I’m Not a Good LASIK Candidate - Now What?
If you are not a candidate for LASIK, you may assume that you have no option but to continue wearing glasses or contacts for the rest of your life. However, while LASIK is the most commonly performed vision correction surgery, it is not the only one. If thin corneas, large pupils, past eye problems, or extreme nearsightedness keep you from being a LASIK candidate, you may still qualify for these three other surgical procedures.
When scientists first conceived of laser eye surgery, photorefractive keratectomy (PRK) was the first procedure they developed. Partially because LASIK typically involves a shorter recovery time, it has largely replaced PRK. However, this procedure still has a very high success rate, and because it does not involve the creation of a corneal flap, it is often an ideal procedure for patients who do not qualify for LASIK. To perform PRK, an ophthalmologist first removes the thin outer surface of the eye, using a buffing brush, surgical instrument, or chemical solution. Using a laser, he then carefully reshapes the cornea so that it properly refracts light. Following the surgery, the doctor provides a soft contact lens that acts as a bandage while the surface of the eye heals. The new cells typically grow back in days, at which time the patient returns to have the contact lens removed. The results of PRK are nearly identical to those of LASIK surgery. Most patients achieve 20/20 vision, and almost every patient has vision between 20/20 and 20/40 after the surgery.
In LASEK (Laser Epithelial Keratomileusis), the doctor carefully separates the outer layer of the cornea from the underlying layer using an acid solution to weaken the outer cells. This enables the surgeon to carefully push aside the flap, exposing the cornea. As in LASIK and PRK, the surgeon can then reshape the cornea with a surgical laser. LASEK may be a good option for patients with thin or irregular corneas since the flap is much thinner than that created in LASIK surgery. Additionally, LASEK is often a more effective treatment for patients who suffer from extreme nearsightedness.
Intraocular Lenses (IOLs)
Intraocular lenses are another option for patients with extreme nearsightedness and for those who have thin, irregular corneas. IOLs work much like contact lenses, but they are implanted in the eye, replacing the natural lens. Ophthalmologists offer a range of IOLs, designed to address specific needs. Traditional IOLs are monofocal and offer vision correction only at one distance. They are typically used in cataract surgery to replace a natural lens that has become obscured. Though quite effective in restoring vision to cataract sufferers, patients typically must continue to wear glasses. Multifocal IOLs offer vision correction at a variety of distances; they act more like the natural lens in the eye, and many patients do not need to wear glasses after receiving multifocal intraocular lenses. Toric IOLs are multifocal IOLS used specifically to correct astigmatism. Patients can also choose IOLs that filter UV light or that allow for greater contrast sensitivity.
Even if you are not a candidate for LASIK, you still have a wide range of options. Contact an eye surgeon in your area to learn more about these other procedures and to find out if they may be right for you.
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