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Vision Correction: Are LASIK and PRK Your Only Options?


Author:

Julius Shulman, MD

Mt. Sinai School of Medicine

Medically Reviewed On: August 13, 2001

If you've heard about vision correction, you've probably heard about the two most common options: LASIK (laser in situ keratomileusis) and PRK (photorefractive keratectomy). These procedures have become increasingly popular in recent years - last year, an estimated 1.5 million surgeries were performed in the United States alone. Though they are quick, safe, and effective in most cases, LASIK and PRK are not the only vision correction procedures, and some patients may want to consider other options. We talked to Julius Shulman,MD an opthalmologist in New York and the author of No More Glasses (Simon and Schuster, 1984, revised St. Martin's Press, 1993) about the current alternatives.

How common are the alternatives to LASIK or PRK?
JULIUS SHULMAN, MD: Most people who have a corrective procedure have LASIK or PRK. Other options fill about 5 to 10% of procedures done to correct vision.

What are some of these other options?
JULIUS SHULMAN, MD: Intacs are one option. Intacs are appropriate for people who have low degrees of myopia, or nearsightedness. They're tiny little plastic pieces that are inserted into the cornea to reshape it. The surgery takes about 15 minutes and it is as effective in most cases as LASIK or PRK but it's only for low degrees of myopia.

Another option that's fairly new is LTK (as opposed to PRK). LTK is laser thermal keratoplasty. That is only for low degrees of farsightedness or hyperopia. Without touching the eye, the laser reshapes the cornea by placing 16 tiny spots on the outside of the cornea. The whole procedure takes three seconds, and a minute or two after this procedure the farsightedness is gone and people can read without glasses. It's not for everyone. No procedure is for everyone, but it is very effective.

How does a person know if they should have one procedure over another?
JULIUS SHULMAN, MD: It comes down to talking to your doctor, trusting your doctor, and letting him guide you through this array of procedures to correct your vision. You can also get educated yourself by reading material, searching the Internet, and talking to other people, including your family doctor. But it really comes down to trusting your ophthalmologist.

There are certain people who are not necessarily candidates for LASIK or PRK. Would they still be candidates for, let's say, Intacs?
JULIUS SHULMAN, MD: Yes. In certain cases, someone who is not a good candidate for PRK or LASIK can have Intacs or LTK.

What is "wavefront" technology?
JULIUS SHULMAN, MD: Wavefront technology is being done in Europe, and it involves taking a light and shining it into the patient's eye. The light then comes out in a certain pattern which reflects any aberrations or abnormalities, and that pattern is programmed into the laser which is used for vision correction. This differs from regular laser correction in which it's your eyeglass prescription that is programmed into the laser. So theoretically this has the potential for making a perfect eye and giving you vision way beyond 20/20. It's still in its infancy but it's projected that vision of not only 20/20 but 20/10, 20/8, or 20/5 might be possible.

Why would someone want to see better than 20/20?
JULIUS SHULMAN, MD: Why not? I would want to see 20/15, so my long distance vision would be better. I would want to see as well as I'm capable.

 

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