Clear Lens Exchange as a Refractive Surgery

Kurt Buzard MD FACS

Clinical Assistant Professor

Tulane University Medical School
University of Nevada Medical School
Buzard Eye Institute
Las Vegas Nevada

Financial Disclosure

Data analysis performed with Visual Office, an Electronic Medical Records and Practice Management software system. Dr. Buzard is President and CEO of Visual Office.

Issues of Clear Lens Exchange

• Safety
• Infection
• Retina detachment
• IOL Accuracy
• Induced Astigmatism
• Stability

Why Now?....What has Changed?

• Improved Surgical Technique
  • Small Incision
  • More predictable "in the bag" placement
• Better IOL calculations and measurements
• Improved ability to exchange IOL through small incision

Indications

• Extreme myopia (>15 diopters)
• Moderate hyperopia (>2 diopters)
• Incipient cataract
• Age greater than 50

Clear Lens vs. LASIK

• Incipient cataracts present several difficulties to LASIK
• Laser may exacerbate lens changes
• Lens changes may create refractive changes in the future
• Cataract surgery negates LASIK

Clear Lens vs. Phakic IOL

• I believe phakic IOL is the future of refractive surgery...better lenses/less glare/reversibility fewer long term complications
• For the older patient or patient with incipient cataract, Clear Lens is the procedure of choice

Technique

• The way clear lens extraction is done is a major part of the success and prevention of complications
• We use Blue Line incision technique
• Calculate IOL with Hoffer program
• Star 3-piece IOL

Blue Line

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