Fort Collins and Denver area eye surgeon Dr. Paul Cutarelli provides LASIK alternatives for patients. Due to varying medical conditions, infections, injuries and various other factors, not everyone qualifies for LASIK eye surgery.
Alternatives to LASIK
- In cases where patients do not qualify for LASIK, alternatives may be considered for vision correction. There are many surgical and non-surgical options to choose from, but only an experienced ophthalmologist can help you decide which is best for your individual needs.
PRK (photorefractive keratectomy)
LASIK is usually the most popular form of vision correction, but sometimes due to lifestyle, your career, cornea thickness or other abnormalities, PRK may be required.
What is PRK?
- PRK came before LASIK and was the first modern operation using a laser to correct vision.
- Photorefractive Keratectomy (PRK) is a laser surgical procedure effective in correcting nearsightedness, farsightedness, and astigmatism. Much like LASIK, PRK uses an excimer laser to reshape the cornea to the desired shape, resulting in a reduction or elimination of glasses and contact lenses.
- About 15% of patients receive PRK for their laser vision correction, particularly if they have thin or irregular corneas.
- This reshaping is done on the outside surface of the cornea, rather than under a flap as in LASIK.
PRK Surgical Procedure
During the PRK procedure, Dr. Cutarelli does not create a flap, but instead gently removes the epithelium cells, the thin layer of protective cells on the surface of the cornea. He then uses the cool beam of the excimer laser to precisely reshape the cornea to its desired shape, in the same manner as LASIK, with the same visual results. PRK eye surgery generally requires about twenty minutes of operating room time, but the actual duration may vary according to the type and amount of correction needed. A mild sedative, such as Valium, Xanax or Ativan, may be given to help you relax. Eye drops will be administered to numb your eyes. You will be lying on the laser bed and your eyelids will be held open with a device called a lid speculum. You will be asked to focus on a special fixation light in a microscope. For a more detailed explanation see: LASIK surgery.
After the PRK surgery is complete, Dr. Cutarelli will place a soft contact lens on the cornea to protect the eye and reduce discomfort while healing. Until the contact lens is removed, your vision will be remain blurred. The blurriness may go away within a short time or may be that way for a number of months. You will be required to use medicated and lubricating eye drops to assist the healing process. It will generally take a few weeks for your vision to stabilize.
Both LASIK and PRK lead to the same visual outcome. In PRK and LASIK, you can usually read a clock across the room immediately after the procedure. PRK however, has a slightly longer recovery period, usually taking a week or so before a patient reaches optimal visual acuity. Immediate recovery time and time off from work is two to four days.
For the first few days after your procedure, you may experience discomfort, ranging from scratchiness, to actual pain; your vision may be blurry and/or may fluctuate between being clear and being blurry. In some cases, a patient’s vision improves immediately afterwards, but later becomes blurry. This can affect various patients differently; some may not be bothered, other patients may be more intolerant to the discomfort or lack of visual acuity.
Functional vision typically recovers shortly thereafter. Several weeks or months may be required to attain final visual results.
You may need glasses or other corrective lenses after the procedure on a temporary basis, depending on the severity of your visual error/prescription.
PRK includes the same risks as LASIK, plus some discomfort caused by the removal of the protective epithelium, or skin, of the cornea. This sometimes persists for 2 to 3 days until the epithelium grows back, during which time the patient continues to wear a protective contact lens and use pain relief medication. Although rare, sometimes patients might develop a haze on the cornea due to a over procedure of epithelium cells. This condition normally occurs in those with severe visual errors. Dr. Cutarelli can easily treat corneal haze by removing the epithelium cells and allowing them to grow back naturally. Patients who undergo this procedure will need to wear a protective contact lens for 1-3 weeks.
Visian Implantable Collamer Lens®
The Visian ICL® is an excellent LASIK alternative for patients who are either poor candidates for LASIK or concerned about the reversibility of the procedure.
Sometimes called the “implantable contact lens”, the Visian ICL® is a clear flexible lens that is gently implanted between the eye’s iris and natural crystalline lens. The surgery is very similar to intraocular lens implant after cataract surgery, with the biggest difference being that the eye’s natural lens is not removed. The Visian ICL® can be used to treat nearsightedness, and many patients who receive this implant are freed from their dependence on glasses and contact lenses.
Studies have even shown that patients with great degrees of nearsightedness see with greater clarity and sharper image quality with the Visian ICL® than with LASIK. Also, unlike LASIK (which permanently reshapes the cornea), the Visian ICL® implantation is reversible. If complications should arise, which are rare, the Visian ICL® can be safely removed.
Verisyse™ Phakic IOL
Verisyse™ Phakic intraocular lenses are artificial lens implants that are placed in the eye’s anterior chamber. In a procedure similar to cataract surgery, Dr. Cutarelli can fix the Verisyse™ Phakic IOL to your eye’s iris.
This provides a second focusing lens to correct nearsightedness. Like the Visian ICL® procedure, Verisyse™ Phakic IOL implantation is slightly more complex than a LASIK procedure but is less involved than cataract surgery.
Refractive Lens Exchange
Refractive lens exchange is a newer option that can treat high refractive errors, early stage cataracts, and/or presbyopia. Following a procedure identical to that of cataract surgery, Dr. Cutarelli can remove the eye’s natural crystalline lens and replace it with any of a number of premium accommodative or multifocal lens implants. These lenses are specifically designed to reduce or eliminate the need for glasses and contacts for post-cataract patients, and are capable of doing the same for patients with mild cataracts, high prescriptions, and/or presbyopia.