For those who rely on glasses or contact lenses, the idea of vision correction surgery is often appealing. In recent years, laser-based procedures like LASIK and LASEK, which reshape the cornea, have gained popularity for their relative simplicity. However, patients with severe refractive errors—such as high myopia over -6 diopters or marked astigmatism—may not be suitable candidates for these procedures.
Correcting high myopia or severe astigmatism requires removal of significant corneal tissue, which may excessively thin the cornea, compromising structural integrity and heightening the risk of complications. Some patients may be deemed ineligible for laser surgery. Although newer laser technologies reduce the amount of corneal tissue removed, they remain insufficient for cases of ultra-high myopia or severe astigmatism.
Anatomical factors also influence surgical eligibility. Patients with thin corneas, large pupils prone to glare, chronic corneal disorders, or severe astigmatism are often unsuitable for conventional laser procedures.
For these patients, intraocular lens (IOL) implantation offers an alternative. Unlike laser surgery, IOLs do not alter the cornea, making them suitable regardless of corneal thickness or shape. This approach preserves ocular structure and is reversible, as lenses can be removed if complications occur.
Intraocular lens implantation places the lens either in front of or behind the iris. Posterior chamber implantation—between the iris and natural lens—is now the most common, offering minimal postoperative discomfort and faster recovery. Because it avoids corneal reshaping, this approach lowers the risk of side effects such as dry eye or nighttime glare, and is especially beneficial for patients with thin corneas.
Despite its advantages, intraocular lens implantation carries risks. The implanted lens must precisely match the eye’s dimensions to prevent complications. An oversized lens can block aqueous humor flow, raising intraocular pressure and risking glaucoma, while an undersized lens may shift, potentially damaging the corneal endothelium or contributing to cataract formation. These risks underscore the need for meticulous preoperative measurements—including the eye’s internal dimensions and astigmatism axis—and a highly skilled surgical team.
Postoperative care is equally critical, requiring regular monitoring of corneal endothelial cell counts and lens positioning. Compared with LASIK or LASEK, intraocular lens implantation demands more intensive follow-up, making it vital to select a clinic with strong pre- and postoperative care systems.
For patients with high myopia, severe astigmatism, or thin corneas that preclude laser surgery, intraocular lens implantation provides a practical alternative. It is also suitable for those needing re-correction. However, because the lens is placed directly inside the eye, comprehensive preoperative assessment and diligent postoperative care are essential.
Consulting an experienced ophthalmologist is strongly recommended to determine the most appropriate procedure for each patient’s needs.
Kim Kuk Ju, HEALTH IN NEWS TEAM
press@hinews.co.kr