Refractive surgery is the term used to describe a variety of eye surgeries to correct refractive errors such as myopia, hyperopia, astigmatism and presbyopia to reduce dependency on eyeglasses or contact lenses. Fortunately, today’s technology has allowed for a large increase number of choices available.
The most popular refractive surgery today is LASIK, a laser vision correction procedure that improves eyesight by reshaping the front surface of the eye with an excimer laser. ("LASIK" is an acronym for "laser in situ keratomileusis," which means, "to reshape the living cornea.") LASIK combines the sophisticated precision of the excimer laser to reshape the cornea with a protective flap, the latter of which is created by either a mechanical microkeratome or a second type of laser known as the femtosecond laser, this procedure is known as "Intralase".
Photorefractive keratectomy (PRK) is a procedure in which the surface of the cornea is reshaped using the same excimer laser as in LASIK but PRK does not involve creation of a corneal flap and therefore, the protective superficial layers (epithelium) of the cornea must heal post-operatively. This generally means that patients who undergo PRK will require significantly more time than LASIK patients to achieve their best vision but can be a very viable alternative to LASIK especially if you are not a candidate for LASIK because the cornea is too thin or there is another eye health concern.
Phakic Intraocular Lenses (IOL) or “Implantable contact lenses" are lens implants that are placed inside the eye without removing the eye's natural lens - hence the term phakic, which refers to the presence of the natural lens. There are presently two phakic IOLs that have been FDA approved: the Verisyse phakic IOL and the Visian ICL™. This procedure is generally recommended in high refractive errors when the patient is not a good candidate for a corneal refractive surgery procedure.
Refractive Lens Exchange (RLE) or Natural Lens Replacement is a procedure that should be reserved specifically for individuals that are significantly presbyopic (reading glasses dependent), who are at least 40 to 50 years of age, and in whom other less invasive procedures (such as LASIK, PRK and phakic IOLs) do not fully meet the individual's needs. If you are above the age of 55 or 60, you should strongly consider RLE due to increasing presbyopia. A simple way to describe RLE is doing cataract surgery before there is a cataract present by removing the natural lens and then replacing it with the proper intraocular lens to give desired visual outcome.
The best way to determine if you are a candidate for refractive surgery is to see one of our doctors for a refractive surgery evaluation. (Note: Contact lenses should be removed for 2-3 weeks preceding the appointment for accurate measurements.) At this visit your doctor can determine if you are a candidate for refractive surgery and if so what options you may have. After discussing the risks, benefits and alternatives our doctors can provide the appropriate surgery referral and help you through the process.