While many people are happy with wearing glasses to correct their vision, a growing number of Americans want to be able to function without artificial eyewear. Millions have had Lasik for this reason. Lasik sculpts the cornea, the front window of the eye, to nearly eliminate the need for distance glasses. To a 20 year old, this allows for both distance and near vision, since the lens of the eye is usually flexible enough to focus from distance to near vision for reading and fine close work.
Unfortunately, as our eyes approach their 40th birthday, the natural lens becomes less flexible, reducing the eyes focusing ability, which coincides with a mild discoloration of the natural lens, the earliest sign of cataract formation. This “Presbyopia” is the reason that most people need reading glasses or bifocals as they enter midlife. People in their 40’s and 50’s who have had Lasik will usually still need glasses for reading.
For some, “monovision,” where one eye is focused for distance and one eye for near vision, helps provide more seamless vision without glasses. There is some loss of contrast vision and depth perception, but approximately 60% of people who try monovision adapt to it readily. It can be most easily accomplished with contact lenses, and those who are successful can have their eyes surgically adjusted and be relatively free of artificial vision aides using monovision powered lens implants.
Laser In Situ Keratomileusis (LASIK) is a laser surgical procedure effective for nearsightedness, farsightedness, and astigmatism. LASIK combines corneal flap surgery with excimer laser reshaping under a thin flap of corneal tissue. PRK (Photo Refractive Keratectomy) applies the laser sculpting directly to the surface of the cornea. Since the cornea, which is like the front windshield of the eye is responsible for a large part of the focusing strength of the eye, subtle shape changes can result in significant vision improvement.
Visual recovery is rapid after LASIK. Within one or two days, most patients see clearly, with minimal side effects. Most patients experience little or no discomfort following surgery and vision generally stabilizes within one month. Antibiotic, anti-inflammatory and moisturizing drops are required for at least a few days after surgery.
The temporary side effects following LASIK are minimal and are most often limited to slightly drier eyes, minor increases in light scattering, decreased clarity in dim light, and seeing halos around bright lights at night. These effects are most common when the pupil is larger than normal and the correction is high. It is rare for these side effects to interfere with normal activities, and they decrease as the eye heals. Healing with PRK can be associated with more initial discomfort and slightly longer healing times, but is used when eyes are not good candidates for the LASIK flap procedure.
Only a complete examination with special testing can determine if LASIK or another procedure is best for your eyes and vision needs. We look forward to seeing you and answering your questions about your options.
Who Benefits Most?
People with moderate to high degrees of nearsightedness or farsightedness
Specific Advantages of Implantable Lenses
- Correction for very high degrees of nearsightedness and farsightedness where Lasik results may not be as good
- Predictable outcomes, even in high corrections
- Fast visual stabilization
- Does not alter the tissue of the cornea
- Minimal side effects
- Can be combined with other corrective options
- Reversible in effect
How Implantable Lenses Work
Implantable Lenses are tiny lenses designed to be placed permanently within the eye to correct vision problems. They are manufactured of materials that are biocompatable, so they can rest within the eye without needing any care. Various types of lenses are designed to rest in selected positions in the front chamber of the eye. Implanting one of these special lenses offers dramatic results that are quite predictable and reversible, if necessary.
Lens implantation is a simple outpatient procedure. Patients are not put to sleep, but are sedated with oral or intravenous medications, if necessary. In most cases, topical drops are used to anesthetize the eye, so no injection is necessary.
Visual recovery after a lens has been implanted, in most cases, is rapid. Shortly after the surgery, patients are able to see well enough to engage in regular activities with dramatically increased visual freedom. Full visual recovery may take a few days to a few weeks. Eye drops are used for three to four weeks.
Side effects are minimal. Patients can expect increased light sensitivity for a few days, so sunglasses need to be worn more often than usual during this time. The implanted lens cannot be felt inside the eye.
If the stable visual result is not ideal, a second surgical procedure to adjust or replace the lens is generally possible.
No surgical procedure can guarantee short term or long term perfect vision at distance and near. Please be sure to discuss your needs and expectations with your surgeon.
Refractive Lens Exchange
Currently available Premium (Presbyopia Correcting) Lens
Presbyopia is the age-related loss of the ability to focus up close to read. Advanced technology implants developed for use after cataract surgery can to a large extent reverse these changes and allow relative independence from glasses after surgery. Three of these Intraocular Lenses (IOL’s) are now approved by the FDA.
At Weston Eye Center we are familiar with these advanced lenses and carefully evaluate whether or not our patients will benefit from them. Dr. Weston was the first in Oregon to use this advanced technology and is the only surgeon in Roseburg to offer its benefits.
Medicare and other insurance plans do not fund refractive surgery or the additional cost of these newest types of implants and the related services needed for their use. Medicare patients are allowed to purchase these IOL’s so that they may enjoy the advantages of presbyopia correcting IOL’s following cataract surgery.
For this only a complete examination with special testing can determine which option or another procedure is best for your eyes and vision needs. We look forward to seeing you and answering your questions about your options.
Refractive Lens Exchange (RLE) vs. LASIK
While Lasik, which changes the focusing shape of the cornea, is the most common refractive surgical technique used today, some eyes have corneas that are too thin or too irregular to safely perform this procedure. Some people with strong prescriptions have an increased risk of developing corneas that are too thin or irregular after LASIK, reducing the quality of vision significantly.
Refractive Lens Exchange benefits our patients who quailify in a number of important ways:
- Reduce or eliminate the need for glasses or contact lenses, as does Lasik
- Can eliminate the need to wear readers for presbyopia.
- Requires no cataract surgery later in life