More Procedures Mean More Choices for Those Seeking Vision Correction

DALLAS, July 18, 2022 – Responding to the significant, pandemic-driven surge in vision correction procedures, the Refractive Surgery Council (RSC) reminds those considering eye correction surgery of the spectrum of options available to meet a broad array of vision needs. Advances in laser and lens technology, technique, and safety have resulted in a wider variety of procedures to help more people, including those once considered ineligible for LASIK, see clearly without relying on glasses and contact lenses, which can get in the way of an individual’s active lifestyle.

“When people think about laser vision correction, they think only of LASIK, which is understandable as it is the most common vision correction procedure performed today and has a 24-year track record of safety and efficacy,” said Eric Donnenfeld, M.D., member of the RSC editorial advisory board. “At one time LASIK was off limits to people with thin corneas, dry eye, astigmatism, or prescriptions in higher ranges. However, today, surgeons have access to a variety of vision-correcting procedures that can address these challenges and be customized to meet a patient’s visual needs and lifestyles.”

While the approach and technologies differ, vision correction procedures have a few things in common:

• They are best suited to adults with stable vision, meaning the prescription hasn’t changed significantly in a year or more
• They reshape the surface of the eye, known as the cornea, to improve the eye’s focusing power or a permanent lens is placed inside the eye to improve clarity of vision
• Topical numbing drops plus oral anti-anxiety medications are used to keep patients comfortable throughout the procedure

LASIK (Laser in Situ Keratomileusis)

First introduced in 1998, today’s advanced LASIK technologies treat nearsightedness, farsightedness, and astigmatism with precision.

The procedure, performed in two steps, uses a laser to first create a micro-thin flap in the surface of the eye that is gently folded back to expose the surface below where an excimer laser is then used to reshape the cornea permanently. The flap is repositioned over the reshaped surface and the procedure is complete. Patients see better almost immediately, and recovery typically takes just a day or two. Most patients go back to everyday activities and work the next day. More than 7,000 clinical studies support LASIK as safe and effective with a higher than 96% patient satisfaction rate.

RSC Editorial Advisory Board member Dr. Vance Thompson noted, “For those who are good candidates, the freedom, performance, and safety of having clear vision without relying on glasses and contacts cannot be overstated as demonstrated by the 20 million procedures performed in the U.S. Further, today’s LASIK technologies benefit even more, including those with astigmatism and higher prescriptions.” 

SMILE Eye Surgery (Small Incision Lenticule Extraction)

SMILE eye surgery uses the same advanced laser technology – the femtosecond laser – used to create the flap in the LASIK procedure. Good candidates for SMILE are nearsighted with mild astigmatism and are interested in a minimally invasive approach to vision correction.

“SMILE uses a femtosecond laser to create a thin disc of tissue within the cornea. It’s called a lenticule. By removing the lenticule through a very small incision in the cornea, the shape of the cornea is changed with minimal disturbance to the surface of the eye,” said John Doane, M.D. of DiscoverVision. “SMILE works by changing the curvature of the cornea to optimize the focusing power of the eye for excellent distance vision. In that way, it is a lot like LASIK and PRK.”

To date, more than 400 clinical studies have been performed about SMILE to determine it is safe and effective for those who are good candidates. That research shows SMILE achieves virtually the same visual results as LASIK for nearsightedness.

Implantable Lenses (ICLs)

Recently approved implantable lenses are now an option. Also known as phakic intraocular lenses, ICLs are clear lenses that work within the eye to focus vision. ICLs treat moderate to severe nearsightedness. 

“An ICL surgery is often for people with stronger prescriptions seeking life with clear vision without having to wear heavy, expensive glasses. It’s typical for patients who are well-suited for ICLs to have been informed they may not be ideal candidates for laser vision correction for a variety of medical reasons such as thin corneas or chronic dry eye from long-term contact lens use,” said Greg Parkhurst, M.D. of Parkhurst NuVision. “We know ICLs are safe because more than 1 million have been implanted worldwide and in use here in the U.S. since 2005.”

Implantable lenses offer permanent vision correction, however, implantable lenses can be removed. Clinical studies of the ICL procedure show nearly 100 percent of patients achieve 20/20 or better vision 3 months after the procedure.

PRK (Photorefractive Keratectomy)

PRK is often recommended for patients with thin corneas, or those who enjoy playing contact sports or who have jobs with a high risk for eye injury. The excimer laser is applied to the surface of the cornea to improve vision. While results from PRK are similar to LASIK, the recovery from PRK takes several days and can be a more uncomfortable recovery in the beginning. Patients looking into their vision correction options should consult a refractive eye surgeon about their eligibility for one or more vision-correcting procedures.