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LASIK vs SMILE: What’s the Difference?

Posted on by Lisa Scheibenzuber

LASIK and SMILE are both laser vision correction procedures that can correct refractive errors. They are both safe and effective procedures, but there are some key differences between them.

What is LASIK?

LASIK stands for laser-assisted in situ keratomileusis. In LASIK, a flap is created in the cornea, the clear front of the eye. The excimer laser then reshapes the cornea underneath the flap. The flap is then replaced, and the eye heals.

What is SMILE?

SMILE stands for small incision lenticule extraction. In SMILE, a small lenticule is removed from the cornea using a femtosecond laser. The lenticule is a disc of tissue that is removed from the cornea to reshape it.

Which is right for you?

The best way to decide which procedure is right for you is to talk to your eye doctor. They can assess your individual needs and help you choose the best option for you.

At TLC Vision, we are committed to providing our patients with the best possible care. That’s why we take a conservative approach to new technology. We want to make sure that any new laser technology we offer is safe and effective, and that it provides our patients with the best possible outcomes.

We understand that new technology can be exciting, but we also know that it’s important to be cautious. That’s why we often wait to adopt new technology until more is known about its safety and effectiveness over the long run.

One example of this is SMILE. SMILE is a newer laser vision correction procedure that is less invasive than LASIK. However, it is still a relatively new procedure, and there is not yet a lot of long-term data on its safety and effectiveness. We have not yet adopted SMILE at TLC Vision. We want to make sure that we can offer our patients the best possible care, and that means waiting until we have more information about this new procedure.  We do not mean to imply that SMILE is not safe or effective – simply, in our view, based upon the relative volume of experience in the medical community with LASIK over a greater number of years as compared to SMILE, we are more confident in offering LASIK than SMILE.

If you are interested in learning more about SMILE, we encourage you to talk to your eye doctor. They can help you understand the risks and benefits of this new procedure and determine if it is right for you.

Sources:

American Academy of Ophthalmology. “SMILE vs. LASIK: Which Offers Better Early Visual Recovery?,” October 17, 2018. https://www.aao.org/education/editors-choice/smile-vs-lasik-which-offers-better-early-visual-re.

American Academy of Ophthalmology. “Changes in Corneal Sensitivity and Dry Eye Symptoms After SMILE vs. LASIK Surgery,” October 5, 2022. https://www.aao.org/eyenet/academy-live/detail/corneal-sensitivity-dry-eye-symptoms-smile-lasik.

Refractive Surgery Council. “What Is the LASIK Success Rate?,” August 16, 2022. https://americanrefractivesurgerycouncil.org/laser-eye-surgery-lasik-success-rate/#:~:text=The%20LASIK%20success%20rate%20%E2%80%93%20or,achieve%2020%2F20%20or%20better.

Evo ICL Vs LASIK

Posted on by TLC Laser Eye Centers

When it comes to addressing your vision issues, making an informed decision that best suits your needs and eye health is crucial. You may have come across a relatively recent eye surgery known as EVO ICL, which serves as an alternative to LASIK. In this article, we will provide a clear definition of both procedures and dissect their distinctions to empower you in making the optimal choice for your vision. 

What is EVO ICL? 

EVO ICL surgery represents a form of refractive surgery that can be likened to the introduction of specialized permanent “contact” lenses into your eyes. These lenses, referred to as Implantable Collamer Lenses (ICL), possess dimensions that are thinner and smaller compared to typical contact lenses. A skilled ophthalmologist implants this lens within the interior of the eye, typically behind your iris and in front of your eye’s natural lens. Within the core of the ICL lens lies a perforation designed to facilitate fluid circulation around the lens and iris. Notably, this ICL lens is permanent and does not necessitate removal or cleaning akin to regular contact lenses. 

EVO ICL VS LASIK 

In contrast to EVO ICL surgery, which entails an incision in the eye for lens placement, LASIK operates entirely on the cornea, the transparent, front part of the eye. LASIK achieves vision correction by reshaping the cornea, altering its curvature to provide improved vision. Before commencing the LASIK procedure, numbing drops with anesthetic properties are applied to your eyes. Once your eyes are fully anesthetized, a LASIK surgeon employs a laser to create a thin, hinged corneal flap, which is then gently folded back to expose the cornea. Subsequently, a computer-controlled laser emits controlled pulses of light to reshape the cornea, customizing the correction to your individual visual needs. The corneal flap is repositioned over the cornea and healing begins immediately. The flap adheres through natural suction, eliminating the need for sutures. The precise lasers employed during LASIK procedures reshape the cornea to rectify the patient’s vision. 

Risks Associated with EVO ICL 

STAAR Surgical, a leading manufacturer of ICL implants, reports the following risks associated with EVO ICL lenses: 

  1. Additional (Secondary) Surgery: EVO ICL surgery, while generally successful, may necessitate additional surgeries in some cases. These secondary procedures might be required to remove, replace, or adjust the position of the EVO ICL lens. Furthermore, additional surgery may be recommended if you develop complications such as cataracts or increased pressure inside your eye. 
  2. Raised Intraocular Pressure (IOP) and Glaucoma Development: Normal intraocular pressure (IOP), which measures the pressure inside the eye, typically falls within a range of 10-21 millimeters of mercury (mmHg). When IOP exceeds this normal range,  it is termed ocular hypertension, which, if left untreated, can lead to optic nerve damage, a condition known as glaucoma. Patients with high levels of nearsightedness are at an increased risk of developing glaucoma. 
  3. Cataract Formation: Cataracts are characterized by the clouding of the natural crystalline lens within the eye, leading to decreased vision. EVO ICL lenses are implanted inside the eye, near the crystalline lens, which poses a risk of cataract development. Factors such as older age and higher levels of nearsightedness prior to surgery can further elevate the likelihood of cataracts. This risk continues to rise with each year that the EVO ICL lens remains in the eye. Cataracts affecting vision may necessitate surgical removal. Consequently, it is essential to maintain regular eye exams to monitor for cataract development. The long-term risk of cataracts beyond seven years post-EVO ICL surgery remains unknown. In cases where cataract surgery is recommended, both the ICL lens and the cataract are removed, followed by the implantation of another intraocular lens, mirroring the routine cataract surgery procedure. 
  4. Loss of Best Corrected Vision: Post-surgery, there is a possibility that your vision may deteriorate. This decline can manifest as a loss of two or more lines on an eye chart, emphasizing the importance of cautious consideration and assessment of potential outcomes. 
  5. Endothelial Cell Loss: The cornea, the eye’s outermost layer, relies on a thin, single layer of cells called endothelial cells to maintain clarity by regulating water levels. As individuals age, these cells naturally decrease in number. However, additional loss beyond the typical age-related decline can occur following various eye surgeries, including EVO ICL. Excessive endothelial cell loss may result in corneal cloudiness and reduced vision. Before undergoing EVO ICL surgery, a comprehensive eye exam is conducted to evaluate whether you are a suitable candidate. Patients receiving the EVO ICL lens may experience a degree of endothelial cell loss, which, over time, may surpass what is expected with aging. Depending on the extent of this loss, it can lead to fluid accumulation or corneal swelling, a condition known as corneal edema. In severe cases, corneal transplantation may be required. 
  6. Glare and Halos: Glare and halos, visual phenomena characterized by the perception of bright, scattered light, may become more pronounced following EVO ICL surgery. These effects are particularly noticeable in low-light conditions when the pupil is dilated. It is worth noting that even individuals who did not experience glare and halos before the surgery may develop them post-surgery. For those currently dealing with glare and halos, there is a possibility that these visual disturbances may intensify after EVO ICL surgery. 
  7. Additional Risks: Beyond the aforementioned risks, STAAR Surgical also notes that EVO ICL surgery may be associated with additional potential complications, including: 
    • Movement of the colored portion of the eye (iris) through a surgical wound to a position outside the eye (iris prolapse). 
    • Bleeding in the area of the retina responsible for reading vision (macular hemorrhage). 
    • Bleeding beneath the retina (subretinal hemorrhage). 
    • Increase in focusing error (astigmatism). 
    • Lifting or pulling of the retina from its natural position (retinal detachment). 
    • Inability of fluid to flow from the back chamber of the eye to the front chamber, frequently blocking drainage and raising eye pressure (pupillary block glaucoma). 
    • Unequal pupil size (anisocoria). 
    • Abnormal release of pigment particles from cells in the eye that could block fluid drainage from inside to outside the eye (pigment dispersion). 
    • Scar tissue formation at the outer edges of the front chamber of the eye (peripheral anterior synechiae). 

EVO ICL surgery offers significant benefits in terms of vision correction, but it is important to be aware of the associated risks. Patients considering this procedure should engage in thorough discussions with their eye care professionals to make informed decisions about their eye health. Regular post-operative check-ups are vital for monitoring potential complications and addressing them promptly, ensuring the best possible visual outcomes after EVO ICL surgery. 

Similarly, LASIK offers significant benefits in terms of vision correction, but like all medical procedures, also presents its own set of associated risks. These may include dry eyes, glare, halos, and the potential need for enhancement surgeries. To determine the most suitable treatment for your specific needs, you can begin with a LASIK consultation conducted by a professional specializing in LASIK. 

At TLC Laser Eye Centers, we provide complimentary consultations to assess your candidacy for LASIK. If you are eligible, we are delighted to offer you the opportunity to undergo traditional LASIK, granting you the gift of improved vision. However, if LASIK is not a viable option for you, our medical team can discuss alternative approaches, which may include EVO ICL, tailored to your unique situation. 

How Long Does LASIK Last? Exploring Stability and Concerns

Posted on by Lisa Scheibenzuber

How Long Does LASIK Last?

Curious about the longevity of LASIK? Dive into the world of laser-assisted in situ keratomileusis, a refractive surgery addressing vision issues. Uncover its lasting benefits, limitations, and essential considerations for potential candidates.

LASIK’s Vision Correction:

LASIK, a powerful refractive surgery, addresses common vision problems like nearsightedness, farsightedness, and astigmatism. Its goal is to reduce dependence on glasses or contact lenses by reshaping the cornea.

Longevity of LASIK Results:

In general, LASIK offers enduring results. Nonetheless, remember that LASIK isn’t an everlasting solution. While most recipients enjoy sustained vision improvement, approximately 2% may require a second procedure from their initial surgery.

Addressing Presbyopia:

Presbyopia, an age-related condition, diminishes the eye’s lens flexibility, impairing near vision. LASIK doesn’t correct presbyopia. Individuals who have LASIK surgery before the onset of presbyopia may still find it necessary to use reading glasses or bifocals when presbyopia eventually develops.

Cataracts and LASIK:

Cataracts, which cloud the eye’s lens due to aging, can impact vision. While LASIK doesn’t treat cataracts, cataract surgery effectively restores vision by removing the clouded lens and replacing it with an artificial one.

Personal Suitability for LASIK:

LASIK is a viable option for many, yet personalized suitability matters. Engage in a conversation with your eye doctor to determine if LASIK aligns with your needs. Aspects like age, prescription, lifestyle, and medical history influence the decision.

Choosing the Right Path:

If contemplating LASIK, diligent research is crucial. Opt for a qualified LASIK surgeon with a robust background in LASIK. Inquire about the surgeon’s experience and number of procedures to make an informed choice.

The longevity of LASIK results can vary, but for many patients, it provides lasting vision correction. While it doesn’t address presbyopia or cataracts, many patients report its benefits outweigh the risks. To determine if LASIK is the right fit, consult your eye doctor, delve into your individual circumstances, and make an educated decision.

Sources:

U.S. Food and Drug Administration. “LASIK,” October 7, 2022. https://www.fda.gov/medical-devices/surgery-devices/lasik.

Refractive Surgery Council. “How Long Does LASIK Last? Is LASIK Temporary or Permanent?,” August 11, 2022. https://americanrefractivesurgerycouncil.org/how-long-does-lasik-last/.

“Cataract Surgery – Mayo Clinic,” September 9, 2023. https://www.mayoclinic.org/tests-procedures/cataract-surgery/about/pac-20384765.

Does LASIK Cause Dry Eye?

Posted on by TLC Laser Eye Centers

Does LASIK Cause Dry Eye?

LASIK, a widely sought-after laser vision correction procedure, treats nearsightedness, farsightedness, and astigmatism. While generally safe, it’s essential to recognize potential risks, including the occurrence of dry eye. Discover the relationship between LASIK and dry eye, its symptoms, and ways to prevent it.

Dry Eye Defined:

Dry eye arises when tear production is insufficient or tears evaporate rapidly. Its symptoms encompass burning sensations, gritty or scratchy feelings, excessive tearing, light sensitivity, and/or blurred vision. This prevalent issue can affect people of all ages, with a higher prevalence in women and those frequently exposed to screens.

The LASIK Connection:

LASIK surgery can contribute to dry eye due to its impact on tear distribution across the eye’s surface. The creation of a corneal flap during LASIK may disrupt the tear film’s equilibrium, hindering even tear distribution and leading to dry eye symptoms.

Risk Assessment:

The likelihood of dry eye post-LASIK is relatively common. Most LASIK recipients encounter no symptoms, but some might experience mild to moderate discomfort that typically resolves with time.

Consultation and Prevention:

When considering LASIK, engaging in a conversation with your eye doctor is paramount. Discussing potential dry eye risks equips you to make an informed choice. In case dry eye emerges after LASIK, your eye doctor can suggest tailored treatments.

Preventing Dry Eye After LASIK:

  • Effective preventative measures include:
  • Regular use of artificial tears
  • Refraining from eye rubbing
  • Introducing a humidifier at home
  • Ensuring sufficient sleep
  • Staying well-hydrated

Managing Post-LASIK Dry Eye:

Should dry eye symptoms manifest after LASIK, promptly consulting your eye doctor is advised. Their expertise aids in identifying optimal treatments aligned with your specific needs.

Conclusion:

Understanding the reported link between LASIK and dry eye enables you to navigate the procedure’s risks effectively. Prioritizing your eye health through informed decision-making, preventative measures, and professional guidance ensures a positive LASIK experience.

Sources:

Refractive Surgery Council. “Is LASIK Safe? What You Need to Know,” October 13, 2022. https://americanrefractivesurgerycouncil.org/is-lasik-safe/#:~:text=LASIK%20is%20one%20of%20the,of%20patients%20suffer%20complications%20LASIK.

Shtein, Roni M. “Post-LASIK Dry Eye.” Expert Review of Ophthalmology. Taylor & Francis, October 1, 2011. https://doi.org/10.1586/eop.11.56.

Optometrists.org. “Dry Eyes After LASIK – Optometrists.Org,” November 12, 2021. https://www.optometrists.org/general-practice-optometry/optical/guide-to-laser-refractive-surgery/dry-eyes-after-lasik/.

How Does Bladeless LASIK Work?

Posted on by TLC Laser Eye Centers

Are you considering the benefits of LASIK eye surgery, and wondering what type of procedure is right for you? There are many types of laser eye surgery available, with different tools, technology, and techniques to meet the unique needs of LASIK patients. Bladeless LASIK eye surgery is a common alternative to traditional LASIK, with many similarities and a few key differences. In this post, we’re going to take a closer look at how bladeless vision correction works, and what LASIK patients can expect from the procedure.

Bladeless Laser Eye Surgery: How Blade Free LASIK Works, and What to Expect

Learning about laser eye surgery options online is a great first step, but it’s important to note that only your laser eye surgeon can recommend the right procedure for your unique needs. So, if you haven’t scheduled your free laser eye surgery consultation yet, now is a great time to do so.

The first step toward learning more about bladeless LASIK is explaining some of the lingo:

 Also Known As…

During your research you may find that bladeless LASIK is referred to by a few different names, but each refers to the same procedure. Some of the common names for bladeless LASIK include blade free LASIK, and all-laser LASIK. You may also see a brand name integrated with one of those common terms for bladeless LASIK.

How Bladeless Laser Eye Surgery Works

If you’re learning about laser eye surgery, you may already be familiar with the concept of the LASIK flap, which is created at the start of the procedure and allows your LASIK eye surgeon to address vision problems at the correct level of the eye. During traditional LASIK procedures, the flap is created by an instrument called a microkeratome, which is an oscillating diamond blade.

  • Instead of using a microkeratome, bladeless laser eye surgery relies on the use of a specialized laser to create the LASIK flap. This is where the terms “bladeless” and “all-laser” LASIK come from, as well as the key difference between bladeless and traditional LASIK.
  • By using the most advanced LASIK technology, your laser eye surgeon is able to map the eye, based on the unique structure of each individual’s eye, to create a custom LASIK flap.
  • After the flap is created, the bladeless LASIK procedure works very similarly to traditional LASIK. Most importantly, bladeless surgery significantly reduces intra and post-operative complications making it a safer procedure.

What to Expect from Bladeless LASIK Surgery

While blade free LASIK has a few key differences from traditional LASIK, the preparation, procedure, and healing process share many similarities. The process begins with a visit to your local TLC Laser Eye Center for a free consultation.

  • During your free consultation, your laser eye surgery specialist will review your vision correction needs, and discuss your laser eye surgery options.
  • Before the bladeless vision correction procedure, you’ll have a pre-operative visit, which makes specific measurements of your individual eye. This is when much of the “customization” is done for the procedure.
  • On the day of your procedure, your laser eye surgery team will prepare you for surgery, and after the procedure there will be a brief recovery period. Bladeless LASIK is an outpatient procedure, which means that you get to go home the same day.
  • The recovery process begins with rest on the day of surgery, and continues with follow-up visits to check on your progress. As healing progresses and vision stabilizes, there is a longer gap between each follow-up visit.
  • While every patient is unique, most patients see very well the next day. As with any surgery it takes a time to heal. Most patients are able to resume normal daily activities within a few days and the eye is completely healed in 3 months. You are seen for scheduled visits along the way. Overall, you may notice many similarities between bladeless and traditional LASIK, along with the differences that set each procedure apart.

Scheduling your free laser eye surgery consultation is the best way to learn more about bladeless vision correction, and the laser eye surgery options available. You can schedule your consultation by calling your local TLC Laser Eye Center, or filling out a quick form online.

20-20-20 Rule: Eye Care in Today’s Technology

Posted on by TLC Laser Eye Centers

Digital screens are everywhere. We work with screens, play with screens, and look at screens while we’re waiting in line. All of that screen-time comes with potential downsides, and may take a toll on our eyes over time. To try to minimize the negative effects and digital eye strain of extensive time looking at screens, many eye doctors suggest using the 20-20-20 rule as part of your eye health care. The catchy name makes it easy to remember, and ahead we’ll dive into the details of exactly how the 20-20-20 rule works.

Eye Care and Digital Eye Strain

What is the 20-20-20 rule?

Whether you’re using a phone, computer, tablet or watching TV, the idea behind the 20-20-20 rule is actually very simple: every 20 minutes that you’re looking at a screen, take a break and stare at an object 20 feet away for at least 20 seconds. That’s it. You don’t have to worry about walking off the distance, or pulling out a tape measure to make sure that the object is exactly 20 feet away. The idea is to pick an object that is close to 20 feet away.

The trick is making sure that you remember to do it every 20 minutes when you’re using a digital screen, and making sure that you look at the object for at least 20 seconds. This is a rule that you can follow almost anywhere, whether using a screen for productivity or enjoyment.

What about activities that don’t require a screen?

Screen time isn’t the only activity that can cause eye strain, and the 20-20-20 rule may apply in other situations, as well. If you’re reading a paper book, writing, or doing work that requires you to focus your vision consistently on very small details, then it may also be a good idea to give your eyes a rest using the 20-20-20 rule. No matter what activity you’re doing, the basics behind the 20-20-20 rule remain the same when considering your eye health care. Take a break every 20 minutes to look at an object 20 feet away for 20 seconds.

Do I really have to do it every 20 minutes?

When you’re working, reading, or watching a video, it’s easy to get caught up in what you’re doing. But yes, it’s a good idea to stay on schedule with the 20-20-20 rule whenever possible. The good news is that most of the devices you’ll be using will also have built in timers you can use to set reminders. Setting 20-20-20 reminders on your computer and phone is a great way to stay on track, and eventually taking those breaks simply becomes a habit.

Why follow the 20-20-20 rule?

Humans normally blink about 15 times per minute, according to the American Academy of Ophthalmology. However, when using a computer or other digital screens, we may only blink about one-third as often, which can lead to eye strain.

Digital eye strain caused by extensive screen use may be connected to certain vision problems, and can cause unpleasant symptoms like dry eyes, headache, light sensitivity, and eye fatigue. So in addition to potentially helping with long-term eye health issues, the 20-20-20 rule can also be an easy way to help limit some of the most common symptoms that come with extensive digital screen time.

If you have any questions about the 20-20-20 rule, how it works, or how it applies to you, speak with your eye health care provider to learn more. If you don’t have an eye doctor, use our doctor search to find a TLC Affiliate Eye Doctor near you. It’s a small step to take, and it may make a big difference.

Am I Too Old for LASIK?

Posted on by TLC Laser Eye Centers

One of the most common questions about LASIK eye surgery is whether the procedure can be considered for older people, and the good news is that the key points of LASIK candidacy are the same for seniors as they are for anyone else. If you have a stable vision prescription, healthy eyes, and are in good overall health, then you may be a good candidate for LASIK eye surgery. However, it is true that our eyes and visual needs change quite a bit throughout our lives, so there are a few special considerations to deliberate when thinking about laser eye surgery later in life.

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Why There’s No Upper Age Limit on LASIK

The only real age limit for a LASIK procedure, per the FDA, is that each surgical candidate should be at least 18 years of age. Our eyes and corresponding prescription requirements may change frequently at that age, and it’s important to wait until that tendency to change stabilizes before having laser eye surgery. There are a few other developmental milestones in life that often motivate people to consider laser eye surgery, beginning in early adulthood.

  • The most common range for LASIK patients is between 20 and 45 years old. Vision prescriptions often stabilize in the mid-twenties, so this is a natural time for people to consider LASIK eye surgery.
  • Next up is the 45 to 55-year age range, the time when many people begin to feel the early effects of presbyopia, which is related to the natural aging process and causes difficulty with near vision. While LASIK may be a treatment option for some presbyopia patients, we certainly have more vision correction technologies to offer our presbyopic patients, such as Monovision.
  • Beyond age 55, cataracts may start to develop even though they may not affect your vision at early stages. When cataract is determined to be the main reason for changes in your vision, cataract extraction surgery becomes the preferred method of treatment to improve your vision instead of LASIK eye surgery.

The basics for LASIK candidacy include a stable vision prescription for at least one year, no eye diseases, and good overall health. If you’ve got those things, then you’re off to an excellent start.

It’s important to note that good overall health doesn’t have to mean perfect health. Not every potential health issue for seniors impacts the eyes, and speaking with a LASIK specialist is the best way to learn how laser eye surgery fits in with various health needs.

Regardless of your age, are you curious whether LASIK eye surgery is the right fit for your vision health needs? The easiest way to find out is to schedule a free consultation with TLC LASIK specialist, where you can determine if you’re a candidate and learn more about what laser eye surgery can do for you.

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