30/Jul/2015

There are other refractive procedures that can eliminate your need for glasses even if your corneas are too thin for LASIK. During a refractive exam at Price Vision Group, many special tests are performed to ensure you are indeed a good candidate for LASIK, including corneal thickness. The average corneal thickness is between 520 microns and 540 microns, however, the normal range for cornea thickness can range from as thin as 470 to as thick as 630 microns. In order to be a candidate for LASIK there needs to be enough corneal tissue to make a flap, take away the tissue in order to correct the refractive error, and still have enough corneal tissue to ensure that corneal ectasia, a progressive bulging of the cornea, does not occur. To learn more about cornea thickness and how it affects LASIK candidacy, please click here. If the cornea is not thick enough to result in a corneal bed, the remaining cornea beneath the flap, of approximately 300 microns then LASIK is likely not the best refractive procedure for you. During a refractive exam at Price Vision Group, the doctor runs calculations to ensure that the cornea is thick enough for LASIK.

Cross Section Visian ICL in eye

A phakic IOL may be a better refractive option to eliminate your need for glasses or contact lens visual correction if the cornea is not thick enough. The Visian ICL (Implantable Collamer Lens) is FDA approved to correct myopia ranging from -3.00 D to -15.00 D. This small lens implant is implanted behind the iris (colored part of the eye) and in front of the natural lens inside the eye to correct the refractive error. The lens is designed to stay in position in the eye and requires no special care and the corneal thickness is not altered as in LASIK. The best candidates for this refractive surgery option are those under the age of 50.
If you are above the age of 50 and not a candidate for LASIK because of a thin cornea, then a refractive lensectomy or refractive lens extraction may be a better refractive surgery option. The natural lens is removed, as in cataract surgery and an IOL is implanted. The IOL is calculated to correct your refractive error. There are implants to correct astigmatism and even multifocal IOLs that allow patients to see well at both distance and near. This refractive surgery allows for the correction of myopia, hyperopia, and astigmatism without altering the cornea thickness.
If you have been told you are not a candidate for LASIK there are other safe surgical options that can eliminate your need for glasses or contact lenses.

Admin

16/Jun/2015

Cataract surgery for a keratoconus patient does require some additional testing and consideration for the best visual outcomes. Choosing the appropriate lens and lens power can be more challenging with keratoconus. The length of the eye and the shape of the cornea are important factors when calculating an intraocular lens (IOL).

If you are wearing a contact lens it is important that the lens be discontinued prior to your eye exam. At Price Vision Group we recommend discontinuing rigid gas permeable contact lenses for 2 weeks and soft contact lenses for 1 week prior to your cataract exam. This will allow the cornea to return to its natural shape in order to accurately evaluate the degree of corneal astigmatism and eye length. Regular astigmatism is linear and can be corrected with glasses and irregular is not linear and cannot be corrected with glasses correction. A rigid gas permeable contact lens can correct irregular astigmatism.

The correct IOL is very important for the keratoconus patient. The monofocal IOL is the “standard” IOL. This IOL is covered by most insurance plans and works well for low amounts of regular astigmatism or irregular astigmatism. If a patient has irregular astigmatism a rigid gas permeable contact lens may still be indicated after cataract surgery to correct the irregular astigmatism.

A toric IOL can be a good option to correct higher amounts of regular astigmatism in keratoconus cataract patients. These lenses can improve your uncorrected visual acuity and significantly reduce your dependency on glasses post cataract surgery. It can be more difficult to fit contact lenses with a toric IOL, so this should be considered prior to a toric IOL selection. Glasses can be worn post operatively, if needed, to correct any residual refractive error. A toric IOL is considered a “premium” IOL and is not covered by insurance.

A multifocal IOL is not a good option for most keratoconus patients. The multifocal IOLs are best when the cornea is pristine and obviously if you have keratoconus your cornea has irregularities. The multifocal IOL is not a good option for those with keratoconus.
When you are ready for cataract surgery accurate pre op testing and IOL selection are key to the best visual results.

THE LATEST NEWS FROM PRICE VISION GROUP

I have been told I am not a candidate for LASIK because my corneas are too thin. Does that mean I am stuck in these glasses and contact lenses?

I have keratoconus and now I am developing a cataract. Does this present a challenge when I need cataract surgery?