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Vision correction surgery, also called refractive and laser eye surgery, refers to any surgical procedure used to fix vision problems. Recent years have seen huge advances in this field. Refractive and laser eye surgery allow many patients to see better than any other time in their lives.
Most types of vision correction surgery reshape your cornea, the clear front part of your eye. That lets light travel through it and focus properly on the back of your eye, or retina. Other procedures replace your eye’s natural lens.
Your optometrist provides an impartial assessment about the best options for correcting poor vision including surgery. Many optometrists also co-manage pre- and post-surgical patients with an ophthalmologist. There are several surgical options available when considering vision correcting surgery to reduce your dependence on glasses or contact lenses, but not every patient is a candidate for every option.
Photo-refractive Keratectomy (PRK)
In PRK the outer layer of the cornea is gently removed and a laser is used to reshape the cornea. The epithelium regenerates within 3-5 days but during that time a contact lens is used to minimize discomfort and provide a protected environment for good healing. PRK achieves excellent results but the main drawbacks are there is some eye pain or irritation and the prescription can take up to three months to stabilize. There is less likelihood of dry eye symptoms than other procedures.
Laser In-Situ Keratomileusis (LASIK)
LASIK is the most common type of refractive surgery since it provides faster vision recovery and minimal eye discomfort. A flap of the cornea is produced using a blade which is folded back and laser is applied to the cornea. The flap is then repositioned where is binds tightly without the need for stitches. The drawback to LASIK is dry eye symptoms, glare or halo and instances where the flap is dislodged.
Intralase SBK
SBK is very similar to LASIK except the flap is produced using a femtosecond laser which creates a uniform flap. This uniform flap has potentially fewer complications then blade flaps.
RLE and PRELEX
RLE stands for refractive lens exchange. Other names include PRELEX, clear lens exchange (CLE), clear lens extraction (CLE), and refractive lens replacement (RLR). It’s the same as cataract surgery. The doctor makes a small cut at the edge of your cornea. They remove your natural lens and replaces it with a plastic lens implant. The procedure can correct extreme farsightedness or nearsightedness. It works well for people with thin corneas, dry eyes, or other minor cornea problems. A LASIK or LASIK-related procedure can be combined with RLE to correct astigmatism.
PRELEX, short for presbyopic lens exchange, is a procedure used for presbyopia, or loss of flexibility in your eye. The doctor removes your lens and replaces it with a multifocal lens. It is the same as the above, just with a multifocal implant to help you see far and near.
Intacs
Intacs are also known as intracorneal ring segments, or ICR. The doctor makes a small incision in your cornea and places two crescent-shaped plastic rings at the outer edge. The rings flatten your cornea and change the way light rays focus on your retina. ICR was used to treat nearsightedness, but that has been replaced by laser-based procedures. Now it’s used to possibly fix keratoconus, an irregular-shaped cornea that causes your cornea to thin and results in vision loss.
Phakic Intraocular Lens Implants
Phakic intraocular lens implants, or implantable contact lenses (ICL), are designed for people who are too nearsighted for LASIK and PRK. The doctor makes a small incision at the edge of your cornea and either attaches the implant lens to your iris or inserts it behind your pupil. Unlike RLE, your natural lens stays in place. Visian ICL is the main type of phakic lens implant used.
LRI
LRI is short for Limbal Relaxing Incision, or an astigmatic keratotomy. It isn’t laser eye surgery but a surgical procedure used to correct astigmatism. When you have astigmatism, your eye is shaped like a football instead of being round. The doctor makes one or two incisions at the steepest part of your cornea. This helps it relax and makes it more rounded. This procedure can be done alone, or in combination with other laser eye surgeries like PRK, LASIK, or RK.
Discussing your options with your optometrist who is not affiliated with any particular ophthalmologist will provide the most impartial professional opinion on which options are best suited for your eyes and what the expected outcome should be. The patient’s age and overall eye health is the key to setting reasonable expectations and a comprehensive eye examination should always be your first step. Book your appointment with Dr. Saari to discuss the options available for your eyes.
