Clear Lens Extraction (CLE) is a procedure designed to eliminate the need for distance glasses or contact lenses and it can be used to treat a wide range of prescriptions. With specialist treatment it can also correct reading vision as well as distance vision.

It is most suitable for those over 50 years of age. This is because when the natural lens of the eye is removed all ability to adjust the focus of the eye is lost. This natural focus changing ability is called ‘accommodation’, and it is slowly lost with age. It is this loss of accommodation that accounts for near vision/reading glasses after the mid 40s. When CLE is performed on those over 50 the loss of accommodation is irrelevant as it has already been lost through the natural process described above.

Unlike laser techniques that correct vision by changing the shape of the cornea, CLE corrects vision by removing the natural crystalline lens and replacing it with a new artificial implant (IOL) of a different focusing power, much like what happens in cataract surgery. However, in cataract surgery the lens that is removed is cloudy whereas in this procedure it is clear, hence the name Clear Lens Extraction or Lens Exchange with IOL.

Like the lens of a camera which focuses images sharply on the film, the eye’s lens focuses light and images on the retina (back of the eye). Precise, state-of-the-art ultrasound instruments are used to measure the eyes and these individual measurements are entered into sophisticated formulae to calculate exact implant power.

The surgery takes 30 minutes for each eye and is done under local anaesthetic with the use of drops only. No injections and no stitches are required. The small incision that is made (2.8 mm or less) heals rapidly with vision settling within 2 days. Following surgery, drops are used for four weeks but the patient is able to return to normal activity within two days.

The next big thing

The traditional implant used is monofocal which means focused for one distance only so a patient would require reading glasses post surgery. The latest implant is multifocal which, as the name suggests, is focused at a number of distances so allows the patient to be free of glasses.

Results for this procedure have been outstanding and it is fast becoming the more popular choice for treatment.
Apart from those mentioned above, the main advantage of this procedure is that once it is done the patients has no chance of developing a cataract as there is no natural lens present. Therefore the results following surgery do last a lifetime.

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This article is written by Mr C T Pillai, Consultant Refractive Surgeon at Advance VisionCare, London

Last Editorial Review: 6/6/2010

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