Clear Lens Extraction (CLE)
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), also called refractive lens exchange, may be an option for you. 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 younger people who need reading glasses or have a variety of eye conditions that make them unable to undergo other surgical vision correction procedures. Because your eye’s natural lens is removed during surgery, you will never 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.
Monofocal Lenses
These lenses correct distance vision, but you will need glasses for near-work activities like reading. Alternately, monofocal lenses can provide near vision, or both near and distance vision by giving one eye the ability to see near, and the other the ability to see far.
Astigmatism-Correcting Lenses
Toric lenses correct astigmatism and distance vision. Glasses will still be required for near work.
Presbyopia-Correcting Lenses
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.
The Process
If you are interested in clear lens exchange, you will begin the process by having an eye exam with one of our board-certified ophthalmologists who will discuss all of your vision correction options and help you select the best one for you.
A Complete, Free Eye Evaluation
You will undergo a complete evaluation of your eyes. You should not wear contact lenses for two weeks 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 for one year. 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
Before Surgery
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 avoid contact lenses for at least two weeks prior to your evaluation. You may then wear contact lenses up to your surgery date. You will need to identify an adult to drive to and from your outpatient procedure.
The Day of Surgery
You will meet with the surgeon and anesthesiologist in the pre-operative area. You will be given drops to numb and dilate your eyes, and you will receive medications from the anesthesiologist 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 five minutes.
After Surgery
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
Recovery is generally quick, with better vision by next 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.
Long-Term Results
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.
Best Eye Hospital in North Carolina
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 2025–2026.
Why Choose Duke
Experience Matters
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.