Are you like many people in Northern Colorado who are weary of the on again off again of wearing glasses or contact lenses? Happily, today we have several surgical options that can correct your vision and grant you the ability to have excellent vision without the aid of corrective lenses.
LASIK is by far the most popular and well known vision-correcting (or refractive) surgery available right now. There are other options that are available as well. below is a overview of several refractive surgery options and their comparison to LASIK:
PRK
Here in Fort Collins, Loveland and Greeley and across the nation, PRK (photorefractive keratectomy) has the honor of being the very first laser vision correction procedure approved in the US. It was approved in 1995 by the FDA. The procedure became commonplace as it was an alternative to radial keratotomy (RK). RK was the only real surgical treatment for nearsightedness that was available to people at that time. PRK procedure was recognized for it’s ability to minimize or eliminate most of the negative side effects of RK, which included fluctuating vision, glare, halos around lights, infection, unpredictable outcomes, decreased visual acuity and regression (return of nearsightedness).
Similarly to LASIK, PRK makes use of an excimer laser to remove corneal tissue to correct the shape of the eye and thus correct a person’s vision. The difference with PRK is that the laser treatment is applied directly on the surface of cornea of the eye. With LASIK it is under a flap of corneal tissue providing less healing time of the eye itself. 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, many people find that their vision is a bit blurred for up to two weeks post PRK or until the eye heals.
The number of PRK surgeries dropped dramatically after LASIK was approved for practice in the US. This happened because there is usually little or no pain post LASIK and many people have found that their vision recovers much 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
LASIK (laser-assisted in situ keratomileusis) is similar to PRK, with the exception of 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. The primary a benefit of LASIK vs PRK is that there is the pain associate with it is minimal, and a person’s eyesight is usually fairly clear within a few hours of the procedure rather than days.
LASEK
LASEK (laser-assisted sub-epithelial keratomileusis) is simply a modification of the LASIK surgery, in which the corneal flap is thinner, and contains only epithelial cells. During the surgery the delicate epithelium is removed by loosening it from the underlying cornea with an alcohol solution. It’s then pushed to the side and the laser treatment is applied. The epithelial “flap” is then replaced and covered with a bandage contact lens until it reattaches to the underlying cornea. Most people in Northern Colorado find that there is less pain after LASEK in comparison to PRK and in many cases the recovery times can be quicker. LASEK is occationally chosen in comparison to LASIK when a person’s cornea is judged to be too thin for a safe LASIK surgery.
Epi-LASIK
Epi-LASIK is very much like LASEK, with the exception of a unique cutting tool that is used to separate the epithelium from the underlying cornea prior to the laser treatment. This little change eliminates the possibility of the patient having an adverse reaction to alcohol be placed directly on the eye and may even add to a more speedy healing of the eye post – procedure compared to LASEK. Similarly to LASEK, epi-LASIK is occasionally chosen over LASIK when the Surgeon is concerned about the patient’s corneal thickness.
IntraLASIK, iLASIK
In Fort Collins, Loveland and Greeley, IntraLASIK and iLASIK are terms sometimes used to describe a LASIK procedure when the corneal flap is created with an IntraLase brand femtosecond laser instead of a bladed instrument (called a microkeratome) for a blade-free, all-laser surgery. All-laser LASIK eliminates the risk of certain complications that may happen when the flap is created with a microkeratome.
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. In a wavefront-guided procedure, the mapping is more precise than ablations that are determined by simply using an eyeglasses prescription. They can also correct more subtle optical imperfections called “higher-order aberrations” that regular ablations can’t treat at all. There are several studies which have shown that wavefront-guided ablations do provide sharper vision outcomes than conventional (non-wavefront) LASIK or PRK. This may also minimize any risks of nighttime glare and halos.
CK
CK (conductive keratoplasty) a laser-less form of refractive surgery which incorporates the use of a hand-held instrument to deliver low-heat radio waves to any number of spots in the peripheral cornea. This application of radio waves then causes the corneal tissue to diminish in these specific areas, which increases the curvature of the cornea and that is how it corrects mild amounts of farsightedness or restoring usable near vision, mainly to people over 40 who have presbyopia.
CK for presbyopia is commonly referred to as NearVision CK. It can be used to correct presbyopia for almost anyone who has previously had LASIK surgery.
Phakic IOLs
The “Phakic” part of the name is in reference to the fact that a person’s eye lense stays inside the eye during the surgery. During a phakic IOLs (intraocular lenses) surgery, small lenses are put inside the eye to correct vision issues. These miniature lenses are usually put in front of or behind the pupil. Phakic IOL implantation has the ability to correct higher amounts of nearsightedness as compared to LASIK. However, because it is an internal eye procedure the risks are greater. The price point of this surgery is quite a bit higher as well.
Refractive lens exchange
Here in Northern Colorado, refractive Lens Exchange (or RLE) is another laserless, internal eye surgery. RLE is very similar to cataract surgery. During the surgery the surgeon removes the clear natural lens of a person’s eye and puts in an artificial lens which is shaped differently. The differing of the shape of the new lense is to reduce or eliminate high amounts of farsightedness. With the RLE procedure people have a higher risk of complications and the cost of the surgery is higher than LASIK. The removal of the natural lens of a young patient will most likely eliminate any near focusing ability, which means reading glasses would be required in the future. Because of the risks listed above, RLE is typically used only in situations where the patient has severe vision correction needs.
Cataract surgery
Cataract surgery is also in the same category as a refractive surgery. We are now finding that new lens implants have the ability to restore a person’s near vision in part while also correcting nearsightedness and farsightedness. Multifocal IOLs or accommodating IOLs are the lenses usually used in these procedures by many cataract surgeons, with excellent results.
Medicare and health insurance will usually cover the basic costs of cataract surgery, you will have the choice to be able to pay out-of-pocket for the additional expense of these more newer lenses that have the potential to restore a full range of eyesight.
Which procedure is right for you?
If you are like many people in Northern Colorado and are interested in LASIK or other vision correction surgery, call our office for a comprehensive eye exam and consultation. We will be more than happy to discuss whether you are a good candidate for refractive surgery and which procedure may be best for you. During your visit we can also recommend an experienced refractive surgeon if you choose to proceed with surgery.
New lens implants developed for cataract surgery can partially restore a person’s near vision in addition to correcting nearsightedness and farsightedness. These lenses, called multifocal IOLs or accommodating IOLs, currently are being used by many cataract surgeons, with promising results.
For additional information or to schedule an appointment, please call 970-204-4020 or click on the link on the side of the page.
