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Refractive Intraocular Lens Correction ∞
Refractive IOL Correction
This same procedure is used in cataract surgery, where the the cloudy natural crystalline lens is replaced with the intraocular lens.
This procedure has been used with great success for 4 decades with over a million cataract operations per year.
New types of intraocular lens have been developed to insert within the eye without removing the natural crystalline lens. This lens is placed either behind or in front of the existing one. Persons under 40 years of age are candidates for such lenses. People over 40 tend to have less “room” to insert a lens, so their existing one is removed.
An example of a Phakic Intraocular Lens (coexisting with the natural lens) is the Artisan Myopia Lens (ICL/Artisan). Lenses used to replace the natural lense are CLE.
How does Refractive IOL Correction work? ∞
A small incision (approximately 3 – 5 mm) is placed at the periphery of the cornea.
The synthetic lens is placed into the anterior eye chamber through the incision, and it is secured into place on the iris or between the posterior surface of the cornea and iris with two small flexible hooks.
The lenses used are foldable and small enough to be inserted through a self-sealing, “no-stitch” incision, providing clear vision after surgery.
For lens exchanges (CLE), first the eye’s natural lens is removed by ultrasound, and it is then replaced with a synthetic lens.
The procedure takes about 20 minutes.
Upsides to Refractive IOL Correction ∞
- Reliable
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Synthetic lens implants (ICL / Artisan) are known for the high potential of exact predictability and the reproducibility of the surgical success.
- Reversable
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The intraocular anatomy or physiology of the eye is not changed. The center of the cornea is not touched prior to surgery and nothing about the anatomy of the eye is changed.
- Correctable
- If a refractive error remains after a synthetic lens implant, it can be corrected with a laser surgery, also known as LASIK.
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FIXME – What about getting a different lens?
- Duration
- The intraocular lens is made of biocompatible material and will generally outlast your eyes. =)
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No healing contact lens.
Downsides to Refractive IOL Correction ∞
- Visible
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The lens is visible under inspection, just like a contact lens.
- One eye at a time
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Surgery on both eyes is performed at an interval of approximately 1 week.
- Bandage
- On the day of surgery, the eye is covered with a bandage.
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FIXME – what is this “bandage”?
- Vision stabilization
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It takes approximately 8 – 12 weeks (or up to 6 months!) for your vision to reach final stabilization.
- Not always perfect
- Total freedom from wearing eyeglasses cannot be achieved in all cases.
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(FIXME – Needs more explanation)
- Post-Op Examinations
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Postoperative checkups up to 3 months after surgery.
- Cost
- Pre-op examinations
- Post-op examinations
- Costs for LASIK surgery to enhance this are an additional expense
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Reported as $2500 (Canadian Dollars) per eye, all costs included.
- Vision Problems
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When the pupil is dilated at dawn and at dusk, the refraction of rays of light at the edge of the synthetic lens can lead to an increase in glare or halos.
- No Long-Term Data
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Long-term results dating back numerous years are not yet available for some of the newer and more modern synthetic lenses.
- Bad Stuff
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Infection, pupillary distortion, cataract, secondary glaucoma, corneal opaqueness
- Medication
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For 7-10 days after surgery.
Refractive Lensectomy ∞
This is the removal of the eye’s natural, or crystalline, lens to correct high degrees of near- or far-sightedness. In these cases, the power of the eye is too strong to be corrected by corneal refractive surgical procedures such as LASIK or PRK. In some cases, an intraocular lens implant (artificial lens) may be inserted to produce an even greater effect.
Photorefractive Keratectomy ∞
(PRK)
LASIC Eye Surgery ∞
LASIK for Hyperopia (Laser-in-situ Keratomileusis)
A flap is cut off the eye and a laser is applied to reshape the underlying surface.
The procedure takes about 15 minutes per eye.
Concerns With LASIK Eye Surgery ∞
- May permanently lose vision
- Some patients may lose some vision or experience blindness
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Thin Corneas — The cornea is the thin clear covering of the eye that is over the iris, the colored part of the eye. Most refractive procedures change the eye’s focusing power by reshaping the cornea (for example, by removing tissue). Performing a refractive procedure on a cornea that is too thin may result in blinding complications.
- Results may not be lasting
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Long-term results are not known
- Development of visual symptoms
- glare, halos, starbursts, etc. and that night driving might be difficult.
- Large pupils present a risk for nighttime halos. They can cause symptoms such as glare, halos, starbursts, and ghost images (double vision) after surgery. In some patients these symptoms may be debilitating. For example, a patient may no longer be able to drive a car at night or in certain weather conditions, such as fog.
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Glare may last up to four weeks
- Contrast sensitivity
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Your vision could be significantly reduced in dim light conditions
- Bilateral treatment
- Additional risks of having both eyes treated at the same time.
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(.. which are?)
- Drops/medications
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Drops in your eyes at regular intervals
- Be prepared to wear an eye shield
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You need to protect the eye for a period of time after surgery to avoid injury
- Expect some pain/discomfort
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(When, for how long?)
- Changing vision
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Final results could take months
- Dry Eyes
- LASIK surgery tends to aggravate this condition.
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Dry eyes may last up to four weeks
- Eye Shield
- Up to four weeks of wearing an eye shield at night.
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This is my most serious concern.
- Stable refraction
- Before any further surgery – if you don’t get the desired result, do not have an enhancement until the prescription stops changing, which may take months.
- If further correction or enhancement is necessary, you should wait until your eye measurements are consistent for two consecutive visits at least 3 months apart before re-operation.
- It is important to realize that although distance vision may improve after re-operation, it is unlikely that other visual symptoms such as glare or haloes will improve.
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If you develop any new, unusual or worsening symptoms at any point after surgery. Such symptoms could signal a problem that, if not treated early enough, may lead to a loss of vision.
- Blurred vision
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for maybe a week
The Cost of LASIC Eye Surgery ∞
From $1000 to $2000 (Canadian Dollars) per eye, with additional costs for pre- and post-procedure assessments by your optometrist or ophthalmologist.
Payment plans may be available.
LASIK Eye Surgery Resources ∞
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U.S.A. Food and Drug Administration: LASIK Eye Surgery
- What should I expect before, during and after LASIK eye surgery?
- LASIK Surgery Checklist
- FDA-Approved Lasers
— Keep in mind that doctor’s are legally permitted to use lasers for “off-label” uses, such as other surgery types.
Laser Eye Surgery Resources ∞
- Health Canada: Laser Eye Surgery
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ESEC – The Eye Surgery Education Council
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