Clear Lens Exchange

Clear Lens Exchange (CLE) – also known as Refractive Lens Exchange (RLE) – is another alternative to Laser Eye Surgery. The basis of the procedure is the same as that of cataract surgery, except it is performed when no cataracts are present.

Like ICLs, CLE can be used to correct almost any prescription.

However, unlike ICLs, CLE involves the removal of the internal crystalline lens. This is replaced with a synthetic lens designed to correct the specific prescription of the patient. This synthetic lens is placed inside the capsular bag that used to contain the natural lens. In contrast, ICLs are placed in front of the natural lens.

The fixed focus of the synthetic lenses used in CLE means that the eye’s natural ability to focus is removed. For this reason, CLE is usually used in presbyopia patients who have little short focus reserves. For younger patients (usually under the age of 65), ICLs are preferred.

However, in some patients with hyperopia outside the range for Laser Eye Surgery, there may not be enough space in te eye to fit an ICL. In this case, CLE may be the only appropriate surgical option.

CLE may also be an option for presbyopia patients who are unsuitable for Laser Eye Surgery and whose eyes will not accommodate ICLs.

Benefits and Risks of CLE

CLE is often cited as a permanent fix to refractive errors. This is true insomuch as the change in refraction following CLE is permanent; however, the cornea will continue to change shape from the age of around 40 which may affect the patient’s prescription later on.

While it might seem obvious that CLE is more invasive and less safe than Laser Eye Surgery, this point is often overlooked or minimised.

Serious risks such as bleeding or infection are indeed very rare. However, CLE patients are generally younger than those undergoing normal age-related, visually significant Cataract Surgery. There may also be a higher risk for retinal detachment or swelling in the back of the eye.

In conclusion, CLE is a vision correction option for patients but must be discussed thoroughly and weighed against all other options. As stated in The Royal College of Ophthalmology Guidelines, all alternative interventions need to be discussed that could meet the vision correction needs with less risk, including from other practitioners.