Laser Eye Surgery vs Clear Lens Exchange (IOLs)

Considering ocular surgery can be a daunting prospect, no matter what your circumstances. Knowing which procedures are right for you can be even more difficult. For many, the choice often comes down to two treatments: Laser Eye Surgery and Clear Lens Exchange – intra-ocular lens (IOL).

Both of these procedures work in different ways and offer their own distinct advantages. But first, let’s briefly summarise the nature of each treatment.

Laser Eye Surgery refers to a number of laser procedures that are carried out to adjust the shape of the corneal bed in order to improve vision. It has been used for 40 years to treat refractory errors such as long-sightedness (hyperopia), short-sightedness (myopia), and astigmatism.

Clear Lens Exchange (IOLs) works by replacing the eye’s natural lens with a synthetic lens, designed to correct refractory errors. This procedure has been used in Europe for around 20 years. It is often used as a treatment for cataracts but can also treat short- and long-sightedness.

So, back to the decision! To help you understand your options more clearly, we’ve put together a few of the most commonly asked questions about Clear Lens Exchange and Laser Eye Surgery…

Will either of these treatments allow me to get rid of my glasses completely?

The changes applied to the eye in Laser Eye Surgery are permanent. This means that, following treatment, you will most likely be able to get rid of your glasses for many years – if not forever. You will learn more about the exact likelihood of this during the screening process.

If surgery is carried out when you are under the age of 40, it is likely that you will still develop presbyopia (natural ageing of the eyes) as you get older; however, it is likely that this will develop slowly and gradually. This may mean that you will have to go back to wearing glasses – though there is another laser solution to presbyopia.

PRESBYOND® Laser Blended Vision is a procedure that corrects both reading and distance vision. It is suitable for around 97 per cent of patients, including the majority of patients who have previously undergone Laser Eye Surgery. The effects of this Enhancement procedure tend to last for many years – and often til the end of the patient’s life.

By contrast, as Clear Lens Exchange (CLE) involves the complete replacement of the natural lens, the focusing ability of the eye is eliminated. This means that patients will most likely have to wear reading glasses as they get older.

In recent years, a number of IOL implants have been developed with points of focus at near, far, and intermediate distances, with the aim of treating presbyopia. However, multifocal IOLs split the light that enters the eye which may reduce image quality and lead to symptoms such as glare and haloes, especially in low light. In some instances, they are not tolerated by patients and may have to be removed.

How do the risks compare between IOLs and Laser Eye Surgery?

As one of the safest elective procedures in the world, Laser Eye Surgery is generally considered to be much lower risk than Clear Lens Exchange.

Laser Eye Surgery is often a minimally-invasive procedure – particularly with the growing popularity of ReLEx SMILE. As this treatment does not require surgeons to ‘go inside’ the eye, it carries a much lower risk of infection.

The implantation of IOLs can also carry a heightened risk of other complications (such as retinal detachment). Overall, the risk of significant and even permanent loss of vision in an eye undergoing CLE is approximately 1 in 1,000.

The chance of complications in Laser Eye Surgery is extremely small. In fact, the chance of permanently losing vision in an eye that has been treated with Laser Eye Surgery is believed to be as little as 1 in 5 million. This is significantly lower than the risk of blindness from contact lens infections.

What if I choose Laser Eye Surgery, and later develop cataracts?

Sometimes patients choose IOLs over Laser Eye Surgery on the basis that it will also prevent them from developing cataracts in later life. However, as mentioned above, Clear Lens Exchange is a more invasive and higher risk procedure than Laser Eye Surgery.

It is, therefore, not recommended that IOLs be used for correcting refractory errors – except in the unlikely event that the patient is unsuitable for Laser Eye Surgery.

If you develop cataracts later in life after undergoing Laser Eye Surgery, you will still be able to undergo cataract surgery (phaco-emulsification). In addition, you will still have the advantage of having had an increased depth of field placed in the cornea. You will, therefore, be able to benefit from a high-quality optics intra-ocular lens, as opposed to the more commonly used multi-focal lenses.

If you have any questions about Laser Eye Surgery or CLE intra-ocular procedures, one of our friendly and expert team would be more than happy to hear from you.