Imagine it. Clear vision without prescription glasses and contacts ... vision correction can be life-changing.
Corrective eye surgery isn’t the right choice for everyone. But modern lasers and new procedures offer more surgical options to correct a wider variety of vision issues.
Which procedure is right for your eyes? Start with a consultation to discuss your goals with an ophthalmologist. They'll give you an eye exam to determine if you’re a good candidate for laser vision corrective surgery.
Should I get LASIK?
LASIK (Laser In-situ Keratomileusis) may be a good option for you if you need to correct nearsightedness or farsightedness, with or without astigmatism. “LASIK is best suited for healthy patients with a stable refraction that hasn’t changed much over time,” said Dr. Sonia Yoo, a board-certified ophthalmologist with Bascom Palmer LASIK and Laser Vision Center.
In less than five minutes per eye, your LASIK expert painlessly creates a thin, hinged flap on the cornea then corrects the curvature of the cornea with a laser. “Using our new-generation femtosecond laser and eye-tracking technology, we can ensure precise positioning, even if your eye moves during the procedure,” Dr. Yoo says.
Following a typical LASIK procedure, patients can return to their normal daily tasks with significantly improved eyesight within 24 hours. Although LASIK surgery offers great results with very low risk, it is not for everyone. Those with a thin cornea, irregular astigmatism, other ocular conditions (such as dry eye disease, uncontrolled glaucoma, or keratoconus), lupus, rheumatoid arthritis, or diabetes may not be candidates for this surgery.
What other laser surgery options are available?
If your cornea is too thin for LASIK, you and your ophthalmologist may consider the Photorefractive Keratectomy (PRK) procedure. PRK can correct the same refractive prescriptions as LASIK (nearsightedness, farsightedness, and astigmatism). But it uses an excimer laser to reshape the cornea without the need for a hinged flap. There is a minor risk that the corneal flap created during the LASIK procedure can potentially be displaced. This happens even years later, if impacted with significant force. As Dr. Yoo points out, “PRK might be a better choice for patients engaged in contact sports or professions that may involve impact to the face or head.” The PRK procedure requires a slightly longer healing time (four to seven days) and the avoidance of prolonged UV light exposure for six weeks.
The newer technology behind the ReLEx SMILE (Small Incision Intrastromal Lenticule Extraction) procedure is well suited for patients who need higher vision correction due to myopia or astigmatism. This surgery is not yet approved in the U.S. to correct farsightedness (hyperopia).
“With the SMILE procedure, we use a femtosecond laser to separate a thin layer of the cornea and flatten the cornea to correct myopia,” said Dr. Yoo. This laser emits pulses of light lasting just 1 billionth of 1 millionth of a second, resulting in smooth treatments. “Our equipment’s computer-generated 3-D mapping system enables us to customize your procedure with enhanced precision.”
A typical SMILE surgery can permanently restore good vision virtually overnight. Patients typically experience less temporary dryness after the procedure, and it leaves the eye relatively resistant to direct injury.
What if I’m too nearsighted for laser surgery?
“At Bascom Palmer, we offer an alternative treatment for those whose eyes are too myopic for laser surgeries like LASIK, PRK, and SMILE,” Dr. Yoo said.
Phakic Intraocular Lenses surgically places a lens in the front part of your eye, with your natural lens left in place behind the new lens. This treatment is helpful for those with higher degrees of myopia.
What if cataracts are an issue?
For patients developing cataracts, a Lens Exchange with an intraocular lens implant may be the solution for vision correction. “If you have already cataracts, you’re unfortunately not a candidate for LASIK, PRK, or SMILE,” said Dr. Yoo. “But, we can offer short corneal incisions or astigmatic keratotomies to reduce astigmatism during cataract surgery or even after a corneal transplant,” Dr. Yoo said. To correct larger degrees of astigmatism in patients with cataracts, toric intraocular lenses are available. Multifocal intraocular lenses can improve both near and distance vision for patients undergoing cataract surgery.
Corneal cross-linking method can strengthen the cornea if your cornea has been weakened by keratoconus. “With this treatment, we use ultraviolet light and a photosensitizer (riboflavin eye drops) to strengthen the collagen in the cornea and halt progressive corneal bulging,” Dr. Yoo said. Cross-linking is highly effective and safe.
What’s the next step?
Your vision care needs are based on your unique corneal abnormalities and overall eye health, medical history, age, and lifestyle. Consider how often you rely on your prescription lenses or contacts. If you want to be independent from daily wear glasses or contacts, speak to a board-certified ophthalmologist to discuss vision correction, your goals, and any concerns.
Call Bascom Palmer Eye LASIK & Laser Vision Center at 877-GO-LASIK (52745) for more information or to see if you are a candidate.
Dana Kantrowitz is a contributing writer for UMiami Health News.