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CALL (949) 631-4780
Every pair of eyes is different, and not every eye is a LASIK eye. Thin corneas, very high prescriptions, significant dry eye, or simply being at an age where the eye’s natural lens is the real problem: each points to a different answer. Dr. Feinerman performs the full range of vision correction procedures, so the recommendation you get is based on your anatomy, not on the one procedure a practice happens to offer. Here are the three main alternatives, and who each one serves.
Photorefractive keratectomy (PRK) is laser vision correction without a flap. Instead of creating a corneal flap, the surface layer of cells is removed and the cornea is reshaped directly; the surface cells regenerate within days. PRK suits patients whose corneas are mildly thin but healthy, and some patients with occupations or sports where a flap is undesirable. Recovery is slower than LASIK (expect a few days of discomfort and blurred vision), but outcomes at three months are very similar. One honest caveat: PRK still removes corneal tissue, so if your cornea is genuinely too thin for LASIK, PRK is usually ruled out for the same reason, and the EVO ICL™ becomes the conversation.
The EVO ICL is a biocompatible Collamer lens placed inside the eye, behind the iris, where it works with your natural lens rather than replacing it. It is FDA approved for ages 21 to 60 and treats nearsightedness from -3.00 to -20.00 diopters, with or without astigmatism, which covers prescriptions far beyond LASIK’s comfortable range. Because it removes no corneal tissue, thin corneas are not a barrier. Because there is no flap and corneal nerves are largely undisturbed, its dry eye impact is lower than LASIK’s. And because the lens is reversible (it can be removed by a qualified surgeon), it preserves every future lens option for the day, decades from now, when presbyopia or dysfunctional lens syndrome makes lens replacement worth considering. More than 4 million implantable collamer lenses have been sold worldwide, and among patients studied, the implantable collamer lens carries a 99.4% satisfaction rate.
If you are over about 45, the honest answer is often that your cornea is not the problem: your natural lens is aging, stiffening, and starting the slow slide toward cataract. Dr. Feinerman generally does not recommend LASIK over 45 for exactly this reason. Refractive lens exchange (RLE) replaces the aging natural lens with an advanced intraocular lens, the same platform as modern cataract surgery, done electively and earlier. It corrects distance vision, can restore reading range, and means you will never develop a cataract. Lens choice is personalized to your anatomy, lifestyle, and goals from our full diagnostic workup; the options span monofocal, extended depth of focus, trifocal, and the Light Adjustable Lens (LAL). Learn more about RLE or read about dysfunctional lens syndrome.
A useful shorthand while you wait for your evaluation: thin corneas with a moderate prescription often point to PRK; thin corneas with a high prescription, or dry eye concerns at any prescription, usually point to the EVO ICL™; and changing near vision after 45 points toward a lens-based answer like RLE. These are starting points, not diagnoses. Your consultation with Dr. Feinerman, with imaging from our iTrace, Pentacam, and corneal diagnostics, determines which procedure your eyes actually support.
Schedule your consultation with Dr. Feinerman, or take the candidacy quiz to see where your eyes likely land. Call (949) 631-4780.
Anyone over the age of eighteen who has not had a significant change in vision over the past 6 months and can see clearly with contact lenses or glasses may be a good candidate for LASIK or one of our other vision correction procedures. Take our LASIK candidacy test to find out more.
Ordering contact lenses and glasses regularly can get expensive. Use our savings calculator to estimate how vision correction can save you money over your lifetime. If you’re interested in financing options, click here.
This quiz is educational and does not diagnose any condition or guarantee candidacy for any procedure. Candidacy is determined only by a comprehensive evaluation, including corneal imaging and a full eye exam, performed by Gregg Feinerman, MD, FACS. Feinerman Vision · 320 Superior Ave, Suite 390, Newport Beach, CA 92663 · (949) 631-4780 · FeinermanVision.com