What Is Laser Treatment For Lens
Surgery to improve your eyesight is known as refractive surgery or vision correction. There are 2 different types: laser eye surgery and lens surgery.
Both types of surgery can make you less dependent on glasses or contact lenses. Research shows that both are safe and effective.
What type of refractive surgery will suit you best depends on a range of things, including your eyesight, eye health, age, budget and lifestyle.
Your surgeon will examine your eyes, assess your needs and help you decide on the best option for you.
When weighing up the risks and benefits of refractive surgery bear in mind that wearing contact lenses also carries some risks for your eye health.
Refractive surgery is not available on the NHS for people who just want to improve their eyesight.
Most people have it done at a private clinic. Costs vary according to what kind of surgery you’re having.
A cataract occurs when the eye’s natural lens becomes cloudy. During traditional cataract surgery, cataract surgeons use a small blade to enter the front of the eye and another instrument to make a circular incision on the lens capsule to reach the cataract. Ultrasound waves break the cataract into tiny pieces, which are then removed. The new artificial lens is inserted to replace the cloudy natural lens.
In laser cataract surgery, a laser is used to make the incision and lens opening and to fragment the lens,” explained Dr. Horne. “It creates a more reliable, repeatable, precise incision than a surgeon can do by hand. Even a very good surgeon can’t make a perfectly circular opening as precisely as a laser can.”
Better Vision Following Cataract Surgery
The laser is particularly useful when a cataract is dense or the opening is difficult to create. However, the laser’s accuracy is also important when surgeons want to implant a multifocal lens, which corrects distance and close-up vision, or a toric lens that corrects astigmatism, Dr. Horne said. “We use these lenses when patients want more options in terms of how they function with their vision, such as wanting to drive, read, do computer work, or play golf without needing to wear glasses. The precision of the laser, its ability to consistently create incisions helps us do that.”
A laser can also be used to correct minor astigmatism by reshaping an imperfectly curved cornea. “Often, we can do that by hand, but the laser allows us to do it more reliably and more precisely,” she said. “This leads to a better and more predictable vision outcome.”
Because the laser requires less energy than ultrasound to break up the cataract, it also reduces the risk of corneal swelling, which can impact vision. “If we use less energy and have less corneal swelling, the eye can heal faster,” Dr. Horne said.
Should You Consider Laser Cataract Surgery?
While laser cataract surgery has its advantages, it’s not for everyone. Because the use of the laser and the premium lenses are not covered by insurance, people will incur more out-of-pocket expenses than with traditional cataract surgery.
“When we see people who need cataract surgery, we determine if they would be a candidate for a premium lens as well as the use of the laser, and educate them about the benefits and alternatives. We then help the patient decide if they want traditional surgery or laser cataract surgery,” Dr. Horne said.
Who is it suitable for?
Laser eye surgery is suitable for most people over 18. Ideally your eye prescription will have stayed more or less the same for about 2 years. Lens surgery may be more suitable if you have a high spectacle prescription or later in life.
What does it involve?
There are 3 main types of laser eye surgery: LASIK, SMILE and surface laser treatments.
- LASIK – this is done with 2 lasers, one to open up a thin flap in the surface of the cornea, and another to reshape the cornea underneath. The protective flap is then smoothed back over and stays in place without stitches.
- SMILE – the surgeon reshapes your cornea through a small, self-sealing hole.
- Surface laser treatments (PRK, LASEK and TransPRK) – the clear skin covering the cornea is removed so the surgeon can reshape your cornea with a laser. The skin then grows back naturally.
All 3 types of laser eye surgery have similar results. Your surgeon will talk through your options with you and help you decide on the most helpful one for you.
Laser Treatment For Eyes Side Effects
About 1 in 10 people who have laser eye surgery need more surgery to get the best possible results. There’s usually no extra cost for this.
Common side effects include:
- Mild, gritty discomfort – artificial tears can help with this and your eyes will usually feel comfortable again in about 3 to 6 months
- Visual disturbances (such as glare from oncoming headlights when driving at night) – this usually resolves or can be treated successfully
- Red marks on the white of your eye – these always fade away in about a month
Severe loss of vision is very rare.
Lens surgery
There are 2 main types of lens surgery: phakic intraocular lens (PIOL) surgery and refractive lens exchange (RLE).
Phakic intraocular lens implantation (PIOL)
With PIOL artificial lenses are placed in your eyes without removing your own natural lenses. It’s a bit like building contact lenses into your eyes.
Because the lens is inside your eye, you can do things you could not normally do in contact lenses, such as swimming or water sports.
Who is it suitable for?
PIOL can be a good option for younger people who are not able to have eye laser surgery, perhaps because they have a high eye prescription or a high degree of astigmatism. Later in life, RLE may be a better alternative.
What does PIOL involve?
The surgeon makes a small cut in the surface of your eye and slips the news lens in through this. No stitches are needed.
Are there any risks?
Your surgeon will discuss any side effects and risks with you before you go ahead with surgery.
It’s normal to get some disturbance in your vision after PIOL but this should gradually settle down. Glare from oncoming headlights while driving at night is common to begin with.
The surface of your eye may feel uncomfortable for a while. You may also have red blotches on the white of your eye for few weeks.
Serious complications are rare and, if you do have any problems after surgery, they can usually be corrected. Cataracts (when the lenses in the eyes become cloudy) may develop earlier in life after PIOL.
Refractive lens exchange (RLE)
RLE is basically the same as cataract surgery. The natural lens in your eye is removed and replaced with a new, artificial one.
Who is it suitable for?
RLE may be a good option if you’re older and you are not suitable for laser eye surgery, perhaps because you have a high eye prescription or have the beginnings of cataracts.
What does RLE involve?
There are 2 different types of artificial lens used for RLE: monofocal and multifocal.
- Monofocal – these improve your distance sight but you will still need to wear glasses for near work.
- Multifocal – these offer clear distance, middle and near vision, but about 1% of people find they cannot get used to them and opt for another lens exchange operation.
Are there any risks?
Most people have some visual side effects and discomfort in the weeks or months after surgery but these should gradually settle down.
Serious complications are more common after RLE than after laser eye surgery or PIOL surgery. About 1 in 500 people have significant loss of vision after RLE.
Your surgeon can tell you more about the risks before you go ahead with surgery.
LASER EYE SURGERY COST
The cost of LASIK eye surgery varies drastically, ranging anywhere from $1,000 to $4,000 per eye. However, the average price for LASIK surgery in the U.S. in 2020 was $2,632 per eye, according to a 2021 report in Clinical Ophthalmology[1]. It’s worth noting that advertisements offering LASIK for as low as $250 dollars are often for minimal corrections, and are often teaser rates to attract patients to seek more information.
Several factors can affect the cost of LASIK, says Vicente Diaz, M.D, an ophthalmologist and assistant professor of ophthalmology and visual sciences at Yale School of Medicine in New Haven, Connecticut.
The first is geographical location. “There are macro trends in terms of some areas having a higher cost of living than others and so elective procedures such as refractive surgery tend to follow those trends,” he says.
The doctor’s overhead can also influence price, explains Diaz. For example, if your doctor owns the laser equipment outright, then the marginal cost of doing a procedure is lower and they can pass those savings to the patient. However, doctors who are leasing, or who have a high cost per case, need to raise their price to make it worthwhile economically.
Price also fluctuates depending on the brand power or experience of the doctor or center. “If the doctor is in high demand, usually because of a well-deserved reputation, then that surgeon’s time is at a premium and market forces will drive the price up,” says Dr. Diaz.
However, the cost of surgery should not depend on how bad your eye vision is. “LASIK is typically a set price, as it covers the cost of correction within LASIK’s safe treatment range from minor to high corrections of nearsightedness, farsightedness and astigmatism,” says Neda Shamie, M.D., a LASIK, cataract and corneal surgeon at the Maloney-Shamie Vision Institute in Los Angeles and a Forbes Health Advisory Board member.
However, for patients that are not candidates for LASIK due to severe nearsightedness or farsightedness (or other factors), they may be candidates for higher-cost surgeries such as implantable contact lens (ICL) or refractive lens exchange (RLE). Typically, both ICL and RLE surgery is more expensive than LASIK.
What is Included in the Cost of LASIK?
Your overall cost can also be influenced by what’s included in the surgery and the prices associated with those inclusions, such as follow-up appointments and enhancements. “An enhancement is a second procedure done on a previously operated eye,” says Dr. Shamie.
A small percentage of patients (less than 5%) after an initial refractive procedure (such as LASIK) benefit by having a fine-tuning laser procedure, due to residual nearsightedness, farsightedness or astigmatism after their primary surgery.
“Patients more likely to need enhancements include those with large prescription corrections at their first surgery,” she adds.
While services that are included in the cost of your LASIK surgery will vary depending on the surgeon, Dr. Shamie explains that the total cost typically includes the following:
- Pre- and post-operative exams for at least one year
- Facility and surgeon fees
- Postoperative eye drops
- Follow-up procedures should there be a need for fine-tuning the correction
Additional Costs of LASIK
In terms of the surgery itself, there shouldn’t be additional LASIK costs, according to Dr. Shamie, “unless you have it performed by a surgeon who offers the procedure at a low upfront cost and charges separately for the more advanced and safer technology, follow-up visits and medications.”
However, any type of a la carte pricing to minimize costs is not recommended, “because the latest technology and follow-up care are essential to an excellent outcome, not optional line items,” she says.
Some LASIK centers, though, may charge more for “custom” procedures over standard.
“Custom surgery is when a map of the patient’s actual cornea is used to treat higher-order aberrations caused by the shape of that particular patient’s eyes,” says Dr. Diaz. This is more time-consuming than standard LASIK procedures, as it takes into account the particular eye shape.
Other costs may include medications needed to recover from surgery, says Dr. Diaz, however, these are typically covered by medical insurance and are subject to copay arrangements.