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

Soft Nucleus Phaco

• Soft nuclei need different technique to remove safely
• No cracking.. too soft
• Our technique...groove with suction then tear out a quadrant…rotate out nucleus

Soft Nucleus Removal

3 mm sutureless IOL Exchange

• Sometimes IOL exchange can function in a refractive capacity
• The lens is rotated out of capsule
• Using the lens loop from Gueider, the IOL is transected
• Pieces are removed and IOL substituted

3 mm IOL Exchange

Staar Collamer IOL

• No need to bisect to remove
• Simply grasp the lens and remove “hand over hand” similar to the technique for removing the IOL
• The collamer lens will not cut

Incipient Cataract

Case Study

• 52 y/o male with:
  • -4.25 + 2.25 x 95 20/20
  • -4.50 + 2.75 x 85 20/20
• Incipient cataract OU
• LASIK performed
• one day 20/30 sc OU
• Patient unsatisfied with vision
• Clear lens exchange OU
• 20/15 oc OU

Clinical Study

• 68 patients
• 13 myopic patients
  • 8 for myopia>15D
  • 5 due to age >55
• 55 hyperopic patients
  • 6 for hyperopia >2D
  • 49 due to age>50
• All follow-up >1 year

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