Laser eye surgery has been used for over decades now. Laser eye surgical procedure has also become a common procedure and many people use this medical intervention with a fair degree of success. If you want to live a life with healthy vision and freedom from contact lenses or glasses, laser vision correction procedures are a must. Laser eye surgical procedures can be a process to improve your quality of life (and vision).
History Behind Laser Eye Surgeries
Vision correction has existed since the 1930s. Prior to laser technology was adapted for eyesight problem resolution, radial keratotomy existed. Laser eye surgery was not initially used for correcting vision. In the 1980s, it was the work of a scientist from IBM that kick-started the use of laser surgery for the eyes. The discovery that made this possible was that organic tissues could be accurately cut without damage to the surrounding tissues. Laser vision corrections were performed more than three decades ago. The first procedure (PRK)to be performed in the 1980s is also known as LASEK or ASLA. Technology is always advancing and laser surgery technology has undergone considerable upgrades. ASLA, LASIK and a modern procedure called SMILE is now used for laser eye surgery.
Clinicians perform laser eye surgery using numerous terminologies. But the recovery sir roughly the same, though those recovering from LASIK may heal faster than ASLA or SMILE.
Benefits of Laser Eye Surgery
Laser vision surgery can also correct astigmatism. It is for those with long as well as myopic/shortsightedness. Laser eye surgery can treat astigmatism alone or with correction of hypermetropia or myopia.
The most popular cause of laser eye surgery was a practical one. Professionals including sportspersons, chefs or ICT workers have to use laser surgery to perform optimally and make life easier. Laser eye surgery does not cost as much as people expect.
Financing for the same is easy and clinics have payment plans that make it easier to get financing options for laser eye surgical procedures over an extended period of time.
Precautions to Take During Laser Eye Surgery
Blinking during laser eye surgery/vision correction does not impact the procedure. Eye monitoring technology has made it easy for the laser to lock on and follow even the tiniest eye movement. As a means of further reassurance, surgeons can outperform the system in less time. Laser eye surgery is not painful. In fact, the eye becomes numb before surgery using anesthesia. Pressure or moments of discomfort may be felt in a small percentage of the cases.
The procedure is performed in different ways depending on the unique case. Aesthetic drops are applied to the eye, following which a precise laser is used for sculpting and reshaping the eye. Surgery usually takes around ten minutes for being carried out. As the surface of the eye heals quickly, quick recovery is possible.
Laser surgery permits people to avoid wearing glasses or contacts. This is a suitable alternative to those who want to avoid glasses or a lengthy cleaning routine. Many reasons are there to consider laser eye surgery. Eliminate the risks associated with contacts which can lead to infection of the eye. Glasses and contacts can be a real problem for those who enjoy sports and outdoor activities. Numerous studies have shown laser eye surgery may provide better vision correction than contacts or glasses.
Another important point is that prices and procedures available are based on the individual case. While the procedures are not covered by insurance, many providers offer financing and payment plans.
It is important to consider different facilities require different standards and training protocols. Honest answers to your questions are essential before undergoing such procedures.
This includes knowing what may or may not be a good option. If laser eye surgery is being taken into account, here are the factors that have to be considered.
A common error is that people with high prescription are not suited for laser eye surgery. This is false. Even people with very high prescription can make a difference. Many people are not comfortable with laser eye surgery because they have been told the procedure involves pain. No pain may be felt during laser eye surgery. In fact. the chance of small visual complications is very low and lasers used in laser eye surgery cannot damage toe skin or burn the eyes.
One of the most common myths is that this field is new and still evolving so it is worth your time to wait for surgery. Another myth is that this method of surgical intervention does not work or it cannot correct hypermetropia. That this method can't correct astigmatism is another myth which needs to be busted. Correction of the need for glasses as one gets ages or presbyopia can also be corrected by laser eye surgery.
If something goes wrong, it cannot be undone is one of the other myths that need to be busted. Another myth is that the prescription has to be to a certain standard. If cataract occurs, laser eye surgery can put it right. Night vision is in no way damaged by laser eye surgery and it is also not true that contact lenses are safer than laser eye surgical procedures. Another factor that is associated with laser eye surgery is the recovery. A common myth is that recovery takes a long period of time. This is not so for laser eye surgery which sees recovery from complications in days or even hours. In fact, some procedures like LASIK offer same day recovery.
Laser Surgery: History and Types
Laser vision correction was a procedure first performed over 4 decades back in Dresden Germany. The PRK or LASEK procedure was used for this. Now laser technology has undergone thirty+ platform upgrades.
Presently, there is more than one type of laser vision correction procedure namely ASLA, PRK or LASEK, and LASIK as well as a new procedure called SMILE.
Most people can legally drive the very next day.
Further, laser vision correction serves to treat astigmatism using this procedure. Whether you’re a sportsperson, a chef or IT worker, laser eye surgery can be a way to professional success.
Across the long run, laser eye surgery is not as expensive as most individuals think. Ongoing replacements of the prescription glasses, replacement of contact lenses and other costs incurred will exceed laser eye surgery cost across the years. Most clinics offer financial payment plans making it easier to spend money on laser eye surgery over a certain extended time period.
Blinking at the time of laser vision correction does not impact the procedure. People sneeze during treatment and it does not matter. Presently, eye-tracking technology makes it easier for the laser to follow even the small eye movements because no one can keep their eyes still. Further, surgeons can override the system at any time in a split second.
Laser eye surgery is not so painful. The eye feels numbed prior to the surgery using anesthetic drops. Certain people feel pressure or moments of discomfort yet others feel nothing at the time of laser eye surgery.
Types of Laser Eye Surgery: Know More
1. LASIK Surgery
Tons of people have undergone LASIK eye surgery since it was first performed close to 23 years ago. A lot of individuals continue to have questions regarding LASIK and wonder if it's safe. Here are important things to know about LASIK eye surgery.
How Does LASIK Eye Surgery Work?
LASIK, scientifically known as “laser-assisted in-situ keratomileusis,” serves to correct astigmatism, nearsightedness as well as farsightedness. Many people opt for prescription eyeglasses or even contacts for correcting such vision issues. Yet another option is correcting these issues through LASIK surgery for changing the cornea shape.
In this procedure, a surgeon cuts a cornea flap and flips it open to a mid-part of the eye known as the stroma. Laser pulses further are applied to your stroma to correct the cornea shape. Post LASIK, most folks don't need contacts or eyeglasses.
History of LASIK Surgery
An excimer laser was first used in 1987 on the cornea for correcting refractive errors. In the year 1995, Photorefractive Keratectomy received approval, and by the year 1996, the US FDA authorized LASIK. Following this, other types of laser surgeries were introduced including Custom Wavefront LASIK.
The Statistics and Success Rate
Close to 9.5 million US residents have received LASIK on a single or both the eyes. In 2017 alone, over 700K procedures were carried out. Close to 95 percent of individuals having this procedure were satisfied with outcomes such as improved vision and eyesight. Post LASIK surgery most people regain 20/20 or a minimum of 20/40 vision.
Recovery and Complications
Once the first few days have passed after LASIK, patients frequently say the eyes feel a sense of irritation discomfort, dryness, and light sensitivity. Certain individuals also suffered night vision problems. Over time, most symptoms disappeared.
Eye doctors will agree that LASIK does indeed carry risks linked with surgeries. But just a tiny percentage of the LASIK patients have reported that these side effects have considerably impacted lives. Some patients have further reported they still require prescription eyeglasses at specific times to enhance the vision.
Eye surgeons will assess if one is a potential candidate for corrective eye surgery, like LASIK or another surgical or laser procedure. Close to 1 in 2,000 people suffer from the weak cornea. But they are not suited for LASIK as the cornea cannot withstand the process. People with cataracts should also not undergo surgery.
Given the ease which, it can be performed, LASIK surgery will continue to grow in popularity. Presently, people are working on eye issues, including nearsightedness on account of digital devices. So many people just staree at virtual screens without resting their eyes by blinking or looking at a distance. This causes stress and damages the eye.
As this surgery is an elective procedure, most individuals people pay for the procedure from their pocket. But, checking the vision and availing medical benefits is important.
Some plans do cover part of the cost.
This type of eye surgery is considered by adults for vision correction when they use contact lenses and glasses for distance vision. But knowing what it is, who it is for and how much it costs besides its safety is important.
LASIK Surgery: Know More
LASIK eye surgery is another option, along with glasses and contact lenses. It’s used for treating common and perpetual vision problems (such as nearsightedness, astigmatism, or farsightedness). LASIK eye surgery has been approved in the mid-90s. But it became the most popular elective procedure in 2001, just 10 years within its inception.
The procedure is based on the surgical expertise of doctors trained in the art of ophthalmic surgery. LASIK surgeons specifically use the excimer laser for reshaping the cornea. Many people who opt for laser eye surgery reduce their requirement for additional vision correction, such as via contact lenses or glasses.
People may have LASIK eye surgery in both the eyes on one day and return to work just a couple of days later. Vision further improves at once, though it will improve for a single year. Since the year 2003, customized technology, known as “WaveFront” technology, has become available for effective laser vision correction. Conceived by NASA, WaveFront customization offers safer and better results for a lot of patients.
Ideal candidates for LASIK surgery range across the following:
- 80% of the adult population is a candidate for LASIK eye surgeries.
Most of these share certain traits and demographic features.
- Specifically, these individuals are aged 18 or older, as their prescriptions are stabilized by this time.
- They also face common vision problems like astigmatism, nearsightedness or farsightedness.
- Such individuals lead to active lifestyles.
- These individuals either cannot or do not prefer to wear contact lenses or glasses. They are also in good health.
- Along with this, there are also certain medical conditions which must be met. These include strong tear production as well as thick corneas.
Individuals can find out easily if these criteria are met by opting for a professional consultation.
These consultations take anywhere from an hour to an hour and 30 minutes. It depends on the state of your eyes and the specialization and skills of your medical care professionals.
How much does LASIK surgery cost?
For a custom bladeless LASIK surgery, which is among the safest and most advanced forms of surgery, the cost is somewhere around USD 2000 per eye. The price varies depending on package inclusions, the experience of the surgical doctor and where you're located. It also depends on whether you are seeking enhancements for life or the first year post surgery.
Most insurers leave out laser eye surgery, as it is an elective procedure for many people – this sometimes excludes firefighters, military servicemen, entertainers, or servicewomen; many others can sometimes make a case this procedure is required. ) A lot of insurance companies seek to negotiate discounted rates through some providers.
Opting for FSA, HRA or HSA can save you money in in taxes and help in affording laser surgery.
LASIK Surgery: A Question of Safety
Technological improvements using Bladeless wavefront technologies have risen in safety. The majority of the individuals who opt for surgical procedures go through no long term complications. Most of the problems associated with surgery date back to those times when surgeons lacked experience and surgical procedures and technologies had not advanced.
Post surgery, it is a common thing to opt for antibiotic drops or steroid drops to enable the eyes to heal faster. This lasts for roughly a week. The eyes are further sensitive to light within this period or time frame, and many experience dry eyes or even night halos for many months post surgery (though it can also be sometimes longer). In spite of this, a common concern for people after surgery is that there is no reason why they should have waited so long to opt for laser eye surgery.
Facts About LASIK Surgery
LASIK is counted as one of the most regularly performed operations in the United States of America. To shed some light on this extremely popular surgery, here are the facts you need to know:
#1 Be Clear About Your Options
Be certain about your options prior to surgery and post the procedure. Choose this surgical procedure after considering your condition and all the aspects that come into play. Above all, seek a
board-certified ophthalmologist with expertise and experience. Ask pertinent questions concerning the surgeon's experience as well as complication rates. Be clear about whether the surgeon will take care of you post the surgery or not.
#2 Understand Your Refractive Error
More nearsighted or myopic individuals are likely to require a repeat procedure, known as refinements. Check with the doctor regarding your refractive error and whether refinements are needed. Also, do check if you are eligible for this procedure. LASIK does not work well for everyone. For example, those suffering from a severe case of dry eyes, specific corneal diseases or eye-related conditions should avoid LASIK.
#3 Know Your Procedure
Be sure to completely understand the entire procedure. As the surgery does not involve general anesthesia, you will be awake for most of it.
#4 Learn About the Odds, Risks & Complications
Post laser refractive surgery, many individuals enjoy improved (but not perfect) vision in the absence of their old glasses. Nobody assures a 20/20, a 20/25, or even a 20/30 vision. Remember that like all medical procedures, it has an equal chance of success and failure. Laser refractive surgery is a surgery, first and foremost. There's no such aspect as minor eye surgery. Complications range across over-correction, under-correction, damaging the cornea, causing the pupil to fall off center, swelling, and infection.
While statistics state a chance of about 2% to 5% complications, note that when it happens, it is 100% for real!
LASIK corrects nearsightedness plus astigmatism. Further, laser refractive surgery does not prevent individuals from needing reading glasses as middle age approaches. LASIK patients will need help with age-related vision decline just like anyone else.
Mostly, LASIK is ideal for mild or moderate nearsighted individuals seeking an uncorrected vision of 20/40 or higher post the LASIK surgery without contacts or glasses. Some may even have 20/20 vision or less. Exceptional results are not certain when there is a more severe form of nearsightedness.
#5 Be Clear About Post-operative Care
Your family and you must understand postsurgical eye-drop routines. As these medications impact corneal healing, the final visual outcome depends exceedingly on the correct use of such eye drops. Be clear about the kind of care one receives post the operation and how often doctors will seek to see you. Check regarding any limitations experienced after surgery, such as engaging in sports or putting on makeup.
#6 Know the Alternatives
Besides LASIK, there are a host of other laser eye surgery options, such as INTACS, PRK, and LASEK available. Always check with the surgeon regarding the very best way to manage the eye condition. Be clear about all possible avenues of treatment. Experienced eye surgeons can work on three to four ways for managing the same patient. Carefully weighing any decision for participating in innovative research trials is essential.
Unfortunately, one does not realize is how simple, safe, and effective the procedure works out to be!
Benefits of LASIK Surgery
#1 A Quick Procedure
LASIK is a quick and simple procedure. Prior to the commencement of the procedure, the eyes will be numbed using eye drops across the area to be treated. The drop
impacts the eye almost immediately and lasts across the complete surgery.
Once the patient is numb and ready for the surgical procedure, the doctor will create a single flap on your cornea through a laser. The flap is then lifted and vision correction begins! Further, one may go through a blurred vision for a couple of minutes – this is normal if it is temporary only.
Then there is a part where the laser shapes the top corneal layer again, thereby correcting the vision.
While LASIK is a safe procedure that has advanced with time and technological progress, choosing an experienced surgeon with certification ensures the procedure runs smoothly. Knowing that one is in good hands also enables a certainty that everything will be fine. Additionally, the procedure is pain-free. If the nerves get better of you, choose an oral sedative to relax. Don’t let fear get in the way of good eyesight.
#2 Advanced Technologies
LASIK surgery is not a recently discovered procedure. It has been around for a long some time and continues to become sophisticated through technological advancements.
In 1988, more than four decades ago, the first laser eye surgery was performed a 60-year-old woman with a black cancerous spot on her eye, which was melanoma. The procedure was experimental but soon received approval in 1991 by Canadian medical authorities. Just 4 years later, in 1995, it received approval in the United States.
#3 Fewer Complications
With 0.1 chance of minor eyesight complications, the good part about LASIK eye surgery is that side effects can be treated by surgeons. There is a common myth that laser eye surgery causes blindness. It does not do so, because the latest procedures use a digitalized eye tracking system to ensure precision and quality results.
#4 Quick Recovery
The best aspect of LASIK is that most individuals can come back to work and even drive their cars the next day. But do remember that protecting the eyes from such harsh UV rays is additionally important. Participation in any sport oriented activities is not preferred until 3 days after the procedure. Your vision is further blurred post the surgery, but after rest and sleep, the eyes should return to normal and vision should improve.
What To Watch Out For
LASIK surgery is a life-changing experience, but it's mission critical to arm yourself with all the knowledge including surgery cost, risks, after and recovery time before carrying out the procedure.
Research Your Options
Don't just look for a seasoned or board-certified ophthalmologist, but also one with low complication rates.
Additionally, one should avoid wearing contact lenses and wearing make-up before LASIK surgery. To avert potential complications, patients should wear soft contact lenses discontinuing the contacts 2 weeks before the surgery, while individuals wearing hard or even gas permeable contacts discontinued this three weeks before. Wearing contacts, however, does alter the cornea shape, and it is critical these return to their original shape prior to surgery. Make-up avoidance further reduces the chance of contracting infections post-surgery.
Outpatient Surgical Procedure
LASIK is an outpatient surgery procedure. One may be awake at the time of surgery, but the surgeon uses eye drops as an anesthetic to numb the eye's surface at the time of the procedure.
Perfect Vision Is Not Guaranteed
While 96% of patients achieving 20/20 vision pos LASIK, perfect vision is not always assured. If the doctor promises a regular 20/20 vision, know that this is not something that can be ethically guaranteed post any laser or surgical procedure.
Check if You’ll Need Repeat Procedures
The worse the eyesight is to start with, the more likely it is one will need a repeat procedure, called as “refinements”. Those who are more myopic need refinement surgery post LASIK.
It’s a quick procedure besides which one is on the feet in no time at all. Bear in mind that this surgery comes with its own share of risks. Complications are not common, but knowing ahead of time means one is prepared regardless. Risks include inflammation, over or under correction and infection.
Asking questions ahead of time can avoid surprises and lower anxiety.
Study Your Alternatives
Being one's own advocate is important. Check with the surgeon if LASIK works out as the best option for the situation. Seasoned eye doctors offer many LASIK alternatives but you need to be clear whether or not you’re a good candidate. So weigh your options and make the best choice.
LASIK is not for each and every person. Check if you are free of corneal conditions, severe dry eyes and other eye conditions that do not require LASIK.
Knowing the facts regarding post-surgery care before is essential. When used effectively, prescription eye drops impact corneal healing and the final visual outcome. Check regarding follow-up visits, time for waiting before trying on makeup and playing sports, Facts about post-surgery care should be obvious beforehand.
For those interested in LASIK surgery, it is important to remember this surgery is not for everyone and does not fix vision problems.
This is because though LASIK surgery is just a two-step procedure, there’s a lot of work involved.
Step 1: This involves making a micron-thin, circle shaped flap in the cornea which is the surface of the eye. This completes in a couple of seconds. The surgeon uses microkeratome or even a femtosecond laser. Then, the flap is lifted to expose where actual vision correction treatments take place, just beneath the surface of the eye.
Step 2: During this phase, a computer-guided excimer-type laser is deployed for permanently removing microscopic tissue pieces for creating vision problems for patients. The flap is further laid back in place to serve as a natural bandage for protecting the reshaped corneal portion when it heals.
As LASIK eye surgery was initially approved by the FDA, greater than 19 million LASIK procedures were carried out in the United States. LASIK has further received over 45 US FDA approvals, for treating myopia, presbyopia, hyperopia, astigmatism and many more.
Lasers are simply light beams that move within the same wavelength at differing speeds. The femtosecond laser is often used for creating the flap. It is an infrared laser pulsing at one quadrillionth of a second for creating microscopic tissue disruptions in the cornea. This excimer laser corrects the vision in cool, UV light beam with 1000 Hz pulse rates. Each laser references different colors. The given laser uses only a single color of light from the wavelength spectrum.
Lasers are deployed in surgeries of different types on account of incredible precision. This is more so as many people assume LASIK involves cutting or slicing the eye. These are not accurate descriptions. The complete LASIK procedure takes place entirely within corneal layers, while other parts of the eye are not involved. This is possible because lasers are safely used without damaging the surrounding tissues.
LASIK eye surgery is painless as the numbing drops anesthetize the eye prior to and during the procedure. Patients experience pressure from eyelid holders to prevent blinking, but they can be made comfortable through lubricating and numbing drops. Post the procedure, patients have mild discomfort that lasts for 5 hours.
Along with numbing drops, one is also given a sedative like a valium ensure you stay calm. If the eye moves, the tracking capabilities of the laser follow the eye. If one sneezes or abruptly moves the body excessively, the laser automatically switches off.
Is LASIK considered safe? This is among the first questions folks want to have an answer to. LASIK is easily the most studied elective procedure. Close to 7K clinical studies are conducted and published regarding LASIK surgery. As a consequence of this, there is massive data supporting safety, impact, and effectiveness. LASIK remains an eye surgery with high patient satisfaction rates, as against other elective procedures, close to 96%. LASIK patients have better vision than with the best glasses before surgery.
In greater than 40 million procedures performed globally, there has not been a case of blindness on account of LASIK in those who are healthy, exceptional candidates.
Some symptoms may be experienced during the healing period post LASIK. This is a surgical procedure that takes only fifteen minutes. This recovery duration is expected and eyes may feel some amount of dryness, light sensitivity or irritation while one heals. Check with the doctor about symptoms of post-LASIK visits.
Some individuals experience LASIK side effects, that generally comprise visual symptoms for night vision such as glares, starbursts, halos, and ghosting besides dry eyes. More so, these steadily and gradually resolve in themselves across a few weeks or even months, maybe as long as a year. Certain individuals need additional eye drop courses to prevent or reduce inflammation or even dry eye contributing to visual symptoms. In rare events, fewer than 5% of the time, advanced LASIK treatment is recommended for addressing residual vision problems. One can also wear thinner glasses or lighter contact lenses.
Most surgeons indicate that close to 20% of the LASIK consultations lack eligibility. Thin corneas or those that are irregular, as well as specific eye diseases such as glaucoma, can disqualify LASIK patients. Specific autoimmune diseases such as lupus or RA/rheumatoid arthritis, and medicines such as corticosteroids for impairing the healing process, making laser vision corrections procedures a less than perfect choice.
A refractive surgeon or board-certified ophthalmologist completing surgical training performs LASIK and other vision correction procedures.
One can decide, in such cases, if LASIK eye surgeries are the right option. Once there is understanding that one is a good candidate, with surgeons one can respect feel comfortable towards, the right decision can be made. For patients seeking to be less dependent on contacts or glasses, LASIK outcomes and technologies work better than before. A tremendous body of clinical research and literature serves to back up.
Laser eye surgery has been around for over 20 years.
This vision correction is a life-altering procedure, but plenty of myths and questions are centered around it.
Prior to laser technologies, the radial keratotomy procedure was used. This involves reshaping the cornea by flattening and reshaping it in the center. Laser eye surgery technologies were not used for eye surgery. It all began in the 80s when IBM scientists making microscopic circuits in microchips with excimer lasers could accurately cut organic tissues without denting the surrounding tissue.
LASIK Surgery: Safety Profile
LASIK along with other types of laser eye surgery, like PRK and LASEK come with excellent safety profiles and extremely high rates of success. Such procedures are designed for treating myopia/nearsightedness hyperopia/farsightedness along with astigmatism. It becomes easier to live without contacts or glasses.
Sight-harming complications like a significant loss of vision stemming from LASIK surgery are not at all common but instead, extremely rare. A lot of side effects eye complications post-laser surgery can be dealt with through additional medical treatment or surgery.
Like many other types of surgery, there are certain potential risks, clear side effects and drawbacks you should be alert about Choose a skilled, experienced surgeon for it helps to reduce risks and enable individuals to achieve the perfect results via laser eye surgery.
Do consider whether you're the right choice for vision correction laser eye surgery. The eye doctor will perform a thorough diagnostic eye examination to assess suitability for LASIK surgery. The ophthalmologist evaluates various parameters before performing the operation, such as:
- Shape and thickness of your cornea
- Refractive errors and pupil size;
- The moistness of your eyes (to check for dry eye syndrome)
- General health and medical history
- Other medications you are taking.
Even when one is not able to opt for LASIK due to medical considerations, there are other options like PRK, LASEK or even implantable lenses.
Who Cannot Opt for LASIK Eye Surgery?
Everyone is not a suitable candidate when it comes to LASIK eye surgery. Certain anatomical and medical conditions increase the risk of undesirable outcomes or limit optimal eye surgery results. These ranges across:
- Large pupils
- High refractive error
- Thin or irregular corneas
- Age factors
- Dry eyes
- Unstable vision
- Degenerative or active autoimmune disorders.
- Surgical Contraindications
Millions of US citizens have undergone LASIK eye surgery since it made a foray into American shores decades ago. Serious complication rates are pegged below 1 percent.
While LASIK complications or side effects can occur, such problems can be resolved with enhancement surgery or medical treatment.
• Temporary discomfort and vision problems: This can range across light sensitivity and mild irritation. Halos, starbursts, glare in low light environments, dry eye symptoms, reduced vision sharpness, and hazy vision are some of the problems. These are temporary problems which can disappear within 3-6 months. Flap Complications: LASIK involves creating a thin hinged flap on the cornea's front surface. For laser reshaping of the eye, this is lifted during surgery. The flap is replaced to form a bandage that is natural.
In the event that the LASIK flap is incorrectly made, it does not adhere to the surface of the eye or lead to microscopic wrinkles called striae that develop in the flap. These complications lead to distorted vision and optical aberrations.
Studies suggest that flap complications take place from 0.3 to 5.7% of all LASIK procedures, as per a 2006 American Journal of Ophthalmology study in April. In another research of 3,009 consecutive LASIK operations performed from 2002 to 2009, where the femtosecond laser was used for flap creation, flap complications occurred in less than half of 1% (around 0.37%) and all complications were effectively managed surgically in the same session.
The risk of LASIK complications can be mitigated by choosing a reputable, experienced eye surgeon.
LASIK Flap Complications
#1 Night Star Halo
Post-operational nighttime halos may occur.
#2 Irregular Astigmatism
This is the result of an unequally curved cornea surface. Irregular forms of astigmatism also take place from laser correction that is not properly centered on the eye or due irregular healing. Consequent symptoms include double vision/diplopia/ghost images.In such cases, eyes may require re-treatment or even enhancement surgery.
#3 Epithelial Ingrowth
When the cells from the cornea’s outer layer (or epithelium) evolve under the flap post the LASIK surgery. In many cases, epithelial ingrowth is restricted and causes no issues In certain cases, (between 1 and 2%of LASIK procedures)discomfort or instances of blurred vision can take place. Additional surgery is required to lift flaps and remove epithelial cells.
Diffuse lamellar keratitis (DLK)
Termed “Sands of the Sahara,” it is swelling or inflammation beneath the LASIK flap that has a lot of causes. Specific corneal inflammation to some degree post LASIK surgery as usual. But when DLK is noted, the healing stops and vision loss results. When DLK takes place, it generally responds to antibiotics, topical steroids, and other therapies. Further, the flap may require lifting and clean for removing inflammatory cells and preventing tissue damage.
Keratectasia or keratoconus
This is the bulging of the eye's surface which is uncommon. It can occur if excessive tissue removal from the cornea LASIK takes place. Based on a study of corneal topography, the weak cornea can be a problem for LASIK surgery. Keratoconus develops post LASIK with no clear risk factors. Further, enhancement laser surgery is generally not suited. Further, gas permeable contact lenses and.or corneal implants or Intacs are for holding the cornea in place. There's also a treatment known as corneal collagen crosslinking can strengthen the cornea.
On account of hormonal changes at the time of pregnancy, eyes can be impacted so it is recommended to wait for childbirth to be over before opting for LASIK surgery.
Certain individuals with LASIK surgery experience low tear production that triggers eye discomfort as well as blurred vision. Close to half of all LASIK surgeries result in temporary dry eye syndrome as per a 2006 American Journal of Ophthalmology study.
Dry eye syndrome post LASIK surgery is temporary and can further be effectively treated using lubricating eye drops or different measures. Dry eye problems don’t persist when eye healing is complete. This can take close to six months. Individuals with dry eye in severe forms are eliminated as LASIK candidates.
Extreme Undercorrection, Overcorrection or Regression
One rare possibility is that it did not respond with respect to laser eye surgery predictably. Another possible reason is that your eyesight may have been optimal post LASIK but regressed across time on account of “over-healing.”
In many cases, there is significant under-correction or even regression is successfully treated using additional laser vision correction once the surgeon confirms the stable residual refractive error.
Infections don’t generally occur post LASIK. As the corneal flap serves as a natural bandage, eye infections are less frequent post LASIK than post-flap-free and corneal refractive procedures such as PRK. Medicated eye drops can avoid infection and control inflammation, once the eyes heal.
LASIK and other categories of laser eye surgery, like PRK and LASEK, are characterized by excellent safety profiles and extremely high success rates.
The safety and effectiveness of LASIK surgery are known, on the basis of increasingly sophisticated technologies, optimal patient selection, and surgical skill.
Complications were more common during the early stages of LASIK when studies in the 90s suggest that up to 5%of people with laser vision correction faced different problems. Presently, the number is under 1% for serious complications.
A global meta-analysis showed 95 percent of individuals who underwent LASIK surgery from 1995 to 2003 successfully improved their vision because of the surgery.
LASIK has grown in recent times due to a strong success rate. Laser eye surgery also reduces the reliance of individuals on corrective eyewear
Laser eye surgery has effectively treated successive patients and had high patient satisfaction rates.
For persistent dry eye problems post LASIK, photochromatic lenses can relive photophobia.
PRK or photorefractive keratectomy is a kind of refractive surgery or laser eye surgery to correct hyperopia, myopia, and astigmatism.
PRK is the first kind of laser eye surgery for correcting vision. It is a predecessor to populist LASIK procedures. However, PRK recovery is more extended as compared to LASIK eye surgery, PRK is a popular procedure and offers advantages as against LASIK for specific patients.
Like LASIK besides other types of laser eye surgery like PRK, the doctor reshapes the cornea using excimer laser.
This permits light coming into the eye for proper focus onto the retina for the vision that is clear.
The key difference between LASIK and PRK is the procedure’s first step
For LASIK, thin flaps are created on the cornea using a microkeratome or femtosecond-type laser. In this surgery, the flap is lifted for exposing the underlying corneal tissue. It is replaced after the reshaping of the cornea with an excimer laser
In PRK, the thinner external or outer layer of the cornea namely the epithelium is discarded and removed before reshaping underlying corneal tissue using an excimer laser. The epithelium further repairs itself growing back over on the corneal surface within a couple of days post surgery.
LASEK is a variant of PRK.
Rather than removal of the outer or external epithelial layer of the cornea just like PRK, LASEK involves the lifting of the epithelial layer (through the surgical instrument known as a trephine), preserving it at the time of surgery replacement on the eye's surface towards the close of the procedure.
LASEK has become less common. This is due to the slower recovery of vision as against PRK because the replaced epithelial layer recovers in a long time using LASEK as against the growth of a new PRK epithelial layer.
The final outcome of PRK surgery is easily compared to LASIK outcomes, though initial PRK recovery is gradual. It takes a couple of days for new epithelial cells to become regenerated and cover the eye’s surface.
There also is a greater risk of eye infection and vision haziness in the first few days post-surgery. LASIK patients usually experience less discomfort, besides quicker vision stabilization. Vision improvement using PRK is steady and the final outcome can last across weeks.
PRK surgery does offer some clear benefits, however.
As PRK surgery does not require the creation of a corneal flap containing epithelial and deeper stromal tissues, the complete thickness of the stroma is an added bonus.
This works out well if the cornea is excessively thin for LASIK or if one has undergone LASIK previously and has a thinner residual cornea. There also is no chance of flap complications, and the possibility of removing the cornea too much with the excimer laser is further lowered.
- This procedure is suitable for patients with thin corneas.
- There’s no chance of corneal flap complications.
- Reduced risk of compromise on the corneal thickness is there.
- The depth of laser treatment is less than LASIK.
Pitfalls of PRK
- This procedure has a slower recovery period than LASIK.
- Ideal vision takes longer to achieve
- There are increased chances of post-surgery infection, haze, and inflammation.
- Eye discomfort risks are higher.
How PRK Is Performed?
First, the eye doctor removes the central portion of the corneal epithelium, using an alcohol solution along with a buffing instrument or blunt surgical device.
Then the excimer laser reshapes the corneal surface curvature. This highly specialized, the computer-controlled laser delivers cool UV light pulses removing microscopic tissue in a precise way.
The “bandage” soft contact lens is further placed on the cornea for protecting the eye. New epithelial cells further grow back in close to 4-5 days,
After this, the bandage contact lens is removed by the ophthalmologist.
The first step is therefore to choose an experienced eye surgeon.
Next, an eye exam is undertaken to ensure suitability for this form of laser surgery.
The doctor will measure pupil size, the possibility of dry eyes, measurement of corneal thickness and mapping the corneal shape.
The doctor also assesses general health along with medications taken to determine if LASIK and PRK are suitable.
If one wears contact lenses, one may need to stop wearing them for a time period prior to the eye exam, as contacts transform the natural shape of the cornea. The eye doctor further carries out both the exam and the consultation.
During the Surgery
This laser eye surgery is an ambulatory procedure. This simply means it can be performed on a walking-in, walking-out basis. This surgery takes only 15 minutes of the total time for both the eyes.
One may be awake at the time of the procedure, but the eye surgeons also provide you mild oral sedatives to help individuals to relax.
Numbing eye drops are further applied to the eyes. Then an instrument known as the lid speculum is required to keep one’s eyelids wide open. The surgeon next uses the excimer laser programmed for the exact prescription over the eye.
Patients look at a target light for a short period of time while the surgeon watches the eye via a microscope when the laser sends light pulses to the cornea.
The laser energy further microscopic tissue amount and corneal reshaping take place. Most individuals do not feel any sense of discomfort, though pressure may be felt in the eye. Further, the surgeon has complete control of the laser and it can be switched off any time.
Once the treatment is over, the surgeon covers the cornea using a bandage contact lens. Within just a couple of days, new epithelial cells emerge, and the bandage contact is then removed.
Post the PRK Surgery
After resting for a short period after the surgery, patients can be escorted or driven back home.
The surgeons further prescribe topical antibiotics along with anti-inflammatory plus pain medications to reduce discomfort, minimize inflammation and speed up healing post the operation.
As with any of the other surgery, it's very critical to follow the doctor's instructions and ensure an optimum result. Patients must attend regular follow-up appointments with doctors over the next couple of weeks to monitor healing processes.
PRK recovery also takes longer than recovery through LASIK surgery. It could days or weeks before the eyesight improves. It may even take longer for vision stabilization.
Most individuals undergoing PRK surgery can start driving a car within a couple of weeks after surgery. However, it does take 3-6 months before the vision completely stabilizes.
The results post LASIK and PRK are pretty much the same. While most patients achieve 20/20 vision, others achieve 20/40 visual acuity or more.
If there is dissatisfaction with the vision after the eyes have fully healed follow-up or enhancement procedures can further sharpen the eyesight.
Another choice is to wear eyeglasses for certain required tasks.
If light sensitivity is a problem post PRK, a pair of photochromatic or light sensitive glasses could help
For those with a residual refractive error that is minor post surgery, low-powered prescription lenses using anti-reflective coating sharpen the vision for activities like driving in the dark.
Post-surgical PRK, as well as LASIK complications, are not common, but they can occur in rare cases. RThis includes infection, halos or starbursts at night around lights.
Bear in mind that no form of laser surgery (including PRK) can reverse the loss of near vision or presbyopia due to aging.
LASIK may be the most well-known laser vision correction surgery, but you need to also find the right fit, and for some, this may be PRK.
3. SMILE Surgery
This form of laser eye surgery is essential for correcting nearsightedness. Along with LASIK, patients now have the option of a new laser eye procedure called SMILE. This form of laser eye surgery gained US FDA approval for treating Americans in the year 2016.
SMILE stands for Small Incision-Lenticule Extractions procedure.
It’s different from LASIK surgery in many ways. In LASIK, large openings of around 20 mm are needed to enable excimer lasers to reshape the cornea underneath. As against this, in SMILE, a small opening less than 4mm facilitates the removal of lenticules.
The SMILE laser eye surgery uses the VisuMax femtosecond laser. This laser is a proprietary technology patented by Carl Zeiss Meditec. This specific femtosecond laser is used in the SMILE procedure. It serves to craft a small, lens-shaped tissue called the lenticule in the cornea. then using the femtosecond laser, mall arc-shaped incision are made in the corneal surface The lenticule is extracted through this incision and discarded.
With the removal of the tiny lenticule, the corneal shape is altered. This serves to correct nearsightedness. Such corneal incisions heal on their own without stitches, and vision acuity improves by leaps and bounds.
SMILE is a laser procedure for correcting up to -10.00 diopters (D) in terms of nearsightedness, Besides this, patients must be a minimum of 22 in age. They should have no more than -0.50 diopters of astigmatism. Eyeglass prescriptions must also be stable for a minimum of 12 months.
Carl Zeiss Meditec estimates 1 million SMILE procedures have been performed globally with fewer complications.
SMILE: The Advantages
- LASIK and SMILE have the same levels of visual acuity for correcting nearsightedness.
SMILE does not require a LASIK style corneal flap.
- Research showed in one study that 327 people reported a 20/40 uncorrected visual acuity while 88% had UCVA of 20/20 or even better.
- Compared to earlier procedures like LASIK, there are fewer chances of dry eye symptoms after SMILE. As the latter procedure takes place sans a massive corneal flap, few corneal nerves are impacted by the procedure.
- The small incision doctors made through SMILE enables the cornea to have greater biochemical stability after SMILE procedures, as against LASIK.
There are, however, greater chances of needing enhancement procedures to attain visual clarity desired without glasses. There is less chance of requiring an additional procedure post SMILE for correcting huge amounts of myopia, as less corneal dehydration takes place at the time of the SMILE procedure.
Pitfalls of SMILE Laser Eye Surgery
There are many downsides to SMILE as well. To start with, SMILE corrects only nearsightedness while LASIK and PRK can tackle other issues like astigmatism and farsightedness.
Treatment ranges for SMILE in the US are set to expand. Doctors using SMILE can cure patients with higher levels of astigmatism in the EU. LASER and PRK treat higher order aberrations that impact night vision as opposed to SMILE which treats fewer HOAs.
If there is a residual refractive error, post a SMILE procedure, and additional vision correction is needed, in fact, PRK is the preferred enhancement for best outcomes.
With the latest or newer vision correction or laser eye surgery, it is necessary for the surgeon to perform a considerable number of SMILE procedures prior to the mastery of surgical techniques. The surgical techniques are needed for optimal outcomes and minimum risks Bear in mind that SMILE or other vision correction surgeries should be discussed with the refractive surgeon.
Most refractive eye surgeons levy approximately the identical price for SMILE laser surgery as all-laser customized LASIK surgery This is somewhere around USD 2000 to 3000 per eye.
Numerous factors contributed to the total fee the surgeon charged. This includes the doctor’s experience, the location or area of practice and whether the degree to which additional follow-ups or treatments are needed.
If one is nearsighted and meets the other criteria here, SMILE laser vision correction may be a good option. For this, there needs to be a comprehensive eye exam by the ophthalmologist and a consultation held by with your refractive surgeon.
4. EPI LASIK Surgery
This is a laser vision correction system very much like LASIK and PRK/LASEK. It is the perfect alternative for certain eyes.
During the epi-LASIK procedure, the flap the cornea has on it is not as thick as a LASIK flap. For those with thinner-than-usual corneas, this is a real advantage.
The epi-LASIK flap is extremely similar to the thin flap in LASEK surgery. In both these procedures, the flap comprises only cells from the extremely thin external layer of the cornea, known as the epithelium.
The only difference is the way flaps during the epi-LASIK and LASEK procedure are produced.
To create a LASEK flap, a sharp tool is used. On the other hand, the epi-LASIK flap is separated from the corneal layer underneath or the stroma with an instrument referred to as an epithelial separator which has an oscillating plastic blade with a thin but blunt edge.
Unlike LASEK, the alcohol solution is not applied to the eye during epi-LASIK for loosening the epithelial cells from the corneal stroma underlying it. Some refractive surgeons choose epi-LASIK as against LASEK due to this cause, as alcohol is toxic for the epithelial cells plus it increases healing time post the procedure.
Once the epi-LASIK flap forms, it is folded in a backward direction and the central stroma underneath is reshaped using an excimer laser. These steps are also performed during LASIK.
As the epi-LASIK flap is extremely thin, a soft contact lens is typically applied over the flap when repositioned post the laser treatment. These contact lenses serve as a bandage for increasing comfort and permitting new epithelial cells for faster healing to grow onto the cornea more rapidly.
Further, the surgeon or the eye doctor removes the bandage contact lens once a few days elapse after the epi LASIK procedure.
The vision is not perfect at one shot. But within three days, a lot of patients have 20/40 or 20/20 vision, longer is taken by others. This ranges from 3 to 6 months to reach the final results. One can generally drive within a week post surgery.
This recovery period is considerably longer as against LASIK, allows individuals to attain excellent vision from the day of the operation itself up to a couple of weeks later and drive by the day post the surgery.
As in any other form of laser eye surgery, post-Epi-LASIK it is vital to follow the eye surgeon's instructions precisely, as the final vision quality is impacted by the speed and effectiveness with which your corneas heal. Don’t miss out on the eye drops or other forms of medications the doctor prescribes, and heed follow-up appointments.
If you’re suggested the epi LASIK surgery, be sure to check with the doctor about the reasons why. Doctors may consider epi LASIK a better option as against LASIK for certain patients. These include individuals with thin corneas, where the LASIK flap has insufficient tissue.
Epi-LASIK is also safer than LASIK for those with professions and/or hobbies that raise the chance of getting hit in the eye as there is no chance of the flap being dislodged.
Post an epi LASIK surgery, some discomfort is normal. This is generally easily manageable with over-the-counter/OTC painkillers. The discomfort post-Epi-LASIK is decidedly lesser than that experienced post-PRK or LASEK.
5. LASEK Eye Surgery
LASEK is a variant of PRK. This eye surgery seeks to correct many forms of vision problems such as myopia or nearsightedness, hyperopia or farsightedness, as well as astigmatism. LASEK unites certain methods from PRK and LASIK both.
LASIK remains a popular laser eye surgery. But for those seeking vision correction that does not qualify for it, PRK or LASEK is a better option.
LASEK, much like other forms of laser eye surgery, works through the reshaping of the cornea through the excimer laser
This permits light entering the eye to be focused on the retina for clearer eyesight or vision correction.
The basic difference in the ways LASEK, PRK, and LASIK are performed is regarding how the eye is prepared for laser treatments.
The LASEK procedure combines both LASIK as well as PRK. Much like PRK, the corneal epithelium separates from the underlying stromal layer. But rather than discarding and removing this tissue, as observed in PRK, a LASEK surgeon pushes the ultra-thin “flap” of epithelium off to a side of the cornea. , Here it remains attached with the eye (much like the thicker flap of corneal tissue crafted during the LASIK surgery). Once the laser treatment is completed, the epithelial tissues are repositioned on the eye’s surface for covering the lasered stroma, and a bandage contact lens is placed atop eye to ensure the epithelium remains in place when it heals.
Yet another laser eye surgery known as epi-LASIK or e-LASIK, is really similar to the LASEK. But rather than using alcohol for loosening the epithelium much like LASEK, in the epi LASEK procedure, the surgeon generally uses a plastic, blunt blade for separating the epithelial sheet from your eye. This averts the possibility of alcohol reaction, which kills the epithelial cells.
LASEK, PRK, and LASIK have a high success rate, besides certain vision outcomes. As against LASEK, LASIK, and PRK, vision tends is hazier in the first week. Post a complete and thorough eye exam, the eye surgeon advises one regarding the best laser eye surgery for individual requirements and needs.
A hinged flap LASEK surgery is crafted on the epithelial layer in the eye and is thinner than the corneal flaps created via LASIK that contains epithelial and in-depth stromal tissues.
This is vital for those with a naturally thin cornea that serve as a less than perfect LASIK candidates.
The LASEK method evades corneal flap-associated LASIK complications and lowers the chances of removing too much of the cornea using an excimer laser and denting the eye's structural integrity. By giving the deeper flap a miss, there is less risk of dry eyes post the LASEK eye surgery.
LASEK is also a better choice if one has a higher degree of myopia or nearsightedness. This requires additional tissue removal from the cornea’s center for correcting the refractive error or in case one’s occupation or hobbies place one at a higher eye injury risk, besides dislodging the corneal flap for LASIK surgery.
LASEK typically involves a lot of of discomfort and lengthier recovery time as against LASIK surgery.
LASEK is linked to PRK. This involves lifting the really thin epithelium for accessing deeper corneal tissues rather than crafting a thicker corneal flap noted in LASIK surgery.
The key point of difference is LASEK preserves the epithelial layer and then replaces it, whereas for PRK the epithelium removed and discarded. A new epithelial layer grows over the next few days post-surgery.
Many surgeons think that though preserving the epithelium, LASEK offers a faster recovery time as against PRK. Many surgeons have shown that replaced epithelial layers in LASEK heal after a long period of time, as against epithelial layer growth post a PRK.
PRK remains among the commonest and most well-known “surface ablation” techniques.
Before LASEK surgery, the surgeon must carry out a thorough eye examination and general health check up to see if one is a suitable candidate for such LASEK eye surgery. Most eye surgeons recommend LASEK only if LASIK eye surgery is not possible.
If one wears contact lenses, the doctor typically instructs patients to cease wearing them for longer time periods prior to taking measurements for the laser eye surgery as contacts can impact the natural cornea shape.
As driving home away from surgery is something you won’t be able to manage, all you will need help at this stage.
During the surgery, the numbing anesthetic drops are applied to the eye. Following this, the surgeon makes a circular cut in the corneal epithelium using trephine or a fine blade. This leaves a small arc-shaped area of the circle uncut, so the flap remains attached to the eye.
Further, a diluted alcohol solution is placed above the eye for around 30 seconds. This loosens epithelium edges and enables the surgeon to push the loosened flap of epithelium gently to the side.
The excimer laser is easily positioned over the eye for reshaping the stroma of the cornea. This serves to correct the vision. Once the laser treatment is complete, an epithelial flap on the eye is repositioned.
Special contact lens serves as a protective bandage over your eye.
LASEK is a minor surgery which takes around 15 minutes per eye. You remain awake for the procedure and avoid feeling pain. , but the surgeon may offer a mild sedative for relaxing. Post LASEK surgery many people say there’s mild to moderate discomfort in the few days post the LASEK procedure.
One also needs to keep “bandage” contact lens on the eye for around four days while surface epithelial cells further heal or regenerate. The doctor can further prescribe antibiotics and topical steroids for a minimum of 3 weeks to lower chances of infection and aid healing.
Visual recovery post-LASEK and even epi-LASIK is significantly slower as compared to LASIK and has a gradual recovery period post-PRK. Initial visual recovery lasts for a week with LASEK as opposed to 24 hours in LASIK. Final outcomes can be observed in a week to many months.
LASEK and PRK results are just like LASIK outcomes. Most individuals achieve 20/20 vision post-laser surgery, and a majority of all achieve 20/40 visual acuity or higher. Based on the extent of refractive error, one may need to wear a contact lens or eyeglasses.
However, the prescription is lower. Remember that these forms of laser eye surgery are not a solution for age-related decline in near vision. Doctors can advise on whether presbyopia surgery should be opted for instead.
LASEK, as well as PRK and LASIK complications, are similar. Side effects range across vision disturbances like Blurred vision, halos, and glares.
Massive over-correction, under-correction or regression requiring either more surgery or reliance on contact lenses or glasses for certain activities. Dryness of eyes or eye irritation and infection.
LASEK's plus point is that it avoids the corneal flap-related issues associated with LASIK.
In certain cases, the thin flap created during LASEK in the epithelium is not strong to be replaced over treated areas and may require complete removal. For those with high myopia prescription, there's a greater chance of a hazy vision.
Alcohol solution used at the time of LASEK leads to damaged epithelial tissue cells. This tends to limit the healing speed post-surgery. For this reason, Epi LASIK has a quicker recovery period. Alcohol is not used for creating an epithelial sheet.
LASEK eye surgery offers a safer alternative to LASIK but is performed if you don't qualify for LASIK. This is because LASIK surgery is associated with the faster visual recovery and minimal discomfort.
5. Multifocal/Presby LASIK
Multifocal or Presby LASIK is an advanced laser vision correction surgery changing the eye's shape in the cornea to different power zones for seeing at various distances. Currently, it is undergoing clinical trials in the US. The procedure has been performed in different countries with promising outcomes.
It is unclear if FDA approval may occur. Multifocal LASIK could become the latest option for presbyopia patients. Vision blurs as age advances in this vision condition.
This is because the natural lens of the eyes loses focusing flexibility. For those who are nearsighted, and have presbyopia a double complication could be overcome through this form of surgery. Presbyopia is not easy to overcome. It shows up at age 40. Solutions for this condition include multifocal eyeglasses, contact lenses, artificial lenses and now multifocal surgery.
Presently, excimer and femtosecond lasers are focusing on multifocal treatments so those with age-related vision decline can see clearly without reading glasses, bifocals or multifocal eyeglasses. For presbyopic eyes, FDA approved LASIK provides monovision. In this, one eye is corrected for better distance vision and the other eye is corrected to enhance near vision. Most people cannot adapt to such problems as loss of their depth perception. In multifocal LASIK procedures, the excimer laser reshapes the cornea into different zones for far, near and immediate vision. The brain then selects which zone gets the sharpest vision, depending on whether the object is closeby or not.
Within every zone, light is refracted or bent differently, permitting individuals with presbyopia to access good vision at different spans or distances.
While multifocal contact lenses resting on the eye’s surface can move and trigger eyesight distortions. Multifocal LASIK works in a different way. It provides fixed, stationary zones directly on the surface of the eye. Just as artificial lenses and multifocal contact lenses have different designs, numerous advances in multifocal LASIK determine how cornea should be shaped for the best correction of presbyopia.
The best LASIK design for multifocal vision depends on refractive errors in addition to presbyopia.
What to Expect in Laser Eye Surgery
How to manage before, after and at the time of surgery varies from one doctor or patient to another.
The US FDA has mentioned the pointers for laser eye surgery patients pre, post and during the surgery.
Pre Laser Eye Surgery
Those moving ahead with surgery will need an initial or baseline medical evaluation to prepare for the operation.
Don't wear contact lenses prior to baseline evaluation. Switch to wearing glasses full time. Contact lenses can shape the cornea for close to several weeks after the user has stopped depending on the type of contact lenses worn. Not leaving contact lenses out for a certain time can make it tough for the cornea to return to its natural shape.
This can impact surgery in its outcomes in numerous ways. The consequences include inaccuracy in measurement, poor surgical plans, and poor vision post surgery. The measurements determine the extent to which corneal tissue removal may need to be repeated post the initial evaluation and after surgery to ensure they have not changed, especially if hard lenses or RGP/rigid gas permeable lenses are worn.
Hard lenses should not be worn for a minimum of 4 weeks post the initial evaluation. Prior to the initial exam, you need to stop wearing contact lenses. Around 3 weeks prior to the exam, rigid gas permeable lenses should be worn. Around 2 weeks prior to this, soft lenses should be worn. The doctor also needs to be informed about the present, as well as past medical and eye conditions. All the medications that are been taken include OTC and medicines you are allergic to.
The doctor also needs to perform a complete eye exam and discuss whether the patient is the right candidate for the surgery. Additionally, the surgeon should inform you regarding the risks, alternatives, and benefits of surgery and what to expect. Your responsibilities prior to, at the time of and post surgery should be checked too. Ask your doctor all the questions you may have and ensure you review informational pamphlets and literature your medical practitioner shares with you.
Informed consent is an important part of any surgery. Before making the choice, consider the pros and cons. The day prior to surgery, you need to stop using the following: makeup, perfume, lotions or eye creams.
The reason is that products along with eyelash debris raise the chances of infection at the time of and post the surgery. The doctor may also check regarding debris and residues and even scrub your eyelashes prior to surgery.
Prior to surgery, arrange for transport to and from surgery and post first follow-up visit. On the surgery day, the doctor may offer some medicine to help one relax. As the medicine impacts the ability to drive and as the vision becomes blurry, you need someone to drive you home post the surgery.
The surgery should last for less than 30 minutes. The operation involves the laser system which has a computer screen and a machine attached to it.
Post numbing of the eye, it will be cleaned and then prepared for surgery.
Doctors may use mechanical microkeratome (or blade devices ) for cutting a flap in the cornea.
A laser keratome or laser device may also be used.
FDA recommends that from day 1 to two weeks before, patients should desist from using eye makeup. Additionally, for three days post the surgery, no non-contact sports should be played. Four weeks following the surgery, no strenuous or contact sports should be allowed and eye shields should be worn during nighttime. After 8 weeks, avoid swimming or Jacuzzi. If symptoms get worse or severe pain results, you need to visit the medical practitioner immediately post surgery.
Doctors will also see you for 24 to 48 hours post the surgery and at regular intervals for the first 6 months. During the first postoperative visit, the doctor will remove the eye shield, test the vision and examine the eye. Doctors can prescribe eye drops to prevent swelling or infection. Patients may also be advised to lubricate the eye using artificial tears. Don’t start wearing a contact lens if your vision is blurry in the operated eye.
Wait 1-3 days post the surgery before starting non-contact sports, depending on activity, doctor’s instructions and how you are feeling.
To prevent infection, waiting a period of 2 weeks before surgery or till doctors permit makeup, lotions and creams around the eye are something you should definitely heed.
You also may not be allowed to scrub your eyelashes post the surgery. Avoid swimming or hot tubs and whirlpools for a couple of months. Strenuous contact sports like karate, football and boxing should be avoided for 4 weeks post the surgery as well, to minimize chances of damage to the operated area.
The first couple of months post the surgery, it may take time for the vision to stabilize. Difficulty driving in the night, halos and glares, as well as other symptoms, may persist at the time of stabilization. While distance vision correction is easy to attain, other visual symptoms like glare and halos are not possible to improve through this operation.
The FDA also recommends that these problems need to be treated early on or they can exacerbate the loss of vision. Laser surgery for myopia, hyperopia, and astigmatism is effective, but there are risks if you don't follow the doctor's orders.
The Bottom Line
Research by the NHS has also found that LASIK, LASEK, and PRK improve visual acuity. The National Institute for Health & Clinical Excellence (NICE) found 91% of the eyes treated for astigmatism or myopia achieved perfect results with LASIK, as against 92% for LASEK and 89% for PRK with myopia. On the other hand, people with severe myopia were likely to face visual disturbances and corneal infections.
Corneal thinning was also noted in 0.2% of subjects treated with LASIK.
So, when it comes to laser eye surgery, be sure to discuss the pros and cons before embarking on the operation.
Laser eye surgery is the best choice for any kind of eye trouble. From myopia to hypermetropia and presbyopia, there are a host of conditions that need to be taken to the doctor for a surgical intervention. This form of surgery can serve to cure sightedness linked problems as well as deal with other factors like cataract and associated medical conditions. Laser eye surgical interventions are associated with the best outcomes if you choose an experienced clinician who is conversant with advanced technology.