Alternatives to LASIK Eye Surgery

When you are deemed unfit for LASIK eye surgery, opting for alternatives like implantable collamer lens (ICL), photorefractive keratectomy, and LASEK can help in correcting vision problems.
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Alternative to LASIK eye surgery
Caution!
Whichever alternative you choose for your LASIK eye surgery, make sure it is done by an experienced eye surgeon.
Disappointed that you are considered unfit for LASIK eye surgery? Are you wondering that you have no choice but to wear spectacles for the rest of your life? Well, you would be glad to know that there are various alternatives to LASIK eye surgery that are equally effective in correcting vision and removing spectacles.

LASIK eye surgery involves temporarily removing the outer layer of the cornea (corneal flap) to access the middle layer. This is followed by reshaping the underlying corneal tissue using a laser, to achieve vision correction. The flap is then returned to its normal position. However, if the corneal surface is very thin, it is not possible to create a flap, without which, surgery cannot be performed. People with very high degree of refractive error, or those with a large pupil diameter may also be deemed unfit for LASIK eye surgery.

This Buzzle article tries to shed some more light on the possible alternatives to LASIK surgery. We shall also take a look at the recovery period and approximate cost of these alternate procedures.

Options for LASIK Eye Surgery

Photorefractive Keratectomy (PRK)

Although PRK involves reshaping the cornea, the corneal flap is not created. Instead, epithelial cells (that form the epithelium) located on the outer corneal surface are removed. So, essentially the epithelium that coats the corneal surface is removed. It doesn't matter even if the corneal flap is very thin, new epithelial cells eventually regrow to coat the outer surface of the layer. People with irregular corneal shape may also be advised for PRK.

The only drawback of PRK is that its healing time is longer than LASIK. This is because, once the epithelial cells are cleared from the cornea, it takes time for the new cells to regenerate. No wonder, unlike LASIK, where noticeable improvement is seen within the first 2 days after surgery, the eyesight after PRK improves slowly over a week. But it may take several weeks to achieve the desired sharpness and clarity of vision. Also, PRK carries slightly higher risk of eye infection and lack of clarity in eyesight during the initial days after surgery. The approximate cost of PRK for each eye may vary from USD 1,800 to USD 2,500.

Laser-Assisted Subepithelial Keratectomy (LASEK)

LASEK is a new version of PRK in which the epithelium isn't permanently removed. It is only temporarily detached from the cornea, during which the curvature of the cornea is reshaped using the excimer laser. Once it is complete, the epithelium is placed back to its original position. Generally, a trephine blade (surgical instrument) along with an alcohol solution is used to remove the epithelium. It was believed that by not waiting for new epithelial cells to regrow, LASEK would take lesser time to heal than PRK.

But contrary to belief, it is observed that LASEK, that involves reconnecting the epithelium, has longer recovery period than the time taken to regenerate new epithelial cells. Although, LASEK is slightly safer as there is no creation of corneal flap, the healing process is slow and involves more eye discomfort. The post-operative pain is highest for the first 2-3 days, which gradually subsides. So, LASEK can be painful for some individuals with the eye causing significant discomfort after surgery. The cost of LASEK for each eye may vary from USD 1,300 to USD 2,500.

Implantable Collamer Lens (ICL)

Innovations in medical technology has led to the development of implantable collamer lens (implantable contact lens), one of the most popular alternatives to LASIK eye surgery. The material used in making the lens is a collagen copolymer, which is a combination of collagen and polymer. Available under the brand name Visian ICL, it involves implanting lenses without using laser. A very small incision is made to fix the contact lens into the eye. In simple words, it involves inserting a new portion into the eye, but surprisingly, can neither be felt nor be seen to the naked eye. Approved by the FDA in 2005, Visian ICL is not placed on the surface but lies to the rear of your iris; hence can only be detected, when examined under a microscope. So, the issue of contacts falling out does not arise, as they are permanently inserted into the eye.

Unlike PRK where there is gradual improvement in vision, results are noticed immediately after the procedure. Also, eyesight is sharp and crisp, and the vision quality is better than other vision correction procedures, like LASIK, with recovery period not lasting for more than a day. Moreover, the material from which the lens is made provides UV protection, meaning, it blocks the UV rays from penetrating the eye. People who are suffering from myopia (nearsightedness) without astigmatism are suitable for undergoing this procedure.

Concerns have also been raised over implanting the lens permanently. However, in case you are not comfortable wearing the implanted lens (a rarity), the surgeon can always remove these lenses, thereby leaving your eye ready for other vision correcting procedures. Moreover, during the procedure the corneal flap is neither created nor the cornea is reshaped with laser; the purpose is only to implant the contacts to correct the vision. So, there is no question of cornea getting weak or damaged―a common concern associated with LASIK eye surgery. The cost of ICL procedure can vary from USD 2,500 to USD 3,000 per eye. The cost is certainly higher than LASIK due to the high-quality expensive implant that is made after evaluating the size of the eye.

On the whole, when you are considered not suitable for LASIK, consult your eye surgeon, and decide an alternative vision correction surgery that works best for you.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.
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Published: June 17, 2014
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Comments
I went for a laser eye surgery consultation last year and was told I was unsuitable for the procedure due to the shaping on my cornea. I was initially very let down as I thought I was never going to have "crystal clear" vision. I then discovered there were alternatives available to laser which brought back hope. The final option which was suitable for me was lens replacement surgery, specifically IOL. The procedure was carried out last October as I wanted to ensure my vision was corrected for a skiing holiday I had booked in December. I can honestly say having lens replacement surgery is the best decision I have ever made. My skiing has improved due to better vision and an increase in confidence. I had my treatment carried out at Optical Express.

Anyone who is considering laser eye surgery should keep in mind there are alternatives available and I am definitely one to recommend them.
- Colin Copier [June 17, 2014]