CLEAR
Refractive surgery redefined
CLEAR (Corneal Lenticule Extraction for Advanced Refractive correction) refractive surgery for patients:
What is CLEAR refractive surgery?
CLEAR (Corneal Lenticule Extraction for Advanced Refractive correction) is a type of refractive surgery used to correct vision problems like myopia (nearsightedness) and astigmatism. It's a minimally invasive procedure that aims to reduce or eliminate the need for glasses or contact lenses. Other names for this procedure SMILE (Small Incision Lenticule Extraction) / SILK / KLEX etc.
How does CLEAR surgery work?
During CLEAR surgery, your eye surgeon uses a femtosecond laser to create a thin, disc-shaped lenticule within the cornea. This lenticule contains the tissue that needs to be removed to correct your vision. Then, a small incision is made on the surface of the cornea, and the surgeon removes the lenticule through this incision. By removing the lenticule, the shape of the cornea is altered, correcting the refractive error.
Advantages of CLEAR surgery:
1. Minimally invasive: CLEAR surgery requires only a small incision (less than 3mm), which reduces the risk of complications and promotes faster healing compared to other types of refractive surgeries like LASIK.
2. Preserves corneal stability: CLEAR surgery preserves more of the corneal tissue structure compared to LASIK, making it potentially beneficial for individuals with thin corneas or those at risk of corneal instability.
3. Reduced risk of dry eye: Because CLEAR surgery involves a smaller incision and less disruption to corneal nerves compared to LASIK, there may be a lower risk of developing dry eye symptoms after the procedure.
Recovery after CLEAR surgery:
After CLEAR surgery, you may experience some discomfort, blurry vision, and light sensitivity for the first few days. Your eye surgeon will provide you with detailed instructions on how to care for your eyes during the recovery period, which typically lasts a few weeks. It's important to attend all follow-up appointments to ensure proper healing and monitor your vision correction progress.
Candidates for CLEAR surgery:
Ideal candidates for CLEAR surgery are individuals who:
- Have stable vision prescription for at least a year.
- Are over 18 years old.
- Have healthy corneas and adequate corneal thickness.
- Have realistic expectations about the outcomes of the surgery.
Potential risks and complications:
While CLEAR surgery is generally considered safe and effective, like any surgical procedure, it carries some risks, including:
- Undercorrection or overcorrection of vision.
- Dry eye symptoms.
- Glare or halos around lights, especially at night.
- Infection or inflammation.
- Flap complications (although less common compared to LASIK).
It's important to discuss these risks with your eye surgeon before undergoing CLEAR surgery and to follow their recommendations for pre-operative evaluation and post-operative care.
Remember, this information serves as a general guide, and individual experiences may vary. Always consult with a qualified eye care professional to determine if CLEAR surgery is right for you and to address any specific concerns or questions you may have.
Let's delve deeper into the process and considerations involved in CLEAR refractive surgery:
1. Pre-operative evaluation:
Before undergoing CLEAR surgery, you'll have a comprehensive eye examination to determine your candidacy. This evaluation includes assessing your refractive error, corneal thickness, corneal curvature, tear film stability, and overall eye health. Your eye surgeon will also discuss your medical history, current medications, and lifestyle factors that may impact the surgery and your post-operative recovery.
2. Surgical procedure:
On the day of the surgery, you'll be positioned comfortably on a reclining chair. Your eye will be numbed using local anesthesia eye drops to ensure you don't feel any discomfort during the procedure. Here's a step-by-step breakdown of the CLEAR surgery process:
- Creation of lenticule: Your surgeon uses a femtosecond laser (Ziemer Z8) to create a precise, thin lenticule within the layers of your cornea. This lenticule contains the tissue that needs to be removed to correct your vision. The laser energy is applied in a highly controlled manner, allowing for customized correction based on your unique refractive error.
- Small incision: After the lenticule is created, your surgeon makes a small incision on the surface of the cornea, typically around 2 to 3 millimeters in size. This incision is smaller than those used in traditional LASIK surgery.
- Lenticule removal: Using specialized instruments, your surgeon removes the lenticule through the small incision. This alters the shape of the cornea, correcting the refractive error and improving your vision.
- Incision closure: Once the lenticule is removed, the corneal incision usually heals naturally without the need for stitches.
The entire surgical process typically takes around 5 to 10 minutes per eye.
3. Post-operative care:
After the surgery, you'll rest for a short period in the recovery area. Your surgeon will provide you with detailed instructions on how to care for your eyes during the healing process. This may include using prescribed eye drops to prevent infection and inflammation, avoiding rubbing or touching your eyes, and wearing protective eyewear as needed.
You may experience some temporary side effects during the initial recovery period, such as mild discomfort, blurry vision, light sensitivity, and tearing. These symptoms usually improve within the first few days to weeks after the surgery.
4. Follow-up appointments:
It's essential to attend all scheduled follow-up appointments with your eye surgeon to monitor your healing progress and assess the effectiveness of the vision correction. Your surgeon will evaluate your visual acuity, corneal stability, and any potential complications. They may also make adjustments to your post-operative care regimen based on your individual needs.
5. Long-term outcomes:
For many patients, CLEAR / KLEX/ SMILE surgery provides significant and long-lasting improvements in vision quality, reducing or eliminating the need for glasses or contact lenses. However, it's essential to understand that individual results may vary, and some patients may require additional enhancements or may experience gradual changes in their vision over time.
6. Risks and complications:
While CLEAR surgery is considered safe and effective for the majority of patients, it's essential to be aware of potential risks and complications, including:
- Undercorrection or overcorrection of vision
- Dry eye symptoms
- Glare, halos, or other visual disturbances
- Infection or inflammation
- Corneal flap complications (although less common compared to LASIK)
Your surgeon will discuss these risks with you during the pre-operative consultation and provide guidance on how to minimize the likelihood of complications.
In summary, CLEAR refractive surgery offers a minimally invasive and precise method for correcting myopia and astigmatism, with the potential for rapid recovery and long-term vision improvement. However, it's essential to undergo a thorough evaluation and discuss the procedure's benefits, risks, and alternatives with your eye care provider to make an informed decision about whether CLEAR surgery is right for you.
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