The surface of the eye (also known as the cornea) may develop scar tissue, non-adherent cells or an irregular surface that can make the vision blurry, even with glasses, and at times may cause discomfort. When glasses, contact lenses and eye drops are not sufficient for vision or comfort, a surgical procedure may be helpful. Below are some of our commonly performed procedures; some medically necessary and others elective.
Phototherapeutic Keratectomy (PTK) is a common laser procedure performed to smooth the surface of the cornea. This surgery is less invasive than a cornea transplant and the recovery process is not as extensive. Unfortunately, not everyone qualifies for the PTK procedure. Your doctor will discuss which option makes the most sense for you depending on your individual situation.
PTK is performed using the excimer laser to smooth the scarred, irregular, or poorly adhering corneal surface to improve vision and/or to reduce discomfort. The treatment is done under a topical anesthetic and there is minimal discomfort during the procedure.
The surface cells are brushed away, and a cool, non-penetrating laser smooths the surface of the cornea. A soft contact lens is placed on the eye as a bandage and will remain in your eye for approximately 5-7 days after the procedure.
The entire treatment typically lasts less than 15 minutes. You might experience some pain after the surgery, however, medicated drops or pills typically help minimize discomfort. Vision will fluctuate during the healing process, which can take as long as 3-6 months for some patients.
The primary goal of a PTK is to produce a smoother and clearer cornea. You may still need to wear your glasses to reach your best vision after the surgery. You will be instructed to use eye drops and oral medications following the procedure.
An ointment is sometimes recommended for use at night to prevent corneal erosions during the healing period. If prescribed by your physician, you should begin using this medication the evening the contact lens is removed.
Intacs is an FDA-approved procedure for patients with low levels of myopia, or nearsightedness, and very little astigmatism. Intacs implants are also an option for individuals experiencing intolerance to contact lenses who are facing a transplant.
This treatment may be the best option to stabilize the cornea, improve vision, and potentially defer the need for a transplant. The Intacs procedure may also be used as an alternative treatment for LASIK and other types of laser eye surgery.
This procedure is often performed to improve vision and reduce the distortion caused by keratoconus. The implants are placed within the cornea to reshape and flatten the eye so that light rays can more effectively focus on the retina, increasing vision. For those battling Keratoconus, Intacs have the ability to flatten the steep part, reducing the “bulging” or cone area of the eye, often leading to less visual distortions.
The Intacs procedure has a high success rate and offers a less invasive approach than a transplant (and many other surgical eye procedures). The surgeons at Minnesota Eye Consultants who perform the procedure are corneal specialists who have expertise in treating keratoconus. Each surgeon has undergone a rigorous training program specific to Intacs for treating patients with keratoconus.
Anterior Lamellar Keratoplasty with Regional Segments (ALKRS) uses donor corneal tissue in a ring layer of the cornea. The concepts are similar
to Intacs, but rather than using plastic, which can erode through your natural cornea, the tissue used in ALKRS is more similar to your natural cornea. The donor tissue is cut to a specific, individualized size based on each patient’s pre-operative measurements. This allows your surgeon to target the most irregular sections of your cornea.
As opposed to a full thickness transplant, ALKRS tissue is placed into a pocket within your natural cornea created by a laser during the procedure. Because it is only a partial thickness tissue, and sutures are often not needed, it is far less likely to cause rejection (a process where your body recognizes the graft as foreign tissue/material).
At Minnesota Eye Consultants, we often perform ALKRS and corneal crosslinking on the same day.
Individuals best suited for Astigmatic Keratotomy (AK) have minimal or moderate degrees of astigmatism, no major history of eye problems, have had a stable eye prescription for at least a year, and want better vision without the need for contacts or eyeglasses.
With the high levels of success in correcting astigmatism with LASIK eye surgery, Astigmatic Keratotomy is now commonly performed alongside other procedures, most often cataract surgery. You may also hear Astigmatic Keratotomy referred to as “Corneal Relaxing Incisions”.
Simply put, Astigmatic Keratotomy is an incision placed strategically in the eye with the goal of changing its curvature. The incisions flatten the steep portion, making the eye more spherical.
AK can be used as an enhancement following LASIK or PRK, cataract, or lens implant surgery. Most astigmatism, though, is still corrected with the excimer laser.
The cornea is the first part of the eye which focuses light. Pre-operative measurements of astigmatism provide very precise data which determines the ideal location for the incisions. After your eyes are numbed with anesthetic drops, incisions are precisely placed to change the curvature, causing it to be more spherical in shape. Antibiotic drops are then applied to prevent infection.
Normal activities can usually be resumed in two days and although vision improvement varies, many patients can expect improvements between a day and two weeks. If vision improvement is not noticeable, it is not a sign that surgery has not worked but may take longer for specific cases and its best to speak with your eye doctor about the results.
In some patients who have refractive errors outside the range treatable with LASIK, or for those who have some cataract formation, a Natural Lens Replacement procedure may be an ideal option. This treatment is similar to cataract surgery and involves removing the natural lens of your eye and replacing it with an intraocular lens (IOL) to help reduce the need for glasses or contact lenses. There are a variety of lens options available to best suit your visual lifestyle goals. Learn more about Natural lens replacement on our LASIK Alternatives page below.
Patients who would benefit from a Phakic Intraocular Lens Implant (Phakic IOL) are those who:
The surgical technique uses an artificial implant in front of your natural lens to help reduce the need for glasses or contacts.
Using a topical or local anesthetic, the surgeon creates a small incision in the eye and inserts the lens using specialized instruments. The exact technique and placement of the implant will differ depending on the type of lens implant chosen. To learn more about the Phakic IOL treatment, visit our LASIK Alternatives page below.
An Artificial Iris is a prosthetic iris intended to replace a patient’s missing or damaged iris (the colored part of the eye). The iris plays an important part in our vision, adjusting incoming light as we change environments. An absent or partially functioning iris can cause extreme light sensitivity and glare, and even impact the sharpness of vision.
FDA approved in 2018, this technology can be used on a variety of Iris defects (issues from a traumatic injury, for instance), but is often utilized by individuals with Aniridia (a disorder in which the iris is either partially or completely missing).
Although rare, this can be devastating to those affected, both visually and cosmetically. The Artificial Iris not only offers these individuals improved vision by reducing light sensitivity and glare, but it also has the potential of cosmetically improving the appearance of the iris.
Each CustomFlex® Artificial Iris is 100% customized to the individual in need, and the details and care put into each prosthetic iris is truly remarkable. In addition to the size of the device being personalized, the colors within the CustomFlex® Artificial Iris are created to replicate those in the iris of the patient’s uninjured or unaffected eye (if one is present). The silicone CustomFlex® Artificial Iris is made in Germany and as you can imagine, it takes quite a while to customize for the patient (approximately 2 months).
To learn more about the Artificial Iris procedure, please call (952) 888-5800.
Minnesota Eye Consultants is proud to offer patients convenient access to eye care across the Twin Cities. We have 5 locations, each with an onsite ambulatory surgery center (ASC).
