Cataract Center

Refractive Lens Exchange


Since the 1970s, eye doctors have used LASIK, PRK and other refractive surgeries to correct myopia, hyperopia, and astigmatism. Although the procedures have been very effective on patients needing mild to moderate vision correction, they have been less effective on patients with more significant vision impairment.

New techniques, using lens implants can improve vision and reduce or eliminate the need for glasses in patients requiring moderate to severe correction for myopia or hyperopia. Unlike LASIK and PRK which are surgical procedures that alter the surface of the eye, Refractive Lens Exchange also known as Clear Lens Extraction surgery uses techniques and materials similar to those used for over 30 years for cataract surgery. With these procedures, either a lens implant is placed in front of the patient’s natural lens or the natural lens is replaced with a clear artificial lens.

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Are Refractive Lens Implants For Everyone?

Before surgery, the doctor will thoroughly examine your eyes to determine whether lens implant surgery is an option you should consider. Refractive lens implant surgery may be a better alternative in many cases, however, some patients with certain eye diseases, such as diabetes-related glaucoma may not be good candidates. This procedure is recommended for people over age 50 who wears bifocals since their natural lens has already lost its ability to change focus (accommodate) between distant and near objects. Three techniques are used to overcome this loss of accommodation: bifocal or multifocal lens implants, and monovision. A multifocal lens has several correction levels built into different sections of the lens. After surgery with a multifocal implant, the brain automatically selects the section of the lens that will give the clearest view of a particular object, whether near or far. The third option, monovision adjusts one eye for distance and the other for close up vision. Again, after surgery, the brain learns which eye to use to bring objects into clear focus. Both the multifocal lens and monovision techniques allow patients to read or drive a car without glasses.

During The Procedure

Clear Lens Extraction is performed on an outpatient basis. It involves removing the natural lens and replacing it with a new lens implant. While the patient lies on his or her back, the area around the eye is prepared. First, a local anesthetic is used to numb the eye. Then the surgeon makes a small incision and inserts the lens implant. The entire procedure takes less than 30 minutes to complete. The doctor will re-check your eyes following surgery to make sure there is no sign of inflammation or infection.

After Refractive Lens Implant

Shortly after surgery, you will be allowed to go home. Your vision may be blurry immediately following the procedure so someone else will need to drive you home. Any mild discomfort you may experience can be relieved with an over the counter pain medication. Most patients can return to their normal schedule which includes driving within a day or two. The doctor will probably recommend that you keep your hands away from your eyes to avid heavy activity for a few weeks while your eyes heal. Lens implants require no care and can be left in place, giving you good vision for the rest of your life. Everyone’s eyes are different but in many cases, lens implants can reduce or eliminate the need for glasses or contact lenses. An evaluation with Dr. Keith Liang prior to surgery is important to determine estimated benefits and possible complications.

Our Location

Center for Sight
3160 J Street
Sacramento, CA 95816-4403