Tired of wearing glasses or contact lenses? Today, several surgical methods can correct your eyesight and give you the freedom of seeing well without corrective lenses.
By far, LASIK is currently the most popular vision-correcting or “refractive” surgery available. But there are other options as well. Here’s a brief summary of several refractive surgery options and how they compare to LASIK:
PRK (photorefractive keratectomy) was the first laser vision correction procedure approved in the United States, receiving FDA approval in 1995. It soon became a popular alternative to radial keratotomy (RK), which was the only viable surgical treatment for nearsightedness available at the time. PRK promised to reduce or eliminate many of the complications of RK, including fluctuating vision, glare, halos around lights, infection, unpredictable outcomes, decreased visual acuity and regression (return of nearsightedness).
Like LASIK, PRK uses a laser to remove corneal tissue to reshape the eye and correct vision. But with PRK, the laser treatment is applied directly to the surface of cornea, rather than under a flap of corneal tissue as in LASIK. Visual outcomes after PRK are comparable to those after LASIK. But the eye is uncomfortable for a couple of weeks after PRK, until the thin outer protective layer of the cornea (the epithelium) grows back. Also, vision can be quite blurred for a week or two after PRK until the eye heals.
The number of PRK procedures declined sharply when LASIK was introduced, because there is usually little or no discomfort after LASIK and vision recovers faster. However, PRK has made a comeback in recent years due to more effective pain management techniques and because it poses less risk of certain complications.
LASIK (laser-assisted in situ keratomileusis) is like PRK, except that a thin, hinged flap is made on the cornea prior to the laser treatment. This flap is lifted and folded back, and laser energy is applied to the underlying corneal tissue to reshape the eye. Then the flap is replaced, acting like a natural bandage. LASIK’s main advantage over PRK is that there is little or no discomfort immediately after the procedure, and vision is usually clear within hours rather than days.
Wavefront LASIK or PRK
Wavefront (or “custom”) LASIK or PRK means the laser treatment is determined by a computerized mapping of the power of your eye called wavefront analysis. Wavefront-guided procedures are more precise than ablations determined by using only an eyeglasses prescription, and they can correct subtle optical imperfections called “higher-order aberrations” that regular ablations can’t treat. Several studies show wavefront-guided ablations provide sharper vision than conventional (non-wavefront) LASIK or PRK, and may reduce the risk of nighttime glare and halos.
Phakic IOLs (intraocular lenses) are small lenses inserted inside the eye to correct vision problems. The lenses can be place in front of or behind the pupil. “Phakic” refers to the fact that the eye’s natural lens remains in the eye during the procedure.
Phakic IOL implantation can correct higher amounts of nearsightedness than LASIK. But because it’s an internal eye procedure, there are more risks. Cost of the procedure is also significantly higher.
Yes, even cataract surgery can be considered a refractive procedure. The natural lens is removed and a new artificial lens is implanted that is called an intraocular lens implant (IOL). The IOL can correct nearsightedness and farsightedness. Other lenses called multifocal IOLs or accommodating IOLs, currently are being used by many cataract surgeons, with promising results to improve near vision although more night glare is noted by some patients with this type of lens. While OHIP will cover basic costs of cataract surgery for those with significant cataracts, you can elect to pay out-of-pocket for the extra costs of upgrading the lens.
Which procedure is right for you? If you are interested in LASIK or other vision correction surgery, call our office for a comprehensive eye exam and consultation. We will be happy to discuss whether you are a good candidate for refractive surgery and which procedure may be best for you. We can also recommend an experienced refractive surgeon if you choose to proceed with surgery.