Clear Lens Extraction (CLE) | Vista Alpina Eye Clinic

Clear Lens Extraction

In clear lens extraction (Clear Lens Extraction = CLE), the natural lens of the eye is removed and replaced with an artificial lens (an intraocular lens) that remains permanently in the eye.

This can correct nearsightedness, farsightedness, and/or astigmatism.

From the age of 50, age-related farsightedness is usually also present: the natural lens loses the ability to focus sharply at different distances.

The natural "accommodation" is slowly lost.

Advantages of the procedure

The lens allows most patients to live without glasses

The patient will never develop cataracts, meaning that related surgery is no longer necessary

Costs of the procedure

Pre-examination: CHF 350.-

Surgery and premium lens depending on lens strength from CHF 4,900.-

The total costs (surgery, lens) are never covered by health insurance

The patient theoretically also has the option to correct vision errors with an ICL implantation, which would allow for a daily life (sports, etc.) without glasses after a successful procedure. For reading and/or working on the computer, reading glasses would still be necessary. Therefore, Vista Alpina Eye Clinic recommends, starting at the age of 50, to remove the natural lens and replace it with a multifocal intraocular lens, similar to cataract surgery. In this case, it is referred to as a "clear lens exchange" since no cataract is present yet.

As with all procedures, there is also a residual risk of complications with CLE - regardless of the quality of the surgery. For example, the risk of retinal detachment after cataract or CLE surgery is slightly higher than if no surgery is performed. Overview studies with tens of thousands of patients show that retinal detachment occurs in 0.26% of cases in the year following the surgical procedure, which is slightly higher than the risk of retinal detachment in patients who are not operated on (1).

Other studies have shown that the risk of retinal detachment in young patients (< 60 years) is greater (3.8 times more frequent) who undergo cataract or CLE surgery (2). Another risk factor that promotes retinal detachment after cataract or CLE surgery is high myopia. However, the largest risk factor for retinal detachment after cataract surgery is the occurrence of a rupture of the lens capsule ("capsule rupture") during the operation. The capsule rupture is the most feared intraoperative complication and occurs on average in 1.5 - 2% of all cataract surgeries today. After a cataract surgery with capsule rupture complication, the risk of retinal detachment is 20 times (!) higher than after a complication-free surgery (3). All studies also show that the complication rate in cataract surgery is highly dependent on the experience and annual surgical volume of the surgeon.

(1) Stein et al. Ophthalmology 2011; 118:1716-1723 / (2) Clark et al. Arch. Ophthalm. 2012;130:882-888 /(3) Tuft et al. Ophthalmology 2006; 113:650-656