LASIK Alternatives


PRK Surgery DiagramPRK (photorefractive keratectomy) was the first procedure performed using the excimer laser. It corrects vision by reshaping the cornea. The difference between LASIK and PRK is that with LASIK, a corneal flap is created and the laser is applied to the inner tissue of the cornea. With PRK, the epithelium (or outer skin of the cornea) is removed and a laser is applied to the surface of the cornea.

PRK can be used to correct low to high levels of nearsightedness, farsightedness, and astigmatism.

To treat nearsightedness, the steep cornea is made flatter by removing tissue from the center of the cornea. This moves the point of focus from in front of the retina to directly on the retina.

To treat farsightedness, the flat cornea is made steeper by removing tissue outside of the central optical zone of the cornea. This moves the point of focus from behind the retina to directly on the retina.

To treat astigmatism, the cornea is made more spherical — like a basketball instead of a football. This eliminates multiple focusing points within the eye and creates one point of focus on the retina. Astigmatism can be treated at the same time as nearsightedness and farsightedness.

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What is the Difference Between LASIK and PRK?

Both LASIK and PRK use an excimer laser to reshape your cornea (the outer surface of your eye), allowing light to focus properly. With LASIK, our ophthalmologists will create a thin flap in your cornea so that the laser can reshape the tissue underneath. PRK does not require the creation of a flap. Instead, our ophthalmologists will use a laser to reshape the surface of your cornea. The healing time for PRK is slightly longer than for LASIK, but both procedures can achieve excellent vision correction results.

Why Should I Consider PRK Instead of LASIK

While LASIK is an excellent way to improve the quality of your vision, the procedure is not for everyone. If your corneas are too thin or your pupils are too large, it may rule you out as a candidate for LASIK. However, these factors do not impact your candidacy for PRK, making it an excellent alternative. The best way to find out if PRK is the right option for you is to schedule a consultation at our Northeastern Pennsylvania ophthalmology office.

Is PRK Painful?

Our doctors will administer a mild sedative and topical anesthetic prior to your procedure to minimize any discomfort. At most, you may experience a slight pressure on your eyes during your PRK procedure. It is common to experience some scratchiness during the recovery process. PRK has been approved by the FDA for use in vision correction procedures since 1995. The procedure is very safe, and complications are extremely rare.

Am I a Candidate for PRK?
There are several factors that may rule you out as a candidate for PRK. Patients with certain conditions such as vascular disease, keratoconus, immunodeficiency, or autoimmune disease are not good candidates for the procedure. PRK is also not a great option for individuals who form excessive scar tissue (keloids).

If you are pregnant or nursing, you will need to wait until this is completed to move forward with PRK. Also, PRK cannot be performed while taking certain medications such as:

  • Accutane
  • Cordorone
  • Imitrex
  • Steroids

Often, PRK is an excellent alternative for patients who are not suitable candidates for LASIK.

During your initial consultation, our ophthalmologists will thoroughly examine the condition of your eyes to determine whether PRK is the best vision correction solution for you.

Who is NOT a candidate for PRK?

There are several factors that may rule you out as a candidate for PRK. Patients with certain conditions such as vascular disease, keratoconus, immunodeficiency, or autoimmune disease are not good candidates for the procedure. PRK is also not a great option for individuals who form excessive scar tissue (keloids).

If you are pregnant or nursing, you will need to wait until this is completed to move forward with PRK. Also, PRK cannot be performed while taking certain medications such as:

  • Accutane
  • Cordorone
  • Imitrex
  • Steroids
Your PRK Procedure

You will arrive at our Northeastern Pennsylvania ophthalmology office about an hour prior to your procedure. Once you have been checked in, you may be offered a sedative to help you relax. You will then be prepared for surgery. The area around your eyes will be cleaned and a sterile drape may be applied around your eye.

Anesthetic eye drops will be used to numb your eyes; no injections or needles will be used. When your eye is completely numb, an eyelid holder will be placed between your eyelids to keep you from blinking during the procedure.

Your PRK procedure will generally take less than five minutes to complete. During the procedure, your doctor will remove the epithelium, a thin layer of protective skin that covers the cornea. You will be asked to look directly at a target light while the laser reshapes your cornea. The laser will be programmed with the information gathered in your pre-operative exam. The laser treatment will be completed in less than a minute or two, depending on the amount of correction needed.

Following your PRK procedure, your eyes will be examined with a slit lamp microscope. Your eyes may be shielded for protection. Your vision may be somewhat blurry or hazy for up to 7 days. You may experience some discomfort as the epithelium heals and covers the treated area.

Eye drops, pain medication, and possibly a protective contact lens can be used to minimize this discomfort. Most patients resume normal activities within one to three days. Vision can fluctuate for up to three months.

Once the recovery period is over you will get the opportunity to experience the world with clear, improved eyesight. Your dependence on glasses or contact lenses will be greatly reduced.

What is the Recovery From PRK Like?

Recovery time after PRK can last from four days to a week. The more you are able to keep your eyes closed during the recovery period, the faster they will heal. After your procedure, our ophthalmologists will provide you with detailed postoperative instructions. It is important to follow these carefully in order to ensure your eyes heal properly.

You can generally return to work within 24 hours of your procedure, but it is best to avoid strenuous activities for a week or two. We also recommend that you wear sunglasses during the recovery period in order to protect your eyes.

Clear Lens Replacement

If you’re tired of wearing glasses but have been told that you’re not a candidate for LASIK, there is another vision correction option that may be right for you. It’s called Clear Lens Extraction and Replacement, and it’s designed especially for people who are over 40 and are not good candidates for LASIK. Clear Lens Extraction involves surgical removal of the eye’s natural or crystalline lens and replacement with an artificial (intraocular) lens to achieve clearer eyesight.

Unlike LASIK and other refractive surgery techniques that correct vision by changing the shape of the cornea, Clear Lens Extraction corrects your vision by changing the focusing power of the eye’s lens. To do this, we replace your natural lens with a new intraocular lens (IOL).

Like the lens of a camera, which focuses images sharply on the film, the eye’s lens focuses light and images on the retina at the back of your eye. With Clear Lens Extraction, your natural lens is replaced with an IOL selected to give you the best vision for your needs.

Clear Lens Extraction is well suited for people over 40 because that is the age that most of us begin to lose the ability to focus up close. This occurs when the natural lens becomes less flexible, and no longer accommodates as well to change its focus from distant to near vision. Then reading glasses or bifocals are needed for close work.

The Procedure

Before the procedure, your eye is carefully measured using precision state-of-the-art ultrasound instruments. These measurements are entered into a sophisticated formula to calculate the exact corrective power of your intraocular lens. This procedure uses the same advanced techniques that have been so successful in restoring sight for people with cataracts. The lenses described below with regard to cataract surgery are the same lenses you and your doctor will discuss your options for your Clear Lens Surgery.

Determining the Right Procedure for You

Some IOLs used in Clear Lens Extraction have a fixed focal length and do not accommodate. If you select this type, you may prefer to have your new lens provide a sharp distance vision for driving, golf, and similar activities. Or you may want near vision for reading, computer work, and other close activities. A consultation with one of our Northeastern Pennsylvania eye surgeons can help determine if this procedure is a good option for you.

Visian ICL

Visian ICL LogoThe Visian ICL (Implantable Collamer® Lens) is a state-of-the-art refractive error solution that is ideal for anyone who has the need or desire for quality vision correction. Produced by STAAR® Surgical Company, the phakic intraocular lens (IOL) has numerous advantages including its correction of the widest range of myopia.

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The Visian ICL Candidate

Good candidates for the Visian ICL include patients who:

  • Are between the ages of 21 and 45.
  • Are nearsighted, including those with mild, moderate, and severe myopia (-3D to -20D prescription) with minor or no occurrence of astigmatism. The Visian Toric ICL™, capable of correcting myopia and astigmatism, is currently under review with the U.S. FDA. The Visian TICL™ is currently available outside of the United States.
  • Have proper anterior chamber depth and acceptable eye tissue cell density (this will be determined by an ophthalmologist after a comprehensive eye exam).
  • Have not had a change in their eyeglass prescription of more than 0.5D in a year.
  • Are not currently pregnant.
  • Have no known allergies to medications used during refractive surgery or no other contraindications.
  • Have dry eyes, severe myopia, or a thin cornea (non-LASIK candidate).
Visian ICL Benefits

The advantages of the Visian phakic IOL make the Visian ICL a sought after treatment for nearsightedness:

  • High quality of vision – The Visian ICL not only improves your visual acuity, but it also enhances your quality of vision by producing sharp vision.
  • Wide treatment range – In comparison to other refractive procedures, the Visian ICL offers the widest treatment range for treating myopia (-3.0 diopters to -20.0 diopters).
  • Foldable – Because the Visian ICL is foldable, a small incision is required during the procedure. This feature makes the procedure efficient (no sutures needed) and improves healing time.
  • Collamer composition – Collamer is made from collagen, which is a substance that naturally occurs in the body. This makes the lens highly biocompatible with the eye.
  • Proven track record – Implanted in over 55,000 eyes worldwide, the safety and amazing improvement in vision quality of the Visian ICL has been proven over the last 15 years.
The Visian ICL Procedure

The implantation procedure for the Visian ICL (Implantable Collamer® Lens) is refractive eye surgery that involves a procedure similar to the intraocular lens (IOL) implantation performed during cataract surgery. The main difference is that, unlike cataract surgery, the ICL eye surgery does not require the removal of the eye’s crystalline lens.

Since glasses and contacts can easily be misplaced and cannot be worn during every moment of the day, many people with nearsightedness seek more advanced solutions for correcting myopia. Refractive surgery, including ICL vision correction, has become a viable option for correcting nearsightedness.

During a brief outpatient procedure, the Visian ICL can be implanted into a myopic eye to correct nearsightedness. The phakic IOL is often referred to as an implantable contact lens because, like a contact lens, it works with the eye’s natural lens to correct a refractive error. Unlike a contact lens, the Visian ICL is surgically placed in the eye and does not have to be removed or cleaned at the end of the day. The Visian ICL also won’t slip out of place like a traditional contact lens.

Quality of Vision

The main advantage of the Visian ICL over traditional corrective laser eye surgery is that patients may experience significant improvement in the quality of vision after the lens is implanted. Patients experience an almost immediate visual recovery.

Wide Treatment Range

The Visian ICL has proven to be effective in patients within a wide range of refractive errors. In fact, the phakic IOL can correct/reduce myopia from -3.0 to -20.0. Before now, some of these individuals were not candidates for surgical eye correction. Clinical studies have shown how the Visian ICL is truly a breakthrough myopia treatment in terms of results. Because implantation of the phakic IOL does not require any structural alteration of the eye, results are predictable and very stable.

When asked, most people say that they would most like to get rid of their contact lenses and glasses because they feel limited in the pursuit of certain activities. Whether frustrated by the hassle of having to carry prescription sunglasses for use in outdoor activities or an inability to see clearly underwater, people who use glasses and contacts often refrain from enjoying their lives to the fullest. Most patients who have received the lens implantation are pleased with how streamlined their everyday activities have become without the need for glasses and contacts.