One Lens, Two Paths: RLE and Cataracts

The technology we use at EyeLaser Zurich is so advanced that it unites two patient groups. The implantation of a modern multifocal lens (hybrid) allows you to live without glasses. However, the path to achieving this differs depending on your initial situation.

Eye Laser

Path A: Refractive Lens Exchange (RLE)

You don’t have cataracts, but want to get rid of your progressive glasses?
From around 45–50 years of age, the natural lens loses elasticity (presbyopia). Corneal laser treatment has its limitations here. The replacement of the natural lens with a Odyssey hybrid lens permanently solves the problem.

  • Your status: You are a self-payer (lifestyle procedure).
  • The bonus: You can no longer develop cataracts in old age.
Augenlasern Zürich

Path B: Cataract Surgery as an Opportunity

In the past, cataract surgery was a purely “repair procedure.” The cloudy lens was removed and a standard (monofocal) lens was inserted. The patient could see brightly again but still needed glasses for distance and near vision.

  • The Upgrade: Today, we use the necessity of the surgery as an opportunity. Instead of a standard lens, we implant the Odyssey Premium Lens.
  • Your Status: Health insurance covers the basic procedure. You invest in the upgrade (lens & laser).

The result: You not only lose the cataract but also gain freedom from glasses.

The Technology: Evolution to the Hybrid Lens

For a long time, classic “trifocal lenses” were the standard. They had sharp rings that split light. This worked well but often led to glare (halos) and loss of contrast at night.

At EyeLaser Zurich, we rely on the 2nd generation (Hybrid & EDOF), such as the Johnson & Johnson Tecnis Odyssey or Bausch + Lomb Envista.

  • Hybrid Technology: The Odyssey combines the best of two worlds: the excellent near vision of a multifocal lens with the tolerability and contrast of an EDOF (Extended Depth of Focus) lens.
  • Fewer Halos: Optimized surfaces massively reduce light circles around car headlights. This is crucial for road safety.
  • Glistening-Free Material: We only use lenses made from state-of-the-art hydrophobic acrylic. Older materials tended to have small inclusions (“glistenings”). Our lenses remain as clear in 50 years as they were on day one.

Costs & Financing in Switzerland

Transparency is important to us. Here you can find out exactly how the costs are composed.

Ein Leben ohne Brille – Erfolgsgeschichten aus Zürich

1. For Cataracts

In Switzerland, basic health insurance (KVG) covers the costs for the surgical technique “manual with scalpel” and a “standard lens” (monofocal).
If you opt for premium vision, the following costs will be personally incurred by you (self-payer portion):

  • Surcharge for special lens: The additional cost for the multifocal/hybrid lens compared to the standard lens.
  • Surcharge for Femto-Laser (FLACS): Health insurance only covers the manual incision. The precision of the laser is a private service.

2. For Refractive Lens Exchange (RLE)

Since this procedure serves the desire for freedom from glasses and is not medically mandatory (as glasses could also be worn), health insurance does not cover any costs.

  • Full Costs: You bear the costs for the surgery, the laser, and the lenses yourself. However, we offer attractive financing models.

We will explain the process to you in brief:

Multifocal lenses for presbyopia – the procedure in brief

Safety through AI & Laser Precision

A premium lens tolerates no errors. Therefore, we leave nothing to chance in planning.

Ein Leben ohne Brille – Erfolgsgeschichten aus Zürich

1. AI Calculation (Artificial Intelligence)

We measure your eye with the Heidelberg Anterion and CSO MS-39. This data flows into AI-based formulas (such as Kane, Barrett, or Hill-RBF). These algorithms “learn” from thousands of eyes worldwide and predict the position of the lens in the eye more precisely than any classical formula.

2. The Femto-Laser Surgery (FLACS)

We recommend performing the procedure with the femtosecond laser.

  • Precision: The laser opens the lens capsule with micrometre-accurate circularity and centration.
  • Why is this important? Perfect centration is crucial for the optical performance of the hybrid lens. This precision is hardly reproducible manually.
Eyelaser

3. Our Safety Net: Laser Fine-Tuning (Bioptics)

An eye is living tissue. Wound healing is individual.

  • Our promise: Should a small residual diopter (e.g., -0.5 dpt) remain after 3–4 months, we will perform a laser touch-up on the cornea.
  • The Difference: Pure cataract surgeons often cannot offer this. As a laser center, we have the in-house technology to elevate your result from “good” to “perfect.”

When We Say “No”: Anatomy & Risks

Femto-LASIK 7D

We only operate if the anatomy is correct. We rigorously check:

  • Kappa & Alpha Angles: We measure the distance between your pupil center and your actual line of sight. If the angle is too large, you will look past the optics of the lens. This leads to glare. In this case, we advise against the procedure.
  • Retinal Health: With the OCT scan, we ensure that your macula is 100% healthy. Any precursor to macular degeneration is an exclusion criterion.

Scientific Risk Calculator (Retinal Detachment)

Lens exchange is a procedure inside the eye. Especially in young patients with high myopia, there is a statistical risk that the retina may detach years later.

  • Transparency: We use scientific data (based on large European studies such as the Rotterdam Study) to calculate your individual risk.
  • Honesty: If the calculator indicates too high a risk, we decline the lens exchange and recommend safer alternatives (e.g., an ICL lens that leaves the eye intact).

What if I don’t tolerate the lens?

Presbipia

In very rare cases (under 1%), the brain does not adapt to the new vision (“lack of neuroadaptation”).

The solution: We will not leave you alone. A Lens replacement is possible. We remove the multifocal lens and insert a classic monofocal lens. Thanks to our precise preliminary examination (simulation tests), however, this scenario is extremely rare.

Start your treatment process with confidence

Book your eligibility check in Zurich. Experience what happens when state-of-the-art technology meets true Swiss treatment quality.

Book an appointment for a suitability check

FAQ – Frequently Asked Questions in Zurich

What does RLE cost compared to cataract surgery?

RLA (Refractive Lens Exchange) costs approximately CHF 4,500 – 5,500 per eye in Zurich (guideline), as you pay for everything yourself. For cataract surgery, the health insurance covers approx. CHF 2,000 (flat rate). As a patient, you only pay the surcharge for the premium lens (approx. CHF 1,500 – 2,000) and the femto laser (approx. CHF 1,500). Please note: These are guideline values; you will receive an exact cost estimate.

Why do I have to pay for the Femto-Laser (FLACS) myself?

Basic health insurance in Switzerland only covers what is “economical and appropriate.” This refers to manual surgery with a scalpel. The laser is considered “comfort technology” for higher precision. Since it is not strictly necessary to remove the cataract (but is recommended for a premium result), it must be paid for privately.

Does the Odyssey lens last forever?

Yes. The material (hydrophobic acrylic) is age-resistant and “glistening-free.” It remains clear for life. What can happen: The natural capsule in which the lens sits can become cloudy after years (“after-cataract”). This can be painlessly polished in 2 minutes with a YAG laser in the practice.

Is the surgery painful?

No. We use state-of-the-art topical anesthesia. You are awake but feel no pain. You only notice that work is being done on your eye and see colorful lights. The procedure takes only about 15–20 minutes per eye.

Can I drive at night after the surgery?

Yes. Modern hybrid lenses (Odyssey) are designed to minimize halos (light circles). They are significantly more tolerable than old trifocal lenses. In the initial period (3-6 months), the brain adapts (neuroadaptation), during which light effects are still perceived but are gradually filtered out over time.

Why is laser fine-tuning (Bioptics) so important?

Because biological tissue is never 100% predictable. Even with AI formulas, a deviation of 0.5 diopters can remain. A pure lens surgeon often cannot do anything more here. At EyeLaser, we use our excimer laser to smooth away this residual error on the cornea. This is included in the premium package.

Am I suitable with -8 diopters and 35 years of age?

Probably not. At this age, the risk of retinal detachment due to lens exchange is statistically increased. Furthermore, you can often still accommodate (focus) yourself. We would most likely recommend an ICL (Implantable Contact Lens) here. We check this with our risk calculator.

What is the Kappa angle and why is it important?

The Kappa angle is the difference between the optical axis of the eye and your line of sight. Multifocal lenses have rings. If you do not look precisely through the center of these rings (due to a large Kappa angle), you will experience glare and poor vision. We measure this in advance. If the angle is too large, we do not operate with a multifocal lens.

Does supplementary insurance cover costs for RLE?

Some supplementary insurances (VVG) contribute to refractive procedures (similar to laser eye surgery). This varies between CHF 500 and CHF 1,500 per eye. We will provide you with the necessary documents for submission.

How long does it take to heal?

You usually see well the next day. Full visual acuity and neuroadaptation (getting used to the new vision) settle in over 3 to 12 weeks. However, you are usually able to work again after 2-3 days.