People are often unnecessarily disappointed when they’re ruled ineligible for popular vision-correcting LASIK. (Having astigmatism, dry eyes, or thin eye coverings are common disqualifiers.) As featured in the Nov/Dec installment of the Post‘s Medical Mailbox, implanted contact lenses (ICLs), or Visian lenses, that surgeons place over the eye’s natural crystalline one may be an even better choice for some. In this web-exclusive report, we continue our conversation with leading eye surgeon and researcher Francis Price, M.D., about newer ICLs and why photorefractive keratectomy (PRK), the granddaddy of laser eye surgery, may be worth a second look.
Post: What’s the difference between PRK and LASIK?
Price: Both improve vision by reshaping the eye’s covering or cornea with a cool ultraviolet light beam. The difference lies in how the surgeon reaches the inner layer of the cornea in order to treat it. PRK involves removing tiny bits of the cornea’s top surface that gradually grow back. With LASIK, surgeons make a corneal flap that can be repositioned after treatment. LASIK is the more comfortable and convenient option. But when a thin cornea rules out LASIK, PRK is often the treatment of choice.
Post: How do newer lens implants work?
Price: Standard lens implants such as those used in cataract surgery replace the eye’s natural lens. But the implantable contact lens (ICL), or Visian lens, leaves the crystalline lens in place. ICLs are situated in front of or behind the colored part of the eye and can be removed if necessary.
Post: Who is a good candidate for an ICL?
Price: ICLs are especially beneficial for those with moderate to severe astigmatism or nearsightedness. For instance, research shows that ICLs provide better visual acuity than LASIK for people who can only read the top few lines of an eye chart. These lenses are also excellent options for those with very dry eyes that can worsen after laser surgery, and when the cornea is too thin for LASIK, which, as mentioned, requires making a flap in corneal tissue.
Post: Does vision-correcting surgery offer more than an improved appearance and convenience?
Price: Certainly. LASIK and lens implants improve functional vision compared to glasses and contacts, especially when people engage in outdoor activities or exercise. Safety is another big plus of “unaided” visual correction because people don’t need to change and clean their contacts—not just when camping, but in day-to-day living. Additionally, people who require thick lenses due to severe astigmatism often experience less visual distortion with these surgeries than with glasses or contacts.
Post: What about cost and insurance coverage?
Price: The costs of PRK and LASIK are similar and some policies offer partial coverage. ICLs run about $2000 more, an amount generally paid out-of-pocket. Most practices offer payment plans.
Of course, do your homework. Talk to friends who had vision correction. And before scheduling your procedure, ask your surgeon how often he or she has done it.
Francis Price, M.D., is medical director of Price Vision Group in Indianapolis and founder of the Cornea Research Foundation of America (cornea.org).
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