What is refractive surgery?
Refractive surgery is for patients who are tired of struggling with glasses or contact lenses. The term refractive surgery refers to a group of procedures that improve vision by correcting refractive error such as nearsightedness, farsightedness, astigmatism, and presbyopia. There are two main surgical approaches: one is by using a laser to reshape the cornea (the clear front part of the eye) and the other is by implanting a lens inside the eye.
Good vision depends on how well your cornea and lens focus light on the retina. Refractive errors arise from a cornea that is not shaped perfectly or an eye being shorter or longer than normal. This causes light to not be focused on the retina, creating blurry vision. By reshaping the cornea or implanting a lens inside the eye, light can be properly focused on the retina, leading to good vision without glasses. These surgeries are safe and effective and can improve quality of life.
What are the different types of refractive surgery at ESA?
- LASIK (Laser-Assisted in Situ Keratomileusis) is the most well-known and commonly performed refractive surgery. During LASIK, a flap is made in the cornea with a femtosecond laser, the flap is lifted, the underlying cornea is reshaped with an excimer laser, and the flap is laid back down. The procedure is typically painless and takes 15-20 minutes for both eyes. Most patients experience significantly improved vision within 24 hours and it continues to sharpen as the eyes heal over the coming months. While many people are good LASIK candidates, some patients do not meet certain requirements and would be better served by a different type of refractive surgery.
- PRK (Photorefractive Keratectomy) is an alternative to LASIK for patients with thin or slightly irregular shaped corneas. During PRK, the outer layer of the cornea called the epithelium is removed and then the underlying corneal tissue is reshaped with the excimer laser. The procedure is typically painless and takes 15-20 minutes for both eyes. The outer layer of the cornea then grows back and smooths out naturally. Waiting for this outer layer to heal leads to a longer recovery time and more discomfort post-operatively than LASIK, but the long-term vision results are equivalent. PRK patients can expect improved but somewhat blurry vision the first week (as the epithelium grows back), good vision within a month, and excellent vision at 3-6 months (once the epithelium is completely smoothed out).
- EVO ICL (Implantable Collamer Lens) is an alternative to LASIK for patients with thin corneas, irregular corneas, or a large nearsighted prescription. During EVO ICL, a small, thin, biocompatible lens is implanted inside the eye behind the iris and in front of the natural crystalline lens. These EVO lenses come in different sizes and strengths, which allows the surgeon to customize the lens to your prescription and pre-operative measurements. The procedure is painless, typically takes less than 1 hour, and is performed in our outpatient surgery center. It provides excellent vision and recovery is quick. EVO ICL has been a breakthrough in refractive surgery and allows us to help patients who were often times not candidates for refractive surgery before.
- Clear lens exchange (CLE) is an option for patients over the age of 40 with farsightedness and presbyopia (the need for magnifiers when reading). In our 40s and 50s, patients start to lose the ability to accommodate, which is the ability of the natural crystalline lens to change shape and allow for focusing at different distances. During CLE, the patient’s natural crystalline lens is removed through small corneal incisions and a new artificial intraocular lens (IOL) is placed inside the eye within the same support structure that once held the crystalline lens in place. The IOL is customized to the patient based on pre-operative measurements to provide the best vision. Many patients who undergo CLE opt for a multifocal IOL, which splits light and provides both distance and near vision without glasses. The procedure is quick and painless and takes place in our outpatient surgery center.
Am I a candidate? Which surgery is right for me?
The best way to know if you are a candidate is to come into our office for a free refractive surgery evaluation. We will measure your prescription, do a full eye exam, and perform scans of your eyes. With all of our technology, more patients are candidates for refractive surgery than ever before. If you are deemed a candidate, we can then discuss which surgery would be most effective and safe to meet your vision goals.
Bio: Dr. Davenport is a fellowship trained Ophthalmologist with Eye Surgeons Associates. His surgical specialties include all-laser (bladeless) LASIK, standard as well as laser-assisted cataract surgery, clear lens exchange, PRK, and ICL. For more information, please see our website: www.esaeyecare.com.
A patient information booklet is available with a complete listing of the indications, contraindications, complications, precautions and side effects. Not everyone is a candidate. Individual results may vary. The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.