Instead of laser eye surgery, refractive eye problems like myopia, hyperopia and astigmatism (also known as nearsightedness, farsightedness and distorted vision ) can also be treated by other refractive surgery options such as phakic intraocular lenses, multifocal intraocular lenses and clear lens extraction.
These alternative refractive surgery options are available at Somerset Eye.
Phakic intraocular lenses, are also known as implantable contact lenses and are usually made of silicone or plastic. These lenses are surgically inserted into the eye without removing the natural lens to help improve quality of vision.
Phakic intraocular lenses can correct high degrees of nearsightedness that cannot be corrected with other surgical procedures and can also be performed in cases where corneal irregularity is too severe for LASIK eye surgery. The implanted lenses can be surgically removed too.
Phakic intraocular lenses may be necessary for patients who suffer from nearsightedness but cannot benefit from laser eye surgery.
A good candidate for a phakic intraocular lenses is between 21 and 45 years of age and is myopic, or nearsighted. It is also preferable that the patient has not undergone any ophthalmic surgery and does not have a history of eye disease such as iritis, glaucoma, or diabetic retinopathy. Women who are pregnant or breastfeeding should wait until after they have given birth and stopped breastfeeding to have a phakic intraocular lens implanted.
The traditional monofocal lens, including lens implants, focuses light to only one point in space. While a bifocal lens has two points of focus, one at a distance and the other at a nearer point, a multifocal lens has more than one point of focus at the same time.
Multifocal intraocular lenses focus light from a distance and nearby light simultaneously. This addresses both distant and near vision issues and makes the recipient less dependent on glasses or contact lenses. A multifocal lens implantation compensates for the eye's inability to change shape as we age.
The multifocal lens implant helps improve reading and distance vision. However, 25% of patients note glare and haloes around lights at night, a feature that is inherent to multifocal lenses that patients learn to adjust to over time.
As a person ages, the eye’s natural ability to change shape and focus naturally becomes more rigid and functions more like a monofocal lens. Multifocal intraocular lenses can help correct distorted eye problems in this regard.
Although multifocal intraocular lenses can be recommended for most patients, the implants are not advised for patients who have underlying eye disease and high astigmatism, or severely distorted vision caused by uneven curves in the eye’s cornea or lens.
If you receive a multifocal lens there is an 80% chance you won’t need glasses. The odds of becoming free of spectacles are better if your corneal astigmatism is low and your eyes are healthy.
A week before the surgery, an ophthalmologist at Somerset Eye will use a laser to create a small opening between the lens and the front chamber of your eye. This process allows fluid to pass between the two areas and helps reduce the buildup of intraocular pressure before the surgery.
During surgery, the intraocular lens (or ICL) is surgically inserted through a small micro-incision just behind the iris, in front of the eye’s natural lens. The ICL does not touch any internal eye structures, stays in place without maintenance and cannot be seen by you or others.
Most patients experience very little discomfort during the ICL implantation, which takes place under general or local anaesthetic. Following surgery, patients will need to use prescription eye drops or oral medication to manage pain and prevent infection. An eye specialist at Somerset Eye will do a follow-up the next day. Follow-up visits both one and six months after the procedure are also required.
The intraocular lens can be removed if a patient’s vision changes dramatically after the insertion. If necessary, another procedure can be performed at any time. The implant, however, does not treat presbyopia, or difficulty with reading in people over 40, so some patients may need reading glasses.
Occasionally some patients with high refractive error who are not candidates for traditional laser surgery can have a clear lens extraction. Essentially this is the same as a cataract operation, however, the patient has not yet formed a cataract.