Clear Lens Extraction
Used to treat a wide range of hyperopia and myopia, this procedure involves removing the eye's lens and inserting an artificial lens. The process resembles that of cataract surgery; however in cataract surgery the lens is clouded, whereas in this surgery, the removed lens is clear. An advantage is that cataract surgery has been performed successfully for years and is a familiar procedure to many surgeons. Patients should understand that this procedure is generally used to treat patients with extremely high myopia (greater than 12 diopters of correction needed).
There is more risk of infection inside the eye since this is an intraocular procedure. We located ten scientific papers dating back to 1994 that report results on this procedure.6-15 The most frequent complication noted is retinal detachment. It has been noted that this complication can occur even years after the initial surgery. The incidence rate varies widely between studies, with several noting no incidence of the complication and one noting that it occurred in 8% of patients followed for 7 years. It is very important for your surgeon to complete a comprehensive examination and evaluation of your retina and related areas of your eyes prior to making a final decision.
All studies noted a significant increase in best corrected and uncorrected visual acuity postoperatively for the majority of patients and concluded that, with proper preoperative evaluation, this procedure is safe and effective.
Used to treat a wide range of hyperopia and myopia, this procedure involves inserting an implant called an intraocular lens (IOL) into the eye's anterior chamber - the area in front of the pupil - or posterior chamber - the area between the iris and the normal lens. This procedure differs from Clear Lens Extraction in that the eye's natural lens is left in place. Like Clear Lens Extraction this procedure is used primarily to treat extremely high myopia.
Studies have demonstrated that the majority of patients achieve significant increase in uncorrected visual acuity (vision without glasses or contacts).17-19 As with any surgery, there are risks involved. Early reports noted early cataract formation with the need to remove the natural lens, an increase in glare and halos effects, and endothelial cell loss.20-22 However, over the last few years, new materials and designs have been introduced for clinical studies that have demonstrated a significant decrease in risks mentioned.17-19
Patients in the United States should understand that this technology is currently available only through clinical trials. Anyone considering this procedure should carefully review all the pros and cons with their ophthalmologist.
6. Colin J, Robinet A, Cochener B. Retinal detachment after clear lens extraction for high myopia: seven-year follow-up. Ophthalmology 1999 Dec; 106(12):2281-4; discussion 2285.
7. Pucci V, Morselli S, Romanelli F, Pignatto S, Scandellari F, Bellucci R. Clear lens phacoemulsification for correction of high myopia. J Cataract Refract Surg 2001 Jun;27(6):895-900
8. Kaluzny JJ. Clear lens extraction in high myopia. Klin Oczna 2000;102(1):29-32
9. Jimenez-Alfaro I, Miguelez S, Beuno JL, Puy P. Clear lens extraction and implantation of negative-power posterior chamber intraocular lenses to correct extreme myopia. J Cataract Refract Surg 1998 Oct;24(10):1310-6
10. Ceschi GP, Artaria LG. Clear lens extraction (CLE) for correction of high grade myopia. Klin Monatslb Augenhelkd 1998 May;212(5):280-2
11. Lee KH, Lee JH. Long-term results of clear lens extraction for severe myopia. J Cataract Refract Surg 1996 Dec;22(10):1411-5
12. Gris O, Guell JL, Manero F, Muller A. Clear lens extraction to correct high myopia. J Cataract Refract Surg 1996 Jul-Aug;22(6):686-9
13. Izak M, Oslanec J, Gafrikova J, Nikel J. Extraction of clear lens-cataract as refractive surgery in severe myopia. Cesk Slov Oftalmol 1996 Apr;52(2):82-7
14. Lyle WA, Jin GJ. Clear lens extraction for correction of high refractive error. J Cataract Refract Surg 1994 May;20(3):273-6
15. Barraquer C, Cavelier C, Mejia LF. Incidence of retinal detachment following clear-lens extraction in myopic patients. Retrospective analysis. Arch Ophthalmol 1994 Mar;112(3):336-9
16. Uusitalo RJ, Aine E, Sen NH, Laatikainen L. Implantable contact lens for high myopia. J Cataract Refract Surg 2002 Jan;28(1):29-36
17. Jimenez-Alfaro I, Benitez del Castillo JM, Garcia-Feijoo J, Gil de Bernabe JG, Serrano de La Iglesia JM. Safety of posterior chamber phakic intraocular lenses for the correction of high myopia: anterior segment changes after posterior chamber phakic intraocular lens implantation. Ophthalmology 2001 Jan;108(1):90-9
18. Bantra VN, McLeodd SD. Phakic intraocular lenses. Ophthalmol Clin North Am 2001 Jun;14(2):335-8, viii.
19. Maroccos R, Vaz F, Marino A, Guell J, Lohmann CP. Glare and halos after "phakic IOL." Surgery for the correction of high myopia. Ophthalmologe 2001 Nov;98(11):1055-9
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