Refractive Surgery

lady in the operating room

You probably will have heard your optometrist talking about near-sightedness, far-sightedness or astigmatism. These are what is known as ‘refractive errors’ and this is because they are conditions caused by a problem with how the light refracts when it passes through your eye to the retina. In the case of refractive errors, the light gets distorted which in turn causes problems with your vision.

Refractive surgery is the term given to describe surgical procedures that seek to correct or significantly improve refractive errors in your eyesight, and reduce or remove your dependence on glasses or contact lenses. There are different types of refractive surgery, but they all share the same goal.

Types of refractive surgery

Almost all types of vision correction surgery focus on reshaping the cornea (at the front of the eye) so that the light that travels through it is properly focused onto the retina (at the back of the eye). However, there are some types that involve replacing the natural lens of the eye in order to improve vision. Here are some of the most common.

AK or LRI

This is a surgery used to correct astigmatism, and works by making a couple of small incisions at the steepest part of the cornea which cause it to relax and take on a more rounded shape. This surgery is sometimes used in conjunction with others such as PRK, RK or LASIK.

LASIK

LASIK is laser eye surgery that can help to correct vision in people who are near or far-sighted, or have astigmatism. In LASIK a flap is made in the outer cornea so that the surgeon can use a cold laser to reshape the lower corneal tissue so that the light refracts properly onto the retina.

PRK

Short for photorefractive keratectomy, PRK is a laser eye surgery very similar to LASIK, but is delivered on the main surface of the cornea, rather than via a flap to lower level corneal tissue.

RLE

Otherwise known as ‘refractive light exchange’, RLE is identical to cataracts surgery in that it involves a small incision at the edge of the cornea in order to remove the natural lens of the eye and replace it with a silicone or plastic lens. RLE is particularly useful for people who have corneal issues such as dry eyes or thin corneas. If you also have astigmatism, you can combine your RLE treatment with LASIK laser eye surgery.

Intacs

Short for intercorneal ring segments, this refractive surgery is the most common treatment for patients diagnosed with keratoconus. It requires a small cut to be made into the cornea in order to insert two crescent-shaped plastic rings at the outer edges. These rings help to flatten it, which will adjust the way that light is focused onto the retina.

Phakic intraocular lens implants

This surgery has been designed specifically for patients who are too near-sighted for LASIK or PRK to be successful. An implant in inserted through a small incision at the edge of the cornea, and attached to the iris or inserted behind the pupil, leaving the natural lens of the eye in place.

PRELEX

Short for presbyopic lens exchange, this surgery corrects a condition called presbyopia, which is when the lens of the sufferer’s eye loses flexibility, which makes it difficult for them to focus on objects that are close by. In PRELEX a multifocal lens is inserted into the cornea.


Is refractive surgery safe?

Eye surgeries have largely been shown to have very effective results. However, as with any surgery there are some risks and complications that you should be aware of. These can include:

- Changes in your vision such as haziness and blur

- A halo effect in dim light

- Dry eye

- Under or over correction of your vision

- Infection

- Worse vision

However, most side effects clear up very quickly, and more serious complications are extremely rare. Thanks to advances in medical technology, refractive surgery is as currently the safest is has ever been.


Is refractive surgery right for me?

Whether or not refractive surgery is right for you will depend on your ocular needs. However, it could be a good option if you:

- Are far-sighted or near-sighted

- Have astigmatism

- Want to reduce your dependency on glasses on contact lenses

- Are willing to accept the risks and side effects associated with the procedure

- Are free of eye disease and are in good general health

- Accept that you may still need to wear glasses or contacts after the procedure to get the best vision possible

If you are interested in refractive surgery or would like to know more information, we highly recommend that you speak to your optometrist who can assess your candidacy based on your specific requirements.