Alternatives To Laser-Assisted Refractive Surgery

Written by John Taylor

If laser-assisted refractive surgery isn't for you, don't despair of ever being rid of your contact lenses or eye glasses. There are a number of techniques available that can increase the focusing power of your eyes without resorting to laser surgery.

There are a variety of reasons why a person may not be a good candidate for laser-assisted refractive surgery, the main ones being age or a severe case of myopia or hyperopia.

One alternative procedure that can improve the vision of folks who are too nearsighted or farsighted for laser-assisted refractive surgery is intraocular lens implantation. Intraocular lenses are small lenses made of plastic that are placed behind the cornea in the eye. The lenses serve the same function as contact lenses or glasses, they bend light to provide the proper level of refraction for the eye.

Actually, intraocular lenses have been used for decades in cataract therapy. The lenses are used to replace your eye's crystalline lense when it has to be removed because of cataracts. This is a relatively common procedure undergone by more than one million United States residents each year.

In recent years, the lenses have begun to be used to treat nearsightedness or farsightedness, particularly in severe cases that laser-assisted refractive surgery can't help. These implants are called phakic lenses and differ from the ones that are used in cataract treatment in that they are implanted in the eye without removing the crystalline lens. There are two types of phakic implants. Anteriror chamber implants are placed in the front of the iris and are actually visible if you look carefully into your eye. Posterior chamber implants are implanted behind the iris.

This form of surgery is more invasive than laser-assisted refractive surgery and will require a longer recovery time. Also, there's a greater risk of damage to the eye from this type of surgery because the implants are near important structures of the eye.

Corneal rings are another type of implant that can improve vision. These implants are very small pieces of plastic that are implanted in the edge of your cornea. These rings adjust the shape of the cornea, and thus can reduce nearsightedness. These implants are only appropriate for a small number of patients, whose nearsightedness is realtively mild.

Radial keratotomy was a pioneering surgery first used to treat nearsightedness in the 1970s. Radial keratotomy consists of an operation in which your eye surgeon will make a number of small cuts around the edges of the cornea. These cuts are made in a pattern designed to increase the curvature of the cornea in its periphery and decrease the curvature in its center, thus better refracting light to improve nearsightedness. RK has largely been superseded by laser surgery, but is still practiced in some cases.

A pre-cursor to laser-assisted refractive surgery that is no longer being used is automated lamellar keratoplasty. Much like LASIK, a flap was cut into ALK the front layer of the cornea and folded upward. Unlike LASIK, in ALK the device used to make the flap was used again to flatten the cornea somewhat, and thus reducing nearsightedness.

A still-used alternative to laser-assisted refractive surgery is conductive keratoplasty. This procedure uses radio waves to alter the shape of the cornea. It's most commonly used to treat hyperopia and is sometimes used to create monovision, a condition where one eye is adjusted to better seen up close objects to eliminate the need for reading glasses. In general, it takes longer for CK patients to realize the improvements in their vision.

Another alternative to laser-assisted refractive surgery is orthokeratology. While not a surgical correction, this procedure can reduce dependence on contact lenses and glasses. In orthokeratology, the patient uses a series of progressively flatter contact lenses to reduce the cornea's curvature. After the patient completes this treatment, he or she will be able to see with improved vision without the use of eyeglasses or contacts. The patient will have to continue wearing contact lenses at night, and if the patient stops wearing these retainer lenses he or she will lose the gain in vision within about a week. This form of treatment is used to treat patients with mild myopia.

While there are several alternatives to laser-assisted refractive surgery, in terms of availability, usefulness and convenience, laser-assisted refractive surgery is in most cases a more attractive option.