On Feb 21st, 2023, Dr. David Lane gave a lecture to the Ophthalmology Society at the Royal College of Surgeons (RCSI) in Dublin, Ireland.
Dr. Lane discussed his approach to corneal refractive procedures for all ages of adults. Corneal surgery (LASIK, PRK, and SMILE) being the preferred procedures for the 20-50 year old group, who still have the ability to accommodate.
LASIK is Dr. Lane's corneal laser vision correction procedure of choice due to the ability to to create custom ablations, and due to the precise astigmatism correction from iris registration.
PRK is also a good refractive procedure, but is mainly reserved for thinner corneas and higher prescriptions, when LASIK is not possible.
Dr. Lane did note that PRK takes longer to heal than LASIK, and may be somewhat uncomfortable for the first 2 days postoperatively.
SMILE is also a good procedure for moderate to high myopic prescriptions, but does not give iris registration for astigmatism correction, and may be technically challenging when treating smaller amounts of myopia.
Dr. Lane also spoke about clear lens exchange and refractive cataract surgery for presbyopic adults (aged 50 and older).
He gave several examples of patients with abnormal corneas preoperatively who required topography guided PRK first, in order to make the cornea regular enough to give a good result with a multifocal lens implant (IOL).