Clear lens extraction (CLE) eye surgery or Refractive Lens Exchange eye Surgery (RLE)
Clear lens extraction (CLE) surgery is also known as Refractive lens exchange (RLE) surgery may be a better option than LASIK, PRK or phakic IOL refractive surgery for patients above the age of 40 who have presbyopia and are not suitable candidates for LASIK. Similar to laser refractive procedures, Clear lens extraction surgery corrects refractive errors such as nearsightedness, farsightedness, and astigmatism
Clear lens extraction or CLE surgery is like cataract surgery, in fact, it is recommended as the refractive procedure of choice even in patients with early cataracts. During Clear lens extraction surgery, the natural lens of the eye is removed by phacoemulsification, as in the case of cataract, and replaced by an artificial lens.
Clear lens extraction surgery is the procedure of choice in the following situations:
High Myopia - Nearsightedness or short-sightedness
High Hyperopia - Longsightedness or far-sightedness
High Astigmatism
Especially in the presence of:
Presbyopia
Early cataract
Contraindications to LASIK
Age over 40 years
Types Of Lenses
As is true for cataract surgery, three types of IOLs may be implanted to replace the natural lens. The choice of lens is highly individualized, and needs to be customized to your visual needs. Your eye surgeon will discuss the relative merits and demerits of each and help you choose the best fit for your eyes and lifestyle.
The three kinds of lenses available are:
Monofocal or fixed-focus IOLs: Monofocal lenses can provide clear vision for a particular focus only, unlike the natural lens of the eye. That is, your surgeon can help you find perfect vision for either distance, intermediate or near ranges — but not all three at once. Most people choose perfect vision for distance, preferring to wear reading glasses. Toric IOLs to correct astigmatism also are classified as monofocal IOLs. This is the most commonly used IOL after cataract surgery, and is the most affordable option in patients who have preexisting cataract also, as long as you are prepared to wear glasses for intermediate and near distances.
Multifocal IOLs. A multifocal lens provides clear vision at several distances, and is often the choice of patients who want freedom from glasses after the surgery. PRELEX (Presbyopic Lens Exchange) is name given to Clear Lens Extraction with multifocal IOLs, since it corrects both near and distance vision. In patients who are both hyperopic and presbyopic, this is the implant of choice. The Clear Lens Extraction surgery with multifocal IOL implant means you don’t need glasses or contact lenses for distance or reading.
Accommodating IOLs: An accommodating IOL is different from both monofocal and multifocal lenses: it is a special kind of monofocal lens that can focus at multiple distances by shifting its position in the eye. This is analogous to the natural lens of the eye, which actually changes its focal length by changing its shape.
Advantages of Clear Lens Extraction Surgery
Clear Lens Extraction Surgery is a simpler procedure for refractive correction, as most ophthalmologists are well trained in phacoemulsification or surgery for removal of cataract. However, in CLE surgery, instead of a cataractous lens, the clear lens is replaced by an IOL.
It can correct both distance and near vision in people with presbyopia. This means that even people above forty can enjoy freedom from spectacles for near as well as distance.
It is a safe, affordable and predictable surgery since there is no fresh learning curve for the surgeon.
An added advantage of Clear Lens Extraction/Refractive Lens Exchange surgery (CLE/RLE) is that you will never need cataract surgery since the natural lens (which becomes cloudy with age causing cataract) has already been removed, and replaced with an artificial lens implant.
Clear Lens Extraction Surgery Versus LASIK
LASIK is the first choice of refractive surgeons worldwide for correcting myopia and hyperopia. However, it is only in certain situations that your doctor will recommend Clear Lens Extraction Surgery. These include very severe refractive errors, presbyopia or associated early cataract. In this subgroup, CLE surgery often is better than LASIK in terms of visual outcome.
If you have myopia, Clear Lens Extraction Surgery will only be performed if you are not a suitable candidate for any other vision correction surgery. This is because patients with high myopia have a higher risk of retinal detachment during clear lens extraction surgery, and other laser refractive surgery procedures are thus safer.
Clear Lens Extraction (CLE) Surgery especially with multifocal lenses is much more expensive than conventional LASIK, and is also not covered by insurance usually.
Clear Lens Exchange Surgery is more invasive than laser vision correction and is associated with all the complications of cataract surgery.
In patients with severe refractive error, and those who also need additional glasses for reading, the risk benefit ratio is favorable, and Clear Lens Extraction Surgery is considered the best option.