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Alternatives to LASIK Surgery

LASIK is a form of refractive surgery. Refractive surgery corrects nearsightedness, farsightedness and astigmatism by helping the eye’s cornea naturally refract light onto the retina (back of the eye). Wolfe Eye Clinic LASIK specialist, Dr. Reid Turner, performs LASIK surgery at Wolfe Surgery Center in Des Moines, Iowa.The need for eyeglasses or contacts is eliminated or significantly reduced after refractive surgery. Wolfe Eye Clinic understands that everyone’s eyes are different and require personalized care. For this reason, our specialty teams not only determine whether you are a good candidate for LASIK but they consider other refractive surgery options as well such as monovision strategies, photorefractive keratectomy (PRK) or implantable contact lenses (ICL). Because Wolfe Eye Clinic surgeons are experts in subspecialty eye treatment and surgery, we are able to answer questions about options alternative to LASIK and perform more advanced refractive surgeries customized to your visual needs.

Monovision LASIK

Most patients have LASIK performed on both eyes where each is corrected to focus either up-close or in the distance. When patients are over 45 and begin to need reading glasses or bifocals, some may elect to have one eye corrected for up-close and the other for distance. This is referred to as monovision LASIK. In order to move forward with monovision LASIK, patients generally first mimic the effects of monovision by trialing monovision contact lenses. This trial period not only tests whether the eyes’ communication with the brain can adjust accordingly, but also identifies if patients experience unwanted side effects. Most patients will know within a couple days if monovision LASIK is right for them based on the contact lens trial. Your surgeon will discuss with you at your LASIK consultation whether monovision LASIK is a good option for you.

Photorefractive Keratectomy (PRK)

Photorefractive keratectomy, or PRK, is another FDA approved form of refractive laser-eye surgery. It can be used to treat nearsightedness, farsightedness, and astigmatism. PRK uses the same excimer laser technology as LASIK. Therefore, visual results between PRK and LASIK are similar.

PRK is a flapless procedure performed in two steps. During the first step, your surgeon prepares the eye by removing the superficial epithelial layer. Then, the same excimer laser used in LASIK is used to reshape the corneal curvature. The epithelial layer naturally regenerates itself in a couple of days.

Postoperatively, patients typically wear a bandage contact lens for the first three to five days to reduce postoperative discomfort. There can be significant visual fluctuation with most patients and a gradual increase in visual quality. While some patients recover very quickly after PRK, it is not atypical for full recovery to require three to five weeks.

While final visual results tend to be equal between PRK and LASIK, most of our patients choose LASIK over PRK given its more rapid visual recovery. However, certain corneal characteristics and patient desires can make PRK a better option for some patients. Your surgeon will go over more specific healing differences between PRK and LASIK should PRK be recommended. 

Implantable Contact Lens (ICL)

Cornea based refractive surgery is not an option for everyone. A very high refractive error, thin corneas or severe dry eye may prohibit some from being good LASIK or PRK candidates. Fortunately, implantable collamer lenses also referred to as implantable contact lenses or ICL implants may provide an alternative.

Unlike LASIK, ICL implants do not reshape the cornea to correct vision. Thus, concerns related to the cornea such as the cornea being too thin or having extreme dry eyes generally do not disqualify patients from being good ICL implant candidates. Rather ICL implants are inserted through small incisions and then gently unfolded. They are then tucked behind the colored part of the eye (iris) and in front of the natural lens. Because ICL implants are surgically placed within the eye they significantly differ from contact lenses worn over the surface of the cornea. However, ICL implants correct vision similarly to that of a contact lens by adjusting the way in which the eye refracts light, helping you see without eyeglasses or contact lenses.

Biocompatible with your eye, ICL implants are not recognized as a foreign object by the body or visible to the patient and others. Although implantable contact lenses are placed as a permanent treatment, they may be removed. Healing, like LASIK, is relatively short. As with any surgery, there are risks including halo or glare around lights, corneal swelling, increased eye pressure, and cataract development. Your surgeon will review additional possible side effects with you and whether you may be a good candidate for implantable contact lenses.

Refractive Lens Exchange (RLE)

Refractive Lens Exchange (RLE) is another form of intraocular refractive surgery. Unfortunately, as we age, so do our eyes. By the time we reach our early 40s, many of us will typically experience presbyopia, the normal loss of near focusing. This can often prompt the need for reading glasses or bifocals. Near this same time, there can be yellowing of the lens that occurs just prior to “cataract” formation that can impact vision quality. 

Your surgeon may discuss the option of Refractive Lens Exchange (RLE) as a means to solve both presbyopia, an aging lens, and your refractive goals. With this procedure, your natural lens is replaced with an advanced technology intraocular lens (IOL). These lenses can correct nearsightedness, farsightedness, astigmatism, and presbyopia for the right candidate. By replacing the aging lens, RLE eliminates the need for future cataract surgery. Your refractive surgeon will review with you additional possible side effects and your potential candidacy for RLE.

Find the Right Refractive Surgery Procedure For You at Wolfe Eye Clinic

To find out if you are a candidate for LASIK or any refractive surgery, please call one of our LASIK Coordinators at (833) 532-8809 or request an appointment online here to schedule a free LASIK consultation near you. Wolfe Eye Clinic has experienced LASIK refractive surgeons across the state. We offer free LASIK consultations at our Ames, Cedar Falls, Cedar Rapids (Hiawatha), Des Moines, Fort Dodge, Iowa City, Marshalltown, Ottumwa, Pleasant Hill and Waterloo clinics.