Laser vision correction

Modern vision correction technologies allow you to permanently get rid of lenses or glasses through a low-traumatic and highly effective procedure. Laser vision correction (LVC) is considered the most innovative method for correcting pathologies of the structure of the visual apparatus. The procedure has several varieties, recovery periods of different duration, as well as other important features that are best known in advance.

What is LKZ?

Correction of pathology is carried out using high-precision laser equipment. The procedure itself lasts only 10 to 15 minutes; Special drops are used to relieve pain. Laser vision correction is carried out for medical reasons and requires prior consultation with a specialist - an ophthalmologist. Unfortunately, LKZ at the current stage of development is not a panacea for absolutely all "eye" ailments, it has a small list of contraindications. Several years after correction, vision may deteriorate slightly, usually due to age-related changes in the visual apparatus. At the same time, the decrease in visual acuity occurs much more slowly than without surgery. Before correction, you should definitely consult with your doctor, who will determine the appropriate type of laser intervention.

Indications and contraindications for laser vision correction.

The possibilities of laser surgery allow us to eliminate pathologies such as myopia, hyperopia (not all types of MCL) and astigmatism. The choice of the appropriate exposure method depends on the characteristics of the patient, as well as his financial capabilities.

Typically, indications for laser vision correction are the following conditions:

• Hyperopia up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism in the range of -4 to +4 diopters.

The operation is recommended if it is impossible to use contact lenses, as well as in patients whose vision worsens significantly in only one eye. A preliminary consultation and thorough examination by an ophthalmologist will help exclude possible contraindications in which such intervention is not recommended.

In what cases is laser vision correction prohibited?

• During pregnancy and lactation due to unstable hormonal levels.
• If vision loss has been observed during the last two years.
• For pathologies of the corneal structure, chronic inflammatory or infectious diseases of the ocular apparatus.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, breaks and threat of retinal detachment.
• Thin cornea (determined by special tests).

Restrictions also affect age: most clinics prefer patients between 20 and 40 years old. In individual cases, the correction is performed after 40 years, but only if the pathology is not associated with age-related changes in the cornea. Before the age of 21, laser vision correction is practically not performed. This is because around this age the final formation of the ocular apparatus ends, which prevents such intervention. In any case, it is necessary to consult with an experienced ophthalmic surgeon to evaluate the possible consequences and the specific risk level for your body.

Pros and cons of laser vision correction

Unlike traumatic surgery, laser intervention involves minimal impact, high precision and safety of the procedure. The main advantage is the absence of the risk of accidental damage to the ocular apparatus due to the so-called "human factor". The entire process is carefully controlled by automation, so accidents and oversights are excluded. Modern laser equipment significantly facilitates the doctor's work, and for the patient it becomes an opportunity to quickly and effectively restore visual acuity.

The main advantages of laser vision correction:

• Excellent effect after the procedure. Visual acuity will be approximately 100%, which is rarely determined even in people who do not suffer from any pathology of the ocular apparatus.
• Low morbidity. The rehabilitation period varies from several hours to a week, which is very short compared to other types of surgical interventions.
• No serious restrictions. Preparation for laser vision correction, as well as the rehabilitation period, do not require the patient to significantly change his usual life. After the intervention, you will be able to return almost immediately to work, study and sports training.

The disadvantages include the rather high cost of laser correction, as well as a small risk of complications. According to various statistics, about 1. 2% of patients are not satisfied with the results of vision correction and 0. 1% experienced complications that required additional medical intervention.

Types of laser vision correction.

The first successful operations with laser equipment were carried out back in the 80s. During this time, several types of laser correction appeared, the methods of which have significant differences. The essence of all procedures is to correct the shape of the cornea with a laser in accordance with the specified parameters. First, the top layer of the cornea is separated with a special tool. This flap is then returned to its place, and the time required to regenerate the damaged tissue is the patient's recovery period. In some cases, the cut flap is removed completely and special lenses are used to protect the eyeball. The differences between different laser correction methods, as well as some of the nuances of the procedures, are discussed below.

Photorefractive keratectomy (PRK)

This is the oldest method of laser vision correction and is still relevant today. Despite some patient discomfort and a longer recovery period than other operations, PRK is used for medical reasons. In particular, when the patient has a thin cornea and large pupils.

The procedure takes place in several stages:

1. The superficial layer of the cornea is removed.
2. A laser is used to evaporate the corneal tissue (laser ablation).
3. Once the cornea takes the desired shape, a protective lens is installed on top.

The eye surgeon will spend approximately 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are instilled). Immediately after the procedure, you may experience mild pain, dryness, and a burning sensation in the eye, which weakens as the cornea heals.

Special recommendations:

• The eyes' sensitivity to light increases, so during the day it is essential to wear sunglasses with an adequate degree of ultraviolet protection.
• Rehabilitation lasts 3 to 5 days. Special drops prescribed by a doctor are used, it is recommended to rest, work at the computer or spend long periods of time in front of a smartphone or TV screen.
• Mechanical impact on the eyes is excluded. Do not rub, press, or otherwise impact the damaged area. In case of accidental injury and severe pain, change in perspective or appearance of any visual effects on vision, you should definitely consult a doctor.
• If it is necessary to restore vision in both eyes, the intervention is performed at intervals of 10 to 14 days. This helps to better cope with postoperative recovery and avoid intense pain.

After excimer laser correction, vision returns gradually, the process lasts a month or more. If you follow the doctor's recommendations and treatment, the risk of complications is extremely low. The procedure is affordable and has proven effective.

Laser-Assisted Subepithelial Keratomileusis (LASEK)

A variation of PRK, a laser correction technology, is the popular and less traumatic LASEK method. The main advantage is the possibility of use in patients with dry eye syndrome, thinning of the cornea and keratoconus. The first corrective operations successfully performed with this method date back to 1999, during which time numerous statistical data appeared on the success and effectiveness of the procedure.

How is laser correction performed?

1. The top layer of the cornea is cut and the flap is moved to the side. In this case, no scalpel or laser is used, but only an alcohol solution that softens the connections between the lower and upper layers of the corneal epithelium.
2. The bottom layer is burned with a laser to give it the required shape.
3. The flap is placed in its original place and fixed with a bandage lens.

The lenses are selected with a high degree of gas permeability for better and faster healing. You will need to wear them for at least 4 days, the entire recovery period after the correction. Visual acuity returns faster, in about a week. In general, the procedure is less painful than PRK, but it does have some side effects.

Common undesirable symptoms after surgery:

• In the first two days there is discomfort and a sensation of a foreign body in the eye.
• Increased dryness of the eyes, lasting up to six months. To eliminate it, special moisturizing drops are used.
• "Vision" before the eyes, deterioration of twilight vision, blurred vision - all these undesirable manifestations can reappear within six months after the correction.

The appearance of any discomfort or pain should be consulted with your doctor. To timely eliminate unwanted symptoms, periodic examinations and consultations with a qualified ophthalmologist are required. You will need to visit your doctor periodically for a year after the operation, after which the number of visits will be reduced.

Laser-assisted keratomileusis (LASIK)

The LASIK method is now the most popular, it is considered less traumatic and has a high probability of restoring vision. The first operations with this technique were carried out in 1987, the technology has undergone numerous changes, becoming one of the most popular.

The course of the operation is as follows:

1. A flap is formed from the upper layer of the corneal epithelium according to the specified parameters.
2. Corneal defects are corrected and corrected.
3. The flap is returned to its place, covering the operated area.

The surgery is performed without sutures and the use of bandage lenses is not necessary. For the patient, this means a shorter recovery period, as well as vision recovery within hours after surgery.

The LASIK laser vision correction technique is classified into the following groups:

1. Super Lasik.An almost completely automated procedure that allows correction according to the patient's individual parameters. First, a thorough examination of the cornea is performed, the resulting topographic map is loaded into the program, according to which the operation is performed.
2. Femto-LASIK.A special type of laser equipment is used to perform the correction: a femtosecond laser. It cuts a flap of epithelium from the upper layer of the cornea according to specified parameters, which greatly facilitates the patient's recovery period. It is characterized by high cost and low risk of complications (about 0. 1%).
3. Femto Super LASIK.The technology combines all the advantages of Super Lasik and Femto-LASIK. Recommended for patients with a thin cornea, as well as for severe myopia (up to -25 diopters). Laser correction of this type is characterized by a recovery period that is as quick as possible: the patient notices an improvement in vision a couple of hours after the intervention.
4. Presby LASIK.A specially developed technique for laser vision correction after 40 years. Prescribed to patients with progressive presbyopia. The main complaints in this case are the inability to focus on small elements at close range. If the disease develops against the background of myopia, the patient is forced to wear two pairs of glasses. During surgery, the cornea is transformed into multifocal lenses, which completely compensates for this vision defect.
5. Epi-LASIK.A rarely used laser correction method, it is generally used in the early or middle stages of nearsightedness or farsightedness. The shape of the cornea in such cases is flatter, which allows the flap to be cut along the natural edge - the section of the corneal epithelium. After correction, the flap is placed, and a protective lens with a high degree of gas permeability is placed on top. It should be removed no earlier than three days, until final recovery occurs. It is important that literally the next day you can continue your usual rhythm of life, including sports training. That is why this method of laser correction is suitable for active people, as well as for patients whose field of activity involves physical activity.

Performing laser vision correction using this technique can improve visual acuity by up to 100%, as well as increase the clarity of twilight vision. During surgery, thanks to the use of high-precision laser equipment, the degree of eye damage is minimized, which practically eliminates postoperative complications.

ReLEx SMILE femtosecond laser vision correction

The innovative ReLEx SMILE technology eliminates the need to create or remove a corneal flap. With the help of a special laser, a lens of the required shape is formed directly in the corneal tissues. It is called a lenticule and its removal occurs through a minimal incision (2 to 4 mm) in the upper layer. Rehabilitation after correction takes several hours, vision is completely restored almost immediately after the end of the operation. There is practically no information about possible complications, because this method has been actively used for the past five years, which is not enough to evaluate the prospects.

The main advantage is the ability to perform laser vision correction in the case of diagnosed dry eye syndrome. This condition is a contraindication for many ophthalmological operations, including laser vision correction. The disadvantage will be the rather high cost and possible difficulties in choosing a clinic and a doctor who is familiar with the specifics of such operations.

Preparing for surgery

Despite all the technical complexity of laser correction, for the patient it will go almost unnoticed and very quickly. The average time for LKZ is 10 minutes per eye. All necessary manipulations are performed with a high-precision laser and the total exposure time of the laser beam is only a few seconds.

Patient preparation before laser correction includes several important points:

1. Avoid wearing soft contact lenses about a week before your appointment. Rigid contact lenses that the patient has worn for more than a year should be removed three to four weeks before the appointment. Constant use slightly changes the shape of the cornea, which can lead to errors in vision diagnosis, as well as in the calculated path of the laser beam.
2. Mandatory consultation and examination by an ophthalmologist before surgery. It is advisable to immediately choose a clinic and undergo the necessary examinations there. At the appointment, a thorough examination of the fundus and visual acuity is performed. If the patient has no contraindications, the doctor will help him choose the right type of laser correction, as well as conduct a typographic examination of the cornea for the upcoming procedure.
3. It is important to undergo a general health examination. According to the treatment protocol, the list of necessary procedures includes fluorography, monitoring blood sugar levels, general blood analysis, testing for HIV, syphilis, hepatitis B and C.
4. Women should remove eyelash extensions the day before the procedure and also refuse to use decorative cosmetics, creams or lotions.

It is advisable to immediately consider the option of a mini vacation for better recovery after laser correction. Typically, the procedure is performed on an "inpatient day" and the patient returns home a few hours after surgery. It is important to solve everyday problems: who will pick you up from the hospital and help you solve everyday problems. It is important that the patient focuses on rest, leaving aside usual worries for a time.

How does laser correction work and how long does it last?

Most of the fears and concerns associated with the operation turn out to be not completely confirmed. The total time the patient will spend in the operating room does not exceed 10 minutes. The vision correction procedure is performed in a supine position, the eyelids are fixed with a special device that will make free vision difficult. In fact, the patient will not feel anything more than the effect of the anesthetic drops and some minor discomfort when applying the ring to the eye. This device allows you to quickly and accurately remove a flap of the required size. The impact of the laser beam can be felt as a slight warming, but basically all sensations are relieved by the action of an anesthetic drug and the possible discomfort is more of a psycho-emotional nature.

Postoperative: recovery, restrictions, recommendations after correction.

Immediately after laser correction, there are often complaints of dizziness, eye pain, nausea and other discomfort. Basically, these symptoms are associated with psychological stress, which inevitably arises in such situations. After the effect of the anesthetic drops wears off, painful sensations may become real, but usually on the first day the doctor prescribes periodic pain relief. Antibiotic drops and corneal moisturizing drugs are used.

Important nuances of proper rehabilitation after laser correction:

• You cannot touch your eyes, touch them with your hands, rub them or influence them in any other way. This can cause displacement of the flap and the need for repeated interventions.
• In some cases, the patient will need to wear special protective glasses for three or four days after surgery. They prevent eye injuries, the entry of foreign bodies or contaminants.
• During the week after surgery, it is advisable to limit the time spent in front of the television, computer screen or smartphone.
• It is also advisable to avoid additional strain on your eyes, wear sunglasses when leaving the house and avoid exposure to frost or strong winds.
• Reduce physical activity, eliminate heavy lifting, and remain in a bent over position for long periods of time.

During the rehabilitation period after laser vision correction, it is recommended to use eye drops with pantothenic and hyaluronic acid; This is a preventive ophthalmic agent designed to moisturize and accelerate the healing process of the eye. Thanks to pantothenic acid, the drops help: stimulate mucosal regeneration; accelerate cell division and increase the strength of collagen fibers; providing regenerative and anti-inflammatory effects. High molecular weight hyaluronic acid retains water and protects the eyes from negative influences, providing effective hydration and comfort.

It is mandatory to visit your doctor during the rehabilitation period after laser correction. Regular vision checkups will help you see the dynamics of recovery and prevent possible complications.

Possible consequences of laser correction.

The already small risks of complications can only be minimized with self-control and discipline. It is important to strictly follow all the doctor's recommendations, using the prescribed medications, as well as following the hygiene and guidelines recommendations. In general, the risk of unwanted symptoms with laser vision correction is quite low: 0. 1 to 1. 2%.

Postoperative complications include:

• Swelling, inflammation and bleeding in the damaged area.
• Decreased twilight vision (usually goes away on its own 6 to 9 months after surgery).
• Displacement of the flap due to trauma. A common consequence of the patient touching the eye on the first day after laser correction. In some cases, a second operation will be necessary to put everything back in its place.

If you experience any unusual sensations, pain or discomfort, you should consult your doctor. Usually, a specialist will give complete recommendations and warn about possible symptoms in advance, even at the stage of consulting the patient before surgery.

LKZ FAQ

What happens if I accidentally move my eyes during surgery?

These types of situations are completely excluded. During laser vision correction, special devices are used that reliably fix the position of the patient's eyes at the desired angle.

Will my vision decrease again after childbirth?

A common myth that has no statistical evidence. Vision loss at the time of childbirth may be associated with high blood pressure, pathologies of the ocular system and other conditions. After laser correction, there is no need to postpone pregnancy planning and there is no need to worry about vision loss during childbirth.

Is the effectiveness of laser correction not so high?

According to various information, visual acuity of 1. 0 returned to 90. 8% of patients. Another 99. 5% can boast of an increase in vision in the range of 0. 5 to 1. 0, and about 1. 2% were not satisfied with the results of the operation. Even despite the low failure rate and the risk of possible complications (most of which occur when the doctor's recommendations are not followed), LKZ is the most effective and successful type of restoration of visual function.

After what time can you dye your eyes?

Accidental contact of cosmetics with the eyes can cause an inflammatory process, which should be avoided at all costs. Until the cornea is completely healed, which takes 4-7 days, it is advisable to completely abandon cosmetics and not undergo eyelash extensions.

Prohibited sports?

It is best to abandon physical activity the day before surgery. The recovery period depends on the type of intervention. You will have to forget about contact sports for about a month to eliminate the risk of eye injuries. In general, there are no special restrictions for playing sports, the main thing is to wait until the epithelium is restored.

How long will vision be perfect?

Modern methods are not yet designed to achieve lifelong effects. Typically, about 45% of PRK patients and 65% of LASIK patients report stable vision quality. The gradual decrease is largely influenced by the diagnosis: with severe myopathy, visual acuity is preserved by only 25% and 37%, respectively.

Is it possible to repeat the surgery?

With a high degree of myopathy, patients sometimes decide to undergo further surgery to stop the decline in visual acuity. This can be done two years after the first intervention, but the actual indications can only be determined by an ophthalmologist during a personal examination.

The advent of laser vision correction techniques has made it possible for millions of people around the world to stop wearing glasses and contact lenses. This significantly improved the quality of life and made it possible to literally see the world in brilliant colors. Key features and differences between various LKZ techniques, important questions about preparation, rehabilitation and the degree of vision recovery after surgery - all the necessary information on the topic is presented in our review.