What if I Can’t Have LASIK?
You may not be a candidate for LASIK surgery due to thin corneas, severe defocus (myopia, hyperopia or astigmatism), or keratoconus. Fortunately, you have other options! A solution may be the Visian® ICL (Intraocular Collamer Lens), SMILE, or PRK laser vision correction.
The Visian® ICL family of lenses are Intraocular Collamer Lens (in Europe, the same lens is called Intraocular Contact Lens). They are designed to correct a wide range of vision correction needs including myopia, hyperopia, and astigmatism. STAAR introduced the first ICL for myopia in 1997, and now more than a million ICL’s have been implanted. US FDA approved the Visian® in 2006. Next came the introduction of the Visian® Toric ICL in September 2018. The ICL may give you a High-Definition clarity of vision often even better than what you may get with SMILE or LASIK.
The word “phakic” means that your natural crystalline lens is left in the eye. The Visian® ICL procedure involves placing an intraocular collamer lens implant inside the eye. Collamer is a synthetic collagen which is extremely biocompatible with the ocular tissues. The surgery is generally done in a 15 minute procedure under topical anesthesia, one eye at a time. The Visian® ICL™ implant rests between the iris and the lens. This gives the eye another focusing lens that provides high-quality, high-definition vision. If you have high myopia, or near-sighted vision, the ICL has been shown to be better than LASIK! The Visian® ICL can also correct astigmatism. The ICL implant can be removed if needed.
The VHF UBM (Very High Frequency Ultrasonic Bio-Microscope) is an ultrasonic device used to examine the internal structures of your eye. The surgeon can more accurately size the ICL using UBM. Roholt Vision Institute was one of only 3 practices in the country to utilize the original Artemis II UBM for ICL sizing. For your eyes, we will use the Quantel Aviso 50 Hz UBM, which we believe is superior for ease of use, reliability, and accuracy – you should insist on this examination if you are considering a Visian® ICL for myopia. or astigmatism. See the Roholt article on ICL sizing.
Dr. Roholt was the first surgeon in Ohio to offer this life-enhancing option for patients. Even in 2008, Dr. Roholt ranked first among all doctors in Ohio with implanting the most Visian® ICL lenses, and since then Drs Roholt and Celmer have helped many other patients who couldn’t have LASIK, SMILE or PRK. For more information regarding the Visian® ICL visit www.visianinfo.com or contact Roholt Vision Institute to schedule an appointment today.
PRK (Photo-Refractive Keratectomy)
PRK is the traditional method of laser vision correction and was approved by the FDA in 1995 prior to LASIK. Similar methods of performing PRK include ASA (Advanced Surface Ablation), LASEK and Epi-LASIK.
PRK is laser vision correction similar to LASIK, performed without a flap. PRK techniques have evolved over the years so that results are equivalent to LASIK. An excimer laser is used to remodel your corneal surface just as in LASIK. PRK is a simpler procedure than LASIK: no flap needs to be made. A clear skin, “epithelium” covers the cornea. The epithelium is gently removed in PRK; ablation (laser treatment) is then performed. A contact lens (a “bandage” contact lens) is placed, and functions as temporary protection for the surface, to substitute for a LASIK flap. Epithelium resurfaces the cornea beneath the contact lens over the next 3-4 days.
Eye discomfort after PRK is somewhat increased over LASIK for 3 days, and visual recovery is not as fast as LASIK. Outcomes are similar to LASIK. PRK is preferred in some high-stress environments or the military, or if corneal thickness or pupil size is not suitable for LASIK.
If you are interested in scheduling a consultation, contact Roholt Vision Institute today.
RLR (refractive Lens Replacement)
Patients with high degrees of myopia, hyperopia and/or astigmatism may not be candidates for LASIK (i.e thin cornea and age-inappropriate for Visian® ICL or other refractive procedure. Additionally, some people may have incipient or minor degree of lens opacity (early cataract) but don’t qualify for insurance coverage. These patients may elect to have an intraocular lens performed as one of the above listed procedures. RLR is a non-covered, self-pay procedure.