What are Alternative Treatments to Laser Eye Surgery?

Continued development and innovation mean that Laser Eye Surgery can now treat a huge number of refractory errors with minimally invasive techniques. In fact, at London Vision Clinic, we are able to treat around 98% of people who contact us. However, Laser Eye Surgery may not be the right option for everyone.

A small number of patients may be unsuitable for Laser Eye Surgery for a number of reasons. For example, high prescriptions, the shape and/or health of the eyes, the thickness of the corneas, and pre-existing health conditions all need to be considered before a patient is given the go-ahead for laser refractive surgery.

If you told you are not suitable for Laser Eye Surgery – don’t worry! There may be alternative treatment options open to you, including:

  • Phakic Intraocular Lens Implantation
  • Clear Lens Exchange

Phakic Intraocular Lens Implantation

Phakic intraocular lenses, or phakic lenses, are artificial lenses that can be implanted to improve the natural focussing ability of the eye. The word “phakic”, meaning lens, refers to the eye’s natural lens, which serves to add variable focusing power to the focusing ability of the cornea.

In “Phakic” Intraocular Lens Implantation, an artificial lens is implanted in the eye without removing the eye’s natural lens. This can be done using two types of lenses: Iris-Claw Lenses and Implantable Collamer Lenses (ICLs).

Iris-Claw Lens

The Iris-claw lens (also known as the ‘Artisan’ lens) features two clips that grip onto the front of the iris. This allows the lens to sit behind the cornea. Iris-Claw Lens procedures became more popular in the early 2000s due to a lower risk of cataract formation when compared with ICLs.

However, long-term implications for cornea health have since emerged and ICL practice and technology have significantly improved, leading to a reduction in the risk of cataract formation. As a result, the Artisan lens is now much less commonly used than ICLs.

The Implantable Collamer Lens (ICL)

Implantable Collamer Lens surgery is the most commonly performed type of Phakic Intraocular Lens Implantation. It involves implanting a small, thin lens behind the iris and in front of the natural crystalline lens of the eye. ICLs are extremely versatile and can treat almost every possible prescription: in the UK the lens is available to treat short-sightedness from -0.50 to -18.00 D, long-sightedness from +0.50 D to +10.00 D and astigmatism up to 6.00 D. The lens also comes in various sizes to accommodate different eye sizes.

Lenses that had been used previously were found to be linked to a higher risk of cataract formation; however, more modern models, including the EVO Visian ICL, feature a tiny hole – known as the aquaport – in the centre of the lens. This allows for a better flow of aqueous and nutrients around the eye’s natural lens, which was believed to be a contributor to the increased cataract risk of previous models.

The EVO Visian ICL is largely used for the treatment of myopia (short-sightedness). In contrast, these lenses are not used in patients with hyperopia (long-sightedness). Therefore, long-sighted patients may have to have a very short laser procedure a few days before lens implantation to create a hole in the iris for fluid to flow through. This procedure is very straightforward and only takes around one minute per eye.

To date, over 1 million ICLs have now been implanted worldwide. 

Clear Lens Exchange

Clear Lens Exchange (CLE) – also known as Refractive Lens Exchange (RLE) – is another alternative to Laser Eye Surgery. The basis of the procedure is exactly the same as that of cataract surgery, except it is performed when no cataracts are present.

Like ICLs, CLE can be used to correct almost any prescription.

However, unlike ICLs, CLE removes the internal crystalline lens and replaces it with a synthetic lens that has been designed to correct the specific prescription of the patient. This synthetic lens is placed inside the capsular bag that contains the eyes’ natural lens. In contrast, ICLs are placed in front of the natural lens.

The fixed focus of the synthetic lenses used in CLE means that the eye’s natural ability to focus is removed. For this reason, CLE is usually used in presbyopia patients who have little short focus reserves. For younger patients (usually under the age of 65), ICLs are preferred.

CLE may also be an option for presbyopia patients who are unsuitable for Laser Eye Surgery and whose eyes will not accommodate ICLs. Find out more about Clear Lens Exchange, here.

If you would like to find out if you are eligible for Laser Eye Surgery, or learn more about alternative treatment options, get in touch with one of our friendly clinic coordinators. Alternatively, Book a Consultation today.

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