Bioptics (surgery)
Bioptics (surgery) refers to a combination of two or more refractive surgery techniques used to correct vision. This approach is often utilized when a single procedure is insufficient to achieve the desired visual outcome. Bioptics typically involves the sequential use of LASIK (Laser-Assisted In Situ Keratomileusis) or PRK (Photorefractive Keratectomy) followed by intraocular lens (IOL) implantation, or vice versa. The primary goal of bioptics is to provide a comprehensive correction of refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), astigmatism, and presbyopia.
Indications
Bioptics is indicated for patients with significant refractive errors that cannot be adequately corrected with a single surgical procedure. This includes individuals with high degrees of myopia or hyperopia, those with thin corneas for whom LASIK is not advisable, and patients seeking to correct presbyopia in addition to another refractive error. Bioptics offers a tailored approach, combining the strengths of each procedure to maximize visual correction.
Procedure
The bioptics process typically begins with the surgical correction of the cornea using LASIK or PRK. LASIK involves creating a thin flap in the cornea, reshaping the underlying corneal tissue with a laser, and then repositioning the flap. PRK, on the other hand, involves the removal of the cornea's surface layer before reshaping the cornea with a laser. Following the initial procedure, the patient's vision is evaluated. If further correction is needed, an IOL is implanted in a subsequent procedure. The type of IOL used (e.g., multifocal IOLs, toric IOLs, or phakic IOLs) depends on the patient's specific needs.
Advantages
The primary advantage of bioptics is its ability to provide a higher level of visual correction than could be achieved with a single procedure. By combining techniques, surgeons can address a wider range of refractive errors and achieve better overall visual outcomes. Additionally, bioptics allows for staged corrections, where the results of the first procedure can be assessed before proceeding with further interventions.
Risks and Complications
As with any surgical procedure, bioptics carries potential risks and complications. These may include dry eye syndrome, halos and glare around lights, infection, undercorrection or overcorrection of refractive errors, and the need for additional surgeries. The risk of complications may be higher in bioptics due to the involvement of multiple procedures.
Conclusion
Bioptics represents a versatile and effective approach to correcting complex refractive errors. By combining the strengths of different refractive surgery techniques, bioptics can offer patients significant improvements in vision. However, as with all surgical interventions, it is important for patients to discuss the potential risks and benefits with their surgeon to determine if bioptics is the right choice for their individual needs.
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Contributors: Prab R. Tumpati, MD