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 |
