If you are nearsighted (myopic) or farsighted (hyperopic) or have astigmatism, refractive surgery can correct these irregularities and decrease your dependence on glasses or contact lenses. Corneal refractive surgery changes the curvature and shape of the cornea to compensate for the refractive error. There are two main categories of corneal refractive surgery – LASIK and PRK. Intraocular refractive surgery involves placing a lens inside the eye to correct the refractive error. This can be performed in conjunction with removing the natural lens of the eye (cataract surgery) or with leaving the natural lens in place (implantable collamer lens).
LASIK (LASer In-situ Keratomileusis), commonly referred to as laser eye surgery or laser vision correction, is the most common type of corneal refractive surgery. In LASIK, a thin flap in the cornea is created using a femtosecond laser. The flap is then carefully folded back, and a laser procedure using an excimer laser is performed to reshape the inner layers (stroma) of the cornea. The flap is then placed back into position and acts as a bandage. The main advantage of LASIK is fast healing and visual recovery. The main disadvantage of LASIK is that it requires a certain thickness of the cornea to be able to make the flap, and in some situations is not safe if your cornea is not thick enough or shows signs of potential weakening.
PRK, or Photo Refractive Keratectomy, is another category of corneal refractive laser eye surgery. Instead of a flap being created, this procedure is performed on the surface of the cornea. The outer layer of the cornea (epithelium) is gently removed and will grow back on its own after the procedure. Dr. Jones will then use the excimer laser to reshape the cornea correcting the refractive error. The cornea then heals over the course of several days to weeks. The advantage of PRK is less risk of weakening of the cornea (ectasia) and can be performed on thinner corneas. The disadvantage of PRK is longer healing time and discomfort after the procedure. Usually discomfort lasts for 2-3 days after the procedure, and visual recovery takes 1-2 weeks.
For some patients, the cornea is not amenable to laser surgery and the safest option is intraocular surgery. Dr. Jones performs corneal testing (pentacam topography and tomography) to determine if laser surgery on the cornea is safe. In some situations he may recommend alternative refractive surgery procedures such as an Implantable Collamer Lens (ICL) or clear lens extraction with intraocular lens (cataract surgery). Over the age of 50 years due to aging changes of the natural lens in your eye, intraocular surgery is often a better long term alternative to corneal laser surgery.