What is Refractive Surgery?

Vision conditions affect millions of people around the world, and while some of these conditions can’t be cured, medical technology can improve many of them.

One solution is called refractive surgery, which can help fix vision problems through laser treatments. You may have heard of LASIK surgery, for instance – this is one of several major types of refractive eye surgery.

Here are the different types of refractive surgery, their risks and their benefits.

Types of Refractive Surgeries

You may have heard of a few, but there are actually several popular refractive eye treatments available.

LASIK Surgery:

The most well-known surgery, LASIK is a laser procedure that helps correct nearsightedness, farsightedness and astigmatism (distorted or blurry vision). The procedure is called in-situ keratomileusis, and it works by reshaping the tissue below the cornea to help focus the eye.

PRK:

Short for photorefractive keratectomy, this is a less complete form of LASIK surgery. It treats the same things as LASIK, but where LASIK reshapes the tissues below the eye, PRK only affects the surface of the cornea.

Epi-LASEK:

Epi-LASEK is like LASIK, but in this procedure, a doctor uses an alcohol solution to separate tissue from your cornea before reshaping it with a laser.

AK:

Also abbreviated LRI, this stands for astigmatic keratotomy. This is one of the procedures that doesn’t involve a laser in any way. Instead, a doctor makes small incisions in the eye then surgically reshapes it.

Phakic Intraocular Lens Implants:

Similar to PRELEX, this is for people who are too nearsighted or farsighted for LASIK or other laser procedures to work. Unlike PRELEX, where the doctor makes an incision and places a new lens in your eye, your old lens is not actually removed.

LASEK:

Also like LASIK and PRK, laser epithelial keratomileusis uses a contact lens to help the healing process and an alcohol solution to separate tissue layers.

Epi-LASIK:

No alcohol solution, but uses the contact lens to help protect the healing process.

PRELEX:

Stands for presbyopic lens exchange. This is when the lens in your eye loses flexibility, and must be replaced with a multifocal lens. It’s also known as RLE, or refractive lens exchange. You may have heard of it by its more common name: cataract surgery.

During cataract surgery, a doctor cuts into the edge of the cornea and removes the lens, replacing it with a new lens made of plastic or silicone. Cataract surgery helps severe cases of nearsightedness or farsightedness. It’s sometimes combined with LASIK or LASEK surgeries.

Intacs:

Another procedure that doesn’t involve lasers, intracorneal ring segments (ICR) flatten out the cornea and help focus the eye. It was used to treat nearsightedness, but with LASIK and other laser procedures now available, it’s used more often to treat a condition called keratoconus: where the cornea is poorly shaped and affects your vision.

Effectiveness and Side Effects

In almost all cases, refractive surgeries have very high success rates in improving vision problems.

Several of the surgeries can come with side effects, though, and they can be moderate to severe in some cases. Some side effects include:

Incomplete effectiveness: Some people will still need glasses or contacts after the procedure, and in rare cases, vision problems may actually get worse.
Infection: Usually from LASIK or PRK, infection typically only extends the healing time. If infections become severe, speak to your doctor right away.
Regression: The effects of surgery can fade over months or years for some people, and some people may need a repeat surgery.
Halo effect: When you see double images in dim areas. Usually an effect of LASIK or PRK.
Corneal haze: A low-impact symptom that usually doesn’t hurt vision at all and can only be detected through an eye exam. It’s usually not dangerous, and basic medications can prevent it. In some cases, it will require another procedure.
Flap damage: LASIK involves the flaps of your corneas, and there are times where it can leave issues that need to be corrected.
Refractive eye surgery is a big step, but many people find that the benefits far outweigh any potential side effects. If you’re struggling with vision problems and wondering whether refractive surgery might be right for you, speak to your ophthalmologist.