Clear Lens Extraction

Clear Lens Extraction

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada

Clear Lens Extraction

Clear lens extraction, also called lens replacement surgery or refractive lens exchange, may be a

better option than LASIK, PRK or phakic IOL refractive surgery for people with presbyopia and

high hyperopia (farsightedness).

Clear lens extraction (CLE) replaces your eye's clear natural lens with an artificial intraocular

lens (IOL) to correct your refractive error and achieve sharper focus, reducing your need for

reading glasses or bifocals.

Clear lens extraction typically is for people with presbyopia or extreme farsightedness, for whom

LASIK, PRK or phakic IOL surgery generally are not suitable. If you have both presbyopia and

moderate to severe hyperopia, CLE may be the only viable option for clear vision and minimal

reliance on glasses after refractive surgery.

Lens replacement surgery also can correct myopia (nearsightedness), but generally it is not

recommended when LASIK, PRK or phakic IOLs are available.

The procedure for refractive lens exchange is virtually identical to cataract surgery. The

difference is that in CLE, the lens being replaced is clear, rather than a cloudy lens due to a

As in cataract surgery, three types of IOLs are available to replace your natural lens, depending

on your vision needs and the health of your eyes. They are:

 Monofocal fixed-focus IOLs. Monofocal lenses provide clear vision at distance,

intermediate or near ranges — but not all three at once. Toric IOLs to correct astigmatism

also are classified as monofocal IOLs.

 Multifocal IOLs. A multifocal lens provides clear vision at multiple distances.

 Accommodating IOLs. An accommodating IOL is a type of monofocal lens that enables

focus at multiple distances by shifting its position in the eye.

With intraocular lenses, there is no "one size fits all," and your eye surgeon will recommend an

IOL that is most suitable for your individual needs.

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada

Clear Lens Extraction: The Procedure

Lens replacement surgery usually takes about 15 minutes and is performed on an outpatient

basis. Each eye is done separately, usually about a week apart.

Numbing anesthetic drops are used during CLE, so typically there is no discomfort, and most

people report immediate vision improvement after surgery.

Initial recovery from refractive lens exchange — when you can resume normal everyday

activities — usually takes about a week.

Final outcomes of refractive lens exchange can take up to several weeks, and you may notice

vision disturbances such as blurry vision, halos and glare, or a "scratchy" sensation as your eyes

You should be able to return to work and resume driving within a week of surgery, dependent on

your eye surgeon's instructions.

Normally, you won't feel an IOL in your eye, in the same way that you don't feel a dental filling

Also, since the lens is situated inside your eye and not on the surface like a contact lens, it is not

The artificial intraocular lens is a permanent replacement for your natural lens and is designed to

And, because IOLs are not affected by age-related changes, there is minimal risk of regression

(loss of corrective effect or deterioration of vision) over time.

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada

Clear Lens Extraction for Presbyopia

Presbyopia affects just about everyone and becomes noticeable sometime after age 40 in most

cases. Presbyopia is a naturally occurring age-related condition where your eye's natural lens

becomes more firm and inflexible, and you lose the ability to focus on near objects.

CLE: A Treatment for Early Cataracts? 

People who are middle-aged or older may have the beginnings of cataracts that eventually could

worsen and require cataract surgery.

If you have early cataracts, you could choose to have lens replacement surgery instead of waiting

for the cataracts to progress to the point where they cause vision loss and have to be removed.

Intraocular lenses can provide significantly better uncorrected vision at that point, especially if

you are reliant on eyeglasses or contact lenses.

An added benefit of clear lens extraction is that it eliminates the risk of cataracts, because the

eye's natural lens is replaced with an artificial lens implant.

Non-surgical options for presbyopia include reading glasses, bifocal or progressive eyeglass

lenses, and multifocal contact lenses. Another option is wearing contact lenses for monovision.

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada

For people with presbyopia and moderate-to-severe hyperopia, CLE often is the most appropriate

A major appeal of clear lens replacement is the recent availability of FDA-approved multifocal

IOLs (Restor by Alcon, and ReZoom and Tecnis Multifocal by Abbott Medical Optics) and

accommodating IOLs (Crystalens by Baush + Lomb).

Multifocal and accommodating IOLs enable you to focus at all distances, to overcome

presbyopia as well as poor distance vision.

Refractive Lens Exchange Vs. LASIK for Severe Refractive 

While LASIK remains the most popular option for correcting myopia and hyperopia, if you have

a very severe refractive error or an abnormal cornea, lens-based refractive surgery such as clear

lens extraction or phakic IOL implantation may be a better alternative.

Unlike LASIK or PRK, refractive lens exchange can correct almost any degree of hyperopia, and

visual acuity after CLE surgery often is better than LASIK and PRK outcomes in cases of

moderate and high hyperopia.

If you have myopia, CLE usually is performed only if you are not suitable for any other vision

correction surgery. People with myopia have a higher risk of retinal detachment during clear lens

extraction, and other refractive surgery options should be explored first.

Vision After Clear Lens Extraction

Whether you will need eyeglasses or contact lenses after clear lens extraction depends on the

type of intraocular lens used.

Monofocal IOLs have been used extensively in cataract surgery and clear lens exchange. They

offer excellent vision and contrast sensitivity and have low instances of vision disturbances such

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada

However, because monofocals are designed to focus only at one distance, you will likely need

glasses for up-close tasks such as reading fine print and working at a computer (but monovision

can help with your near vision).

Each IOL has advantages and disadvantages in terms of the best uncorrected vision it produces at

near, intermediate and far distances, as well as the likelihood and degree of vision disturbances

such as halos and night glare that might occur after surgery.

Risks and Side Effects

Clear lens extraction is performed essentially the same way as cataract surgery, and therefore

CLE complications are similar to cataract surgery complications.

Lens replacement surgery is more invasive than laser-based refractive surgery such as LASIK

and PRK and comes with slightly more risk.

However, sight-threatening complications are rare, and most complications can be treated

successfully with medication or additional surgery.

While clear lens extraction has been proven safe and effective, all surgery has some degree of

risk, which you should discuss in detail with your eye surgeon. Clear lens extraction risks and

 Retinal detachment, especially in extremely nearsighted people

 Increased eye pressure (ocular hypertension)

 Infection or bleeding inside the eye

 Droopy eyelid (ptosis)

 Glare, halos and blurry vision from multifocal IOLs

6800 Morrison Street, Unit 4, Niagara Falls, Ontario, L2E 6Z8, Canada