Invisalens vs. LASIK Surgery

Which myopia treatment is better for you?

If you are a person with myopia or nearsightedness (also called a myope) looking at treatment options with your eye doctor, you will certainly come across Invisalens, also known as IVIT, Invisalens Vision Improvement Therapy and LASIK surgery.

Before making a choice, it is important to fully understand the pros and cons of each treatment option.

What is the process like? How long is the down time? What should be expected after the surgery or the procedure? How much will it cost? What are the long-term effects?

These are some of the questions you should ask your eye doctor before deciding on a treatment option for myopia.

Still undecided?

Here is a comprehensive guide to help you make that decision.

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LASIK Surgery

According to the vision resource website All About Vision, LASIK, which stands for ‘laser-assisted in situ keratomileusis’, is a commonly performed type of laser eye surgery to treat refractive errors such as myopia, hyperopia (farsightedness) and astigmatism.

Because it is a refractive surgery, the goal of a LASIK procedure is to reshape the cornea so light entering the eye can properly focus onto the retina, thus allowing the eye to see distant objects clearly. LASIK is relatively pain-free and can be completed in under half an hour for both eyes. The results are immediate too. Improved vision, without eye glasses or contact lenses, can be experienced within the next 24 hours.

How is it done?

Before the actual surgery, the doctor will conduct an eye exam to assess the following:

  • The shape and thickness of your cornea
  • Your pupil size
  • Moistness of the eyes (to reduce the risk of developing dry eyes after the procedure)
  • The refractive error you are suffering from
  • Other eye conditions

A corneal topographer will also be used to create a ‘map’ of your cornea.

During the actual surgery, your eyes will be placed under the laser and the lid speculum which is used to keep the eyelids open. Using an ink marker, the surgeon will mark the cornea before creating a flap. A suction ring is used to prevent eye movements or loss of contact that could affect this sensitive part of the procedure.

The eye surgeon either uses a microkeratome, a mechanical surgical tool, or a femtosecond laser, to create a thin, circular flap in the cornea. The hinged flap is then folded back to access the cornea and to remove some corneal tissue using the excimer laser.

You will be asked to look at a target light for a short time, during which the laser directs pulses of light to the cornea. The cool ultraviolet light from this laser removes microscopic amounts of tissue from the cornea to reshape it and allow light to more accurately focus on the retina, thereby improving vision. Although LASIK is considered painless, it is normal to feel some pressure on the eye while the cornea is being reshaped.

After that, the flap is laid back in place, covering the area where the corneal tissue was removed. The cornea will then heal naturally. For this type of surgery, only anesthetic drops are needed, and patients will have no need for stitches or bandages.

Who are good candidates for LASIK?

Laser surgery center TLC Vision provides a detailed breakdown of patients who are ideal candidates for LASIK.

  • Candidates must be at least 18 years old.
  • Candidates must be generally in good health, with no major health concerns such as diabetes or vascular disease. Candidates must not have a compromised immune system.
  • Candidates should have no other eye problems such as glaucoma, cataracts or corneal disease, to name a few. It is the candidate’s responsibility to discuss existing eye problems such as laze eye, dry eyes, muscle imbalance or any active eye conditions or injury.

  • Pregnant or nursing patients are not allowed to undergo LASIK.
  • Candidate’s vision must be ‘stable’ at least a year prior to the procedure. Wearing of contact lens should also be avoided within a certain period so the eye doctor can accurately assess corneal stability.
  • Candidates must have the minimum corneal thickness of approximately 0.5 mm.

Advantages

  • If done correctly and with a certified professional, LASIK has a good track record and has been proven to correct vision in most cases. Most patients tend to no longer need corrective lens or eye wear after LASIK.
  • The procedure itself is relatively fast and painless. There is little downtime as compared to non-laser surgeries.
  • LASIK can offer ‘immediate’ vision improvement. For people long suffering from myopia and other refractive errors, the convenience of not having to fumble for glasses in the morning, not having to wear contact lenses before starting the day or doing physical activities (like swimming or biking) without any interference is priceless.
  • If needed to further correct vision, adjustments can be made years after.

Risks and disadvantages

  • If the laser removes too little or too much corneal tissue, improved vision will not be achieved. It may even result in astigmatism.
  • Vision disturbances can happen post-surgery. These include difficulty seeing at night, seeing glare or halos around bright lights or double vision.
  • LASIK can cause temporary decrease in production of tears causing dry eyes.
  • If not done correctly, the process of removing the flap from the front of the eye can cause complications such as infection or excess tears.
  • Changes to the cornea are irreversible.
  • LASIK does not guarantee 20/20 vision, and certainly not for life. The ‘best vision’ is the highest degree of vision achieved while wearing contacts or eye glasses. Reading glasses may still be needed once you reach 40s because of natural age-related loss of near vision (aka presbyopia).

Because LASIK involves a surgical procedure that has lasting and irreversible consequences, careful consideration and thorough planning must be done before deciding to go through with it. Investing time and resources in a certified LASIK specialist is an absolute must to ensure that the desired results are achieved.


INVISALENS Vision Improvement Therapy (IVIT)

Invisalens Vision Improvement Therapy also known as IVIT refers to the non-surgical process of using special retainers that are designed to reshape the curvature of the eyes. Also called cornea reshaping or overnight vision correction, this scientific technology works by changing how light is focused on the retina which is located at the back of the eye.

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Why is this important?

When our eyes focus on images, it relies on the cornea, the clear front surface of the eye, and the crystalline lens, a clear structure inside the eye that changes shape so we can focus on objects. Normally, these two parts have a smooth curvature that allows them to bend or refract incoming light.

A myopic person has an eyeball that is too elongated or a cornea that is too curved. When this happens, the light entering the eye is not focused clearly. Instead, the “light rays of images” focus in front of the retina, which is light-sensitive, rather than on the retina itself. This is what causes the blurred vision.

The American Academy of Orthokeratology and Myopia Control (AAOMC)explains that the cornea is what “separates the eye from air and the rest of the outside world,” and its curvature which bends light to the back of the eye is responsible for “most of the eye’s corrective power.” The status of the cornea contributes to refractive errors such as myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.

The special and custom designed retainers used in IVIT gently reshapes the cornea while the wearer is sleeping. Upon waking, the wearer will immediately experience the difference—clearer and sharper natural vision.

To create the special custom retainers used in IVIT, the eye of the patient is first mapped using an instrument called a topographer. This allows the doctor to create retainers that match the eye’s unique shape and address its unique problems. The actual retainers  are made from an “advanced highly oxygen permeable” material that was developed with the help of NASA over several Space Shuttle Missions that it is safe to wear at night, allowing the eyes to breathe overnight. Each retainer has several specialized curves and a tear film underneath that continuously flows across the corneal surface. These components are responsible for reshaping the cornea.

IVIT is a safe and reversible procedure. It’s predecessor know as CRT was approved by the Food and Drug Administration (FDA) in 2002.

It is crucial to note that IVIT is not a miracle treatment. The length of the process varies per patient; it can take one to four weeks, based on initial prescription, corneal rigidity, tear quality and quantity and the patient’s own expectations. It is a process which may require repetitive use of the special lenses for the effects to become more long lasting. It also requires constant consultation with a certified eye doctor.

 

Who can benefit from Invisalens?

Before undergoing Invisalens, your doctor will perform some tests to determine if you are qualified for this treatment option. Essentially, the goal of the evaluation is to assess the health of your eyes.

The British Contact Lens Association cited the European Academy of Orthokeratology in saying that Invisalens “works best for people who have up to about -6.00D of myopia with no more than -1.75D of astigmatism.”

Advantages

  • Invisalens eliminates the need to wear prescription glasses or regular contact lenses during the day, thus making it easier to do some activities such as water or contact sports.
  • It also addresses some of the disadvantages of using prescription glasses or regular lenses, such as fogging during cold weather or irritation and dry eyes caused by lenses.
  • It is a safer and more cost-effective alternative to laser eye surgery. Unlike the latter, Invisalens is reversible and non-invasive.
  • It is modifiable as the eyes change and progress.
  • It is relatively pain-free and safe for children.
  • Some studies have shown that, when properly facilitated, Invisalens may slow down the advancement of myopia.
  • It is anchored on solid and science-based technology, with FDA approval.

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Disadvantages

  • First time lens wearers may find it challenging to put them on and remove them.
  • Minor infections, easily addressed by antibiotic drops and greatly reduced by careful cleaning and disinfecting, can happen.
  • The results vary for each patient, and for some, the desired results may be longer than expected. This is why, with Invisalens, regular consultation and strict compliance are key aspects to achieving the desired results.

 

So, LASIK or Ortho-k?

As each person’s pair of eyes is unique, so is the treatment for refractive errors like myopia. Think about your goal, your budget and your long-term life plans because all these are important factors that affect your vision. Consulting with an eye professional is always the first step in deciding whether to go under the laser or to sleep on it.


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