Thanks, I appreciate it. From my layman’s reading, it seems like RLE is very safe and doesn’t have the same side effects as LASIK. I guess my real question is why shouldn’t it be more widely used for younger or less extreme corrections. It’s likely that I am misunderstanding something and I am wondering if it’s obvious to you as an expert what it is.

Ok I get it! It is very simple : RLE implies the removal of the cristalline lens and insertion of an artificial lens that corrects the initial ametropia. The procedure is exactly the same as cataract surgery. The problem is that the lens is the organ that allows accomodation. So while it is usually simple to give you a glass free vision for a given distance, you will need glasses for other distance (usually, you will have a good far vision and glasses to read) which is not something that you want when you are young. The reasoning is that when a cataract surgery will be done anyway a few years after, it is more simple to do one surgery earlier than doing two. Patients with extreme ametropia are more likely to accept glasses. Finally, multifocal lenses exists, but they induce aberrations that are well tolerated when they follow the blurry vision and impairment of cataract, but not so well in previously well-seeing patients.

Got it, thanks. I think it is your last sentence that is most clarifying for me. I thought the multifocal lenses were a good solution but it sounds like they aren’t as great as I had hoped. Thanks for taking the time to reply.