PIE and RLE questions, answered

PIE stands for Presbyopic Implant in Eye. Your natural lens, which has lost its ability to focus up close, is replaced with an advanced lens implant chosen to give you a range of vision with less need for reading glasses.

RLE (refractive lens exchange, also called clear lens exchange) is the general term for replacing the eye’s natural lens to correct vision before a cataract has developed. PIE is a refractive lens exchange focused on presbyopia, which is why our site often writes “PIE/RLE.”

The surgery is essentially the same as modern cataract surgery. The difference is timing: PIE is done to correct focusing problems, rather than waiting for a cataract to cloud your vision.

Usually adults over 40 with presbyopia who want less dependence on reading glasses. Dr. Khanna evaluates each patient individually; your eye measurements and lifestyle guide the decision.

Options include extended-depth-of-focus and trifocal implants, such as Odyssey, PureSee, FineVision HP and Envy, and the Light Adjustable Lens, which can be fine-tuned after surgery. Your surgeon recommends one after measurements.

PIE is about $288 per eye per month for 24 months with insurance, or about $371 per eye per month for 24 months cash, for qualified applicants through our financing partners. Our procedure prices include all exams, measurements, surgeon’s and anesthetist’s fees, implant fees where applicable, 24 months of follow-up, all fine-tunings and enhancements, dry eye care, YAG where applicable, and the drops needed for surgery.

If you have a cataract, medical insurance may cover the basic lens replacement. Clear lens exchange and premium lens upgrades are usually not covered. We accept PPO plans only. We do not accept HMO plans or Medi-Cal.

PIE patients start with a free VIP consult: a surgery consultation focused on candidacy, in-office or virtual. It is not a comprehensive eye exam and doesn’t include take-home reports. For a comprehensive eye exam with records, the VIP lifestyle exam is $395 (self-pay only).

Most patients have the two eyes treated on separate days.

EVO ICL adds a lens and keeps your natural lens; PIE replaces it. Age, presbyopia and your measurements decide.