Refractive surgery is a term that is used for a surgery that’s purpose is to correct someone’s refractive error to help reduce the need for glasses and contact lenses. This is a great time if you are interested in refractive surgery as the technology has never been better and there is even a new surgical technique available. There are several forms of refractive surgery, each having certain pros and cons.
Laser In-Situ Keratomileusis, abbreviated LASIK, is the most widely known and most commonly performed refractive surgery. This surgery involves creating a thin corneal flap, which allows the excimer laser to reshape the corneal tissue beneath the flap. The flap is then carefully replaced over the freshly reshaped cornea. This procedure offers quick recovery, minimal discomfort, and practically instantaneous vision improvement. The main drawback of LASIK compared to other corneal refractive surgeries is that the flap can cause certain complications, although these complications are not common.
Photorefractive Keratectomy, abbreviated PRK, is the second most common refractive surgery performed. This procedure is similar to LASIK, the difference being instead of creating a corneal flap, the surface layer of the cornea is removed altogether. This eliminates any complication related to the corneal flap, as would be possible in LASIK. The downside to PRK is that the recovery is much longer and there is a fair amount of discomfort involved.
Small Incision Lenticule Extraction, abbreviated SMILE, is the newest refractive surgery, gaining FDA approval in 2016. This procedure was designed to reduce the invasiveness of refractive surgery. In the SMILE procedure, the surgeon uses a femtosecond laser to create a lens-shaped disc of tissue within the cornea. Then a very small incision is made to remove this disc of tissue. The benefit of this procedure is that we are causing very limited damage to the surface layer of the cornea. This helps maintain the integrity of the cornea as well as preserve the corneal nerves. This procedure combines the quick recovery and minimal discomfort of LASIK with the fewer complications related to PRK.
Implantable Collamer Lens
Implantable Collamer Lens, abbreviated ICL and also known as an implantable Contact Lens or Phakic IOL, is a procedure that surgically inserts a lens directly in front of the natural lens inside the eye. The advantages of this refractive surgery are that we avoid the cornea altogether and we keep the natural lens in place. So if the cornea is too thin, or there are corneal irregularities, an ICL surgery is a great alternative to corneal refractive surgeries. Also, keeping the natural lens in place
maintains the eye’s ability to change focal distance. Another great advantage is that ICL surgery is the only reversible refractive surgery available. So if technology improves in the future and something better becomes available, there is the ability to remove this lens from the eye.
Refractive Lens Exchange
Refractive Lens Exchange is a procedure where we remove the natural lens inside the eye and replace it with a new lens that corrects your vision. Essentially, it is cataract surgery, without having cataracts. This procedure allows for the correction of very strong prescriptions and it is proven to be a successful and safe surgery given the extensive number of cataract surgeries performed. It also can be thought of as a one-time surgery, as you won’t need cataract surgery later on in life.
Corneal Refractive Therapy (CRT) Lenses
If you are hesitant about undergoing surgery, corneal refractive therapy is a great non-surgical method to correct your refractive error. Corneal Refractive Therapy is a process in which we use specially designed contact lenses to reshape the cornea in order to correct a person’s refractive error. This lens works at night while you sleep, which allows for clear vision during the day without the need for glasses or contact lenses. The treatment is completely reversible and does not require any invasive surgery so it offers a great alternative to refractive surgery. CRT lenses are a fantastic option, but not everyone is a candidate, ask our doctors to know if CRT lenses are an option for you.