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Tired of Wearing Glasses for Seeing at a Distance? Why LASIK May Not Be the Answer

It seems that LASIK has been all the rage in vision correction surgery since it was approved for use in 1998, generally accounting for somewhere around 95% of all refractive surgeries.  But now a new procedure, using the technology that has been successful during cataract surgery, may offer a more desirable option for severely nearsighted patients. 

By implanting a soft silicone lens called an IOL (Intraocular Lens) doctors are now able to offer permanent vision correction for patients with nearsightedness (myopia) as poor as -20D.  During cataract surgery an IOL is used to replace the eyes natural lens after it is removed from the eye in cloudy pieces.  For purposes of vision correction, however, the natural lens is not removed and the IOL is placed in front of it.

The first and (so far) only IOL to receive FDA approval for correcting nearsightedness, called Verisyse, has been available now for just over a year and is starting to give LASIK a run for its money when comes to elective vision surgery.

The results of a 2004 survey presented at the joint meeting of the International Society of Refractive Surgery (ISRS) and the American Academy of Ophthalmology (AAO) show a rising trend in the use of IOLs, especially in patients with higher degrees of nearsightedness.  Ophthalmologists were asked their preferred treatment for a 30 year old patient with -12D of myopia, 40% suggested the use of an IOL with only 17% choosing LASIK (with 32% suggesting that the patient not undergo surgery).

Surgery Specifics

The Verisyse IOL is approved to treat patients that have between -5D and -20D myopia with no more than 2.5D of astigmatism.  Basically this means you have to have pretty bad eyes, but before IOLs started to become popular your options were either to avoid surgery and stick to glasses or to take a chance with LASIK, which statistically provides worse results with poorer eyesight.

The procedure can be as short as fifteen minutes and is usually done as an outpatient surgery with the aid of a local anesthetic administered in the form of eye drops. And as an added bonus, patients usually can return to normal activity on the day following surgery.

Though IOLs are meant to permanent, the procedure is reversible, unlike other vision surgeries, and it can also be combined with other procedures to further improve results.

It’s not all upside though. The little lenses carry a hefty price tag, at about $3,500 - $4,000 per eye, none of which is reimbursed by insurance. Of course, there are complication possibilities looming as well.

In addition to under or over correction and night vision problems like glare or haloes, complications associated with most vision surgeries, there is the possibility of excessive scaring from the incision as well as post-operative cataract development.

While all of these complications are rare and treatable, the possibilities of less than optimal vision or additional surgery are certainly not pleasant ones.

As technology progresses and Ophthalmologists become more comfortable using IOLs, the landscape of vision correction surgery could begin to shift toward a less LASIK dominated one. In the same 2004 survey at the ISRS/AAO meeting 88% of respondents said that they are currently using IOLs for vision correction, or plan to in the future, while 94% said the same for LASIK.

While LASIK certainly isn’t going anywhere, implantable IOLS don’t seem to be either and may just carve out their own little niche in the poor-eyesight patient market.

Phakic IOL Intraocular Lens Surgery Information Guide

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