but for many people, they are also achieving a level of visual freedom they have never experienced before. Many patients are now opting to undergo RLE at earlier ages, before they suffer from vision loss caused by cataracts. They don’t have to let poor vision stop them from living the life they’ve always wanted to live.

Refractive Lens Exchange (RLE) in St. Louis: What to Expect

It is amazing that something as limiting as presbyopia or cataracts can be resolved in just 15 minutes, but it’s true. In our St. Louis facility, RLE takes just a few minutes to complete, and the visual freedom patients obtain can be dramatic.

On the day of the procedure, plan to be at Brinton Vision for about two hours. You will need someone to drive you home, as your vision will likely be blurry immediately following the procedure.

Just as if you were going to an eye examination, you don’t need to wear special clothes or change your attire while you’re here. The only thing we’ll add to your outfit is a small, blue cap which you’ll wear during the procedure.

Prior to beginning, we will repeat some of the same tests that were conducted during your Brinton Vision Ocular Analysis so that Dr. Brinton has the most accurate information possible about your vision.

When you’re ready for the procedure, numbing eye drops will be administered so that you are comfortable during the RLE. You will likely experience what some patients refer to as seeing a light show or looking through a kaleidoscope, but RLE patients should not experience pain. In a quick 15-minute procedure, the lens will be replaced through a small opening. Sutures are not typically needed as the incision is small and self-healing.

After the procedure, you will receive easy-to-follow instructions and a written hand-out on how to use your eye drops. Our highly trained surgical technicians will answer any questions you may have, and Dr. Brinton will provide his personal phone number, should you have concerns once you return home.

Even though RLE involves replacement of the lens, no eye patch is needed. People typically return to work or other normal activities the next day. What’s more, RLE eliminates the need for future cataract surgery. A Brinton Vision Ocular Analysis will determine if RLE is a good solution for you!

LightRx light adjustable lens (LAL)

Brinton Vision has become the first eye surgery center in the state of Missouri to offer the revolutionary Light Adjustable Lens (LAL) for cataract and refractive lens exchange (RLE) patients. The LAL facilitates greater customization of treatment for St. Louis LASIK patients over age 50 seeking RLE or cataract surgery. Made of a photosensitive material, the lens can be precisely adjusted after implantation via targeted ultraviolet (UV) light to improve visual outcomes.

“For the first time since lens implant surgery was first performed in 1949, we can customize a lens implant in our patients’ eyes after the fact to meet their individual vision needs. This is done in our office with a light after giving patients a few weeks to heal and experience their new eyesight.” Dr. Jason Brinton

The advanced technology opens up avenues of treatment not previously available to patients seeking LASIK and cataract surgery.

“For many patients, cataracts aren’t the only condition affecting their vision. They may also have myopia, hyperopia or astigmatism. The Light Adjustable Lens is unique in that I can address more than just the cataracts, and my patients can experience better vision than they may have thought possible. This is a game-changer for cataract surgery patients.”

How the Light Adjustable Lens (LAL) Procedure Works


The Light Adjustable Lens (LAL); The Process


For more information about the Light Adjustable Lens, contact Brinton Vision at (314) 375-2020



What kind of lasers do you use?

As the only practice in St. Louis with multiple femtosecond and excimer laser platforms under one roof, we are better equipped to customize treatment options. We utilize the following lasers:

Intralase iFS laser — 150 Hz

This Intralase laser has been the gold standard of femtosecond LASIK flap makers since its inception in 2002. The iFS is the 5th and newest generation in this laser family, improving the speed of its predecessor by 2.5x. It can create a flap in under 10 seconds and also fashions the pockets we use for KAMRA® Inlay procedure.


This is one of our two excimer lasers. More LASIK cases have been done on the VISX laser than on any other laser in the world. It is also the laser approved for use in U.S. fighter pilots and NASA astronauts.

Allegretto Wavelight

This is the second of our two excimer lasers used for LASIK. The Allegretto Wavelight laser is the fastest excimer laser in the country (the Schwind laser is the fastest excimer laser in the world).

Zeiss Visumax — 500 Hz

This is one of our two femtosecond lasers. A femtosecond is one quadrillionth of a second. This is our newest laser and is the fastest femtosecond laser in the world, firing at 500Hz. It is also the only laser in the world that can do SMILE, a third-generation laser vision correction procedure. SMILE is a 100 percent femtosecond laser-based procedure.

Yag laser

This is a laser that we can use with Visian ICL and RLE surgery.

What vision problems are correctible using laser eye surgery?

LASIK plus its six modern variations are used to correct different degrees of refractive errors, including myopia (nearsightedness), hyperopia (farsightedness), presbyopia, and astigmatism. Refractive Lens Exchange (RLE) is also used as a cataract surgery alternative, and can actually keep cataracts from forming.

Will you correct both eyes at the same time?

Most of the time we will correct both eyes at the same sitting, but there are a few exceptions. Refractive Lens Exchange (RLE) and Implantable Collamer Lenses (ICLs), sometimes called implantable contact lenses, are sometimes done one eye at a time if Dr. Brinton, your surgeon, deems it necessary. Dr. Brinton will discuss this with you and answer any questions you may have at your Brinton Vision Ocular Analysis (BVOA).

Will having laser eye surgery prevent me from having other eye diseases later?

No. With the exception of Refractive Lens Exchange (RLE) which prevents formation of cataracts, laser eye surgery does not prevent diseases like glaucoma, retinal detachment or macular degeneration. LASIK is “disease neutral,” meaning that it does not cause or prevent these diseases. Someone who has had LASIK can develop these eye diseases and be treated just like a normal-sighted person can develop and be treated for a disease.

Why do you offer so many options when other places only have a couple? Isn’t LASIK just LASIK?


No two people have the same fingerprints, and no two people have the same eyes. LASIK is a good option for some people, but there are other procedures that can be a better fit, depending on your eye anatomy, health history, and vision problems. All of this is evaluated using state-of-the-art technology in a Brinton Vision Ocular Analysis (BVOA) in our St. Louis laser eye surgery practice. Dr. Brinton is the only full-time, comprehensive refractive surgeon in the state of Missouri, and one of just a handful in the United States to provide LASIK plus its six modern variations (LASIK alternatives) to his patients. These include SMILEVisian ICLRLE, PRK, KAMRA® Inlay, and SBK. He does so because he believes in providing personalized, customized care to each guest who walks through the door at Brinton Vision.

Learn more about RLE in our series of articles that explore more RLE Questions.