There have also been some advances in refractive surgery, so it’s worth touching on this topic again.

LASIK and PRK are procedures that alter the corneal shape to change the power for correcting vision.

For patients who are nearsighted (they see up close well, but not far away), the cornea is flattened using a laser to ablate it centrally. This is a relatively straightforward correction.

For patients who are farsighted (they see far away better than up close), the cornea needs to be steepened. This is not as straightforward.

There are some farsighted prescriptions that can be corrected this way, but the results are a lot more variable.

Additionally, five-year regression rates are much higher for farsighted than nearsighted LASIK patients. It’s a good chunk of change to spend only to end up in glasses less than five years later.

OK, so what can you do if you’re not a candidate for LASIK?

There are still other options for refractive surgery. For patients who are in their 40s and 50s, and might need bifocal glasses, there is a procedure called “refractive lens exchange” that can be done on almost any prescription.

This procedure is in essence the same thing as cataract surgery, except with no cataract. Behind the iris (the colored structure in the eye) sits a lens in the eye. That lens is where cataracts eventually form, so the bonus is after this procedure you’ll never need cataract surgery.

In this procedure, this lens is removed and replaced with an artificial one that contains your prescription. The lens can be just for distance, but you will still need reading glasses if you opt for that.

Alternatively, there is a multifocal lens implant that works when you can see most of your distance and reading tasks without any glasses.

Lastly, there is an option called “monovision.” In this case, one eye is set for distance and one for reading.

Cataract surgery has been performed day in and day out by lots of ophthalmologists, making refractive lens exchange a very comfortable procedure for most surgeons. With LASIK and PRK, refractive lens exchange, or any other procedure to correct vision, I always warn patients that surgery is surgery no matter what.

No procedure comes without risk, but for those who are desperate for vision correction without glasses, there are options available.

Caroline Bundrick, O.D. is an optometrist practicing at Darling Eye Center, with offices in Bluffton and on Hilton Head Island.