Refractive lens exchange (lens replacement, lens swap) is a procedure in which an artificial lens replaces your own, still clear natural lens and corrects presbyopia together with short- or long-sightedness. At EyeLaser Zurich it costs CHF 5’000 per eye, regardless of the lens, with femtosecond laser CHF 6’000. The procedure takes around 15 minutes per eye.
Transparent, binding and without hidden costs — as Swiss medicine should be.
“We recommend the method that suits your eyes — not the one that happens to be available. That is why we have the established laser and lens procedures in-house and only decide after the comprehensive pre-examination.”Realistic guide values from practice — your personal course is closely monitored at the follow-up checks.
Transparency
Refractive lens exchange is a common, standardised procedure — even so, these points belong on the table:
“Think of blood pressure treatment: you start with one tablet, measure again — and adjust the dose until the value is right. It is the same with the correction of presbyopia: we correct, the brain gets used to the new way of seeing, and if necessary we fine-tune. An enhancement is not a setback but part of a precise treatment — and with us it is included in the price in the first year.”In refractive lens exchange, an artificial lens replaces your natural lens even though it is still clear. The aim is not to treat a disease but to correct presbyopia, short- or long-sightedness and astigmatism in one procedure. Because your natural lens has been removed, a cataract can no longer develop afterwards; clouding of the lens capsule (after-cataract) remains possible.
| Refractive lens exchange | Cataract | |
|---|---|---|
| Reason | clear lens, wish for less dependence on glasses | cloudy lens, medical indication |
| Payer | Self-pay; supplementary insurance sometimes contributes | Basic insurance under TARDOC |
| Price per eye | CHF 5’000 for any lens, with femtosecond laser CHF 6’000 | Surcharge CHF 700 (one distance) or CHF 2’700 (several distances, toric), femtosecond laser plus CHF 1’000 |
| First appointment | Free initial consultation | Examination via basic insurance |
Without Swiss basic insurance, CHF 5’000 or 6’000 respectively also applies to cataract. More about cataract.
The process is the same for refractive lens exchange and cataract surgery. What differs is the reason, the payer and the price. Which artificial lens suits you is decided by the measurements from the pre-examination and your daily life, not by the price: in refractive lens exchange, every lens costs the same.
In refractive lens exchange, every lens costs the same. Whether you can manage entirely without glasses afterwards depends on the lens, your measurements and adaptation.
Multifocal lenses have several focal points; trifocal lenses cover near, intermediate and distance vision. In studies, people with multifocal lenses were less often dependent on glasses than with monofocal lenses, but saw halos more often (de Silva 2016). Every lens is available in a toric version for astigmatism, at no extra cost.
Instead of fixed focal points, EDOF lenses (Extended Depth of Focus) create a continuous range of sharp vision from distance to the screen. Reading glasses are needed for small print more often than with trifocal lenses (Tavassoli 2024). Whether halos are less frequent depends on the lens model (Karam 2023).
Monofocal plus lenses provide sharp vision at one distance, usually far, with somewhat more depth of focus than classic monofocal lenses. You will still need glasses for reading. If you drive a lot at night and are happy with reading glasses, this is often a good option for you. This lens is also available in a toric version for astigmatism. In refractive lens exchange it costs the same as any other lens: CHF 5’000 per eye.
With lens exchange the price is the same for every lens. The choice depends solely on your eyes and your daily life.
Multifocal lenses
Distance, screen and reading at the same time — in studies, least often dependent on glasses. On the other hand, halos around lights are possible in the first few weeks.
EDOF lenses
Distance and screen in focus, often reading glasses for small print. Halos are possible, depending on the model less often than with trifocal lenses.
Trifocal lenses
Three focal points for near, intermediate and distance; better near vision without glasses than with EDOF (Tavassoli 2024).
Monofocal plus
One distance in focus, usually far; glasses for reading. Few light effects.
Toric lenses
Each of these lenses is available in a toric version for regular astigmatism, at no extra cost.
| Starting situation | Why | Instead |
|---|---|---|
| Short-sighted and under around 55, clear lens | Your natural lens can still focus; the retinal risk after refractive lens exchange rises considerably in younger and short-sighted patients (Daien 2015) | ICL |
| Clear lens, good distance vision, only the reading glasses bother you | The laser can compensate for presbyopia at the cornea | PresbyMAX (CHF 3’300 per eye) |
| Macular or retinal disease, pronounced amblyopia | Multifocal optics split the light; contrast is lacking | Monofocal plus or further assessment |
| Untreated dry eyes, irregular cornea | Measurements and visual quality uncertain | treat first; assess for keratoconus |
| Cloudy lens with Swiss basic insurance | medical indication | Cataract surgery |
The online suitability test takes around 45 seconds and shows whether a refractive lens exchange, the ICL or a laser procedure is more likely to be an option. It is free of charge and non-binding; the recommendation becomes binding after the pre-examination.
Suitability test: which route to sharp vision suits you?Most studies come from cataract surgery; there are fewer randomised data for refractive lens exchange. The optics of the artificial lens are the same.
RR 0.63
Less often dependent on glasses with multifocal lenses than with monofocal lenses
10 studies, 1’000 eyes. de Silva et al. 2016 (Cochrane), PubMed 27943250
3 % vs. 30 %
near vision without glasses worse than J2: trifocal versus EDOF
1 study, 60 people. Tavassoli et al. 2024 (Cochrane), PubMed 38984608
0,28 %
of multifocal lenses were removed again because of optical complaints (0.83 % in total)
1’438 eyes. Kermani and Gerten 2016, PubMed 27385256
These figures come from published studies and are not our own data. We will tell you what is realistic for your eye after the pre-examination.
On request, the femtosecond laser performs the incisions, the circular opening of the lens capsule and the fragmentation of the lens (FLACS); the surcharge is CHF 1’000 per eye. Two large randomised studies with more than 1’600 patients combined found no clinically significant difference from the manual technique in visual acuity and complications (Schweitzer 2020; Day 2021). Whether the laser offers an advantage for your eye is something we discuss openly after the pre-examination.
The process is the same for refractive lens exchange and cataract. Plan around two hours for your stay; the procedure itself takes around 15 minutes per eye.
In the pre-examination (CHF 300, credited towards the cost if you go ahead with treatment), we measure your eye with the MS-39 and the Anterion and calculate the power of the artificial lens. On the day of surgery, the pupils are dilated and the eye is anaesthetised with drops; you usually feel only slight pressure.
First a tiny incision (2.2–2.4 mm) is made at the edge of the cornea. This is needed so that the lens capsule can be opened in a perfect circle. Using modified ultrasound (phacoemulsification) the natural lens is liquefied or fragmented and aspirated. If you opt for the femtosecond laser, the incision is made not with a scalpel but with high precision by the laser. In both variants the result is that the empty lens capsule (capsular bag) remains.
Through the tiny incision the artificial lens (monofocal or multifocal lens) is now implanted with an injector. The rolled lens unfolds and takes the place of the natural lens. The substances used during the operation are then aspirated and the wound is sealed.
At the end of the procedure, we inject an antibiotic into the anterior chamber. Afterwards you use eye drops for three to four weeks according to a schedule, on prescription from the pharmacy; in the first few days a protective shield protects the eye. In the first week, no heavy lifting, no rubbing your eyes, no swimming pool and no sauna. Follow-up examinations on the following day, after one week, and after one and three months are included in the price.
At EyeLaser Zurich, refractive lens exchange costs CHF 5’000 per eye, regardless of which artificial lens is implanted; with femtosecond laser CHF 6’000. The price includes the procedure, lens, protective shield, the follow-up examinations in the first three months and any laser fine-tuning in the first year. Separate: prescription medication and eye drops, and thereafter the annual check-up for CHF 180. You pay for refractive lens exchange yourself; some supplementary insurance policies make a contribution. All lens prices and the rules for cataract are on the page Lens implantation costs; on health insurance.
Six months interest-free directly at EyeLaser Zurich; longer terms through HeyLight with a credit check and interest. Prices apply per eye and regardless of the implant. For medically indicated cataract with basic insurance, the surcharge under the TARDOC tariff applies instead (CHF 700 or CHF 2’700 per eye) — see cataract page.
Refractive lens exchange is a procedure inside the eye; it is not risk-free, and no promise of success can be given. The figures come from studies, not from our own data.
| Risk | Frequency in studies | Source | What we do |
|---|---|---|---|
| After-cataract (clouding of the lens capsule) | 5.8–19.3 % of eyes with YAG treatment within five years, depending on the lens model | Ursell 2020 | YAG laser in a few minutes at Strehlgasse, billed via basic insurance |
| Halos and glare with multifocal lenses | Halos around 3.6 times, glare around 1.4 times more frequent than with monofocal lenses | de Silva 2016 | Lens choice based on daily life; adaptation over weeks to months (Rosa 2017) |
| Lens has to be removed again | 0.83 % of 1’438 multifocal lenses, 0.28 % because of optical complaints | Kermani and Gerten 2016 | Exchange for a different artificial lens possible |
| Infection in the eye | 0.023 % (177 of 764’513 operations) | Friling 2024 | Antibiotic into the anterior chamber at the end of the procedure; available around the clock for the first 24 hours |
| Retinal detachment | 0.99 % in four years after cataract surgery; around six times higher with high short-sightedness, considerably higher in younger patients. After refractive lens exchange for short-sightedness above −12 dpt: 8.1 % in seven years | Daien 2015; Colin 1999 | Retinal examination beforehand; for young, highly short-sighted eyes, ICL is preferable |
| Over- or undercorrection | no reliable frequency figure for Zürich | – | Laser fine-tuning by Dr. Derhartunian, included in the price in the first year |
Most people see considerably better by the following day. After around two weeks, wound healing is largely complete; the brain’s adaptation to multifocal or EDOF lenses (neuroadaptation) takes weeks to months (Rosa 2017). We assess the result after around three months.
In the first few days, slight burning, a foreign-body sensation, halos and poorer vision at dusk are common and usually temporary. A protective shield protects the eye; eye drops are available on prescription. The follow-up examinations on the following day, after one week, and after one and three months are included in the price.
If you have unexpected symptoms, contact us immediately: in the first 24 hours after the procedure, around the clock with us; after that, at night, the emergency department of the hospital on duty.
| Refractive lens exchange | ICL (phakic lens) | Laser eye surgery | |
|---|---|---|---|
| Principle | Artificial lens replaces your natural lens | Additional lens in front of your natural lens | Cornea is reshaped |
| Typical age | from around 45 with long-sightedness, otherwise from around 55 | 21 to 60 years (as approved), from 18 with a stable prescription | from 18 years |
| Presbyopia | treated at the same time with a multifocal, trifocal or EDOF lens | not directly (from 45, mini-monovision) | with PresbyMAX |
| Cataract later | no longer possible | possible, then refractive lens exchange | possible |
| Price per eye | CHF 5’000, with femtosecond laser CHF 6’000 | CHF 4’500 | CHF 1’500 to 3’000; PresbyMAX CHF 3’300 |
More on this: ICL in Zürich · Laser eye surgery · PresbyMAX · Overview Lens surgery in Zürich · Guide Refractive lens exchange: when does it make sense?
Study figures come from published research and are not our own data. Study populations differ in age, baseline values and lens model.
The suitability test gives an initial assessment in around 45 seconds. In the free initial consultation, in person at Strehlgasse 33 or by video, we clarify whether the pre-examination is worthwhile for you. The pre-examination costs CHF 300 and is credited towards the cost if you go ahead with treatment. For cataract, instead of the initial consultation, you book an examination via basic insurance.
Book a free initial consultation Check suitability Question via WhatsApp · Call 044 221 95 02
Yes, an artificial lens can be removed and replaced in a second procedure, for example in the case of severe optical complaints or a significant deviation from the target power. This is rare: in a series of 1’438 multifocal lenses this was 0.83 % (Kermani and Gerten 2016). EyeLaser Zurich usually corrects smaller residual values with the laser at the cornea; this laser fine-tuning is included in the price in the first year.
Like any artificial lens, multifocal lenses are made to stay in the eye permanently and are usually not replaced. Because your own lens has been removed, a cataract can no longer develop. Clouding of the lens capsule may occur later (after-cataract); the EyeLaser Zurich team treats it in a few minutes with the YAG laser, billed to basic insurance.
Office and screen work is usually possible again two to three days after a refractive lens exchange. Heavy physical work, dust or work with a risk of eye injury is something we discuss with you individually at EyeLaser Zurich; we issue a sick note if needed. You must not drive yourself on the day of the procedure.
For a refractive lens exchange, EyeLaser Zurich uses trifocal lenses (three focal points), EDOF lenses (extended depth of focus) or monofocal plus lenses (one distance), depending on your measurements and daily life. Each is available as a toric version to correct astigmatism. All cost the same, CHF 5’000 per eye. Trifocal lenses give better near vision without glasses, EDOF lenses a continuous range of focus (Tavassoli 2024).
That depends on your situation, not on the lens. You pay for a refractive lens exchange without cataract yourself: CHF 5’000 per eye, with femtosecond laser CHF 6’000; some supplementary insurance policies make a contribution. For a medically indicated cataract with basic insurance, the operation is billed under TARDOC, and at EyeLaser Zurich you only pay the surcharge: CHF 700 for one distance or CHF 2’700 for several distances, femtosecond laser plus CHF 1’000.
During a refractive lens exchange, the surgeon opens the lens capsule through a small incision of about 2 mm at the edge of the cornea, liquefies your own lens with ultrasound and removes it by suction. The folded artificial lens then unfolds in the capsular bag. At EyeLaser Zurich this is done as an outpatient procedure under anaesthetic eye drops, about 15 minutes per eye; on request, the femtosecond laser makes the incisions (plus CHF 1’000).
The refractive lens exchange itself takes about 15 minutes per eye at EyeLaser Zurich. Including preparation, pupil dilation and a short recovery, plan for about two hours. We operate on both eyes on the same day or separately, as you prefer.
After a refractive lens exchange, most people already see much better the next day. Wound healing is largely complete after about two weeks. With multifocal or EDOF lenses, the brain needs weeks to months to adapt to the new optics. EyeLaser Zurich assesses the result at the check-up after three months.
After a refractive lens exchange, you should not rub your eyes or lift heavy objects in the first week, and you should avoid swimming pools and saunas; swimming is usually possible again after about two weeks once you have been given the all-clear. Walking is possible from the day after the procedure; you can resume light sport without body contact after about one to two weeks and contact sports after four weeks. You do not drive yourself on the day of the procedure. You take the eye drops for three to four weeks according to the EyeLaser Zurich schedule.
After a refractive lens exchange, EyeLaser Zurich recommends not lifting heavy objects, not straining and not rubbing your eyes in the first week. Normal bending in daily life, for example to tie your shoes, is usually allowed. What applies to your eye we discuss at the check-up the next day.
At EyeLaser Zurich, the refractive lens exchange is performed by Dr. med. univ. Victor Derhartunian, Dr. med. Myron Kynigopoulos or Dr. med. Valery Vinzent Wittwer, depending on the case. Dr. Derhartunian is the medical director and oversees all findings and measurement data, including the lens calculation. He personally carries out any laser fine-tuning afterwards; in the first year it is included in the price.
A refractive lens exchange at EyeLaser Zurich costs CHF 5’000 per eye, regardless of which artificial lens is implanted; with femtosecond laser CHF 6’000. Included are the procedure, the lens, a protective shield, the follow-up checks during the first three months and any laser fine-tuning in the first year. The pre-examination (CHF 300) is credited. Charged separately: prescription medication and, afterwards, the annual check-up for CHF 180.
A refractive lens exchange is a common, standardised procedure, but it is not free of risk. Serious infections are rare (0.023 % in a Swedish registry study, Friling 2024). The risk of retinal detachment rises markedly with high myopia and younger age (Daien 2015); EyeLaser Zurich therefore tends to recommend the ICL for young, highly myopic people. We discuss your personal risk after the pre-examination.
Discover our laser eye surgeons in the heart of Zurich
Having learned his craft from the two pioneers of laser surgery, Dr. Victor Derhartunian has performed some 25,000 refractive procedures. The head eye surgeon at EyeLaser in Zurich can consult his patients in 5 languages.
Dr. Valery Vinzent Wittwer joined the EyeLaser Zurich team in 2024. He specializes in lens surgery and performs refractive lens exchange at our clinic.
Dr. med. Myron Kynigopoulos is an ophthalmologist and eye surgeon, FEBO. At EyeLaser Zurich he performs cataract and lens surgery.
