Clear Lens Exchange

Clear lens exchange, also called refractive lens exchange, replaces the natural lens inside your eye with an advanced lens implant before a cataract forms. It can correct nearsightedness, farsightedness, astigmatism and the need for reading glasses in one procedure, and because your natural lens is replaced, you will never develop a cataract in that eye.

Dr. Philip Ngai perform clear lens exchange with the same small incision, sutureless technique used for modern cataract surgery. Your consultation in Redwood City includes detailed measurements of your eyes and an honest conversation about whether clear lens exchange, EVO ICL, laser vision correction or glasses and contacts are the best fit for you.

Who is a good candidate?

Clear lens exchange is usually best for adults in their mid 40s and older, when the natural lens starts to lose its ability to focus up close. You may be a good candidate if you:

• Need glasses or contacts for distance and also for reading
• Are farsighted, or very nearsighted, and want less dependence on glasses
• Are not a good candidate for LASIK because of thin corneas, dry eye or a high prescription
• Have early lens changes that are starting to affect your vision

It may not be right for you if you have certain retina, cornea or optic nerve conditions, or if your eyes are otherwise healthy and you are under about 40, when options such as EVO ICL often make more sense. Very nearsighted eyes have a higher risk of retinal detachment after lens surgery, and we review that risk carefully with you.

Lens implant choices

The lens implant you choose shapes how you see afterward. We help you match the lens to your work, hobbies and night driving.

• Multifocal and trifocal lenses give clear vision far, at arm’s length and up close, so most people read and drive without glasses.
• Extended depth of focus lenses provide a smooth range from distance to computer distance, with milder halos at night.
• Toric lenses correct astigmatism and can be combined with the options above.
• Monovision sets one eye for distance and the other for near, and can be tested with contact lenses first.

Learn more on our premium lens implants page.

What to expect

Before surgery

Your evaluation includes precise measurements of the length and curvature of your eye, a check of your retina and tear film, and a review of your daily visual needs. If dry eye is present, we treat it first so your measurements and results are as accurate as possible.

The day of surgery

The procedure is done at an outpatient surgery center with numbing drops and light sedation. It usually takes about 15 to 20 minutes per eye, and you go home the same day. We treat one eye at a time, and the second eye is usually done after the first has healed well.

Recovery

Most people notice clearer vision within a few days and return to light activities the next day. You will use eye drops for a few weeks and avoid rubbing your eye, swimming and heavy lifting for about one to two weeks. Your surgeon and our team of doctors see you after surgery to check your healing and guide your recovery.

Benefits and risks

Clear lens exchange offers stable, long lasting vision correction and removes the possibility of a future cataract. Like any eye surgery, it has risks, including inflammation, infection, swelling in the retina, retinal detachment, and halos or glare around lights at night, especially with multifocal lenses. Some patients later develop a haze behind the lens implant, which is treated with a quick, painless in office laser. We discuss every benefit and risk with you so you can make an informed decision.

Is clear lens exchange covered by insurance?

Clear lens exchange is an elective procedure to reduce dependence on glasses, so it is not covered by medical insurance and is paid out of pocket. If a cataract is already affecting your vision, cataract surgery may be covered instead, and premium lenses can still be chosen as an upgrade. We give you a written quote before you decide. See surgery costs and insurance and our cataract surgery page for more.

Common questions

What is the difference between clear lens exchange and cataract surgery?

The surgery is the same. In cataract surgery the lens being replaced is cloudy. In clear lens exchange the lens is still clear, and it is replaced to correct your vision and reduce your need for glasses.

Is clear lens exchange better than LASIK?

It depends on your age and your eyes. LASIK reshapes the cornea and does not prevent the need for reading glasses or a future cataract. Clear lens exchange is often a better choice after the mid 40s, for high prescriptions, or when the cornea is not suitable for LASIK.

Will I still need glasses?

Many patients with multifocal or extended depth of focus lenses rarely need glasses. Some still use readers for very small print or in dim light. Your surgeon will set realistic expectations based on your eyes and the lens you choose.

Can a cataract come back after clear lens exchange?

No. Your natural lens is replaced, so a cataract cannot form. Some people later develop a haze behind the lens implant, which is treated with a quick in office laser.

How long does the lens implant last?

Lens implants are designed to last for the rest of your life and do not wear out.