Lens Implants, PRK Refractive Surgery, and More — St. Louis, Missouri
Our vision correction techniques go way beyond LASIK! Other procedures such as PRK (ASA), NearVisionSM CK®, Visian™ Implantable Contact Lenses, and ReZoom™ and ReSTOR® bifocal implants and the Crystalens® Accommodating lens implant are just some of the refractive surgery procedures we offer at our St. Louis, Missouri facility that can change your life and improve your vision.
At Mulqueeny Eye Centers, our job is to identify the best possible candidates for surgery. However, not everyone qualifies. In fact, because of our strict surgical standards, many times we recommend procedures other than LASIK, or discourage surgery entirely if it’s not best for the patient. We’re able to do this because of our exceptional surgical team that features not one but two corneal sub-specialists. This allows us to successfully perform refractive surgery procedures that LASIK-only centers just can’t.
- PRK/ASA (Advanced Surface Ablation) — No-Flap LASIK
- Refractive Lens Implants
PRK/ASA (Advanced Surface Ablation) — No-Flap LASIK
While LASIK surgery can benefit a large number of patients, it is not right for everyone. Fortunately, there are other types of refractive surgery offered at our St. Louis practice that can improve your vision without dependency on glasses or contact lenses.
PRK (Photorefractive Keratectomy), also referred to as Advanced Surface Ablation (ASA), is a laser vision correction much like LASIK with the difference being that no corneal flap is created. Like LASIK eye surgery, PRK/ASA is offered at our St. Louis practice and is a good choice to treat low to high levels of nearsightedness, farsightedness, and astigmatism. The laser treatment itself, whether conventional or custom technology is used, is exactly the same as with the LASIK procedure. The difference between PRK/ASA and LASIK lies in how the eye is prepared for the laser application and the visual recovery time. With LASIK, a corneal flap is created and the laser is applied to the inner tissue of the cornea; with the PRK/ASA refractive surgery procedure, the epithelium (the outer skin of the cornea) is removed and a laser is applied to the surface of the cornea. PRK/ASA is an excellent choice for patients who are not considered good candidates for LASIK due to thin corneas, dry eye or certain occupations such as law enforcement or firefighters who may be at risk for taking a blow to the eye area. We are proud to offer PRK/ASA at our St. Louis, Missouri office.
During the PRK (ASA) refractive eye surgery procedure, the surgeon places a small amount of special solution on the eye. This solution loosens the epithelium, the outer layer of the cornea. The surgeon then gently brushes away the epithelial cells using a sponge, applies the laser treatment, and places a contact lens to keep the patient comfortable during the healing period.
It generally takes three to four days for the surface epithelium to heal. During this time there can be significant discomfort, although the use of certain drops and a type of soft contact lens placed during the procedure helps considerably.
Once the eye’s surface has healed, the bandage contact lens is ready to be removed. At this point, most patients see well enough to carry out their daily activities, and vision will continue improving over the next weeks and months. During this period, it is normal to notice some fluctuation of vision; that is, vision may be clearer and sharper from one time of day to another or from one day to another.
Candidates for PRK/ASA are those who:
- Are over the age of 18
- Have a stable prescription for at least one year
- Want to reduce or eliminate dependence on glasses or contact lenses
- Cannot have LASIK due to thin corneas, eye pressure problems (glaucoma), have diabetes or other health issues affecting their eyes
- Want to minimize dry eye problems following the procedure
There are advantages and disadvantages when comparing PRK/ASA and LASIK laser vision correction. Because we are not creating a flap, it’s a safer procedure because there’s no risk of flap complications. Patients do not need to worry about rubbing or bumping the eye after surgery, disrupting the flap, and there is less chance of dry eyes following this type of treatment. The major disadvantage with a surface treatment is that visual recovery generally takes longer and it may take several weeks for the best visual acuity to be achieved. Though visual recovery may take a bit longer, patients can expect the same and in some cases better results with PRK refractive surgery than with LASIK. Especially for highly myopic (nearsighted) patients, PRK/ASA poses a slightly elevated risk of haze or scarring.
PRK/ASA at our St. Louis, Missouri practice can be a life-changing procedure for those who cannot undergo LASIK surgery. To learn more about PRK/ASA or other types of refractive surgery, contact the St. Louis practice of Dr. Sean Mulqueeny today.back to top
Refractive Lens Implants
The natural lens inside of the eye is called the crystalline lens. Refractive lens implants, offered at our St. Louis, Missouri practice, may be placed inside of the eye in front of the crystalline lens (called phakic lenses), or implants may replace the natural lens as in cataract surgery (called pseudophakic lenses).
There are several different types of IOL's (intraocular implants) divided into two distinct groups:
1) Phakic IOL’s are lenses that are placed within the eye while the natural lens of the eye is kept intact.
- Implantable Contact Lenses (ICL's), such as the Visian ICL™ is a type of phakic IOL procedure being used on a wide range of nearsighted patients who may prefer this technology or who may not be candidates for the more common laser procedures such as LASIK or PRK/ASA.
2) Pseudophakic IOL’s are lenses that replace the natural lens within the eye. Implantation of this type of lens generally is used during cataract surgery or may be chosen as an elective procedure by patients who are not candidates for other vision correction methods such as LASIK. Pseudophakic lenses may be monofocal, meaning that they correct for only one distance or they may be multifocal which gives a good range of correction at both distance and near.
- Monofocal Lenses
- Multifocal Lenses such as ReZoom™ or ReSTOR®
- Accommodating Lens such as the Crystalens®
Monofocal lenses were the original IOL's that corrected vision at one distance only – near, intermediate, or far. Patients may choose a lens that corrects distance in both eyes, or they may choose to correct one eye for distance and the other eye for near or intermediate distance. The latter treatment is referred to as monovision and patients may choose this option to reduce or eliminate their dependency on glasses or contact lenses for distance and near.
Today, with the development of advanced IOL technology, we are able to offer the choice of a multifocal lens implant. With multifocal lenses, such as ReZoom™ and ReSTOR®, patients can obtain good near or intermediate vision in addition to good distance vision. Multifocal lenses are a great option for patients undergoing cataract surgery or as a way for cataract-free patients to enjoy life without dependence on glasses or contact lenses. Read below to learn more about ReZoom™ and ReSTOR®.
An accommodating lens implant, such as the Crystalens®, is a lens replacement that functions much like the natural lens inside the eye. Unlike the ReZoom™ or ReSTOR® lens that remains stable in the eye and provides a combination of distance and intermediate vision or distance and near vision, the Crystalens® has the ability to provide good distance and near vision and every distance in between. An accommodating lens such as the Crystalens® has the ability to move or flex within the eye to provide good vision at all distances. A thorough eye health examination will allow us to determine which type of intraocular lens is right for you. Read more about the Crystalens® below.back to top
The Visian ICL™ gives another option for treating myopia. Now, patients who are seeking the latest approved procedures for vision correction or who want to avoid permanently changing the structure of their eye with laser vision correction have another choice for correction of nearsightedness. The eye doctors and surgeons at Mulqueeny Eye Centers were chosen to perform this surgery on the first patients in the St. Louis metropolitan area and are the most experienced providers of the Visian ICL™ for this area.
Like all intraocular lens implants, Visian ICL™ (implantable contact lens) is placed inside the eye. Unlike an IOL that is used during cataract surgery, however, the Visian ICL™ does not replace your eye’s natural lens. Instead, it is a "phakic lens," meaning it is placed inside the eye in front of the natural lens. Since the implantation of this lens does not affect the cornea, the Visian ICL™ is an excellent option for patients with moderate to severe nearsightedness who cannot undergo LASIK or PRK/ASA laser vision correction due to thin corneas or other eye health issues.
Visian ICL™ implants are made of Collamer, a soft and flexible biocompatible lens that contains collagen and is well-tolerated by the eye. The procedure for this type of lens implant is simple and can be performed at our St. Louis, Missouri surgery center on an outpatient basis, with patients going home the same day and returning to work soon after their procedure.
About the Procedure
About a week before your procedure, your surgeon will make a tiny opening with a laser in your iris, (peripheral iridotomy), to allow fluid to pass between the lens and the front chamber of the eye once your lens is implanted. On the day of your procedure, you will be given topical anesthetic eye drops and a mild sedative to help you relax. Because of their flexibility, the lenses are folded and implanted through a small microscopic incision that heals on its own and does not require sutures. The procedure is quick with little or no discomfort, taking only 10 to 15 minutes per eye, and visual recovery is almost instantaneous.
Advantages of Visian ICL™
- The Visian ICL™ offers the widest range of treatment for nearsightedness, -3.00 to -20.00
- Good option for patients that are not candidates for LASIK or other refractive surgery procedures
- The Visian ICL™ can be removed with a simple surgical procedure, unlike LASIK and PRK, which change the structure of the cornea
- Requires no maintenance
- Extremely safe procedure with consistent and excellent results proven in several clinical trials
- Removable lens
Learn more about the Visian ICL™ and other refractive lens implants offered at our St. Louis, Missouri office by contacting the practice of Dr. Sean Mulqueeny today.
For more information, view our Visian ICL™ Surgery PDFback to top
If you are finding that your vision is becoming hazy or blurry with age, you may be developing cataracts — a clouding or discoloration of the eye’s natural lens. Cataracts are often age-related, and a range of factors (medical conditions such as glaucoma and diabetes, injuries to the eyes, long-term exposure to the sun, smoking, and use of oral steroids and other medications) can contribute to their development. Cataract surgery is a simple, safe and effective procedure that we offer at Mulqueeny Eye Centers.
Since it requires the removal of the crystalline lens (the natural lens inside the eye), cataract surgery is usually combined with the implantation of an intraocular lens — either monofocal or bifocal. Refractive surgery and lens implants discussed below can help our St. Louis cataract patients improve vision, be it near, intermediate, or far.
Read the full explanation of cataracts and cataract surgery on our Eye Care page.
ReZoom™/ ReSTOR® Lenses
For most people over age 45, life without reading glasses or bifocals is something they either experienced before presbyopia or they just dreamed about for most of their lives. Today, refractive lens implants (IOL's) such as ReSTOR® and ReZoom™, easily placed in your eye at our St. Louis, Missouri office, are turning those dreams into reality with breakthrough lens technology. These lenses can provide patients with clear vision at all distances — without bifocals or reading glasses!
Candidates for this type of lens implantation include:
- Cataract patients who desire a bifocal lens implant
- Patients who are over age 45 and are presbyopic (have the loss of near vision)
- Patients who desire vision correction and are not good candidates for LASIK
Those who opt for lens implants experience a dramatic improvement in their close-up vision and a significant reduction in their need for reading glasses or bifocals. For example, if you play golf, you may be able to see where your drive lands, sink your putt and write down your score — all without reaching for your glasses! Or when shopping, you may be able to read the aisle signs and the package labels and write a check for your purchase without the aid of glasses. The overall goal of multi-focal lens implants is to reduce your dependency on glasses for daily activities, both at near and far distances.back to top
The ReZoom™ intraocular lens implant is an excellent choice for patients with cataracts, as well as those who are experiencing presbyopia—the loss of near or intermediate vision after age 40. ReZoom™ is a multifocal intraocular lens implant (IOL), making it excellent at providing good vision while viewing objects far away and at intermediate or arm’s length distances.
This lens implant is best for patients over age 45 who have developed cataracts in one or both eyes, or patients who want to combat the effects of presbyopia (the loss of lens elasticity that results in an inability to focus on up-close objects, such as books). Those who receive ReZoom™ lens implants at our St. Louis, Missouri practice experience a dramatic improvement in their mid-range vision and a significant reduction in their need for reading glasses or bifocals when viewing objects at an intermediate (arm’s length) distance such as their computer screen, odometer, etc.
The ReZoom™ IOL replaces the natural lens and may be implanted at the time of cataract surgery. However, cataract surgery is not a necessary prerequisite for receiving ReZoom™ lens implants; they can also be implanted on their own, a procedure called clear lens exchange. Clear lens exchange (CLE) involves the removal of a natural lens in the eye that is clear, or in other words, does not have a cataract (clouding of the lens) to reduce or eliminate a person’s dependence on glasses or contact lenses. ReZoom™ lens implants are used in this procedure quite frequently.
In studies, a vast majority (92 percent) of ReZoom™ lens implant recipients have no need, or just an occasional need, for glasses. ReZoom™ can be used in conjunction with ReSTOR® lens implants (covered below) with excellent results. For more information about lens implants, contact our St. Louis, Missouri area practice today.back to top
Like ReZoom™ lens implants, the AcrySof® ReSTOR® lens is a multifocal lens implant capable of providing you with multiple viewing distances. While the ReZoom™ lens targets distance and mid-range or arms length vision, the ReSTOR® lens treats distance and near, 12-14 inches, the typical range for reading and other near vision activities. It is an excellent option if you have cataracts and require replacement of your natural lens. Even if you don’t have cataracts, it is also a great alternative to LASIK or another vision correction procedure if you are over the age of 45 and want to reduce or eliminate dependence on glasses or contact lenses for near vision as well as distance.
The ReSTOR® IOL offers unique technology to provide patients with a reduced need for reading glasses or bifocals. Rather than being the same thickness throughout the lens, the ReSTOR® IOL is made up of many tiny steps that radiate out from the center of the lens in concentric rings. This structure allows for light to be smoothly and evenly focused on the retina, providing you with better focusing ability.
In general, the ReSTOR® lens implant yields the best results when implanted in both eyes. In a study, it was shown that while only 23 percent of patients who received a conventional intraocular implant enjoyed complete freedom from glasses, the ReSTOR® lens let patients achieve this total freedom 80 percent of the time.
Learn more about lens implants and other refractive surgery options at our St. Louis, Missouri office by contacting the practice of Dr. Sean Mulqueeny.back to top
Crystalens® Accommodating Lens
The Crystalens® Accommodating Lens is another popular type of intraocular lens (IOL) that may be used following a cataract procedure, or may be chosen as an elective procedure called Clear Lens Exchange (CLE) by patients who are over age 45 and are not considered candidates for LASIK or other types of refractive procedures. Like the ReSTOR® and ReZoom™ implants, the Crystalens® is considered a pseudophakic lens, meaning that it replaces the natural lens within the eye.
The natural lens inside your eye is called the crystalline lens. One of its functions is to change shape, called accommodation, when we view objects at distance, intermediate and near. When we look at an object far away, the lens flattens and allows us to focus on it clearly. As we view things at an intermediate or arms length distance, the lens automatically flexes or bulges forward enough to see clearly at this distance and can also flex even further to see things clearly for near tasks such as reading or sewing.
As we age, the natural lens in the eye loses this flexibility or ability to accommodate, a condition known as presbyopia. It is this condition that causes most people over the age of 40 to become dependent on their bifocal lenses or reading glasses when they attempt near vision tasks such as reading a newspaper, working on a computer or dialing a cell phone.
The beauty of the Crystalens® Accommodating Lens is that its design is one that most mimics the movement of the natural lens inside the eye. Unlike the ReSTOR® and ReZoom™ IOL, this revolutionary design includes “hinges” which are designed to allow the lens to move, or accommodate, to focus on objects near, far and everywhere in between. Just as the human lens (crystalline lens) uses the muscles inside the eye to allow the lens to change shape and allow you to focus at various distances, the Crystalens® works much the same way. Though the Crystalens does not change shape, it does move back and forth within the eye to accommodate varying distances. The lens rests back in the eye for distance viewing, then gently flexes forward for intermediate, and then even further forward for near vision.
Candidates for this type of lens replacement include those who:
- Want to reduce or eliminate their dependence on glasses or contact lenses
- Are over the age of 18 and desire vision correction and are not good candidates for LASIK or other vision correction procedures
- Are cataract patients who desire a lens replacement that allows clear vision at all distances
In most cases, those who opt for this type of lens implantation can expect a dramatic improvement in their vision at distance, intermediate and near ranges. Clinical results with this type of lens replacement indicate that 98.4% of Crystalens® patients are able to read the newspaper or a phone book without glasses; 100% are able to see their computers, dashboards and anything else at arm’s length without glasses and 98.4% are able to see 20/40 or better at distance after their procedure.
At Mulqueeny Eye Centers, we offer a variety of intraocular implants including multifocal implants such as ReStor® and ReZoom™. We will perform a thorough eye health exam to determine the most appropriate treatment for you and recommend the type of intraocular lens that is best suited for your visual needs.back to top
How do you choose which lens implant is right for you?
During your consultation, Dr. Mulqueeny and his staff spend time reviewing which typical daily routine activities are most important to you — and whether being independent of glasses for those activities is something that you would like to achieve. As you prepare for your visit to our office, you may want to begin thinking about your favorite and most important activities so that you can discuss them with the staff.back to top
Learn More about Refractive Surgery and Lens Implants
With our two corneal sub-specialists, Mulqueeny Eye Centers is able to offer a range of safe, effective vision correction procedures that extend way beyond the offerings of LASIK-only practices. Here, you will find friendly, skilled doctors that will give you an honest assessment of which procedure is best for you, and then oversee your care from start to finish. To learn more about LASIK, PRK/ASA, NearVisionSM CK®, refractive lens implants, or other vision correction procedures we offer, or to schedule a one-on-one consultation, please contact the St. Louis, Missouri practice of Dr. Sean Mulqueeny today.back to top