Twentysix eyes had clear lens extraction by phacoemulsification, while 24 eyes underwent trabeculectomy. During followup, patients tended to remain stable, and the risk of retinal detachment was low. Refractive outcomes for eyes with primary angleclosure glaucoma pacg that undergo lens extraction can be unpredictable because of anatomic features such as shallow anterior chamber depth, short axial length, and a thickened lens positioned anteriorly. We attribute our favorable results to careful patient selection and followup. In most cases, the synthetic lens corrects for distance vision, usually requiring a pair of reading glasses for close work. Clear lens extraction in the 19th centuryan early demonstration of premature dissemination. Clear lens extraction exchange another way of performing refractive surgery is by removing the natural crystalline lens and replacing it with intraocular lens implant. Clear lens extraction is becoming controversial because of the danger of complications. Clear lens extraction how is clear lens extraction abbreviated. Because the rle patient already sees well with contact lens or glasses preoperatively, any loss of vision after rle is unacceptable and poorly tolerated by the patient. When errors of refraction are treated with this operation, it is possible either to exchange the lens or to add the synthetic lens in front of the natural lens to help increase the refractive power of the eye. A 29yearold woman presented with symptoms of gradual, progressive, painless diminution of vision in both eyes for past 810 years. Clearlens extraction as a treatment for primary angle closure the.
Refractive iols an alternative to lasik eye surgery. On examination, uncorrected visual acuity was 2060 in the right eye and 20126 in the left eye. Complications of clear lens extraction in axial myopia. While the patient lies on his or her back, the area around the eye is prepared. Angle closure glaucoma acg is one of the major causes of blindness, especially in asian populations. Make double sided rings out of coins tips for beginners duration.
Clear lens extraction for the management of primary angle. Benaim describes clean lens extraction and its benefits. Clear lens extraction is a lens replacement surgery, almost identical to cataract surgery, which involves removing the natural lens, which can no longer focus properly, due to presbyopia. The effectiveness of early lens extraction with intraocular lens. It involves removal of the natural lens in the patients eye, replacing it with a correctly focused lens to overcome nearsightedness, farsightedness or astigmatism. Background to describe the surgical technique and refractive outcomes following clear lens extraction cle in the effectiveness, in angleclosure glaucoma, of lens extraction trial. Clear lens extraction cle is the same surgery that is done to remove cataracts once the natural lens has become cloudy and interferes with vision. Trabeculectomy was more effective than clear lens extraction in reducing dependency on glaucoma drugs, but was. Both involve the removal of the eyes natural lens, replacing it with a synthetic lens implant. It involves removing the natural lens and replacing it with a new lens implant. Refractive lens exchange, also called lens replacement surgery or clear lens extraction, 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 the vision source office of. After clear lens extraction three of the cases had good iop control iop download pdf. Implanting a traditional or monofocal lens in both eyes this gives the patient the best corrected distance vision. In medically uncontrolled iridotomized pacg eyes without cataract, a randomized controlled trial was conducted to compare clear lens extraction by phacoemulsification versus trabeculectomy with adjunctive mitomycin c chemotherapy. The mean extent of synechial angle closure was significantly reduced from 272. Clear lens extraction cle university of utah health. Alternative names occasionally used for rle are clear lens exchange, clear lens extraction or cle. Refractive lens exchange is an effective form of refractive surgery, which may be considered in patients with high myopia in whom excimer laser is inappropriate. Refractive lens exchange clear lens extraction for. Clear lens extraction with iol implantation in the bag pradip mohanta duration. Therefore, clear lens extraction is more effective for the treatment of early glaucoma and is recommended as the. To prospectively evaluate the incidence of complications, particularly retinal detachment, 7 years after clear lens extraction cle for myopia greater than. Clear lens extraction ophthalmologist in chicago, il. To schedule a consultation for refractive lens exchange, please click here.
The clear, natural lens is then replaced with a lifestyle intraocular lens implant, that allows patients the ability to see near, far and everything in between. 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. Formerly, intracapsular lens extraction was performed, but the present surgical method is extracapsular lens extraction or phacoemulsification. Clear lens extraction for angle closure author reply. Clear lens extraction is performed on an outpatient basis. Clear lens exchange cle can be used to treat shortsightedness, longsightedness, presbyopia and astigmatism. Clear lens extraction refractive eye surgery cascade eye. Clear lens extraction how is clear lens extraction. Refractive lens exchange rle clear lens extraction refractive lens exchange rle is a type of vision correction surgery in which the eyes natural lens is removed and replaced with a manmade intraocular lens iol. Clear lens extraction clear lens extraction cle is similar to cataract surgery. Essentially, it is cataract surgery done before the patient has a clinically significant cataract. Clear lens extraction with posterior chamber iol implantation has good outcomes with acceptable predictability and improvement in bestcorrected visual acuity.
Cle is a new procedure that involves removing your own crystalline lens and replacing it with a synthetic one. In the past decade, lens extraction both clear or with cataract with intraocular lens implantation has gained popularity due to good results in. View of clear lens extraction in glaucoma is it still a controversy. Clear lens extraction is a refractive surgery used to compensate axial myopia. This artificial lens, known as an intraocular lens, or iol, is implanted into your eye to. Clear lens extraction for pacg in eagle american academy. Mean selfreported health status, as measured by the european quality of life5 dimensions questionnaire and other measures of visionrelated quality of life, was higher in the lens extraction group. This is also the first prospective randomised therapeutic trial in ophthalmology in which one of the primary outcome measures is patient reported, through. Clear lens extraction in angleclosure glaucoma patients. Most vision correction procedures attempt to change the focusing power of the cornea. Clear lens extraction or cle, also referred to as refractive lens exchange is a surgical procedure that involves removing the natural lens of your eye in exchange for an artificial lens. Clear lens extraction for the correction of high myopia. Four surgical options for clear lens extraction cle there are three options that surgeons currently use when doing clear lens exchange.
Despite evidence that lens extraction can improve intraocular pressure control in patients with narrow angles, use of clear lens extraction as a treatment option is still debatable. Department of ophthalmology and visual sciences, the chinese university of hong kong, hong kong, china. Effectiveness of early lens extraction for the treatment of primary angleclosure glaucoma eagle. Then the surgeon makes a small incision and inserts the lens implant. Clear lens extraction to correct high myopia sciencedirect. Poemen chan clear lens extraction pros and cons thu 210 1609 poeman chan. The following cpt codes can be used for lens extraction based on the scenario. Rle, the surgeon is placed under significant pressure. Choroidal neovascular membrane following clear lens extraction. Pdf retinal detachment after clear lens extraction for.
Lens exchange we are currently updating this page please check back soon. To establish long term outcomes and incidence of complications following refractive lens exchange rle for the correction of high myopia. Clear lens extraction or refractive lens exchange clerle. When performing clear lens extraction ie, refractive lens exchange. Clearlens extraction as a treatment for primary angle closure glaucoma is a multifactorial spectrum of diseases in which progressive optic nerve damage leading to blindness occurs with raised intraocular pressure as the main risk factor. Rle surgery requires the implantation of an iol to restore vision. To assess the refractive outcome and postoperative complications in a single surgeon series of clear lens extraction for high myopia. Refractive iols clear lens extraction latest updates. Anterior segment examination was essentially normal except for a conical protrusion in the pupillary axis of the anterior lens.
Clearlens extraction as a treatment for primary angle closure. Return to article details clear lens extraction in glaucoma is it still a controversy. Clear lens extraction for primary angle closure glaucoma. Refractive lens exchange or lens replacement surgery. This is a guest editorial commissioned by section editor yi sun, md department of ophthalmology, the third affiliated hospital of sun yatsen university, guangzhou, china. The excellent article by barraquer and coworkers on retinal detachment following clearlens extraction in patients with myopia raises the important issue of appropriate thresholds of safety and efficacy for elective intraocular surgery and also helps to define the risk factors for and time course of retinal detachment following extracapsular lens or cataract. Pdf clear lens extraction for primary angle closure. There have been some very exciting advancements in iol intra ocular lens technology that now make different options available to you. Clean lens extraction alabama ophthalmology associates. Clear lens extraction for early angleclosure glaucoma. Like the lens of a camera which focuses images sharply on the film, the eyes lens focuses light and images on the retina back of the eye. If the patient has a visually significant cataract it is a more widely accepted method of treatment. Clear lens extraction, on the other hand, corrects nearsightedness or farsightedness by replacing the eyes natural lens, which has the wrong power, with an artificial intraocular lens iol implant that has the correct power for the eye. Clear lens extraction cle eyes of westwood optometry.
Crsteurope surgical technique for clear lens extraction. The patient will require reading glasses after surgery for near work. Refractive lens implant surgery involves replacing the natural lens with a clear artificial lens. After clear lens extraction three of the cases had good iop control iop lens extraction group. For example, older patients in whom loss of accommodation is not a concern, or in whom early peripheral lens opacities are present, are often good candidates for rle. When the natural lens does not provide good focus, refractive iols and clear lens extraction can be used to correct vision. Clear lens extraction for angle closure request pdf. Pdf clear lens extraction for the management of primary angle. To emphasize the effect of an inflammatory event like lens extraction on choroidal neovascularization. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to pacg, early clear lens extraction will. Pdf clear lens extraction for the management of primary. Like cataract surgery, this procedure involves removing the natural lens of the eye and replacing it with an intraocular lens iol implant, which can be either a multifocal iol implant, a phakic iol, or an accommodating iol. This type of surgery is performed every day when patients undergo cataract surgery. To describe the surgical technique and refractive outcomes following clear lens extraction cle in the effectiveness, in angleclosure glaucoma, of lens extraction trial.
Retinal detachment after clear lens extraction in 41 eyes with high axial myopia. Clear lens extraction is another refractive surgery option for a few select patients. For such patients, clear lens extraction cle is an excellent option worthy of serious consideration. Clear lens extraction as the first line treatment of primary angle.