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Types of Laser Eye Surgery - African American man with his finger on his chin thinkingTypes of Laser Eye Surgery: Exploring Your Vision Enhancement Options

LASIK vs iLASIK or PRK vs ICL? At Restoration Eye Care we understand that you have a lot of questions (and complicated acronyms) to navigate when determining the best option for improving your vision and ocular health. That’s why we put together this helpful guide to introduce you to the basics of LASIK, iLASK, PRK and ICL and cover common questions so you can make a more informed decision on which vision enhancement option is right for you.

What is iLASIK?

LASIK is a safe and permanent procedure designed to provide vision correction for those looking to be free from glasses and contacts. First approved by the FDA in 1995, technological advancements to the procedure have continued over the past twenty years. One popular advancement is the iLASIK procedure, which refers to the fact that the corneal “flap” created during LASIK is produced solely by (femtosecond) laser — making the procedure completely bladeless.

The FDA approved iLASIK in 1999, increasing the accuracy of surgical results with fewer complications than traditional methods. Tailored and targeted surgical results are achieved by scanning the entire optical pathway with the use of a state-of-the-art mapping system, allowing the surgeon to customize each procedure to each unique eye. Restoration Eye Care obtains these tests and measurements by housing the advanced new iDesign Refractive Studio, added to our practice in October of 2018.

Why iLASIK vs. like procedures?

When researching LASIK eye surgery, you quickly find there are many different procedures available, making it difficult to select a practice and surgeon that you can trust. The difference in these procedures are identified by the technology used and the experience of the surgeon. Due to wavefront mapping technology, iLASIK offers the least amount of recovery time and post surgical complications such as glare, halos and night vision.

Although a quality procedure for the least amount of money is ideal, patients need to be wary of “bait and switch” procedure pricing where the surgery itself only costs a few hundred dollars; however, additional charges are added for necessary follow up visits, astigmatism correction, and the use of advanced technology.

Who benefits best from iLASIK?

Who makes a good candidate for iLASIK? Adults aged 18-55 typically experience the best results from iLASIK surgery. A steady (unchanging) prescription is necessary for at least one year prior to the surgery, which usually stabilizes for most people around the age of 18. Conversely, the majority of patients 55 and over will begin to experience visual changes, due to the formation of cataracts or other eye changes.

  • Those with low to moderate myopia (nearsightedness), even with astigmatism are expected to receive the best surgical results following LASIK, as corneal thickness allows for reshaping.
  • Mild hyperopia (farsightedness) can be corrected; however, this is not commonly done due to difficulties creating a steeper cornea.
  • iLASIK can be a contradiction for those with autoimmune diseases due to healing concerns, which are examined by the surgeon prior to surgery.
  • Women pregnant or breastfeeding need to complete nursing for a minimum of 3-6 months before having surgery, as prescriptions change during this time. The same is asked for those on medications with Accutane as a main ingredient.

What is the typical iLASIK recovery time?

Due to advancements in technology over the past two decades, recovery following iLASIK surgery is very minimal. The majority of patients go back to normally scheduled activities the following day with few restrictions. Monitoring of screen time for the first 24 to 48 hours is important in ensuring the cornea stays moist. Dirty, dusty situations need to be avoided for the first week following surgery, as well as swimming or hot tubbing for two weeks postoperatively. UV protection is necessary following surgery as light sensitivity is also to be expected.

Is iLASIK covered by insurance?

iLASIK is still considered an elective procedure, not covered by insurance as deemed non-medically necessary. Savings between 10-15% is offered for carrying a vision plan with insurance, depending on the carrier. Restoration Eye Care offers an extra 5% savings for anyone paying with cash or check. On average across the US, iLASIK procedures cost anywhere from $1,900.00 to 2,500.00 per eye depending on the experience of the surgeon, technology used and region of the country.

Types of Laser Eye Surgery - man and woman with their hands on their chin concentratingWhat is PRK?

Photorefractive Kerotomey, better known as PRK, is a popular alternative to iLASIK surgery, designed to correct low to moderate myopia (nearsightedness), with or without astigmatism.  As a certain amount of corneal thickness is required to perform iLASIK, PRK is done with minimal corneal thickness available. The outer layer of the cornea, called the epithelium, is removed and discarded prior to the laser reshaping the underlying corneal tissue. To ensure proper healing over the course of the following week, a contact lens is implanted to act as the natural bandage the flap serves in iLASIK. Until recently, PRK was the required refractive procedure for those with a higher chance of eye trauma such as athletes, military personnel, and astronauts. Delayed visual rehabilitation and discomfort following PRK are the main reasons this procedure is less popular than iLASIK.

Why PRK vs. like procedures?

PRK is the desired procedure for those with minimal amount of corneal thickness available for the creation of the iLASIK flap, allowing the preservation of the cornea. The surgeon will make this decision based on the tests and measurements obtained at the consultation. Flap complications are rare with iLASIK, however, some patients opt to have PRK to eliminate the risk of these complications post surgery.

What is the typical PRK recovery time?

PRK patients experience a little longer recovery period and discomfort than iLASIK patients do as the epithelium (outer layer of cornea) takes a few days to regenerate new cells. This makes recovery gradual, with the clearest expected vision taking several weeks. PRK patients are asked to have a driver for a few days following surgery, as vision will fluctuate during this time.

Is PRK covered by insurance?

PRK, similar to LASIK, is an elective procedure, making this an out of pocket cost. Patients will receive savings between 10-15% for carrying a vision plan with insurance, depending on the carrier. PRK patients receive the same 5% cash or check savings as iLASIK patients. PRK procedure costs are the same as iLASIK in the US, ranging from $1900.00 to 2500.00 per eye depending on the surgeon, technology used, and region of the country.

Types of Laser Eye Surgery - woman with glasses on looking in the distance with a thoughtful look on her faceWhat is ICL?

ICL, or Implantable Collamer Lens surgery, is a procedure where a biocompatible lens is implanted in the eye to act as a permanent contact. This lens is undetectable to the human eye, and unfelt by the patient after implantation. ICL is designed for those unable to have iLASIK or PRK surgery due to higher prescriptions, thin corneas, or severe dry eye.

PRK Timeline

  1. The surgeon will start with a laser procedure called an iridotomy 1-2 weeks before the implantation procedure. 1-2 openings are made near the edge of the iris, allowing fluids to circulate around the lens post surgery.
  2. On procedure day, corrective lenses are implanted through a small incision by the corner of the iris.
  3. Once implanted, the lens will unfold in the eye with the four corners being placed behind the iris. Unlike iLASIK and PRK, no corneal tissue is removed during this procedure. A mild anesthetic is used for discomfort prior to surgery.
  4. The surgeon will see that patient later that day and the following day to monitor internal pressure and administer post surgical drops, preventing inflammation and infection.

Many find noticeable visual improvements immediately with patients going back to normal scheduled activities within a few days. Full visual recovery takes between 2-4 weeks. The Collamer Lens was approved by the FDA in 2005 and over 500,000 lenses have been implanted worldwide with a 99% satisfaction rate.

Why ICL vs. like procedures?

Although ICL is considered an alternative procedure, there are advantages that iLASIK and PRK don’t offer, such as protection from harmful UVA and UVB rays, allowing visible light to pass through unaltered. The Collamer Lens can be removed any time the patient feels necessary, however, it’s designed to last a lifetime. ICL is ideal for those suffering from dry eye, as this procedure doesn’t create these symptoms. Some patients will need a LASIK procedure following ICL surgery to correct astigmatism, called Bioptics.

Who benefits from ICL?

Who is a good candidate for ICL? Typically ICL surgery is for patients 21-45 years of age, allowing correction for nearsightedness with mild to severe myopia. This procedure is done when there are issues with the cornea being unsafe due to injury or scarring making the patient unable to get iLASIK or PRK. Those concerned with having a procedure that is irreversible have the piece of mind that this can be removed anytime the patient feels necessary.

What is the typical ICL recovery time?

Patients have noticeably better vision immediately following surgery; however, blurry and distorted vision can be expected while the eye is healing. This will gradually stabilize over the next few days, with optimal vision within a week. Recovery periods vary per patient, however, most are going back to normal scheduled activities within a couple days. The use of postoperative drops can be expected for a few weeks following surgery.

Is ICL covered by insurance?

Similar to iLASIK and PRK surgery, this is considered an elective procedure, so it’s not typically covered by insurance. Occasionally, insurance will cover part of the procedure if it is deemed medically necessary. Across the US, ICL surgery is around $4,000.00 per eye.

The More You Know

Phew! If your eyes aren’t sore from the overabundance of information we hope that this guide will serve as a helpful starting point on your journey to improved health and a lifetime of enhanced vision. For more information on any of the procedures we offer, contact Restoration Eye Care for a free personal consultation.

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