Top 4 Alternatives to LASIK
1. PRK
2. ICL
3. SMILE and KLex
4. RLE
You may be asking yourself what other surgical options besides LASIK are available to me? Or you may have been told previously that you are not a good candidate for LASIK.
LASIK has been and still is a very successful option for most people, but there are individuals who are better served by other surgical options.
LASIK involves creating a flap of the surface or cornea of the eye, lifting that flap, using an excimer laser to reshape the surface underneath the flap, and finally replacing the flap.
1. PRK is also performed on the corneal surface of the eye; however, unlike LASIK, there is no flap created. The skin-like surface of the eye, or epithelium, is removed, an excimer laser is used to reshape the eye’s surface (similar to LASIK), and a contact lens is placed and later removed. The contact lens acts somewhat like a band-aid. PRK is a better option for people who have thinner or slightly irregular corneas because it thins the cornea less than LASIK and is therefore safer in those circumstances. If the cornea becomes excessively thin, then vision loss may occur and additional surgery may be required. After surgery, the LASIK flap can rarely become dislodged if there is trauma to the eye, and PRK does not create a flap; therefore, it may be safer for individuals who are prone to being hit in the eye, such as boxers, basketball players, military, police, etc. Some feel that PRK may also cause less drying of the eyes than LASIK, although more recent studies have refuted that fact. Scarring is slightly more common with PRK than with LASIK, although this rarely affects vision and is often treatable.
LASIK and PRK can be used to correct nearsightedness, farsightedness, or astigmatism.
2. SMILE or KLex (Keratolenticular extraction) procedures involve using a laser to cut a lenticule of corneal tissue which is then removed to alter the shape of the cornea and thereby correct nearsightedness and astigmatism. It is not approved in the US for farsightedness. Some studies have found that the outcomes are similar in accuracy to LASIK. Other studies have indicated that SMILE is not quite as accurate as wavefront-guided LASIK. Studies indicate that KLex may initially cause less drying of the eyes than LASIK, although many feel that the difference in dryness is minuscule after 3 months post-op. Similar to PRK, KLex does not involve a flap and therefore may be safer for those prone to being hit in the eye.
3. ICL or Implantable Collamer Lens (also referred to as implantable contact lens) is a procedure where a manmade lens with the patient’s prescription is implanted inside the eye directly behind the pupil. Traditionally, it has been used in individuals who were not good candidates for corneal procedures (ie., LASIK, PRK, KLex) such as high levels of nearsightedness or excessively thin corneas. ICL, like SMILE, is not currently approved in the US for hyperopia and is only approved up to age 45. Currently, ICL has had its indications expanded to include moderate levels of myopia down to -3 diopters. Since ICL does not flatten nor thin the cornea, it is less likely to cause glare, halos, or lessen contrast at night compared to corneal procedures. ICL carries more risk of cataract, glaucoma, and retinal detachment formation than corneal procedures.
4. Refractive Lens Exchange (RLE) is also sometimes referred to as Clear Lens Extraction (CLE). RLE is an intraocular procedure which involves removing the lens of the eye and replacing it with an intraocular lens designed to correct the individual’s prescription. This is generally used in individuals who do not qualify or are not good candidates for LASIK, PRK, KLex, nor ICL. This procedure is similar to cataract surgery but differs in that the individual does not have a prior significant cataract. It is often used in individuals who have farsightedness or are older than 45 and therefore do not qualify for ICL. Individuals having RLE have risks similar to cataract surgery, including risk of retinal detachment and glaucoma.
Intraocular procedures like ICL and RLE tend to be significantly more expensive than cornea procedures (LASIK, PRK, KLex). Sometimes up to double the cost.
At Davis Vision Center, we offer free VIP consultations and can discuss these different options and help you decide which procedure is best for you.
