Refractive Eye Surgery

Surgical Alternatives To Improve Your Vision

Since the 1970's, many exciting technologies have been developed in the field of improving vision surgically. If you have thought about being less dependent on your eyewear or contact lenses, this is worth reading.

Is the surgery safe?

Modern 'refractive' surgery, in general terms, is relatively safe. Unfortunately, long-term studies have not yet been done as more and more new procedures are developed. Approximately 100,000 Canadians have now had some form of refractive surgery, with less than 1% with serious (sight-threatening) complications. With any surgery, there can be complications, and these are fully discussed with you before surgery.

What is currently available?

  • LASIK (Laser in situ keratomileusis) - This involves first cutting a flap of tissue from the front half of the cornea, then using a laser to permanently reshape the cornea. The flap is repositioned so it adheres to the cornea firmly.
  • ICRs (intrastromal corneal ring segments) - These are microthin semi-circular implants inserted around the outer edge of the cornea. It is a reversible procedure and the rings can be changed if vision worsens.
  • PRK (photorefractive keratectomy) - A laser is used to remove tissue from the front surface of the cornea and reshape it.
  • ICL (intraocular contact lens) - A microthin contact lens is placed behind the iris in front of the eye's own lens. This is usually reserved for those with extreme eyeglass prescriptions. The lens can be removed if necessary.
  • RK (radial keratotomy) - This is usually reserved now for those with high astigmatism, and is generally not performed as often for conventional myopia reduction.
  • Refractive Lensectomy - For those over age 50, this procedure is similar to cataract surgery, without the patient having a cataract. A new lens implant is placed in the eye and is a different power than the old lens.

Ask your optometrist and surgeon about which procedures may be right for you. Factors to take into account include:
  • your age and lifestyle,
  • recovery time, preparation & operative time,
  • number of cases performed by the surgeon,
  • cost,
  • stability and
  • predictability.

Can anyone have this surgery?

No. There are several eye and general health conditions that may preclude you from having this done. Please check with your eye care and general practitioners to ensure you are ready.

How do I choose my surgeon and surgery centre?

Good question! As non-surgeons, optometrists have a unique objective role in giving you advice. However, no attempt should be made to recommend one surgery center over another, all factors between the centers being equal. Like any important health care decision you make, you need to trust someone - don't be afraid to ask questions. Your optometrist wants you to be comfortable with the surgical care you are choosing.

Isn't my optometrist against surgical correction?

This is something you need to ask your optometrist - after all, he/she is and will be your eye care practitioner for many years, whether you need glasses or not. Most optometrists see the benefit of the procedures for their patients, and thus recommend this option for those who are best-suited.

What role does my optometrist play?

Other than general counseling, your Doctor of Optometry is trained to provide pre and post-operative eye care for many surgical procedures. When there is a new procedure available, seminars and training are required to ensure you are in good hands from start to finish in the months and years before and after refractive surgery. Often optometrists are consultants to refractive surgery centers. Consult your Doctor of Optometry about the role he/she can play in your pre and post-operative care.