Presbyopia Correction Surgery - Clear Lens Exchange

Presbyopia is a common age-related condition where the eye's lens becomes less flexible, making it difficult to focus on close-up objects.

Understanding Presbyopia Symptoms and Treatment Options

It usually starts after age 45 and can cause trouble reading small print, using smartphones, or doing close-up work. People might notice blurred vision up close, eyestrain, or headaches. Regular eye check-ups are essential for managing presbyopia.¹

Presbyopia can be corrected with glasses, contact lenses, or surgery. Reading glasses with the right prescription help focus on close-up tasks.¹ Bifocals or progressive lenses assist with both near and far vision. Contact lenses like multifocals offer similar help. Surgical options, like Clear Lens Exchange (CLE) or corneal procedures, can also address presbyopia.

Overview of Clear Lens Exchange Surgery

Clear Lens Exchange (CLE) is a type of Presbyopia Correction Surgery. It’s an eye surgery that removes the natural lens of your eye and replaces it with an artificial one.²

It's like Cataract Surgery, but in Clear Lens Exchange (CLE), the lens usually is clear and not clouded by cataracts.³ Both surgeries can help you see better and avoid wearing glasses or contact lenses.

The surgery is done by making a small cut in the cornea of your eye. The surgeon uses a special tool to break up and remove the natural lens. Then, the surgeon inserts an artificial lens through the same cut.

Types of Artificial Lenses Used in Clear Lens Exchange Surgery

The artificial lens can be different depending on what kind of vision correction you need. For example, some artificial lenses can help you see far away, some can help you see near, and some can help you see both far away and near.

Once you receive a Clear Lens Exchange (CLE) surgery, as you have new artificial lenses implanted, you don’t develop cataracts anymore, therefore you don’t need Cataract Surgery in the future, addressing this need ahead of time.²

Surgical Methods for Vision Correction

There are different surgical methods, such as:

Multifocal or Accommodating IOLs: These special lenses are implanted during surgery or as a standalone procedure to help achieve better near and distance vision.
Corneal Inlays: These are tiny implants placed in the cornea to improve near vision.

Both eye surgeries usually take 15 to 30 minutes per eye. You will also need to follow some instructions to take care of your eyes and prevent infection or complications.

Risks and Side Effects of Clear Lens Exchange Surgery

Clear Lens Exchange (CLE) is a safe and effective procedure that can improve your vision and quality of life. However, like any surgery, it also has some risks and possible side effects such as inflammation, bleeding, infection, glaucoma, cataract formation, retinal detachment, or loss of vision.³ Therefore, it is important to discuss with your doctor about its benefits and risks before deciding to have this surgery.

Considerations for Choosing Clear Lens Exchange over LASIK or PRK

Clear Lens Exchange (CLE) may be a better option than LASIK or PRK for people who have thin or irregular corneas, extreme glasses prescription.²

However, is not suitable for people who have other ocular conditions such as age-related macular degeneration, uncontrolled diabetes or diabetic retinopathy, uncontrolled glaucoma, previous keratorefractive surgery, recurrent inflammatory eye disease, or corneal disease.^4,5,6

What are the differences between Clear Lens Exchange (CLE) and Cataract Surgery?

Both Clear Lens Exchange (CLE) and Cataract Surgery are surgical procedures performed on the eye, but they address different conditions:

Cataract Surgery

Cataract Surgery is typically performed to remove a cloudy lens (cataract) and replace it with an artificial intraocular lens (IOL) to restore clear vision.³

Clear Lens Exchange (CLE)

On the other hand, Clear Lens Exchange (CLE) is a procedure primarily intended for individuals without significant cataracts but who have refractive errors like nearsightedness, farsightedness, or astigmatism. Clear Lens Exchange (CLE) involves the removal of the eye's natural clear lens and replacing it with an artificial lens to correct refractive errors, similar to how cataract surgery is conducted.

While both surgeries involve lens replacement, Cataract Surgery is medically necessary due to a cloudy lens impacting vision, whereas Clear Lens Exchange (CLE) is elective, aiming to improve refractive errors in patients without significant cataracts. Consulting with your ophthalmologist will help determine the most suitable procedure for your specific eye condition and visual needs.

Both eye surgeries are safe and effective procedures that can improve your vision and quality of life.^2,3 However, they also have some risks and possible side effects such as inflammation, bleeding, infection, glaucoma, cataract formation, retinal detachment, or loss of vision.^3,5,6 Therefore, it is important to discuss with your eye doctor about the benefits and risks of this surgery before deciding to have it.

As with any medical procedure, risks and potential complications may occur.  Please consult your eye care specialist for detailed information and to discuss these possible risks and complications with you prior to the procedure.

References:

National Eye Institute (NEI) – Presbyopia – At A Glance. REF2022CT4047.
Moran Eye Center – Health University of Utah - Clear Lens Extraction (CLE). (n.d.). Retrieved from https://healthcare.utah.edu/moran/lasik/clear-lens-extraction.php.REF2023OTH5831.
National Eye Institute (NEI) – Facts About Cataract. REF2016OTH0006.
Antony M. Poothullil, Dimitri T. Azar, 1 - Terminology, classification, and history of refractive surgery, Editor(s): Dimitri T Azar, Refractive Surgery (Second Edition), Mosby, 2007, Pages 1-18, ISBN 9780323035996, https://doi.org/10.1016/B978-0-323-03599-6.50063-8. REF2023OTH5829.
Colin J, et al. Retinal detachment after clear lens extraction for high myopia: Seven-year follow-up. Ophthalmoloy 1999;106(12):2281-2285. REF2023OTH5830. Retrieved from https://reader.elsevier.com/reader/sd/pii/S0161642099905262token=EA49452C4E06D658A3E17E6EE3E41C8F4D265CAE103C2A11E4F4629E744D917DB5972C39F014F0 9C6A017FC1C4C4CBA6&originRegion=us-east-1&originCreation=20211126184550
Alió, JL, et al. Refractive lens exchange in modern practice: When and when not to do it? Eye and Vision 2014; 1:10. REF2023CT4047.

PP2023OTH6405