LASIK eye surgery is a well-known and popular form of surgical vision correction. However, not everyone is a good candidate for LASIK. People who have chronic dry eyes, severe farsightedness or other factors affecting their eyes or vision should consider alternatives to LASIK to provide them with options outside of prescription eyewear.
These 5 alternatives can surgically correct or improve patients’ vision, in many cases as effectively as with LASIK.
- conductive keratoplasty,
- phakic IOLs and
- refractive lens exchange
Photorefractive keratectomy (PRK) is a very common alternative to LASIK eye surgery. This procedure actually precedes LASIK, and it has some similar features.
Like LASIK, PRK involves the use of a laser to reshape the cornea, improving
- myopia (nearsightedness)
- hyperopia (farsightedness)
The difference is that where the LASIK procedure creates a flap in the cornea, PRK simply removes a very thin layer of epithelial cells of the cornea. PRK may be indicated over LASIK in patients who have a cornea that is too thin for LASIK, or who have already had the LASIK procedure previously. Some patients report slightly more pain, or a recovery period that lasts a few days longer than LASIK, due to the need to regenerate the epithelial cells.
LASIK vs LASEK
The removal of the epithelial cells in PRK often contributes to a slightly longer recovery time, which has prompted the development of a newer procedure that is somewhere between LASIK and PRK. LASEK, laser-assisted subepithelial keratomileusis, involves the temporary removal of the epithelial cells. The rest of the procedure is similar to PRK. At the conclusion of the surgery, the surgeon replaces the epithelial layer and places a contact lens over the cornea to encourage healing. The fundamental benefit to LASEK over PRK is that it usually means:
- quicker healing
- less pain
- no flap complications that are possible with LASIK
LASEK may be an ideal choice for patients who do not qualify for LASIK but would be good candidates for PRK.
There are many different methods that eye surgeons use to reshape the cornea. In conductive keratoplasty (CK), the surgeon inserts a tiny probe that heats the periphery of the cornea. As a result, the edges of the cornea tighten, an effective treatment for hyperopia. It is often used to create monovision, where one eye is adjusted for near vision and the other for distance vision. CK is ideal for people coping with presbyopia, which is a common form of farsightedness that begins in middle age. However, experts consider CK to be a temporary solution. Over time, the presbyopia may return.
Some people are not good candidates for refractive surgery procedures, or would like to have an option that is possible to repeat or change after a period of years. Contact lenses are useful, but they must be taken out frequently and replaced on a regular basis. Intraocular lenses (IOLs) are like contact lenses that are implanted either on top of the iris or behind it, to correct myopia. They are sometimes called implantable contact lenses (ICLs). The benefit to these lenses is that they can often be removed and replaced with a different lens at a higher prescription, as needed. Visian ICL and Verisyse are two brands of phakic IOLs that are designed to correct moderate to severe myopia. There are also clinical trials currently underway to study possible options for IOLs that would correct hyperopia or astigmatism.
Refractive Lens Exchange
The process for refractive lens exchange (RLE) is similar but not quite the same as a phakic IOL. It may also be called clear lens exchange (CLE) or refractive lensectomy. RLE involves the removal of the crystalline lens of the eye and replacement with an artificial lens. Many patients who have cataracts, a common condition that increases in incidence as people age, get RLE to replace their yellowing natural lenses. RLE offers a wide variety of lens replacement, including multifocal lenses. It is a good alternative for those who are not optimal candidates for LASIK or phakic IOLs because of severe hyperopia.
The beginning of the process for surgical vision correction starts with a comprehensive eye exam to determine a patient’s accurate prescription and look for other potential eye problems. People can choose LASIK or many alternatives like PRK, LASEK, CK, IOLs or RLE. Contact the Sealy Eye Center at (888) 701-0487 to schedule an appointment.