If you want to achieve better vision with surgery but have been told that you are not a candidate for LASIK or PRK, clear lens extraction (CLE) may be an option for you. This procedure, also called refractive lens exchange, is similar to cataract surgery. It can correct nearsightedness (myopia), farsightedness (hyperopia), and age-related farsightedness (presbyopia). It is typically recommended for people with good eye health in their mid- or late-50s or slightly younger people who need reading glasses. Because your eye’s natural lens is removed during surgery, you will not need cataract surgery in the future.
Replacement Lens Options
Recent advances in lens technology and design allow us to offer many choices to improve your vision with CLE. Your surgeon will discuss your individual situation and what you can expect from surgery. This will help determine which replacement lens is right for you. Depending on the lenses you and your doctor select, CLE can correct nearsightedness, farsightedness, astigmatism, and presbyopia.
These lenses correct distance vision, but you will need glasses for near-work activities like reading.
Toric lenses correct astigmatism and distance vision. Glasses will still be required for near work.
Lenses that correct presbyopia -- the loss of near vision due to aging -- can give you freedom from glasses or contacts for most activities. It may still be necessary to wear reading glasses for very small print or in low-light situations.
Duke Health offers locations throughout the Triangle. Find one near you.
A Complete, Free Eye Evaluation
You will undergo a complete evaluation of your eyes. You should not wear contact lenses the week before your evaluation. A technician will perform a basic eye exam, imaging, and diagnostic testing and will take measurements of your eyes. Then your eyes will be dilated, and an ophthalmologist will examine them to determine whether CLE surgery is an option for you.
CLE and Insurance
Because CLE surgery is an elective procedure, it is not covered by most insurance plans. Our evaluation exams are free, and the cost includes the surgery and office visits afterward. We follow you closely, especially the year after surgery, to ensure the results meet your expectations.
Request a consultation appointment for LASIK, PRK, clear lens exchange, intraocular lens exchange, or refractive lens exchange.
What to Expect for CLE
We will answer your questions and explain how to prepare, what surgery entails, and the recovery process. If you wear contact lenses, you will be asked to wear glasses instead for several weeks before surgery. You will need to identify an adult to drive you home from your outpatient procedure.
The Day of Surgery
Your eyes will be examined before surgery to confirm your eye health and your exact vision-correction requirements. You will be given drops to numb your eyes, and you will be given medication through a vein to help you relax. During the procedure, which is performed in a sterile operating room, your surgeon makes a small incision in your eye, removes your natural lens, and inserts an artificial one in its place. Surgery is performed one eye at a time, with at least one to two weeks between procedures. Although you can expect to spend two to three hours at the Eye Center, the surgery itself takes about 15 minutes.
After surgery, you will remain in a recovery room so we can check your eyes. You will go home wearing sunglasses or a protective eye shield but will need someone to drive you. You may have some mild eye pain or discomfort in the day following surgery, but you can take an over-the-counter pain reliever. You will have an office visit the next day. You will return one to two weeks later to have surgery on your other eye.
Recovery is generally quick, with better vision the same day and marked improvement within a week. You can return to your normal activities almost immediately but will need to use special eye drops for the month following your procedure. Follow-up appointments will be scheduled for the next day and again one week later. To ensure that you achieve the best results possible, your eye doctor may recommend an additional procedure to fine-tune your vision.
You can expect the results of CLE to last a lifetime unless there is a medical change in your eyes, and replacement lenses are intended to remain in place permanently. Because your natural lenses are removed during the procedure, you will not need cataract surgery.
Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.
Why Choose Duke
Our vast experience and regular use of the most advanced technology ensure you achieve better vision. Our eye surgeons are board-certified ophthalmologists and fellowship-trained. This means that they have completed several years of advanced training in cornea and refractive surgery. Collectively, our surgeons have performed more than 28,000 refractive procedures since Duke began offering them nearly 30 years ago.
Continuity of Care
Our doctors work with you from your first evaluation through all your follow-up visits. Or if you prefer, we can coordinate follow-up care with your local eye doctor.