Since obtaining FDA approval in 1995, more than 12 million people in the United States have had LASIK eye surgery. By 2000, more than 2 million Americans had received the procedure, though this number has decreased steadily since then. Currently, approximately 700,000 Americans undergo LASIK annually.

There are many reasons to explain the prevalence of LASIK surgery among Americans. Anyone who has ever worn glasses or contacts knows what a hassle they can sometimes be. Glasses break and scratch; contacts tear and become dirty. Both are expensive and need to be replaced over time as prescriptions change. For many people, LASIK offers long-term solutions to many of the problems associated with glasses and contacts.

LASIK, which stands for laser-assisted in-situ keratomileusis, is a refractive eye surgery in which a blade or a laser is used to cut a small flap in the outer epithelium (cornea). This flap is then folded back and a laser is used to reshape the corneal tissue below. After the tissue is reshaped, the outer corneal layer is folded back over. No stitches are required to hold the flap in place. Although originally used to correct moderate nearsightedness (myopia), LASIK can now correct moderate farsightedness (hyperopia) and astigmatisms as well. The procedure takes 5 minutes per eye, has over a 90% success rate, and the recovery time is less than a week for most patients.

With all of this in mind, it’s easy to see why so many Americans choose to undergo LASIK eye surgery. However, approximately 25% of people who want LASIK are not good candidates for the procedure. For some, their corneas are too flat or too thin. For others, their vision problems are too extreme to be corrected by LASIK. Fortunately, there are other laser-eye surgery options for those who do not qualify for LASIK and wish to ditch their glasses or contacts.

LASEK

For people with very flat and/or thin corneas, LASEK is a suitable alternative to LASIK. Rather than using a blade or a laser, this procedure uses an alcohol solution to soften the outer layer, allowing it to be peeled back and exposing the tissue underneath. As with LASIK, a laser is then used to reshape the inner corneal tissue. Similarly, this LASEK does not require stitches. Because it is less invasive, LASEK has a lower risk of infection than LASIK, though the recovery time is longer.

Epi-LASIK

Like LASEK, Epi-LASIK is a less invasive alternative to LASIK. In this procedure, a plastic blade is used to lift and separate the epithelium from the inner cornea. Similar to LASIK and LASEK, a laser is then used to reshape the inner tissue. Next, the blade is removed and a protective contact lens is inserted into the eye to aid its recovery. For patients with thin corneas, this procedure may be a better option than LASIK because it does not penetrate into the epithelium, therefore causing less damage to corneal nerves. Although the initial post-op experience is more comfortable with LASIK, Epi-LASIK has a shorter overall recovery time.

Phakic IntraOcular Lens Implants

For patients with advanced myopia or presbyopia (the inability of the lens to focus) who do not qualify for LASIK, phakic IOLs are an effective alternative. Unlike other laser eye surgeries, this procedure does not cut, peel back, or remove small portions of the cornea. Rather, an artificial lens, usually made from silicone or plastic, is implanted into the eye between the iris and the cornea in order to improve the focusing power of the natural eye. Phakic IOLs are intended to be used as permanent lens implants but can be removed at any time. Recovery time varies depending on the material used to make the lens, but many patients who undergo this procedure notice improvements to their vision the day following the surgery.

Refractive Lens Exchange Surgery

RLE surgery is ideal for patients with extreme myopia, hyperopia, or presbyopia who do not qualify for other laser eye surgeries and wish to eliminate their reliance on glasses or contacts. In this procedure, a laser is used to remove the eye’s natural lens and replace it with an artificial IOL. Similar to phakic IOLs, this lens improves the eye’s ability to focus. RLE surgery can also correct nearsightedness, farsightedness, and astigmatisms with significantly better long-term results than other laser eye surgeries. Because the artificial lenses will never age or get cloudy, RLE patients will never develop cataracts. Additionally, RLE surgery has a short recovery time and its bladeless technology reduces the risk of infection and error.

If you have moderate to severe vision problems and are part of the 25% of people that do not qualify for LASIK, there are other laser eye surgery options available that will allow you to ditch your glasses or contacts once and for all. If you’re interested in any of the procedures discussed here, consult EyeCare 20/20 for more information. Everyone can be a part of the 20/20 club.

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