It’s not uncommon to have your vision change as you get older. As we age, it gets more difficult to focus on objects up close because the lens inside the eye begins to lose its ability to change shape. This is a condition called presbyopia. For those who want to correct this but don’t want to wear glasses or contact lenses, corrective surgery—such as LASIK or refractive lens exchange—can certainly help.
Dr. Aris Delianides, co-founder of Atlantic Eye Consultants in Virginia Beach, has been performing both surgeries for many years. In fact, he was one of the first surgeons in the area to use the Alcon LenSx laser to facilitate surgery and correct astigmatism. He uses his years of experience to select the appropriate procedure for each patient to achieve the best results possible. Here’s what he had to say about the two different procedures:
LASIK stands for “laser assisted in situ keratomileusis,” which means a horizontal flap is created in the cornea using either a mechanical keratome or more recently a femtosecond laser. The flap is hinged at one end and lifted up to allow ablation (removal of material from the surface of any object by vaporization, chipping or other erosive processes) of the corneal tissue underneath by an excimer ultraviolet laser that reshapes it. The reshaping is adjusted such that nearsightedness, farsightedness and astigmatism can be corrected. The flap is then repositioned and adheres to the ablated surface. Vision is improved immediately but improves more within a few days. Very little discomfort is involved.
Pros: Quick, no operating room or sedation required, no incision into the interior of the eye means reduced chance of infection, and both eyes can be done the same day.
Cons: Possible flap complications, farsightedness (hyperopia) correction not very stable over time, cannot correct distance and near vision simultaneously in presbyopic patients, glare and halos common at night due to loss of aspheric property of normal cornea, excessive dryness common after surgery and can last many months or longer, and cannot be used in patients with very thin corneas or those with connective tissue diseases or herpes simplex of the eye.
Refractive lens exchange involves using cataract surgery techniques to remove a non-cataractous lens through a tiny incision, then replacing it with an intraocular lens implant. The lens implant power is chosen to match the length of the eye and curvature of the cornea such that the original refractive error is reduced or eliminated. Nearsightedness, farsightedness and astigmatism can be corrected. Various types of intraocular lenses and a special laser such as LenSx can be used to fine tune the correction during the surgery. There is normally very little discomfort, but sedation is used for comfort, and it must be performed in an operating room. Your vision will start to improve anywhere from the next day to a few days afterward.
Pros: Can be used in patients with thin corneas and underlying connective tissue diseases, generally stable correction with time, can give both near and distance vision if a multifocal lens is used, no issues with post op dryness, no chance of needing cataract surgery later in life, no change in aspherical property of cornea so reduced glare and halos, no corneal flap to cause problems.
Cons: Requires operating room and IV sedation, will result in immediate need for reading glasses unless a multifocal lens is chosen (greater expense), small but finite chance of serious intraocular infection since interior of eye is accessed, small risk of natural lens dislocation during surgery possibly requiring retinal surgery, generally more expensive since operating room is used.
Dr. Delianides can perform an initial exam using state-of-the-art diagnostic equipment to help you determine the best procedure for what you wish to achieve. Give Atlantic Eye Consultants a call at 757-481-3800 to schedule your appointment, or visit their website at AtlanticEyeConsultants.com for additional information.
