Custom Lens Replacement (CLR) DC


An Alternative to Readers, Bifocals, and Cataract Surgery in Washington DC and the DMV

Brusco Vision offers Custom Lens Replacement (CLR) – also known as refractive lens exchange (RLE) – as an alternative to readers, bifocals, and cataract surgery in Washington, D.C. and the DMV. As the premier refractive surgery center in the area, we can help you say goodbye to corrective eyewear and hello to the clearer vision you’ve been longing for. Call our office to learn more or schedule your comprehensive eye examination with our surgeon, Dr. Brusco.

What is Presbyopia?

The human lens is a true evolutionary marvel. When you are young, the natural lens is very flexible and allows us to autofocus on near and far objects and everything in between – much like the zoom function in a camera. Because of this, we don’t need reading glasses or bifocals. At some point in our 40s, however, the lens starts to become rigid and lose its flexibility – it degrades, like many other body parts do as a part of the natural aging process. This stiffening causes the lens to lose the ability to zoom in and results in difficulty seeing up close. Over time, the lens becomes even more dysfunctional, resulting in loss of near vision – presbyopia – that requires the use of reading glasses or bifocals. This is the first stage of a condition called Dysfunctional Lens Syndrome (DLS), which is a natural part of the aging process that affects your eye.

Does Everyone Get Presbyopia?

As you enter your 40s, you’ll start to notice your near vision becoming blurry – even if you had LASIK in the past. No matter how much we focus in the United States on living healthy lifestyles, the inner lenses in our eyes get older, eventually causing every one of us to lose at least some visual acuity. You will have trouble reading text on your phone or computer screen and will have to hold items like books, menus, and newspapers farther away in order to see them.

In addition, as we age, the lens also progressively becomes thick, hard, yellow, and cloudy – this is called a cataract. Cataracts block and scatter light. Light scattering results in glare and halos (especially at night), as well as overall reduced visual quality, quantity, and color perception. This progressive loss of clarity of the natural lens inside the eye is the second stage of Dysfunctional Lens Syndrome. This process typically begins in our 50’s and, if left untreated, eventually results in an even denser cataract – this is the third stage of Dysfunctional Lens Syndrome.

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Frustrated by Reading Glasses or Bifocals?

Presbyopia is a Natural Part of Aging—But You Don’t Have to Live With It

The good news is that you don’t need to be inconvenienced by the burdens of readers, bifocals, or progressives. A lot of people hate wearing any type of corrective lens, sometimes because they don’t like the way they look or the difficulty it adds to doing certain things with them on. Or simply because it’s annoying to find the “sweet” spot. Other times, from the frustration of the on-off-on-off struggle as you switch between near and far tasks. This can lead to the problem of constantly misplacing your readers.

Thanks to incredible advances in technology and science, a procedure called Custom Lens Replacement (CLR) can resolve age-related, “over 40” vision problems we develop with time. CLR has further advanced ophthalmology by adding to the list of life-changing vision correction procedures eye doctors have available to offer patients. More and more people are choosing CLR not only to correct and restore vision, but also to keep cataracts from developing or progressing, and to avoid future cataract surgery.

Through CLR, the eye’s natural lens is replaced with an artificial intraocular lens (IOL) to correct vision loss due to nearsightedness (myopia), far-sightedness (hyperopia), astigmatism, presbyopia, or cataracts. Not only is visual perception greatly improved, but the new lens will last forever, unlike an eyeglass prescription.

Lose Your Readers for the Last Time

Custom Lens Replacement with Brusco in Washington, D.C. and the DMV is an amazing treatment because it is able to fix so many vision issues with one simple procedure. It not only corrects your glasses prescription – in most cases correcting both your distance vision and near vision – it also allows us to fix the clouding of the lens and provide a better quality of vision at the same time. This treatment also prevents any future development of cataracts, so there will be no need for cataract surgery in your future.

A Full Range of Vision Correction Solutions

At Brusco Vision, we are dedicated to offering a full range of vision correction solutions. Your eyes are unique and we’ll work with you to create a customized treatment plan that restores your vision and improves your quality of life. Dr. Brusco can help determine if you are ready for this procedure after your eyes are fully evaluated.

[CLR] is becoming an increasingly popular treatment choice for patients as it eliminates the need for cataract surgery in later life and can also be combined with laser eye surgery in suitable patients to extend the range of astigmatism treatment or fine-tune the focus outcome.
- The Herald

How Does Custom Lens Replacement Work?

More and more people are choosing CLR not only to correct and restore vision, but also to keep cataracts from developing or progressing and to avoid future cataract surgery. Through CLR, the eye’s natural lens is replaced with an artificial intraocular lens (IOL) to correct nearsightedness, farsightedness, astigmatism, presbyopia, or cataracts. Not only is vision greatly improved, but the new lens will last forever. Patients with astigmatism frequently choose toric iols as a treatment since they can help them see better at a distance without the use of glasses or contacts.

During the Custom Lens Replacement (CLR) Procedure

During the procedure, your dysfunctional natural lens is replaced by a new artificial lens called an intraocular lens (IOL). The IOL is gently added to your eye in place of the natural lens, which is removed by an ultrasound device. The intraocular lens implant bends incoming light through your pupil to focus it perfectly onto the retina, similar to how a contact lens works on the surface of the eye.

Unlike traditional contact lenses, implantable contact lenses are maintenance-free. It never dries out or gets dirty. You don’t have to put it in every morning or worry about it getting lost. And you can’t develop an allergy to it over time. Patients tell us they do not feel the new lens implant or notice it’s there, and it’s not noticeable to others.

Unless you share it with others (and we hope you do), only Dr. Brusco will be aware that vision correction has taken place. The new lens will not alter the outward appearance of your eye, but it does drastically improve your vision. We offer different options for intraocular lenses. These lenses can be customized to meet your specific visual needs.

Benefits of CLR

Custom Lens Replacement (CLR) prevents any future development of cataracts, thereby helping to stabilize your vision. At Brusco Vision, we are dedicated to offering a full range of vision correction solutions. Your eyes are unique and we’ll work with you to create a customized treatment plan that restores your vision and improves your quality of life.

Corrects both near and far vision.

Reduces any astigmatism.

Reduces your dependency on reading glasses and bifocals.

Permanent solution that lasts a lifetime.

Should I Wait to Have Cataract Surgery?

This is an individual choice only you can make. The loss of near vision and age-related vision changes are due to Dysfunctional Lens Syndrome, which happens to everyone. These lens changes cause progressive deterioration in our vision, which is unpredictable and varies from person to person. This may lead to changing prescriptions and glasses over the years. With the advancement in technology and the safety of the procedure, many patients are having their lenses replaced at earlier stages to avoid any further decline in vision as cataracts form or progress.

CLR Corrects Vision and Prevents Cataracts

Compared to cataract surgery, CLR is a similar surgical process. But instead of suffering from declining vision and a frequently changing refraction while waiting years for cataract development, your natural lens is replaced with one that corrects vision and prevents cataracts. For many patients, that means no more glasses, no more cataracts, and no more missing out on life’s beautiful moments.

When age-related vision changes begin to affect your quality of life, we recommend that you schedule a comprehensive evaluation (ANOVA) to discuss your options.

Is Custom Lens Replacement (CLR) Safe?

Yes. Intraocular lens surgery, and the surgical techniques involved, was first performed in 1949 but has been popular since the 1980s. It is a proven vision correction procedure involving a foldable IOL. CLR is merely a modern-day variation of cataract surgery – over 3 million cataract procedures are performed in the US annually. In fact, the risks of custom lens replacement surgery are similar to refractive cataract surgery.

CLR Day of Your Surgery

On the day of the surgical procedure, patients can expect to be in our office for 2 hours. The procedure is quick and painless, typically taking 10 to 20 minutes per eye. Come with a friend or family member who can drive you home, since your vision may be blurry in recovery.


Step One

A mild sedative is offered to patients and anesthetic eye drops are applied to numb the eye. A small, gentle eyelid holder is placed between your eyelids so you don’t have to worry about blinking during the procedure.


Step Two

A small, self-sealing incision is made in the far edge of the cornea.


Step Three

The natural lens of the eye is gently removed with a sophisticated ultrasound device.

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Step Four

The custom lens designed for you is then inserted through this small incision and securely positioned in place.

Recovery Time

CLR patients typically experience little if any discomfort during or after the procedure. One day after the procedure, most patients can resume normal daily tasks along with a few restrictions to protect the eye. As with any eye surgery, there is a healing period that must be completed for visual stabilization. You will be using antibiotic and anti-inflammatory eye drops for a week following surgery.

Reasons to Have Custom Lens Replacement at Brusco Vision

Frequently Asked Questions

Yes, it is a modern-day version of cataract surgery, but performed earlier in your life. The concept of a lens being well-tolerated inside the eye has been demonstrated since the 1970s.

Intraocular lenses are made of a specialized acrylic or silicone material, which is inert inside the eye – the eye will not react against the lens. This allows the lens to remain crystal clear, avoiding the degradation and color change occurring in the natural lens with time.

No. Macular degeneration affects the retina in the back of the eye, whereas Custom Lens Replacement addresses the lens in the front of the eye. Patients should continue to schedule annual eye exams to check for naturally occurring eye problems such as macular degeneration, glaucoma, retinal degeneration, or detachment.

The procedure takes about 10 minutes per eye to complete, but you can expect to be at the office for up to 2 hours on the day of your surgery.

Patients are encouraged to relax immediately following surgery but are free to resume normal activities as comfort allows. For the first week, you should avoid rubbing or bumping the eye as well as avoid getting soap or water in your eyes while bathing or showering. Use caution with heavy lifting (greater than 25 lbs) and physical exertion for at least 2 weeks. Patients should also avoid hot tubs or swimming in a pool, lake, or ocean for 1 month.

The Brusco Vision Difference

Brusco Vision is dedicated to helping every person have clearer vision without contacts or glasses and experience the visual freedom they have dreamed of. Call our office for more information about our vision correction procedures or to schedule an appointment for your comprehensive eye exam. Dr. Brusco looks forward to meeting you and determining if you are a good candidate for Custom Lens Replacement or one of our other refractive surgeries.

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