What is the difference between ICL surgery and Clear Lens Exchange?

At London Vision Clinic, we perform a wide range of refractive treatments, from Laser Eye Surgery to Cataract Surgery. But some treatments are more well-known than others. For example, what are ICL Surgery and Clear Lens Exchange? And what are the differences between these two treatments? Let’s find out.

ICL Surgery – What is an ICL?

An Implantable Collamer Lens (ICL) – also known as an implantable contact lens – is a type of synthetic lens made from a unique biocompatible material called collamer. The word collamer is taken from the words “collagen” (the most abundant protein in the body) and “polymer” (a large molecule made up of smaller units).

This small lens is implanted inside the eye, sitting behind the iris and in front of the eye’s natural lens. This is achieved through a surgical procedure called ICL Surgery, which can be used to correct various refractive errors. The procedure can achieve excellent quality of vision with predictable and stable results.

What ICL implant options are available?

ICLs effectively act as permanent contact lenses inside the eye. As such, they can be used to correct a wide range of prescriptions, including myopia (short-sightedness), hyperopia (long-sightedness), astigmatism, and even presbyopia (reading glasses).

The type of ICL used will be determined by the patient’s particular refractive error, the extent of their prescription, and their ocular anatomy. Your optometrist and surgeon will be able to advise you further on this during your pre-operative consultations.

In the video below, Professor Dan Reinstein discusses the types of prescriptions that can be treated with ICL Surgery…

What is Clear Lens Exchange (CLE)?

Clear Lens Exchange (CLE) involves the removal of the eye’s natural, crystalline lens. This is then replaced with a synthetic intraocular lens (IOL), which is placed inside the capsular bag that previously contained the natural lens.

The removal of the natural lens in CLE means that the eye is unable to switch focus between different distances. For this reason, CLE is typically considered a last resort in younger patients, who may be more suited to ICL surgery. Moreover, in some patients with severe long-sightedness, there may not be enough space inside the eye to place an ICL. In these cases, CLE may be the only surgical option.

The biggest difference between ICL Surgery and CLE is that CLE involves replacing the natural lens from the eye. In contrast, in ICL surgery, the synthetic lens is simply placed in front of the natural lens.

Important Information When Considering Lens Surgery

Several inaccurate claims are often made regarding lens surgery. It is important to be clear what you can and cannot expect from your refractive treatment to avoind disappointment.

CLE and Vision Changes Over Time

t is often reported that CLE provides permanent vision correction. While the change in refraction achieved by the lens replacement is permanent, CLE cannot prevent natural changes that affect the cornea as we get older.

These changes continue to affect the prescription in around a third of individuals. Therefore, it is possible for the refraction to shift slightly after CLE. As a result, these patients may still eventually require visual aids, such as reading glasses.

Clear Lens Exchange and Cataract Surgery

In addition to corrective refractive errors. CLE is the procedure used in cataract surgery. When performing the treatment, specialist IOLs can be selected to account for any refractive error, often removing the need for external visual aids post-surgery. However, these specialist IOLs are not routinely available for NHS cataract surgery.

It is sometimes said that CLE removes the need for cataract surgery later in life. While this is true, this shouldn’t be used as the sole reason to opt for CLE over alternative treatments such as Laser Eye Surgery.

It is estimated that around 30% of people in the UK will develop cataracts that require treatment. Therefore, the future possibility of needing cataract surgery should be weighed against the comparatively higher risks associated with intraocular surgery compared to Laser Eye Surgery, particularly for patients under the age of 60.

Other Limitations

Finally, it is important to consider the evolving nature of IOL technology. While current IOL technology is considered extremely effective, providing a wide range of vision, there remain some limitations to be aware of. For example, IOLs can be associated with glare, halos, and decreased contrast sensitivity. As IOL technology improves, it is expected that new designs will evolve over time that decrease the side effects and provide a more natural range of vision.

In conclusion, CLE is a vision correction option for patients but must be discussed thoroughly and weighed against all other options.

To find out more about our vision correction options, get in touch with one of our friendly clinic coordinators or Book a Consultation today!