Which is Better – LASIK Eye Surgery or Lens Implant?

The options that are available today for removing glasses are innumerable. One is bound to be confused as to what to choose since each one of these ‘refractive surgeries’ has a proven record in terms of both – safety and efficacy.  The two important surgeries are lens implant and LASIK surgery.

Two Types of Refractive Surgeries- LASIK & Lens Implant

There are broadly two classes of these refractive surgeries namely – 

1. LASIK and surgeries similar to LASIK like laser vision correction including Advanced Surface Ablations
2. Intraocular Lenses (IOL) which includes phakic IOLs and clear lens exchange (CLE).

The first category is added by laser and aims to reshape the cornea. The latter uses lens implants which are replacements of our eye lens with artificially prepared lenses. These lenses are fit inside the eye in either of the two locations – between the iris and the natural crystalline lens, also called phakic IOL, that is present in the eye or replaces the natural crystalline lens of the eye, this type is called the clear lens extraction or refractive lens exchange procedure. 

All of the aforementioned procedures achieve 20/20 vision without the need for glasses or contact lenses, safely and effectively, if and only if the chosen procedure is well apt to the status of the individual’s eye and their specific visual needs. Choosing the correct procedure is highly essential and is the first step towards better vision without glasses. It can be done in conjunction with your eye surgeon only after a complete, comprehensive and thorough eye examination.

INDICATIONS OF EACH PROCEDURE AND PATIENT SELECTION

1. The following patients are considered ineligible for LASIK surgery – A patient requiring a level of correction that is beyond 6-8 dioptres depending on corneal thickness, thin corneas, prior corneal scars or surgeries, corneal grafts, keratoconus, etc.
2. Intraocular lenses procedure can correct very high levels of myopia – up to 20 dioptres – with very few patient restrictions. However, for correction of less than 3 dioptres, phakic IOLs are not recommended.
3. Cataracts are completely inadvisable when compared to LASIK and phakic IOL procedures as refractive lens exchange is the preferred option of treatment for patients with early cataractous changes. The same surgery, Refractive Lens Exchange, is known as cataract surgery with Intraocular Lens implantation when performed in a patient with visually significant cataract.

DETAILS OF LASIK AND PHAKIC INTRAOCULAR LENS PROCEDURES

• Lasik has an added benefit of being less invasive as the surgeon operates only on the eye surface. For this exact reason, this procedure is also called an extraocular procedure. Like every coin has two sides; the flip side of this procedure is that it involves permanent ablation of a certain part of the tissue of cornea – rendering this procedure irreversible. It is significantly faster as compared to phakic IOLs as it is extraocular and both eyes are operated on simultaneously.
• Since phakic IOLs involve fitting an artificial lens inside the eye, it is much more invasive. This procedure is therefore intraocular. Phakic IOLs, the ones that do not involve removal of the natural crystalline lens of the eye, are entirely irreversible. Clear Lens Exchange involves the removal of the natural eye and hence is irreversible. Since the procedure is highly invasive, it increases the risk of intraocular infection. This is why most surgeons prefer to operate each eye on different days.
• A conferred benefit of lens implants is that it provides additional protection of ultraviolet rays, which are harmful radiations present in sunlight. UV rays have been linked to the formation of cataracts and age-related macular degeneration.

DURATION OF PROCEDURES AND SURGICAL DOWNTIME

If one adds up the time taken for processing of paperwork and transfers to the operating room, the time required for both the procedures is roughly the same. However, as mentioned before, LASIK is done on both the eyes simultaneously while certain surgeons prefer to perform lens implants on different days because of the increased risk of intraocular infection.

• The LASIK procedure takes about 15 minutes for each eye from which laser treatment takes less than a minute approximately per eye.
• Lens implants are comparatively longer procedures and eat up around 20-30 minutes for each eye. A gap of one week is kept between the surgeries on the two eyes.
• The time taken for vision recovery and protocols for follow-ups take almost the same time in both the surgeries.

NEED FOR READING GLASSES– Lens implant

If you need reading glasses for near vision, not all refractive procedures will address this issue. Hence, this is an important factor to take into consideration while deciding which procedure to opt for. 

• In the case of LASIK, monovision is possible. So, it is the recommended choice if you have reading glasses.
• Phakic IOLs or Implantable Collamer Lenses, ICL, cannot correct near vision. While Lens implant and refractive lens exchange with multifocal lenses can correct both – near and distant vision. 
• In case you do not have presbyopia before you get surgery, you will not need reading glasses after it, irrespective of the procedure you choose. The exception to this is if you have a refractive lens exchange with a uni-focal lens. 

COMPARISON OF COST OF THE PROCEDURES

LASIK surgery is not as expensive as lens implants. It is because of the fact that intraocular lens implants are both invasive and take a longer duration to perform. Also, the additional cost of the artificial lens implants adds to the expense of the procedure and makes it more expensive. However, note that the costs are comparable to, if not exactly the same as, newer technologies of LASIK including femtosecond LASIK and Relex SMILE.  You can take health insurance as well.

FINAL VERDICT

LASIK would be the recommended and an ideal choice for patients with low to moderate refractive error and no associated eye diseases. 

Refractive Lens Exchange or lens implants are performed only if the patient is not a suitable candidate for any other vision correction surgeries like LASIK because it is a highly invasive procedure and is much more expensive. RLE is also the best option for patients who have an early cataract. That being said, these procedures can correct almost any degree of refractive error and the quality of vision after lens implants is believed to be better than that after LASIK treatment.

Phakic IOLs are the best choice for patients who have keratoconus and for patients post corneal surgeries. 

Hope this article guided you through your condition and helped you make the best decision for yourself! Remember to get an eye evaluation by your eye surgeon before you proceed with any of these options!

To know more about Lasik and lens implant or other eye surgeries, please visit Eyemantra. Or you can email us on [email protected].

We also offer various services like Retina Surgery, Specs Removal, Lasik Surgery, Squint, Cataract Surgery, Glaucoma surgery, and much more.

To book an appointment with expert ophthalmologists with many years of experience, call Now at +91-8851044355.

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