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Treatment with LASIK or PRK
alone is not suitable for patients with very severe to extreme refractive
errors.
Experienced and responsible ophthalmologic surgeons advise against surgery
in cases of nearsightedness exceeding -10 diopter or farsightedness
exceeding +3 diopter, because the amount of corneal tissue ablation
would be too high and would usually result in a destabilization of the
cornea.
The following alternatives may be offered to these patients:
 Phakic IOLs: Intraocular lens implants for the correction
of severe myopia and hyperopia (ICL, Artisan)
Lens implants and bio-optics are options for young patients because
the lenses of their eyes are still elastic and have not yet lost the
ability to accommodate (they are able to see at close distances without
the need for reading glasses). These patients are given the opportunity
to reduce their dependency on eyeglasses or contact lenses while conserving
the ability of their body's own lenses to accommodate for close-up vision.
Bioptics,
This is a combination of ICL implants and a subsequent treatment with
LASIK surgery to eliminate the remaining refractive error, for example
an existing astigmatism. Also see lens implants.
RLE
(refractive lens exchange; earlier known as clear lens extraction, CLE)
The RLE is restricted to patients who are more than 40 years old and
need reading glasses. RLE is also used when an age related cataract
already exists, which sooner or later would lead to an exchange of the
body's own lens with a synthetic lens.
The most suitable procedure for you can only be determined after a
detailed preoperative eye exam has been performed.
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