eMedicine Specialties > Ophthalmology > Refractive Disorders

Myopia, Clear Lens Extraction: Follow-up

Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Coauthor(s): Pierre E Demers, MD, Assistant Professor, Department of Ophthalmology, Notre Dame Hospital, Centre Hospitalier de l'Université de Montréal; Consulting Surgeon, Lasik MD, Canada
Contributor Information and Disclosures

Updated: Oct 31, 2008

Outcome and Prognosis

Visual outcome is usually excellent.

A 2008 retrospective study of 129 eyes showed CLE with posterior chamber IOL implantation to be safe, predictable, and effective. CLE was shown to achieve excellent visual acuity and refractive outcome with few complications.2

The latest reports with prophylactic 360° therapy of peripheral retina show a statistically lower rate of retinal detachment in those eyes than if they had not been subjected to prophylactic treatment.

Future and Controversies

CLE is becoming a more accepted procedure. Arguments in favor of CLE are as follows: predictability, stability, ease and cost with which a general surgeon can perform the technique, use of toric or multifocal lens technologies and small-incision surgery, and better optical quality vision. Arguments against CLE are as follows: seriousness of complications, rate of complications, and availability of other less invasive refractive procedures.

In a 2004 study comparing the 2 procedures, Arne believed that phakic IOL placement was a safer modality than CLE in the same selected group of patients that corneal refractive surgery cannot address.3

If clouding of the capsule can be eliminated and if a truly accommodating and adjustable lens can be achieved, CLE could become a much more prevalent refractive procedure.

The advent of the ReSTOR and ReZoom lenses in 2005 and 2006, respectively, increased the frequency of this procedure, and the advent of newer and better lenses continues to increase demand and quality of results.

 


More on Myopia, Clear Lens Extraction

Overview: Myopia, Clear Lens Extraction
Workup: Myopia, Clear Lens Extraction
Treatment: Myopia, Clear Lens Extraction
Follow-up: Myopia, Clear Lens Extraction
Multimedia: Myopia, Clear Lens Extraction
References
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References

  1. Fernandez-Vega L, Alfonso JF, Montes-Mico R, et al. Visual acuity tolerance to residual refractive errors in patients with an apodized diffractive intraocular lens. J Cataract Refract Surg. Feb 2008;34(2):199-204. [Medline].

  2. Dúbravska Z, Rozsival P. [Refractive lensectomy--long-term results]. Cesk Slov Oftalmol. Jan 2007;63(1):28-35. [Medline].

  3. Arne JL. Phakic intraocular lens implantation versus clear lens extraction in highly myopic eyes of 30- to 50-year-old patients. J Cataract Refract Surg. Oct 2004;30(10):2092-6. [Medline].

  4. Colin J, Robinet A. Retinal detachment after clear lens extraction in 41 eyes with high axial myopia. Retina. 1997;17(1):78-9. [Medline].

  5. Colin J, Robinet A, Cochener B. Retinal detachment after clear lens extraction for high myopia: seven-year follow-up. Ophthalmology. Dec 1999;106(12):2281-4; discussion 2285. [Medline].

  6. Dholakia SA, Vasavada AR, Singh R. Prospective evaluation of phacoemulsification in adults younger than 50 years. J Cataract Refract Surg. Jul 2005;31(7):1327-33. [Medline].

  7. Gris O, Guell JL, Manero F, et al. Clear lens extraction to correct high myopia. J Cataract Refract Surg. Jul-Aug 1996;22(6):686-9. [Medline].

  8. Jimenez-Alfaro I, Miguelez S, Bueno JL, et al. Clear lens extraction and implantation of negative-power posterior chamber intraocular lenses to correct extreme myopia. J Cataract Refract Surg. Oct 1998;24(10):1310-6. [Medline].

  9. John ME, Noblitt RL, Coots SD, et al. Clear lens extraction and intraocular lens implantation in a patient with bilateral anterior lenticonus secondary to Alport's syndrome. J Cataract Refract Surg. Nov 1994;20(6):652-5. [Medline].

  10. Kolahdouz-Isfahani AH, Rostamian K, Wallace D, et al. Clear lens extraction with intraocular lens implantation for hyperopia. J Refract Surg. May-Jun 1999;15(3):316-23. [Medline].

  11. Lee KH, Lee JH. Long-term results of clear lens extraction for severe myopia. J Cataract Refract Surg. Dec 1996;22(10):1411-5. [Medline].

  12. Lyle WA, Jin GJ. Clear lens extraction for the correction of high refractive error. J Cataract Refract Surg. May 1994;20(3):273-6. [Medline].

  13. Lyle WA, Jin GJ. Clear lens extraction to correct hyperopia. J Cataract Refract Surg. Sep 1997;23(7):1051-6. [Medline].

  14. Osher RH. Clear lens extraction. J Cataract Refract Surg. Nov 1994;20(6):674. [Medline].

  15. Ripandelli G, Billi B, Fedeli R, et al. Retinal detachment after clear lens extraction in 41 eyes with high axial myopia. Retina. 1996;16(1):3-6. [Medline].

  16. Seiler T. Clear lens extraction in the 19th century--an early demonstration of premature dissemination. J Refract Surg. Jan-Feb 1999;15(1):70-3. [Medline].

  17. Siganos DS, Pallikaris IG. Clear lensectomy and intraocular lens implantation for hyperopia from +7 to +14 diopters. J Refract Surg. Mar-Apr 1998;14(2):105-13. [Medline].

  18. Sinskey RM. Clear lens extraction. J Cataract Refract Surg. Nov 1994;20(6):673-4. [Medline].

  19. Smith SE. Crystalens gains approval. Cataract & Refractive Surgery Today 2004 Jan;. 4(1):67-8.

  20. Wallace RB 3rd. Multifocal vision after cataract surgery. Curr Opin Ophthalmol. Feb 1998;9(1):66-70. [Medline].

  21. Werblin TP. Barraquer lecture 1998. Why should refractive surgeons be looking beyond the cornea?. J Refract Surg. May-Jun 1999;15(3):357-76. [Medline].

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Further Reading

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Keywords

myopia, clear lens extraction, CLE, refractive lens exchange, RLE, shortsighted, nearsighted, nearsightedness, vision loss, visual loss, visual deficit, ametropia, refractive error, refractive surgery, refractive procedures, laser in situ keratomileusis, LASIK, photorefractive keratoplasty, PRK

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Contributor Information and Disclosures

Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD
Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Pierre E Demers, MD, Assistant Professor, Department of Ophthalmology, Notre Dame Hospital, Centre Hospitalier de l'Université de Montréal; Consulting Surgeon, Lasik MD, Canada
Disclosure: Nothing to disclose.

Medical Editor

Daniel S Durrie, MD, Director, Department of Ophthalmology, Division of Refractive Surgery, University of Kansas Medical Center
Daniel S Durrie, MD is a member of the following medical societies: American Academy of Ophthalmology and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Louis E Probst, MD, Medical Director of Refractive Surgery, Chicago, Madison, Milwaukee, and Windsor Centers, TLC the Laser Eye Centers
Louis E Probst, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, and International Society of Refractive Surgery
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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