Laser vision correction

Modern vision correction technologies allow you to permanently eliminate lenses or glasses through a minimally traumatic and highly effective procedure. Laser vision correction (LVC) is considered the most innovative method for correcting pathologies of the structure of the visual system. The procedure has several varieties, recovery periods of varying lengths, 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 takes only 10-15 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 all "eye" ailments, it has a small list of contraindications. Several years after correction, vision may worsen slightly, usually due to age-related changes in vision. 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 provide the elimination of pathologies such as myopia, hyperopia (not all types of MCL), astigmatism. The choice of the appropriate exposure method depends on the characteristics of the patient and his financial capabilities.

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

• Farsightedness up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism between -4 and +4 diopters.

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

In which cases is laser vision correction prohibited:

• During pregnancy and breastfeeding due to unstable hormone levels.
• If vision loss has been observed in the last two years.
• For pathologies of the corneal structure, chronic inflammatory or infectious diseases of the ocular system.
• Diabetes.
• Immunodeficiency.
• Cataracts and glaucoma.
• Damage, breakage and threat of retinal detachment.
• Thin cornea (determined by special tests).

Restrictions also affect age: most clinics prefer patients between the ages of 20 and 40. In individual cases, 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 due to the fact that around this age the definitive formation of the ocular apparatus ends, which precludes such intervention. In any case, it is necessary to consult an experienced eye surgeon to evaluate the possible consequences and the level of specific risk for your body.

Pros and cons of laser vision correction

Unlike traumatic surgery, laser surgery 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 system due to the so-called "human factor". The entire process is carefully controlled by automation, so accidents and oversights are excluded. Modern laser equipment greatly 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 have pathologies of the ocular system.
• Low morbidity. The rehabilitation period varies from a few hours to a week, which is very short compared to other types of surgeries.
• 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 surgery you can return to work, study and sports training almost immediately.

The disadvantages include the rather high cost of laser correction and 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% have had complications requiring further medical intervention.

Types of laser vision correction

The first successful operations with laser equipment were performed in the 1980s. During this period, 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 according to the specified parameters. First, the upper layer of the cornea is separated with a special instrument. Subsequently, this flap is put back in place and the time needed to regenerate the damaged tissue constitutes 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 are discussed below, as well as some nuances of the procedures.

Photorefractive keratectomy (PRK)

This is the oldest method of laser vision correction and is still relevant. Despite some discomfort for the patient and a longer recovery period than other interventions, 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. After the cornea has taken the desired shape, a protective lens is installed on top.

The eye surgeon will spend about 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are instilled). Immediately after surgery you may feel some mild pain, dryness and burning sensation in the eye, which becomes weaker as the cornea heals.

Special recommendations:

• The sensitivity of the eyes to light increases, so during the day you should definitely use sunglasses with an adequate degree of protection from ultraviolet rays.
• Rehabilitation lasts 3 to 5 days. Special drops prescribed by the doctor are used, rest is recommended, work on the computer or prolonged stay in front of the smartphone or TV screen is excluded.
• 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 visual effects on your vision, you should definitely consult a doctor.
• If it is necessary to restore vision in both eyes, the operation is carried out at intervals of 10-14 days. This helps to better deal with postoperative recovery and avoid severe pain.

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

Laser assisted subepithelial keratomileusis (LASEK)

A variant 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, thinned cornea and keratoconus. The first successful correction operations using this method date back to 1999, a period in which numerous statistical data on the success and effectiveness of the procedure appeared.

How laser correction is 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 alcoholic 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 the required shape.
3. The flap is placed in its original position 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. Overall, the procedure is less painful than PRK, but it does have some side effects.

Frequent unwanted symptoms after surgery:

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

The occurrence of any discomfort or pain should be discussed with your doctor. For timely elimination of unwanted symptoms, regular examinations and consultation with a qualified ophthalmologist are necessary. You will need to see your doctor regularly for one year after the operation, after which the number of visits will be reduced.

Laser assisted keratomileusis (LASIK)

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

The procedure for the operation is as follows:

1. A flap is formed from the upper layer of the corneal epithelium according to 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 required. For the patient, this means a shorter recovery period, as well as the return of vision within a few hours of surgery.

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

1. Super Lasik.An almost completely automated procedure that allows correction based on individual patient parameters. A thorough examination of the cornea is first performed, the resulting topographic map is loaded into the program, according to which the operation is performed.
2. Femto-LASIK.To carry out the correction, a special type of laser equipment is used - a femtosecond laser. It cuts a flap of the epithelium of the upper layer of the cornea according to the specified parameters, which significantly facilitates the patient's recovery period. It is characterized by high costs and low risk of complications (about 0. 1%).
3. FemtoSuper LASIK.The technology combines all the advantages of Super Lasik and Femto-LASIK. Recommended for patients with thin corneas and severe myopia (up to -25 diopters). Laser correction of this type is characterized by the fastest possible recovery period: the patient notices an improvement in vision within a couple of hours after the operation.
4. Presby LASIK.A technique specially developed for laser vision correction after 40 years. Prescribed to patients with progressive presbyopia. The main complaints in this case are the inability to fix vision on small elements at close range. If the disease develops against the background of myopia, the patient is forced to use two pairs of glasses. During surgery, the cornea is shaped into multifocal lenses, which completely compensate for this visual defect.
5. Epi-LASIK.A rarely used laser correction method, it is usually used in the early or middle stages of myopia or hyperopia. The shape of the cornea in these cases is flatter, which makes it possible to cut the flap 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 fixed on top. It must be removed no earlier than three days, which requires permanent recovery. It is important that literally the next day you can adhere to your usual rhythm of life, including sports training. That is why this method of laser correction is suitable for active people, as well as 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 low-light vision. During surgery, thanks to the use of high-precision laser equipment, the degree of damage to the eye is reduced to a minimum, virtually eliminating postoperative complications.

Vision correction with ReLEx SMILE femtosecond laser

The innovative ReLEx SMILE technology eliminates the need to create or remove a corneal flap. Using a special laser, a lens of the required shape is formed directly in the tissues of the cornea. It is called a lenticule and its removal occurs through a minimal incision (2 to 4 mm) on the upper layer. Rehabilitation after the correction lasts several hours, vision completely returns 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 possibility of performing laser vision correction for diagnosed dry eye syndrome. This condition is a contraindication to 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.

Preparation 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 using a high-precision laser, and the total exposure time of the laser beam is a few seconds.

Patient preparation before laser correction includes several important points:

1. Avoid wearing soft contact lenses about a week before your consultation. Hard contact lenses that the patient has worn for more than a year should be removed three to four weeks before the consultation. Constant use slightly changes the shape of the cornea, which can lead to errors in the diagnosis of vision, as well as in the calculated trajectory of the laser beam.
2. Mandatory consultation and examination by an ophthalmologist before surgery. It is recommended to immediately choose a clinic and undergo the necessary tests there. At the appointment, a thorough examination of the fundus and visual acuity is checked. If the patient has no contraindications, the doctor will help you choose the appropriate type of laser correction, as well as perform a typographical 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, control of blood sugar levels, a general blood test, testing for HIV, syphilis, hepatitis B and C.
4. Women will need to remove eyelash extensions the day before the procedure and refuse to use decorative cosmetics, creams or lotions.

It is advisable to immediately evaluate the possibility of a mini holiday for better recovery after laser correction. Typically, the procedure is performed on a "hospital day, " with the patient returning home within a few hours of surgery. It is important to solve everyday problems: who will pick you up at the hospital and help you solve everyday problems. It is important that the patient focuses on rest, putting aside the usual worries for a while.

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 completely unconfirmed. The total time the patient will spend in the operating room will not exceed 10 minutes. The vision correction procedure is performed in the supine position, the eyelids are fixed with a special device that will make it difficult to see freely. In fact, the patient will not feel anything except the effect of the anesthetic drops and a slight discomfort during the application of the ring to the eye. This device allows you to quickly and precisely remove a flap of the required size. The impact of the laser beam can be felt as a slight warming, but essentially all sensations are alleviated by the action of an anesthetic drug and any discomfort is more of a psycho-emotional nature.

Postoperative period: recovery, restrictions, recommendations after correction

Dizziness, eye pain, nausea and other complaints often occur immediately after laser correction. 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 can actually 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 correct 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 lead to flap displacement and the need for repeated operations.
• In some cases, the patient will wear special protective lenses for three or four days after surgery. They prevent the entry of eye injuries, foreign bodies or contaminants.
• In the week following surgery it is advisable to limit the time spent in front of the TV, computer screen or smartphone.
• It is also advisable not to strain your eyes further, to use sunglasses when leaving the house and to avoid exposure to frost or strong winds.
• Reduce physical activity, eliminate heavy lifting, and stay in a bent 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 to: stimulate the regeneration of mucous membranes; 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 the doctor during the rehabilitation period after laser correction. Regular eye checks 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 prescribed medications, as well as following hygiene and regimen 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 light vision (usually disappears on its own 6-9 months after surgery).
• Displacement of the flap due to trauma. A common consequence is that the patient touches the eye on the first day after laser correction. In some cases a second operation will be necessary to put everything back in place.

If you experience any unusual sensations, pain or discomfort, you should consult your doctor for advice. Typically, a specialist will give comprehensive recommendations and warn of possible symptoms in advance, even at the stage of patient consultation before surgery.

Frequently asked questions about LKZ

What happens if I accidentally move my eyes during surgery?

Such 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 decline again after giving birth?

A common myth that has no statistical proof. Loss of vision at the time of birth may be associated with high blood pressure, eye disease, and other conditions. After laser correction, there is no need to postpone pregnancy planning and no need to worry about vision loss during childbirth.

Is the effectiveness of laser correction not that high?

According to various information, visual acuity returned to 1. 0 in 90. 8% of patients. Another 99. 5% can boast an increase in vision of between 0. 5 and 1. 0, and about 1. 2% are dissatisfied with the results of the operation. 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 eyes can provoke 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.

Sports banned?

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

How long will the vision be perfect?

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

Is it possible to repeat the surgery?

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

The advent of laser vision correction techniques has allowed 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 vivid colors. Features and key differences between various LKZ techniques, important questions about preparation, rehabilitation and the amount of vision restored after surgery - all the necessary information on the topic is presented in our review.