A Good Alternative to Laser Eye Surgery for Short-sightedness?

Short-sightedness, or myopia, occurs because your cornea is too curved, or your eyeball is too long, so that light rays from distant objects focus in front of your retina.  This makes objects seem fuzzy or blurred.  Nearby objects don't look fuzzy, because the light rays enter your eye at a slight angle, and focus on your retina properly.  In recent years, laser refractive surgery has been used as a corrective procedure for people wanting to avoid wearing glasses or contact lenses.  A newer procedure is the surgical insertion of phakic intraocular lenses; in contrast to laser surgery, which removes parts of the cornea, the phakic lens is placed in front of the iris in the anterior chamber, or behind the iris in the posterior chamber, just in front of the natural lens.

The Cochrane Systemic Reviews have just published a review of three randomized controlled studies comparing these two types of treatment for moderately severe myopia.  There were 228 eyes in the three studies.  The chances of achieving 20/20 vision (or better) without glasses was the same for the two types of surgery.  Phakic lens insertion was superior from one point of view – it was accompanied by less loss in the best acuity score when wearing glasses after 12 months postoperatively.  Phakic insertion also resulted in better contrast sensitivity than laser correction (think of your TV), and scored higher on patient satisfaction questionnaires.  On the other side of the balance, phakic surgery was associated with a low risk of developing early cataract.

The authors of the review conclude, rightly, that more studies are needed to best define the optimal use of phakic lens insertion, as well as its long-term safety.