Treatments / PRELEX

Presbyopic Lens Exchange

PRELEX (Presbyopic Lens Exchange) replaces the natural lens with an advanced multifocal or extended-depth-of-focus IOL. Most often the right choice from around age 50, especially when presbyopia is starting to bother you and a cataract is still years away.

Book a consultation What is PRELEX? →

Quick facts about PRELEX

Best candidate age Age from 40 to 45 and up
Procedure time 15–30 minutes per eye
Anaesthesia Topical drops
Visual recovery 1–3 days
Pre-empts The cataract surgery you'd otherwise need 5–15 years later

What is PRELEX?

PRELEX surgery replaces the eye’s natural lens with a precision intraocular lens to correct presbyopia before cataracts develop surgically.

PRELEX aims to reduce dependence on glasses for distance and near vision, depending on the IOL selected; some patients still need spectacles, and no lens design provides perfect vision at every distance.

How the treatment works

Cataract surgery, performed earlier and chosen differently

The mechanics of PRELEX are technically identical to modern cataract surgery. A self-sealing incision of around 2.2 to 2.8 millimetres is made at the edge of the cornea. A circular opening is created in the front of the capsular bag, and the natural lens is broken up gently using high-frequency ultrasound (phacoemulsification). The fragments are aspirated out through the same small probe.

What follows is the same as in cataract surgery — a folded artificial lens is loaded into an injector, slid through the incision, and unfolds into the empty capsular bag where it centres and stabilises. Because the eye is otherwise healthy, recovery tends to be a touch faster than for a dense cataract, and visual outcomes are typically excellent within days.

  • Monofocal — one focal point with sharpest contrast; suited to patients comfortable continuing to use readers.
  • Toric — corrects significant astigmatism, available alongside any of the optical designs below.
  • EDOF (extended depth of focus) — a continuous range of clear vision through to intermediate, with light reading support.
  • Multifocal / trifocal — engineered focal points for distance, intermediate, and near; the most spectacle-independent option, with some trade-off in night halos.

Who PRELEX is for

PRELEX is at its best when presbyopia is changing how you live and an existing refractive error compounds the problem — or when early lens changes are already starting to show.

Presbyopia is here

Patients in their mid-forties through sixties feeling the daily limits of presbyopia

Two problems, one fix

Existing myopia, hyperopia, or astigmatism on top of presbyopia — PRELEX handles both at once

Wanting off readers

Anyone who wants to come off readers, varifocals, or a long-running reliance on contacts

Lens is starting to change

Patients in whom the natural lens is showing early changes — not yet a true cataract, but on its way

Not the right fit if: there is untreated retinal disease, untreated dry eye disease that hasn't been stabilised first, or expectations about night-driving glare or perfect spectacle freedom that the optics realistically can't meet. Each of those is a reason to map carefully before the conversation about IOLs begins.

When presbyopia changes the conversation.

From around 45 onwards the math shifts. PRELEX is rarely the first option someone hears about — it is often the right one once they understand it.

Book a consultation How we work
Your treatment experience

From assessment to year-one review

PRELEX is a single afternoon in theatre, with the planning, lens choice, and twelve months of follow-up all happening at the clinic with the same surgeon.

01

Pre-op assessment at EEC

Optical biometry, IOL power calculations, corneal topography, dry-eye check, OCT of the macula, and a slit-lamp examination. Dr. JD walks you through findings and IOL options the same day.

02

Surgery day at the partner theatre

You arrive at our partner facility. Drops dilate the pupil and numb the eye. The procedure itself takes 15–30 minutes; you are in the theatre suite for around an hour total.

03

Same-day discharge

You go home a few hours after surgery with prescribed drops, a clear protective shield for the night, and a written aftercare plan. Most patients sleep, and notice clearer vision the next morning.

04

Post-op reviews at EEC

Day 1, Week 1, and Month 1 reviews back at the clinic, with the same doctor and the same chart. A long-term review at twelve months confirms stability.

Aftercare & recovery

What to expect, week by week

Most patients see well within a couple of days, but the eye continues to refine through the first month. The drops and the activity restrictions are what protect the result.

First 24 hours

Mild blur, normal sensations

Slightly blurred or watery vision is normal as the eye settles. Expect mild grittiness rather than pain. Wear the protective shield while sleeping. Begin the prescribed drops on schedule.

First week

Back to most of life

No heavy lifting, no swimming, no rubbing the eye. Sunglasses outdoors. Most desk work resumes within 2–3 days. Vision sharpens noticeably across the week.

First month

Drops continue, vision sharpens

Tapering schedule of anti-inflammatory and antibiotic drops; vision continues to refine as the eye stabilises and the brain adapts to a multifocal optic where applicable.

Beyond

One-year review and beyond

Long-term review at twelve months. The IOL itself is permanent and stable; an occasional posterior capsule clouding is treated in clinic with a brief YAG laser procedure if it ever appears.

Meet your specialist

Care led by specialists you'll meet in person.

Dr. JD Ferwerda
Lead Ophthalmologist · Cataract and Retina Surgeon

Dr. JD Ferwerda, MD

Dr. JD Ferwerda, MD: Dutch-trained ophthalmologist specialising in cataracts, lens exchange, retinal disease, glaucoma, and AMD.

Book with Dr. JD See profile →

When readers stop being enough.

+84 (0) 28 2253 3572
Call Zalo
Book a consultation