Dr.

Sami Ata Dassan

Medics Index Member
 CLEAR LENS EXTRACTION
CLE
DEFINITION
Clear lens extraction ( CLE ) or Refractive lens
exchange (RLE ) is a surgical procedure in which the
non cataractous crystalline lens is removed with or
.without an intraocular lens for refractive purposes

INCLUSION CRITIRIA
6Ds. < -Myopia
.Hyperopia > 4Ds-
Myopia and hyperopia of any degree in too thin-
.corneas
.Children :anisometropia , Neurobehavioral disorders-
.Keratoconous-

EXCLUSION CRITIRIA
Previous intraocular inflammation ( irises-
.(,uveitis,choroiditis,retinitis
.(Previous intraocular surgery (RD,glaucoma-
.Previous penetrating ocular injury-
.Severe ocular media opacity-
.Heterochromia-
.Glaucoma
Congenital diseases associated with unstable lens,-
.capsule or zonules
.Diabetic patients or other chronic systemic diseases-
.Autoimmune diseases-
.Immune deficiency patients-

AGE
.years old, as there is no accommodation 40<-

Any age: anisometropia,kertoconous,OR without-

.any cause

CORRECTION OF NEAR VISION IN >40

.Bilateral under correction-
.Monovision-
.Glasses for near-
.Multifocal or accommodating intraocular lenses-

Preoperative preparation
.Full ophthalmic history-
Corneal topography, pachymetry, subjective and-
objective refraction, cycloplegic refraction, steep and
flat K-readings, axial length, biometry ( SRK-T ),
.detailed retinal examination
Argon laser prophylactic retinal treatment: Do-
.surgery after one month
.Full medical history-
COMPLICATIONS
Retinal detachment, 0-8% (2%), and is related to the-
.myopia itself rather than surgery
If prophylactic argon laser done, do the surgery after
.one month at least
.Posterior capsule opacification, 6-60%-
.Do YAG laser after three months at least
.Square shaped edge IOLs are better than round
.Acrylic IOLs are better than silicon
.Endophthalmitis , 0.01%, early diagnosis, close f.up-
.Cystoid macular edema, especially after pc rupture-
.Uveitis, 1%-
.Flare-
.Persistent corneal edema-
.Wound leakage-

HINTS
Peripheral and central retinal myopic changes might-
increase after surgery or this might be due to normal
.myopic progression
Use the regression formulas biometry like SRK-T or-
.HolladayII
Very long axial lengths may not be a candidate for-
.surgery
Refraction surprise, post op refracation might be-
.unpredictable
Residual refraction might be corrected by other-
.(…refractive surgery ( Lasik, PRK, INTACS
Full counseling of the patient to allow informed-
.consent to made; outcomes and complications
.Long follow up period-

Dr. Sami Ata Dassan

Medics Index Member

http://medicsorg.tripod.com/drsamiadassan/index.htm

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samidassan@yahoo.com