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The other lens procedure that is used sometimes in lieu of LASIK is refractive lens exchange: cataract surgery with an intraocular lens (IOL) implantation used to get people out of glasses. Typically, this surgery is used for patients over age forty-five that have very high prescriptions or have early cataracts (cloudiness of the natural lens of the eye). In this procedure, the natural lens is broken up and removed with ultrasound and replaced with an IOL, with a focal power customized to the eye. Some newer IOLs have been developed to provide reading vision in addition to distance vision.

An oversize model of the Vista Vision ICL

An oversize model of the Vista Vision ICL

Looking to the future, LASIK and PRK will still be the predominant method of correcting low degrees of prescription. While there could be some minor improvements in the laser delivery systems and the microkeratome, the procedure is currently so effective that it will likely not change significantly.

What will change is that lenses (like the Vista Vision ICL and the IOL) will be performed more commonly because they tend to give better vision quality than lasers. This is because unlike lasers— which change the optical properties of the cornea— lens-based procedures do not. These lenses are additive to the eye (not subtractive; i.e., tissue removing, like laser corrections) and have the potential to optically correct reading vision at the same dougherty-header (1)time, something that is not, nor will be in the foreseeable future, feasible with the lasers. The current generation of lenses have some ability to return reading vision in the eye of a patient over forty-five years of age, but in the future, we may have lenses that more closely mimic the natural flexion of the lens, comparable to when patients were in their twenties.

Dr. Paul J. Dougherty

Medical Director – Dougherty Laser Vision