Patients in their mid to late 40s who are adamant about becoming glass free commonly ask us, “Is LASIK possible for me?”
They are looking for a refractive procedure to get freedom from glasses. Most of these patients have gotten reading glasses and don’t like the idea of having to carry them all the time. These patients are looking for a solution for correction of presbyopia. Some of them also wear distance vision glasses along with reading glasses.
While there is no medical contraindication for LASIK in their 40s and 50s, the procedure might be counterproductive. They will become glass-free for distance vision; however, they will still require near glasses. As we observe their dejection, questioning why this choice was not made 20 years ago or whether the lack of technology prevented them from having a glass-free life, we see disappointment on their faces. This gives us an opportunity to describe a surgical procedure that can make their dreams come true.
In this blog, we will discuss a procedure known as Clear Lens Extraction (CLE) or Refractive Lens Exchange (RLE). This is a surgical refractive surgery option.
Clear Lens Extraction or refractive lens exchange is a procedure in which we replace the clear crystalline lens that is present inside the eye since birth with an artificial Intraocular Lens (IOL). The surgical technique used is similar to that of cataract surgery, with the only difference being the absence of cataracts. CLE Surgery is thus an alternative to LASIK or laser refractive eye surgery.
Thus, just like in cataract surgery, the intraocular lenses implanted can correct all the refractive errors like far-sightedness, near-sightedness, presbyopia (most common), and astigmatism. Patients are provided with a choice to select the premium IOL which makes them clear for far, computer distance and near (Trifocal IOL), which is the intended result any presbyopia wants.
To know more about lenses visit our Best Cataract lens page.
The correct lens power is calculated by performing an A Scan which measures the size of the eye. With these measurements we use some lens power calculation formulas to help us decide the lens power.
The best candidates for CLE Surgery are:
Clear lens extraction is also a preferred procedure for primary angle closure glaucoma, where the intraocular pressure increases and the thickness of the natural lens may contribute to the condition. By performing a clear lens extraction, the IOL is much thinner than the natural lens, and the eye pressure may reduce after the procedure. It is important to note that the same procedure would not work in synechial angle closure.
From our perspective, it is crucial to follow patient selection protocols to ensure complete satisfaction for our patients.
Patients with retinal problems, such as a history of retinal detachment, and those with other eye diseases are not suitable candidates for clear lens extraction.
The advantages of CLE Surgery include,
The same methods used for cataract surgery are used for clear lens extraction treatment.
As with any surgery, there are theoretical risks to some extent. These concerns should be thoroughly discussed with the surgeon. Similar to Cataract Surgery, clear lens extraction carries the same risks and potential complications, including:
However, it’s important to note that in the hands of experienced surgeons, these complications rarely occur.
CLE Surgery can be the treatment of choice for patients who are poor candidates for Laser eye surgery or have high prescriptions. The procedure is preferred by presbyopes who are motivated to eliminate their dependence on glasses.