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The CLEAR Procedure FAQ

What is the CLEAR Procedure?

CLEAR is a LASIK like procedure for patients over age 45. For a long time, LASIK was only available for patients in their 20’s and 30’s. But now for patients over age 45, we have an option that we call the CLEAR Procedure. The CLEAR Procedure is sometimes called Refractive lens exchange or Clear Lens replacement.

Why are patients over age 45 unique?

Patients over age 40 experience a deterioration of the natural lens of the eye that affects near vision. It gets progressively worse from the 40’s onwards. These changes start as presbyopia at age 40 and culminate in cataracts after the age of 60.

The transition from presbyopia to cataract is sometimes called Dysfunctional Lens syndrome (DLS). DLS will typically manifest as worsening near vision, night vision and distance vision (usually in this order). If you are tired of needing reading glasses, the CHOICE is CLEAR.

What does CLEAR standard for?

The CLEAR Procedure is a LASIK like procedure for patients over age 45. In our office, it is an acronym that stands for Custom Laser Lens Extraction and Replacement. At other practices, it is sometimes called Refractive Lens Exchange or Clear Lens Replacement.

The CLEAR procedure entails exchanging your deteriorating natural lens with a new, artificial Presbyopia Correcting lens. Typically, this lens called a the Panoptix lens that is designed to correct vision for far, near and intermediate vision. The procedure is laser assisted.

The easiest way to think of CLEAR is as an elective form of Cataract surgery that is performed early (before the lens has a visually significant cataract) and electively to allow the use of a Presbyopia Correcting lens.

How does CLEAR “Extend Your RUNWAY”?

Being located near DFW Airport, we see a lot of pilots as patients. Some of our patients describe the CLEAR Procedure as a way of “extending your runway”.

  • The life expectancy of Americans is currently around 76 years.
  • If a person waits till 70 to have cataract surgery, they would theoretically only get 6 years to benefit vision with a Panoptix lens.
  • On the other hand, if you have the CLEAR Procedure at age 46, you could potentially enjoy your Panoptix lenses for 30+ years.

Is the CLEAR Procedure FDA Approved?

CLEAR is a LASIK like procedure for patients over age 45. If you look up CLEAR on the FDA database, you will not find it listed. This is because CLEAR entails the off-label use of some FDA approved devices to provide you with Visual Freedom from glasses. A partial list of these FDA approved devices include a Femtosecond Laser and the Panoptix Presbyopia correcting lens. Once the FDA approves a device, the approval is for specific uses (in this case cataract), but the FDA allows Doctors to use the devices “off label” for other uses.

Is the CLEAR Procedure safe?

The CLEAR procedure is a safe procedure. It is very similar to Cataract surgery with the main difference being that it is performed early and electively. Cataract surgery is one of the most frequently performed surgeries in the US. It is also one of the surgeries with the highest success rates (as high as 98%).

Who is a candidate for CLEAR?

A limited list of the types of patients who qualify for CLEAR:

  • Age 45 to 60. (For Farsighted patients, this age limit can be as low as 43).
  • Normal shaped corneas.
  • Healthy eyes without eye diseases.
  • No evidence of a visually significant cataract.
  • Realistic visual expectations.
  • Have a prescription within the range that can be corrected with a Panoptix or Panoptix TORIC Presbyopia correcting lens.
  • Have taken the time to research the CLEAR procedure.

There are other factors that may limit your candidacy for CLEAR. The best way to be sure is a paid Medical Evaluation exam in our office. We also offer Free Consults.

Please call 214-328-0444 to schedule.

Over age 45, what are the vision correction options?

Patients over the age of 45 are unique in that the natural lens of the eye deteriorates. This deterioration that starts in the early 40’s as Presbyopia culminates in a visually significant cataract in the 60’s to 70’s. This progressive deterioration of the lens means there are 2 temporary fixes and only 2 permanent fixes for vision correction for patients over 45.

The permanent fixes:

  1. The CLEAR Procedure: This is a LASIK like procedure for patients over the age of 45. It involves using a laser to assist with the extraction and replacement of the natural lens of the eye with a Presbyopia correcting lens. The goal is to correct vision for far, near and intermediate distance. Once performed, cataract surgery is not required in the future. This procedure is elective and is paid fully by the patient.
  2. Cataract surgery: The 45 year old has the option to wait until they need cataract surgery to undergo laser assisted vision correction with a Presbyopia correcting lens. Unfortunately, Medicare and commercial insurance do not cover the use of a laser or presbyopia correcting lens. Thus, most of this cost is still borne by the patient.

The temporary fixes:

  1. Full correction LASIK/PRK/SMILE: This would improve distance vision. For patients over age 45, it means reading glasses almost immediately after surgery. This is because LASIK is not a permanent fix for Presbyopia. This procedure is elective and is paid fully by the patient.
  2. Monovision correction LASIK/PRK/SMILE: This means correcting one eye for distance and the other eye for near. There is a period of time where your brain has to adapt to the difference between the two eyes. If successful, the procedure would delay the need for reading glasses until the late 40’s or early/mid 50’s. Thereafter reading glasses are required. This procedure is elective and is paid fully by the patient.
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