Custom Lens Replacement (CLR)

Many people aren’t aware that nJoy Vision offers custom lens replacement (CLR) surgery in Oklahoma City. CLR is also known as refractive lens exchange (RLE) and can treat nearsightedness, farsightedness, or astigmatism by replacing the eye’s natural lens with a specialized intraocular lens (IOL). We call this laser vision procedure Custom Lens Replacement or CLR. It is virtually the same as the procedure we perform for laser cataract surgery but is designed for men and women who haven’t been diagnosed with cataracts.


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What Is Custom Lens Replacement?

Technological advances have made CLR, or refractive lens exchange (RLE), a desirable option for patients aged 45 or older who want to minimize their need for glasses and contacts. The intraocular lenses (IOLs) now available to replace the natural lens in our eye can reduce reliance on reading glasses or bifocals due to presbyopia. Presbyopia is the age-related worsening of vision that typically begins at about age 40. Our CLR procedure corrects for other refractive errors, such as nearsightedness, farsightedness, and astigmatism, and sharpens your vision’s focus.

The technology used in refractive lens exchange is the same as that used for laser cataract surgery. Using the high-precision image-guided femtosecond laser, our eye surgeons create a perfectly-sized opening to access the natural lens and replace it with a specialized lens. The results reduce or eliminate the need for glasses or contact lenses.

Can I Benefit from Custom Lens Replacement?

When we’re young, the lens of our eye is clear and elastic and can change its shape to seamlessly adjust its focus when we look at objects at various distances. As we age, however, the lens is less adjustable and ultimately most people need reading glasses to see objects up close. This is called presbyopia.

The aging of the eye’s lens gradually continues and eventually becomes cloudy and opaque, as cataracts develop. Men and women used to wait until this point to undergo eye surgery, replacing cataracts with IOLs. Advances in technology now offer people the chance to exchange the lens of their eyes with IOLs much earlier, greatly reducing the need for reading glasses or contact lenses.

This solution is designed for anyone aged 45 or older who hasn’t been diagnosed with cataracts and finds it frustrating to rely on glasses or contacts for vision correction. Determining if you’re a good candidate for this procedure begins with a pre-operative eye test. The results of that exam determine if CLR can correct your vision.

Customized IOLs

At nJoy Vision, we offer various basic and premium IOLs that can be customized to suit your specific condition and lifestyle. These options treat different types of vision problems and our board-certified eye surgeons can help determine the IOL that’s right for you.

Basic Monofocal IOL

Monofocal IOLs are basic artificial lenses that have one focusing distance. Your choice depends on what type of vision is most important to you—up close (reading), medium range (computer screen), or distance vision (driving). A monofocal IOL that results in clear distance vision can be supplemented by wearing glasses for reading and other close-range needs.

There are many available monofocal IOLs, including the new TECNIS Eyhance™ IOL that defies conventional thinking about monofocal IOLs by delivering not only high-quality distance vision, but also better low-light image contrast.

Toric IOL for astigmatism

Basic lens implants are not able to adjust for astigmatism (an imperfection in the curvature of your cornea) which may also be affecting your vision. Toric IOLs are able to correct for astigmatism and, therefore, give you a better chance of good distance vision without glasses or contacts after your surgery.

AcrySof ® Toric IQ (Alcon), TECNIS® Toric II (J&J) and STAAR Toric (STAAR) IOLs are three of several brands of toric IOLs available that treat astigmatism as part of an RLE.  Your surgeon will select the lens for your eyes based on the examination measurements.  Over 125 million AcrySof® Lenses have been implanted and counting.

Multifocal IOL

Multifocal IOLs provide both distance and near focus at the same time. The lens has different zones set at different powers and is designed so that your brain learns to select the right focus automatically. With multiple points of focus, one image is in focus at a time.

The AcrySof® IQ PanOptix® Trifocal IOL is the first in the United States that has the ability to provide enhanced vision for distance, intermediate and near.  It is a type of multifocal IOL used to focus images clearly onto the back of your eye (retina) to allow clear vision after the cataract removal. In addition, the center of the AcrySof® IQ PanOptix® Trifocal IOL allows for better near (reading) vision and intermediate (computer work) vision versus what a monofocal lens would provide.

The TECNIS® Multifocal IOL is optimized for those favoring intermediate and near vision activities like grocery shopping and reading or sewing.  It delivers tailored clarity at a theoretical reading distance of 50 cm.  The TECNIS® Multifocal Family of IOLs features multifocal lenses capable of providing a full range of high-quality vision tailored for each patient’s lifestyle with sharp vision across near, intermediate and distance vision.

Advanced Technology Extended Depth of Focus IOL

The TECNIS Symfony® Extended Depth of Focus IOL is a breakthrough for RLE procedures. The TECNIS Symfony® lens is the first IOL available to correct for presbyopia that provides a continuous full range of high-quality vision. These lenses allow you to see clearly at near, intermediate and far distances and also minimize side effects associated with multifocal IOLs like glares and halos around lights.

The AcrySof® IQ Vivity™ Extended Vision IOL is a type of IOL used to focus images clearly onto the back of your eye (retina) to allow clear vision after the cataract removal. The AcrySof® IQ Vivity™ Extended Vision IOL provides clear distance vision (e.g., for watching children playing in the backyard). In addition, the AcrySof® IQ Vivity™ Extended Vision IOL allows for better intermediate (working on a computer, applying makeup or shaving) and some near (reading, knitting) vision compared to what a monofocal IOL would provide. The AcrySof® IQ Vivity™ IOL is not a multifocal IOL, as it uses a new Wavefront-Shaping technology to provide the broader range of vision.

Accommodating IOL

Crystalens® AO Lens is an artificial lens implant that can treat both a person’s cataracts and presbyopia —the clouding or hardening of your lenses, and the loss of near and intermediate vision, respectively. Crystalens was modeled after the human eye. Like the natural lens, it is a lens implant that uses the eye muscle to flex and accommodate in order to focus on objects in the environment at all distances. Crystalens dynamically adjusts to your visual needs. Many patients will have greater freedom from glasses after surgery, but you may still need reading glasses for small print or other near vision tasks.  The Crystalens® AO Lens may have less halos and glare when compared to multifocal IOL options.



How is CLR/RLE different than LASIK?

LASIK reshapes the cornea using a laser. It corrects common refractive conditions, including nearsightedness, farsightedness, and astigmatism. Custom Lens Replacement is typically reserved for patients who experience changes to their vision due to the natural aging of the eye, which requires them to wear reading glasses.

What’s the difference between CLR/RLE and cataract surgery?

Cataract surgery is a medically necessary procedure performed when glasses or contacts can no longer adequately correct someone’s vision because of cataracts. Custom lens replacement (CLR), also known as refractive lens exchange (RLE) surgery is an elective procedure that patients choose to reduce their need for glasses or contacts. Both procedures use essentially the same technique.

Are both eyes corrected at the same time?

Typically, our surgeons treat the eyes separately about 1 or 2 weeks apart. This can be discussed during the consultation.

Is CLR/RLE safe?

Laser cataract surgery is the most common surgical procedure performed in the U.S., with more than 3 million such surgeries performed annually. CLR/RLE uses the same technique and its safety is one of the reasons it’s becoming increasingly popular. Your eye doctor will discuss the potential risks with you during your consultation.

Is CLR/RLE covered by insurance?

Vision insurance does not cover elective procedures such as CLR/RLE. We offer a number of payment options, including financing and other flexible payment plans. If you have a Flexible Spending Account (FSA), also known as a Flex Account, or Health Savings Account (HSA), you may be able to pay for your procedure with pre-tax dollars.

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