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Clear Lens Extraction (CLE)

This procedure is essentially the same as that of cataract extraction with placement of a clear intraocular lens implant.

With classic cataract extraction, the natural lens is cloudy due to age-related changes and results in painless, progressive blurring of vision. Upon surgical removal of the lens, a clear intraocular lens implant is placed to provide clearer vision. With clear lens extraction, the procedure is essentially the same however, the natural lens is clear and not cloudy. This procedure is particularly effective with high levels of refractive error, especially hyperopia (farsightedness).

What can I expect if I decide to have this type of surgery?

Before surgery

Once you and your ophthalmologist (eye physician and surgeon) have decided that you will have your cataract or clear lens removed, a physical examination is necessary so that he or she may be alerted to any special medical risks.

Ask your ophthalmologist if you should continue your usual medications. Your eye will be measured to determine the proper power of the intraocular lens that will be placed in your eye during surgery.

The day of surgery

Surgery is usually done on an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery.

Upon arrival for surgery, you will be given eye drops, and perhaps medications to help you relax. You will also be given an anesthetic (the type will depend on your particular situation) to numb the surgery site. Though you may see light and movement, you will not be able to see the surgery while it is happening, and will not have to worry about keeping your eye open or closed.

The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head.

When the operation is over, the surgeon will usually place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home. You should plan to have someone else drive you home.

Following surgery, you will need to:

  • Use the eye drops as prescribed;
  • Be careful not to rub or press on your eye;
  • Use over-the-counter pain medicine if necessary;
  • Avoid very strenuous activities until the eye has healed;
  • Continue normal daily activities and moderate exercise;
  • Ask your doctor when you can begin driving;
  • Wear eyeglasses or shield as advised by your doctor.

    How is the surgery done?

    The most common type of cataract surgery performed in the United States is phacoemulsification.

    Under an operating microscope, a small incision is made into the eye.

    Microsurgical instruments are used to fragment and suction the cloudy or clear lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place. A plastic intraocular lens implant will be placed inside the eye to replace the natural lens that was removed.

    The incision is then closed. When stitches are used, they rarely need to be removed.

    When is the laser used?

    The posterior capsule sometimes turns cloudy several months or years after the original cataract operation. If this blurs your vision, a clear opening can be made painlessly in the center of the membrane with a laser.

    Laser surgery is never part of the original cataract operation. If needed, excimer laser to correct residual refractive error may also be utilized after clear lens or cataract extractions.

    Will cataract surgery improve my vision?

    Over 95% of cataract surgeries improve vision, but a small number of patients may have problems. Symptoms including infection, bleeding and swelling or detachment of the retina are some of the more serious complications that may affect your vision. Call your ophthalmologist immediately if you have any of the following symptoms after surgery:

    - Pain not relieved by non-prescription pain medication
    - Loss of vision
    - Nausea, vomiting or excessive coughing
    - Injury to the eye.

    From American Academy of Ophthalmology

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    Copyright 2015 Washington University School of Medicine