Information Sheet for Patients Unsuitable for Corneal Laser Surgery
There are a number of different surgical techniques for correcting prescriptions that are beyond the range of corneal laser surgery. These operations can correct high degrees of myopia (short-sightedness), hyperopia (long-sightedness) and also high degrees of astigmatism, the latter being the situation where the eye is rather elliptical.
All of the techniques used to treat patients who are not suitable for Lasik involve using implants that are placed inside the eye in front of the crystalline lens or alternatively removing the natural lens in the eye and replacing it by an implant with a suitable power to correct the optical problem. The latter technique is a type of surgery that we use to correct patients with cataracts and many millions of patients have been treated by this all over the world but the former techniques although using similar material to the implants in cataract treatment are newer methods and like laser surgery the longer term effects on the eye over 10 or 20 years are less well known although the results to date appear to be very good for the majority of people. Almost any degree of myopia, hypermetropia or astigmatism can be corrected by these implants and the results are generally excellent but there are a number of risks involved that need to be born in mind. These are all surgical procedures and carry the general risks of any type of surgery which are rare cases of infection or unexpected haemorrhages that can potentially damage the eye.
- Certain types of these implants may be associated with a slightly increased incidence of cataract formation. This can be dealt with very effectively by cataract surgery.
- There may be a small risk of the implant damaging the delicate under surface of the cornea which has a potential for getting worse over the years and can be a serious problem.
- Certain varieties of the implant can result in increased pressure in the eye and this would need to be monitored or treated.
- For patients with very large optical errors the implant will generally correct most of this so that the vision without spectacles may well be extremely good but sometimes a small degree of fine tuning of the prescription can beneficially be done by corneal laser surgery or occasionally exchanging the first lens for one with a slightly different power and prescription.
- As with laser surgery in some people glare and optical aberrations can be a problem from the implant although this may improve with time.
- If the results of the implant and the effects of it are not satisfactory they can generally be removed quite easily. Excepting cataract type implants.
I will discuss all of these points with you at the consultation and clarify any details that you wish me to before deciding whether you are suitable for this type of operation.