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There are several surgical treatments to correct hyperopia, which is better known as farsightedness. Most farsightedness surgery options utilize special lasers and heat sources to reshape the cornea. The different laser surgical options are hyperopic laser in-situ keratomileusis (H-LASIK), excimer laser photorefractive keratectomy (H-PRK), laser epithelial keratomileusis (H-LASEK) and laser thermokeratoplasty (LTK). Intraocular lens (IOL) implantation surgery and conductive keratoplasty usually do not include a laser during the procedure.
The degree of farsightedness along with other factors will determine the type of surgical procedure to be performed. In most cases, mild to moderate farsightedness can be treated with H-LASIK, H-PRK, H-LASEK and thermal keratoplasty procedures. People who have severe farsightedness are typically treated with IOL implantation. With any type of surgery, certain risks and complications should be taken into careful consideration. Complications can range from over-correction to corneal scarring, which could eventually lead to blindness.
One of the more common farsightedness surgery procedures performed is H-LASIK. Similar to other eye-correcting laser procedures, H-LASIK changes the shape of the central cornea by making it steeper. Using a knife or laser, a thin flap is cut from the cornea, allowing contact between the laser and central corneal tissue. Many people experience little to no pain after the procedure is completed.
Both H-PRK and H-LASEK farsightedness surgery procedures use surface ablation to change the shape of the central cornea. In H-PRK, the surface cells of the cornea are removed to reshape the cornea, whereas H-LASEK loosens and eventually replaces the surface area of the cornea. Unlike H-LASIK, both H-PRK and H-LASEK procedures do not involve cutting into the cornea to create flaps. Generally, the recovery times and pain intensity involving H-PRK and H-LASEK farsightedness procedures are longer and more painful than with the H-LASIK procedure.
Thermal keratoplasty can be performed via a non-contact technique or contact technique. The non-contact technique, LTK, uses a laser to apply pulses of light onto the cornea. The contact technique called conductive keratoplasty uses probes to deliver radio frequency energy onto the cornea. In both techniques, the collagen fibers in the cornea contract, causing the reshaping of the cornea to occur. A common complication of both thermal keratoplasty procedures is the risk of astigmatism formation.
There are various IOL farsightedness surgery procedures that are effective for severe farsightedness, such as clear lens extraction (CLE) and phakic intraocular lens (PIOL) implantation. In CLE, the natural lens of the eye is replaced with an IOL or a clear refractive lens. The ability of the eye to focus from far to near is greatly reduced after a CLE with IOL implantation procedure is performed. A PIOL procedure deals with the implantation of an IOL alongside the eye’s natural lens.