Refractive Surgery

Parker Cornea specializes in a wide variety of refractive surgical procedures, aimed at providing you with your best vision possible.

Refractive surgery describes a category of operations that reduce or eliminate the need for glasses or contact lenses.  In the United States, the best-known refractive procedure is an old one — LASIK.  In recent years, however, new technologies have emerged which, for many patients, offer safer and better results. Some of these operations include implantable collamer lenses (ICLs), refractive lens exchange (RLE), and pinhole pupilloplasty (PPP).

Implantable Collamer / Contact Lenses (ICLS)

Implantable collamer lenes (also called implantable contact lenses) are specially designed soft lenses that may be permanently placed inside the eye. This is a refractive procedure (like LASIK) which may take the place of glasses or soft contact lenses to correct moderate or large amounts of nearsightedness and/ or astigmatism.

Compared to LASIK, ICLs have numerous advantages. First, ICLs are able to correct significantly greater amounts of nearsightedness and generally result in better quality vision compared to LASIK.  Second, ICLs also tend to be safer, since (unlike LASIK) your cornea is not permanently weakened by the procedure and because the ICL can be easily removed at a later date. Third, many people who are not candidates for LASIK are candidates for ICL implantation (for example, people with corneal conditions like keratoconus).

You may be. Although ICLs are highly effective for the treatment of moderate to high amounts of nearsightedness and astigmatism, not everyone is a good candidate, depending on the health of their eye.  Some disqualifying conditions including pre-existing cataract, glaucoma, a history of severe intraocular inflammation, or poor corneal endothelial function.

ICL implantation is a minor procedure, performed within the specialized procedural wing of our Birmingham clinic.  The process takes approximately 10 minutes, you’ll see better immediately.

Most insurance plans do not currently cover ICL implantation.

Refractive Lens Exchange / Clear Lens Extraction


Inside the eye, there sits a naturally clear lens, present from birth. Unfortunately, this natural does not always develop into the proper strength, and particularly as a person grows up and transitions from child to adult, the lens may not be powerful enough to produce a clear image (which is why many people need to wear glasses).

Refractive lens exchange (RLE) is a minor surgical procedure in which your natural (clear) lens is exchanged for an artificial lens with the correct power for your eye.

The procedure usually takes about 5-10 minutes per eye and is performed comfortably and conveniently in our office.

RLE is very effective at reducing or eliminating the need for glasses or contact lenses, especially for older adults. It also prevents the need to ever have cataract surgery, because a cataract cannot develop within the artificial lens implant.  For these two reasons, RLE is an especially attractive option for adults >45 years old.

You may be.  Although RLE is an excellent option for patient wishing to be independent from glasses or contact lenses, certain people may be poor candidates for this procedure, especially patients with pre-existing retinal problems.

Mmost insurance plans do not cover refractive lens exchange / clear lens extraction.

Pinhole Pupilloplasty (PPP)


Pinhole pupilloplasty (PPP) is a minor surgical procedure to reduce the need for glasses or contact lenses in patients with severe corneal warpage.

In the office, many patients notice that their vision is shockingly improved when viewing the eyechart through a pinhole occluder.  This works because the pinholes only allow undistorted, focused rays of light to pass into the eye.

The power of the pinhole can be recreated surgically by using microscopic sutures to sew the pupil into a small pinhole size.  The name of this procedure is pinhole pupilloplasty (PPP).

Many patients with severe corneal warpage (for example, from prior radial keratotomy or RK) are dependent on strong glasses and / or specialized contact lenses for their eyesight.  PPP significantly reduces this dependence, by giving the eye a new way to focus light – the pinhole.

PPP is safe and – importantly – reversible since these microscopic sutures can be released or removed at any time.

You may be. The very best candidates for PPP are people with otherwise healthy eyes, but with severe irregular corneal warpage (for example, from prior RK).  You may not be a candidate if you have other serious problems with the health of the eye, for example retinal disorders or glaucoma.

Most insurance plans do not cover PPP.