Patients with myopia are nearsighted, meaning they can see near objects clearly but things at a distance are blurred. Myopia usually results when the eye is too large or elongated, which causes light entering the eye to focus before reaching the retina.

LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with myopia.

Patients with hyperopia are farsighted, meaning they have good distance vision but close-up objects appear blurred. Hyperopia is due to the eye being smaller than normal, causing light entering the eye from close-in objects to come into focus too far behind the retina.

LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with hyperopia.

Astigmatism is a condition that can impair vision close up and at a distance. It occurs when the cornea and lens of the eye is oval in shape instead of round. This lets light entering the eye to focus at several points on the retina instead of one, causing blurring. Astigmatism often occurs with myopia or hyperopia.

LASIK (laser assisted in situ keratomileusis) is one of the most popular vision correction procedures for patients diagnosed with astigmatism.

Most patients begin to experience presbyopia, meaning old-eyes, in their 40s. This occurs as the eye lens hardens naturally with age and loses the flexibility to focus on close-up objects.

There now are laser vision correction options available for presbyopia, including monovision LASIK and PRK surgery, in which one eye is corrected for distance vision and the other is corrected for near vision.

Surgeons at the Laser Refractive Center conduct a thorough examination to see if the patient can adjust to this vision correction procedure. That involves a simulation in the office or having the patient test monovision glasses or contact lenses for a few days.

Some people with presbyopia choose Refractive Lens Exchange (RLE), a procedure identical to cataract surgery with a lens implant that corrects for blurred objects at close range.

A cataract is a clouding of the transparent dome-shaped surface of the eye that prevents light from reaching the retina. It results in blurred vision, glare and halos around objects.

There are three types of cataracts:

• Nuclear cataracts, which form in the nucleus or center of the lens, usually as patients age.
• Cortical cataracts, which form in the cortex, outside of the eye lens. Over time, this cataract extends from the outside to the inside of the lens. They are common in diabetic patients.
• Subcapsular cataracts, which form at the back of the lens. This type of cataract is common in diabetics, people taking steroid medication and those who are farsighted or have retinitis pigmentosa.

When a patient has small or slowly developing cataracts, they can compensate temporarily with prescription glasses or bifocals or avoiding activity such as driving at night. Eventually, surgery to replace the clouded lens may be needed.

At UC Irvine Healthcare’s Gavin Herbert Eye Institute, our top priority is outstanding patient care. That is why our surgeons meet with each patient to determine his or her vision correction needs.

A typical evaluation begins with a vision counselor at the Laser Refractive Center at the Irvine campus. The counselor discusses different vision correction procedures and treatments that are available and gives a tour of the center.

The patient next meets with an ophthalmic surgeons. The ophthalmologist personally supervises all necessary measurements and tests, while answering many of the patient’s questions. Based on the examination and test results, the surgeon determines which vision correction procedure—LASIK, PRK, implantable contact lens or cataract surgery—is right for the patient. The surgeon and counselor remain available to the patient for further questions on the procedure and the healing process.

After the procedure, the surgeon continues to meet with the patient for post-operative testing, measurements and follow-up care. By guiding the patient through each step of the process, we are able to individualize patient care, which results in greater patient satisfaction.

At UC Irvine’s Laser Refractive Center, we are dedicated to improving our patients’ vision. We do this by offering the best vision correction lasers available – the Visx and the Allegretto lasers. Many vision correction centers only offer one laser option. By having two different systems, the Laser Refractive Center surgeons are able to precisely tailor the vision correction procedure to the individual patient’s needs.

Our ophthalmologists use the Intralase Method™ for all our LASIK treatments. The blade-less Intralase® femtosecond laser is the safest way to create the corneal flap for vision correction treatment.

The Intralase® femtosecond laser has a special association with UC Irvine’s Gavin Herbert Eye Institute and Department of Ophthalmology, whose professors Dr. Ronald Kurtz and Tibor Juhasz co-invented the blade-less laser. Institute director Dr. Roger Steinert has pioneered its use in corneal transplants.

The Intralase Method™ uses a computer-guided, ultra-fast laser used to create a corneal flap without affecting the cornea. Using pulses of light, the laser creates microscopic bubbles at a pre-determined depth just below the cornea surface that are gently separated to create the corneal flap and expose a smooth treatment area for LASIK treatment.

The precision of the Intralase Method™ makes it an option for patients with thin corneas who haven’t been candidates for traditional LASIK. Results from clinical studies have shown that more patients have 20/20 vision and report less trouble seeing in dimly lighted conditions after having LASIK done in combination with the Intralase Method™.

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LASIK (laser-assisted in situ keratomileusis) surgery was first approved for use in the United States in 1995. It remains one of the most popular vision correction procedures to correct nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. Millions of patients worldwide have enjoyed clear, crisp vision after undergoing LASIK surgery.

Using the latest in LASIK technology, UC Irvine's Refractive Surgery LASIK Center surgeons customize each procedure to deliver even more precise vision correction. Many patients find that they have better vision than when they wore glasses or contact lenses.

During the LASIK procedure, the surgeon carefully creates a thin flap that is gently folded back to expose the corneal surface for reshaping with the Visx or Allegretto lasers. The flap is then carefully re-folded over the treatment area, acting as a bandage as the eye heals. Most patients see their vision improve within hours after treatment. Many are ready to return to work or their normal activities the following day.

Not all patients are good candidates for LASIK surgery. For patients whose corneas are too thin or who have other conditions, other options are PRK (photorefractive keratectomy), LASEK (laser epithelial keratomileusis) or Epi-LASIK surgery.

During these procedures, the laser treatment is done directly on the surface of the cornea after removing a small amount of the outer layer of cells.

The PRK procedure can be done to correct nearsightedness (myopia), farsightedness (hyperopia), or astigmatism.

Patients for whom LASIK or PRK is not indicated because of extreme nearsightedness, thin corneas or other conditions have another treatment option, often called an “implantable contact lens.”

The implant, technically known as a phakic intraocular lens, is surgically inserted without removing the natural lens. Implantable lenses are currently available to correct nearsightedness and are in development for patients with farsightedness and astigmatism.

At the Laser Refractive Center, we offer two types of implantable lens. The first is a soft, foldable lens made of a polymeric material that resembles the natural collagen of the cornea and is biocompatible with the eye. During the procedure, the surgeon makes a small incision at the edge of the cornea. The lens is folded and carefully inserted into the anterior chamber of the eye and placed behind the iris, or colored part of the eye.

Healing is relatively quick and patients often see immediate improvement in their vision. Most patients don’t feel or notice the lens once it is implanted. The lens is intended to be placed permanently but it can be removed if necessary.

The second type is a phakic intraocular lens for patients with moderate to extreme myopia who aren’t good candidates for LASIK surgery. This type of lens is placed behind the cornea and attached to the iris to give the eye additional focusing ability. Microscopic stitches used to close the incision dissolve over time. After patients recover from surgery, they usually have good distance and near vision.

After a phakic lens implant, most patients no longer need glasses. However, as the patient ages, it is normal for natural lens function to decrease, which may make reading glasses necessary. Cataracts also may develop over time. If cataract surgery is required later, the phakic implant is removed and the surgery proceeds in a standard manner.

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Patients with cataracts that impair visual function often have surgery to replace the natural lens with a soft plastic intraocular lens (IOL). This microsurgery, involving tiny incisions, is performed in an outpatient ambulatory surgery center.

The intraocular lens is designed so be folded and inserted into the eye through a small incision during surgery. After insertion, the lens gently unfolds and its supporting arms work to maintain proper positioning within the patient’s eye.

The procedure is usually completed in less than 20 minutes. Numbing medicine on the eye makes it painless. Most patients find their vision improved immediately after the surgery.

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