Laser or lens-based? Leaps and bounds in corrective eye surgery mean there’s something for everyone, says AVC surgeon Goran Helgason MD.
For a long time, corrective eye surgery was synonymous with laser eye surgery and to many potential patients, it still is. As a result, some vision correction clinics have been reluctant to incorporate other technologies into practice but this is very limiting for those patients whose eyes are not suitable for this kind of treatment.
The lens-based surgical implant options that are now available greatly increase the opportunities for both patients and surgeons to find a mutually agreeable solution to a very wide range of refractive errors.
A driving factor behind this sea-change in the market is increasing demand from the growing presbyopic population – in other words, the baby boomer generation who are now at an age when they can’t read the small print and who do not want the inconvenience of having to keep reaching for a pair of reading glasses.
So, what is the difference and how do patients know which one is best for them? Should they choose LASIK or PRK (laser procedures) or phakic IOLs (implantable contact lenses) or CLE (clear lens exchange)?
There is so much information available online about corrective eye surgery that often patients have decided on a specific treatment before they set foot in the clinic. They may have chosen the right option but equally they may find that a new alternative is more appropriate.
Unlike the one-stop-shop laser clinics, AVC has fully embraced all new technologies which means we are able to find a solution for practically every refractive error. The key to a successful conclusion is putting forward the case for each option in a way that patients can understand.
Intraocular lenses for presbyopic patients
The biggest deciding factor when it comes to patient suitability for IOLs (intraocular lenses) is the patient’s age. Word has spread to patients that this technology can solve the problems of presbyopia and achieve freedom from spectacles for reading and distance vision. Many in the older age bracket, including cataract patients, who think their age precludes them from any option that corrects their refractive error, can also benefit from this option.
Multifocal IOLs
In our clinics, the evolution of multifocal implants has positioned these lenses as the first choice for treating presbyopia. We have been using most of the common multifocal implants for more than 10 years with very positive results. Our patients want value for money and these are more likely to deliver spectacle freedom than with accommodating lenses. After surgery the patient is often reading well within a few days and halos tend to fade within weeks. Depth of focus, which is often better than with other multifocal models, strengthens capability and increases the ability to read a computer screen at 50-60cms.
LASIK and PRK for higher myopia or hyperopia
The latest generation of lasers, keratomes and femtosecond lasers has made LASIK eye surgery considerably safer, making flap complications and induced aberrations rare these days.
Implantable contact lenses (ICL) – remarkable results for the widest range of refractive errors
The Visian ICL brand of implantable contact lenses provides impressive predictability and excellent quality of vision, even with very high prescriptions. The treatment range is remarkable, covering nearly all refractive errors from 10.00 to -18.00D, with or without astigmatism up to 5.00D.
The fact that the procedure is reversible and that no tissue is removed seems to particularly appeal to patients. No stitches are needed and the 2mm incision in the cornea is self-sealing.
Take it from the horse’s mouth – in 2004 I became a satisfied Visian ICL patient myself which has most definitely increased the trust and popularity of this technology among our patients.
Dr Helgason is recognised as a leading authority on the ICL technique and spent five years training surgeons all over the world when the technology was first developed.
