Wellbeing

Laser eye surgery alternatives

Laser surgery not an option? Here are some alternatives.

Written by Dr Michael Lawless
Studio portrait of a japanese mature man looking at camera with relaxed expression. The man has around 50 years and has glasses, short hair and a short grey beard. Vertical colour image from a medium format digital camera.

Every day I see patients who want to reduce their dependency on glasses. It’s extremely rewarding to perform laser eye surgery, as I have witnessed the difference this makes to the lives of thousands of people.

Many patients arrive in our clinic wondering if they are actually suitable for a procedure. After we perform a comprehensive range of tests, we find the vast majority of patients are suitable for SMILE, LASIK, or ASLA – the three main laser vision correction procedures available today.

However, there are occasions when people may not be suitable for a traditional form of laser eye surgery. There are a number of reasons why this can be the case, and in most cases there is another surgical option to correct their vision that doesn’t involve laser.

Below, I’ve outlined some circumstances when I might recommend an alternative procedure.

"This works much like a contact lens but involves implanting a tiny artificial lens within the eye."

1. A high prescription

If your prescription is over -10, you may be better suited to a phakic IOL, also called an implantable lens. This works much like a contact lens but involves implanting a tiny artificial lens within the eye. While you won’t feel the lens, it can be removed if necessary at a later time.

2. The discovery of early cataract

For most people, cataracts don’t develop until after the age of 60, although they can occur at younger ages. Cataract surgery today involves replacing the natural focussing lens inside your eye with an artificial lens. These sophisticated man-made lenses can be tailored to correct your vision so that you have minimal, if any, need for glasses or contact lenses after surgery.

3. Ageing

As you reach your mid-40s, you start to lose reading vision. This is called presbyopia and is completely natural – it happens as the lens of your eye, and the muscles that help it to focus, weaken with age. So while traditional laser eye surgery may not be the right answer, there are other solutions.

If you’re in your 40s you may be suitable for a procedure called monovision – one eye is adjusted for distance vision while the other is adjusted for near vision. The brain allows you to naturally ‘blend’ what you are seeing and allows you to focus well both at near, and into the far distance. Normally we would get you to try this with a simple contact lens simulation to decide if it's what you'd like.

If you’re over 50, the most suitable option will be a refractive lens exchange. This is the same procedure as cataract surgery, except in this case the procedure is purely for vision correction. Again, we often use trifocal lenses, which offer patients the best chance of getting out of glasses.

"If you’re in your 40s you may be suitable for a procedure called monovision – one eye is adjusted for distance vision while the other is adjusted for near vision."

4. Keratoconus

This is an eye disease that requires careful monitoring. It’s when the cornea of the eye gradually thins, causing the eye to ‘bulge’ in a cone-like shape. Treatments range from glasses to a corneal transplant.

However, it is not possible for a person who suffers from keratoconus to have a laser eye surgery procedure.

5. Corneal scarring or dry eye

These issues will need to be addressed before a laser eye surgery procedure can occur. The latest vision correction procedure, SMILE, is particularly suited to people who suffer from mild dry eye.

6. Too young

Generally you wouldn't perform a vision correction procedure on someone under the age of 21 because their vision is still changing. It’s important that your vision has settled – this is usually established when your prescription has remained stable for 12 months.

So, are you suitable for a laser eye surgery procedure? If you don’t fall into any of the above categories the answer is most likely ‘yes’.

Of course, you won’t know what options there are for you until you have a comprehensive examination. The good news is there’s now a wide range of alternatives that will suit just about anyone.

Learn more at visioneyeinstitute.com.au

Find a Medibank Members' Choice vision specialist at medibank.com.au

Written by Dr Michael Lawless

Dr Michael Lawless is one of Australia’s most experienced vision correction surgeons, with decades of experience in laser eye surgery.

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