What’s the Difference Between Cataract Surgery, Lens Exchange, and Laser Eye Surgery?

There are a variety of issues that can impact your vision – from cloudy cataracts to astigmatisms. On top of these issues, there are multiple ways that we treat eye conditions. With that said, it’s easy for patients to get confused when discussing cataract surgery and lens exchange. People also often think that both are done via laser eye surgery, which isn’t always the case. In this article, we’ll cover each type of procedure so you can understand what’s best for your eyes. 

Cataract surgeon operation using microscope

What is Cataract Surgery?

Ophthalmologists perform cataract surgery to treat cataracts. Cataracts are the clouding of the lens of the eye. This occurs when the fibres and proteins that make up your lens break down. As a result, things begin to appear hazy, blurry, and even less colorful. Cataracts are often linked to aging or injury, as well as genetic disorders that cause other health problems which increase the risk of cataracts.


When ophthalmologists perform cataract surgery, they remove the cloudy lens and typically replace it with a new, artificial lens. Prior to surgery, they perform an ultrasound to measure the shape and size of your eye, which allows them to determine the best type of lens implant (also referred to as intraocular lens or IOL). Some IOLs are flexible and some are rigid. There are several different types that can improve your vision. The procedure typically takes less than an hour and you remain awake throughout.


There’s usually no harm to your eye if you choose to wait to have cataract surgery. If your vision is still reasonably good, you may never need the surgery. However, if you’re struggling to see while driving, reading, watching TV, or doing other daily tasks, you might consider cataract surgery.


Additionally, your optometrist may recommend cataract surgery if your cataract is interfering with the treatment of another problem. For example, cataracts can sometimes make it difficult to examine the back of the eye, which is necessary to monitor and treat other issues. These issues include conditions like diabetic retinopathy and macular degeneration. If you have these conditions, you might need cataract surgery so that your optometrist can properly manage them.

What is Lens Exchange?

lens exchange, also known as refractive lens exchange, is almost identical to cataract surgery. However, people who undergo a lens exchange don’t have cataracts. Instead, they are either nearsighted or farsighted. The surgery is completed to eliminate the need to wear spectacles or contact lenses. 


Like cataract surgery, during a lens exchange, the patient receives topical anesthesia and sometimes a mild sedative. The ophthalmologist then makes a small cut at the edge of the cornea, removes the natural lens, and adds a new, artificial lens. The lens should improve the vision and reduce the need for spectacles.


While a lens exchange is an option for anyone who requires a vision prescription to see clearly, there are some people who benefit more than others. It’s particularly helpful for people over 50 years old who are experiencing the preliminary stages of cataract development, as it will protect them from developing cataracts later in life. It’s also a great alternative for those who don’t qualify for LASIK or PRK surgery.

Laser Eye Surgery

Laser eye surgery is a medical procedure that reshapes the surface of the eye using a laser. It may be completed to improve or correct presbyopia, astigmatism, nearsightedness, or longsightedness. In other words, laser eye surgery is used to treat all types of sight issues, like difficulty seeing up close due to age, minor vision issues, and more severe issues.


During surgery, an excimer laser, which is controlled by a computer, is used to reshape the surface of the eye. The cornea is thin later on the front of the eye which allows light in. Laser eye surgery can be done in a few ways and may involve removing microscopic amounts of tissue from the cornea, removing the cornea and reshaping the underlying layers, or lifting the cornea and working underneath. Laser eye surgery may also involve a femtosecond laser or microkeratome.


Common types of laser eye surgery include LASIK, photorefractive keratectomy (PRK), IntraLase, and SMILE. Regardless of which type of surgery you get, it’s important to note that laser eye surgery doesn’t necessarily guarantee that you’ll no longer need spectacles. Some people still need to wear spectacles or contact lenses to experience optimal vision.

The Difference

You’re likely wondering – aren’t cataract surgery and lens exchange both types of laser eye surgery? The answer is yes and no, because cataract surgery and lens exchanges are not exclusively done by a laser. In both cases, your ophthalmologist may use an ultrasound probe or laser to break up and remove the lens. However, they may also use surgical tools to make an incision to remove the front capsule of the lens. Whether they use a laser or a surgical tool, the ophthalmologist leaves the back capsule of your lens, which serves as the place for your artificial lens to rest.

There are a couple of other differences between cataract surgery and lens exchange. First, lens exchanges are performed on people who are experiencing the preliminary stages of cataract development, while cataract surgery is typically performed after a person has well-developed cataracts. A lens exchange is also often recommended to people who have extreme nearsightedness or farsightedness. These people often don’t qualify for laser surgeries, like LASIK or PRK. In these cases, a lens exchange is a good alternative procedure.

Additionally, lens exchange can reduce the potential halo or glare that sometimes occurs due to PRK or LASIK surgery. Despite the benefits, it’s important to note that lens exchange can result in more serious side effects than LASIK or PRK. Lens exchange is typically done on patients with extremely impaired vision, so there is a higher risk for retinal tears, detachments, or holes.

Not sure which procedure is right for you? Contact Simon Kleyn Opticians. 

You can email our Frinton On Sea location frinton@skopticians.co.uk, or our Earls Colne location earls@skopticians.co.uk