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Corrective Eye Surgery Basics

Is Corrective Eye Surgery For Me?

Are you tired of wearing glasses, soft, or hard contact lenses? What are the available surgical methods for correcting eyesight? Can you gain freedom of great eyesight without ever again requiring your corrective lenses?

Corrective eye surgery ranges from reshaping of the eye surface with a procedure known as LASIK and PRK to surgical insertion of artificial lenses for correcting your eyesight. Below is a brief overview of refractive surgery options:

PRK

PRK or Photorefractive Keratectomy, was the first laser vision procedure to receive USA approval, earning FDA approval in 1995. PRK rapidly replaced radial keratotomy (RK), which was the viable surgical treatment for nearsightedness prior to that time. PRK promised breakthrough results reducing or even eliminating many earlier complications of RK such as halos around lights, fluctuating vision, glare, decreased visual acuity and even the regressive return of nearsightedness. PRK greatly reduced the risk of infection and other unpredictable negative results.

Similar to LASIK, PRK uses a laser, removing small amounts of corneal tissue and thus reshaping the eyeball to correct a patient’s vision. The difference between the two is that PRK applies the laser directly to the surface of the cornea, as compared to LASIK where the laser goes under a flap of corneal tissue. Improved visual acuity results for PRK and LASIK are comparable however PRK delivers more acute discomfort to the patient’s eye for weeks, until the thin outer protective layer of the cornea (the epithelium) heals. Vision blurring for multiple weeks after PRK is common through the healing.

PRK procedures were sharply declined in favor of LASIK owing to low levels of LASIK discomfort and faster recovery. PRK, nevertheless has had a comeback due to highly effective pain meds and because it poses less risk of some complications. Studies also prove PRK and LASIK efficacy as similar in the long-term.

LASIK

LASIK (laser-assisted in situ keratomileusis) is where a thin, hinged flap is made on the cornea prior to the laser treatment. This flap is then lifted and folded so that laser energy can be directed to underlying corneal tissue thus reshaping the eyeball. Upon completion the flap is replaced so that it becomes a natural bandage. LASIK’s main advantage over PRK is that there is almost no discomfort after the procedure. Vision is typically clear within hours rather than days, after PRK.

LASEK

LASEK (laser-assisted sub-epithelial keratomileusis) is a modification of LASIK in which the corneal flap is much thinner. The delicate epithelium is removed by loosening it from the underlying cornea with a solution. It is pushed aside and laser treatment is applied. The flap is then replaced and bandaged until it reattaches to the cornea as it heals. Generally there is less post-operative discomfort with LASEK compared to PRK, and vision recovery is faster. LASEK may be preferred over LASIK when the patient’s cornea is thin opting for a safer LASEK vs LASIK procedure.

Epi-LASIK

Epi-LASIK is quite similar to LASEK, but a cutting tool is used to separate the epithelium from the underlying cornea prior to the laser treatment. This procedure eliminates the adverse reaction to alcohol placed on the eye and thereby quickens the healing process. Epi-LASIK may be preferred over LASIK where concerns of corneal thickness are exhibited.

Bladeless, All-Laser LASIK

Blade-free LASIK is often preferred especially because it involves the use of a laser vs. a mechanical cutting tool to create the flap in LASIK. All LASIK procedures -IntraLASIK, iLASIK or femto LASIK – eliminate the risk of those complications which might occur when the flap is created.

Wavefront LASIK – PRK

Wavefront (or “custom”) LASIK – PRK uses laser treatment determined by computer mapping the power of your eye. This is also referred to as wavefront analysis. Wave front-guided procedures use computer precision much greater than typical eyeglasses prescriptions. They can correct subtle optical imperfections know as “high-order aberrations” which typically may be too difficult to treat. Studies suggest that wave-front-guided ablations deliver significantly sharper vision compared to conventional (non-wavefront) LASIK or PRK. They may even be thanked for reduction of high-risk nighttime halos or glare.

CK

CK or Conductive Keratoplasty, is refractive surgery without the use of a laser. It uses a hand-held device which delivers low-heat radio waves to multiple spots on the peripheral cornea. This causes corneal tissue shrinkage which increases the curvature of the cornea. The shrinkage in turn correcting mild amounts of farsightedness or restoring usable near vision to people over 40 who have presbyopia.

CK for presbyopia is called NearVision CK, and it can be used to correct presbyopia for people who previously had LASIK surgery.

Phakic IOLs

Phakic IOLs -Intra-Occular Lenses -small lenses are inserted into the eye for correction of various vision problems. These lenses are placed in front of or behind the pupil.

Phakic IOL implantation can correct much more severe nearsightedness than LASIK. Due to the fact that this is an “internal” eye procedure there are relatively greater risks. The financial costs of this procedure is typically also therefore higher.

Refractive Lens Exchange

Refractive lens exchange -RLE, is also a non-laser, internal eye procedure. RLE is similar in many ways to cataract surgery. Whereas with cataracts the surgeon removes the eye’s natural lens which has become scarred and “cloudy”, the surgeon removes a “clear” natural lens and replaces it with an artificial lens of altered shape, reducing or eliminating related farsightedness.

RLE is potentially risky with complications causing a much more expensive procedure compared to LASIK. It is important to note that removing the existent natural lens of a young patient will affect their close-focus ability, forcing them to require reading glasses. Therefore RLE is preferred only in cases of severe vision correction requirements.

Cataract Surgery

Cataract surgery is considered to be a refractive procedure. New lens implants partially restore a patient’s vision thus correcting nearsightedness and / or farsightedness. These lenses, which are called multi-focal IOLs, or accommodating IOLs, are used by many cataract surgeons. They are still the cutting edge and provide excellent results.

It is recommended to consult with your Medicare-aid and other health insurance providers to be certain what they do or do not cover of the basic costs of cataract or any eye surgery. Of course you can always opt out-of-pocket payment for the benefits -which outweigh the extra costs of these more modern procedures and lenses. The potential of restoring a fuller range of vision adds significant life value far offsetting the short-term cost.