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

Monovision

• Many patients choose monovision for both near and far vision
• 47% of eyes in study done for near
• We aim for between -1.5 to -2 depending on patient age and desires
• 100% + 1D from 1.5D

Postop Near Spherical Equivalent

Hyperopic pt's #30

Complications

• No significant complications
• No retina detachments over entire series (up to 4 years)
• No infections
• No wound leaks
• No broken capsules

Larger Study

• 633 eyes
• 225 myopic for distance
• 175 hyperopic for distance
• 162 myopic for near
• 71 hyperopic for near
• Average Age 56 + 8 years
• Average IOL power:
• Hyperopia 25.8 + 3.6 D
• Myopia 17.2 + 16.1 D
• Average follow-up 2.1 years
• No operative complications
• 1 retinal detachment 2 years after surgery

Preop Spherical Equivalent Hyperopia

Preop Spherical Equivalent Myopia

Distance Uncorrected Vision

Results

• 5.6% lens exchange
• 40% slit lamp astigmatic corrections
• Patients with poorer vision either converted to monovision or were
• amblyopic preop

Summary

• Lens exchange is a safe and effective treatment for refractive disorders
• Particularly effective for hyperopia with none of the glare, drift or inaccuracy encountered in corneal hyperopic operations

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