Laser Eye Surgery vs Clear Lens Exchange (IOLs)

Working out whether to have Laser Eye Surgery or Clear Lens Exchange intra-ocular lens (IOL) procedure can be a tricky process.

The two procedures both have their unique advantages, and they work in distinctly different ways.

Whereas Clear Lens Exchange works by replacing the eye’s natural lens and is a common solution to cataracts, Laser Eye Surgery adjusts the eye’s natural lens and is considered a safer and more effective way to treat refractive errors like shortsightedness and longsightedness. 

That being said, deciding which one is right for is not always so clear cut. So to help you in the process, we’ve put together a few answers to some of the most commonly asked questions about CLE and Laser Eye Surgery.

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

The changes to the eye by Laser Eye Surgery are permanent. That means after Laser Eye Surgery, you will most likely be able to get rid of your glasses for many years, if not forever (your exact likelihood will be determined during your screening process).

Although Laser Eye Surgery is permenant if you have the treatment prior to the age of 40, you will still develop presbyopia (natural ageing of the eyes. affecting the reading vision) in later life. However, this is likely to develop slowly and gradually.

Aside from having to go back to glasses, there’s also another laser solution to presbyopia: PRESBYOND® Laser Blended Vision. PRESBYOND® Laser Blended Vision is a procedure which corrects both reading and distance vision, and is suitable for around 97 percent of patients.

The effects of the revolutionary treatment tend to last for many years – and often for the rest of the patient’s life. Patients who have had previous laser eye surgery at London Vision Clinic and then gone on to develop presbyopia in middle age, are often eligible for a PRESBYOND® Laser Blended Vision Enhancement procedure.

By contrast, with Clear Lens Exchange (CLE), the focusing ability of the lens is eliminated (as the natural lens is removed), so patients of CLE will have to wear reading glasses once they reach middle age.

In recent years, a number of IOL implants have become available which claim to treat presbyopia, as they have points of focus at near, far, and intermediate distance. However, by splitting the light that enters the eye, multifocal IOLs can reduce image quality and cause symptoms of glare and haloes, especially in low light. In some instances, they’re not tolerated by patients and have to be removed.

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

Laser Eye Surgery is known for being one of the safest elective procedures in the world, and as such, it is much lower risk than Clear Lens Exchange (CLE).

CLE is an intra-ocular procedure, and therefore carries a higher risk of infection than Laser Eye Surgery, which is performed on the cornea and does not require the surgeon to ‘go inside’ the eye.

Implantation of IOLs also carries a heightened risk of other complications (such as retinal detachment) when compared to the chances of complications in Laser Eye Surgery. Overall, the risk of significant and permanent loss of vision in an eye undergoing CLE is approximately 1 in 1000. The risk of going blind from laser eye surgery with an expert surgeon using today’s technology is almost too small to measure –Technically there is an exceedingly small risk of blindness with laser eye surgery but it is lower than the risk of wearing monthly contact lenses for one year, so a risk that everyone seems to accept as perfectly reasonable.

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.

Therefore, we do not recommend this option for correcting refractive error, except in the unlikely event that a patient is found unsuitable for Laser Eye Surgery.

If you undergo Laser Eye Surgery and later develop a cataract, you will still be able to have cataract surgery (phaco-emulsification) to have it removed, but you will still have the advantage of having had an increased depth of field placed in the cornea so will be able to benefit from a high-quality optics intraocular 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.