Nearsightedness: Your Surgical Options Explored
January 17th, 2020 by David Martin
Vision correction surgery has quickly evolved over recent years. Patients are now getting consistently excellent results from these safe and accurate treatments for a variety of eye conditions. As a result, more and more people are turning their back on contact lenses and glasses in favor of surgical options.
Nearsightedness, or myopia, is an increasingly common problem. According to a study published by the American Academy of Ophthalmology, around half the total global population will be myopic by 2050. Whilst the increase in myopia is a worrying trend, the good news is that there are now a variety of ways of treating myopia, including surgically.
Why consider surgery for myopia?
If you are affected by myopia and need to correct your vision to go about your day-to-day life safely and comfortably, you will have probably explored these non-surgical options: glasses, contact lenses or Ortho-K lenses. While many people are very happy using one of these for myopia control, they do have their downsides.
Patients may find glasses:
- Unsuitable for their line of work
- To be easily lost or broken
- Cause them to feel self-conscious or unattractive
Patients using contact lenses may find they are:
- More prone to infections, dry eyes or conjunctivitis
- Put off by the hygiene routine associated with contact lenses
- Discouraged by the regular costs of replacing contact lenses
- Allergic to contact lens solutions
Ortho-K lenses are worn at night only, so they suit a greater number of people than traditional contact lenses. They are a popular non-surgical option that applies gentle pressure to reshape the cornea and improve vision. However, they carry some of the infection risks of contact lenses.
If any of these problems affect you, then you may wish to consider a more permanent, surgical alternative for vision correction.
What are the surgical options available for myopia control?
If you have myopia, your ability to focus on nearby objects is good, but you will struggle to clearly see objects in the distance. Refractive eye surgery is the general name given to any eye surgery that corrects or improves the eye’s focus. Common surgical procedures reshape the front curvature of the cornea so that the correct focus can be achieved.
There are two main categories of refractive eye surgery frequently used to correct myopia are:
- Excimer laser procedures: A laser is used to alter the shape of the cornea.
- Implant procedures: The shape of the cornea is altered using an implant.
Within these main categories, there are several different options for treatment. Here, popular surgeries for those affected by myopia are explained.
Excimer laser procedures
LASIK stands for laser-assisted in situ keratomileusis. Firstly, a small flap is lifted from the surface of the cornea. An excimer laser then modifies the shape of the cornea underneath, before the flap is replaced. While this may feel a little uncomfortable for a few hours post-surgery, recovery is rapid. With LASIK surgery, vision is often restored within a few hours.
PRK is short for photorefractive keratectomy. It’s a surgical treatment suitable for those with low to moderate myopia.
First, the epithelium is removed from the eye. This is the very fine layer that coats the surface of the eye. An excimer laser is then used to sculpt the outer surface of the cornea. However, longer healing time and greater discomfort are associated with removing the epithelium. For this reason, most eye doctors usually recommend LASIK over PRK.
LASEK stands for laser-assisted epithelial keratomileusis.
In LASEK surgery, the epithelium is also removed, and the cornea beneath reshaped using an excimer laser. In this procedure, however, the epithelium is preserved and reused as a sort of bandage to aid the healing process. This means recovery is faster than from PRK, but it’s still generally more uncomfortable than LASIK.
Next-generation technology is now increasingly being used to improve on existing excimer laser procedures. This new technology uses specialized information acquisition equipment, dedicated software, and specific adaptations to provide a detailed, customized treatment for each patient.
This has enabled more patients to be treated using excimer laser and with even better accuracy, too.
Intracorneal ring segments (ICRS) are often referred to as INTACs, a brand name. Thin, semi-circular pieces of rigid plastic are inserted into the cornea to correct mild myopia. They flatten the shape of the cornea, therefore altering focus power.
Recovery time depends on when the sutures that close the small incision are removed. This may be somewhere between one and four weeks post-surgery.
The ICRS procedure has the potential advantage of being a reversible surgery. The cornea will return to its original shape if the ICRS are removed.
IOLs stand for intraocular lenses and are sometimes referred to as ‘implantable contact lenses.’
These lenses are inserted into the cornea, in front of the eye’s natural lens. This procedure has helped many patients with a higher degree of myopia than could be corrected by LASIK or PRK surgeries. However, it’s a more invasive surgery, so the risks of complications are slightly higher.
I’m interested in eye surgery for myopia. What should I do next?
The types of eye surgery mentioned here provide an overview of the options that may be available to you. There are further surgical options under development, and others well-proven but less often used. Your eye doctor can discuss your suitability for a particular type of eye surgery, based on the degree of myopia you experience and your overall eye health.
Thorough preparation, including a full eligibility questionnaire, is vital before any surgical procedure. Potential risks and side effects must be weighed against the benefits, and an informed decision made.
However, when the right surgical procedure is matched with the right patient, myopia is almost always successfully eliminated, so the need for glasses or lenses is gone.
Dr. Millicent M. Grim, Specialist Ophthalmologist & LASIK Specialist, is the Medical Director of Gulf Eye Center in Dubai. Since 2002, Gulf Eye Center’s highly qualified ophthalmologists and optometrists/ODs have been successfully treating a wide range of eye conditions using advanced techniques. They also provide comprehensive eye care and vision restoration procedures for people of all ages.