Who doesn’t want good eyesight? Humans are very visual creatures, which means among the sensory organs, we tend to use our eyes the most. Much of our lives are centered on our sense of sight, from the clothes we wear and the house we live in down to the food we eat and the people we associate with. Some of the things that have brought us to the top of the animal kingdom also depend on our sight: learning, writing, interpreting symbols, communication, and others. For these reasons, a fully functional sense of sight is essential to most people.
Over the years, much have been invested into developing treatments and techniques to ensure the well-being of the eyes and maintain our sense of sight. Among the most recent of these, and one of those that have gained immense popularity in the last couple of years, is refractive eye surgery. While the term may often be associated with laser-assisted in situ keratomileusis (LASIK), it can refer to a variety of procedures of which LASIK is only one. The other treatments belonging to this broad term have their own advantages and answer the needs of different kinds of patients.
What is refractive eye surgery?
The American Optometric Association very briefly defines refractive surgery as a method for changing the refractive properties of the eyes. This is to treat conditions like nearsightedness or myopia, farsightedness or hyperopia, and astigmatism, among others. These conditions are often addressed through prescription glasses. Refractive surgery treats these conditions and reduces or eliminates the need for glasses or special lenses.
The American Academy of Ophthalmology (AAO) suggests that refractive surgery may be good for you if:
- You don’t want to be too dependent on glasses or contact lenses
- You do not have existing eye disease
- You accept that the procedure may have inherent risks or side effects
- You understand that even after the procedure, you may still need to wear contact lenses or glasses to achieve the best vision
- You have the appropriate refractive error
What are the different types of refractive surgery?
There are many different types of refractive surgery besides LASIK. They are:
- Photorefractive Keratectomy (PRK). PRK is a procedure that uses laser to sculpt the cornea into a more ideal shape. A vibrating, blunt microkeratome is used to remove the epithelial layer of the cornea before the laser can do its work. A more recent technique, called advanced surface ablation, cools the cornea prior and after the surgery to reduce the discomfort you may experience. You will be given a special contact lens that acts as a bandage that facilitates the healing of the epithelial layer, a process that may take up to four days. Antibiotics and anti-inflammatory medication, as well as pain killers may be administered as well.
- Laser Epithelial Keratomileusis (LASEK). Laser Epithelial Keratomileusis uses a trephine blade, which is finer than that used in Lasik, to create a flap. An alcohol solution is used to lift the epithelium, after which an excimer laser will reshape the corneal tissue through ablation. This procedure takes about 15 minutes for each eye and require four to seven days of recovery. Vision improves within six to eight weeks. LASEK is a great choice for people with less corneal tissue and compared to LASIK, causes no stromal trauma and poses less risk of causing dry eyes.
- Radial keratotomy (RK). Radial keratotomy is a surgery that addresses nearsightedness. This is done by making small cuts in the cornea in order to flatten it. If you also have astigmatism, your surgeon may make more incisions. The surgery can take between 10 to 15 minutes on each eye, but surgeons may wait up to six weeks after treating one eye before operating on the other eye to prevent infection. Recovery takes a few days, although you’d have to make frequent visits to the surgeon after the procedure. More recent developments in refractive surgery, such as LASEK and PRK, means that RK has lost most its popularity among patients.
- Conductive keratoplasty (CK). Conductive keratoplasty is a refractive surgery designed to help reduce your dependence on reading glasses especially if you are middle-aged. It is also used to treat hyperopia. Unlike many modern types of refractive surgery, CK does not use lasers. Instead, it uses low-frequency radio waves to reshape the cornea. The treatment lasts a few minutes and causes some mild eye discomfort, especially once the numbing eye drop applied prior to the procedure begins to wash off. You will experience almost immediate improvement, although it may take a few weeks before you gain optimal results.
- Intraocular lenses (IOLs). Intraocular lenses are artificial lenses inserted into the eyes to replace natural lenses damaged by conditions such as cataracts. These man-made lenses are made from either acrylic or silicone and are coated with a special material that protects the eyes from the sun’s UV rays. There are several types of lenses to choose from, each offering their own benefits and features. It’s best to discuss with your doctor when selecting the best lenses for you.
- Limbal Relaxing Incisions (LRI). Limbal relaxing incisions are cuts on the cornea made to treat astigmatism. The incisions are made on the limbus, or the junction between the sclera and the cornea. Astigmatism is caused by corneas that are either too elongated in one axis and too flat in another. The procedure relaxes the axis where the cut was made, leaving the cornea with a more rounded shape and as such, necessitates very precise planning on where the cuts will be made. Despite what the process may suggest, the procedure is actually relatively painless and eliminates the need for distance glasses.
With the many advanced and painless procedures available today, you may not have to depend on your glasses or contact lenses to improve your vision after all. It worth noting though, that to ensure that these treatments work for you, it’s best to pay your doctor a visit and inquire about the feasibility of refractive surgery. This way, you’d know which one is best for your condition and your specific needs.