Laser vision correction

Modern vision correction technologies make it possible 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 of correction of pathologies of the structure of the visual apparatus. The procedure has several types, recovery periods of different lengths, as well as other important features that are well known in advance.

What is LKZ?

Pathology correction 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 performed for medical reasons and requires prior consultation with a specialist - an ophthalmologist. Unfortunately, at the current stage of development, LKZ is not a panacea for all "eye" diseases, but has a small list of contraindications. A few 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 more slowly than without surgery. Before making the correction, you must consult your doctor who prescribes the appropriate type of laser intervention.

Indications and contraindications for laser vision correction

The possibilities of laser surgery ensure the elimination of pathologies such as myopia, farsightedness (not all types of MCL), astigmatism. The choice of the appropriate exposure method depends on the characteristics of the patient, as well as financial possibilities.

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 when it is not possible to use contact lenses, as well as for patients with significant deterioration of vision in only one eye. An initial consultation and thorough examination by an ophthalmologist will help to rule out possible contraindications for which such an intervention is not recommended.

In which cases laser vision correction is prohibited:

• Due to unstable hormonal levels during pregnancy and breastfeeding.
• If vision loss has been observed in the last two years.
• For pathologies of the corneal structure, chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Immune deficiency.
• Cataract and glaucoma.
• Risk of injuries, tears and 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 carried out after 40 years, but only if the pathology is not related to age-related changes in the cornea. Laser vision correction is practically not carried out until the age of 21. This is due to the fact that the final formation of the eye apparatus is completed at this age, which excludes such an intervention. In any case, you should consult an experienced ophthalmic surgeon to assess the possible consequences and level of risk.

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 that there is no risk of accidental damage to the eye apparatus due to the so-called "human factor". The entire process is carefully controlled by automation, so there are no accidents and out-of-control. Modern laser equipment significantly simplifies the doctor's work and becomes an opportunity for the patient to quickly and effectively restore visual acuity.

The main advantages of laser vision correction:

• Excellent effect after the procedure. Visual acuity will be about 100%, which is rarely determined even in people without any pathology of the eye apparatus.
• Low morbidity. The rehabilitation period is from a few hours to a week, which is very short compared to other types of surgical intervention.
• There are no strict 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 can return to work, study and sports almost immediately.

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 in the 80s. During this time, several types of laser correction appeared, their methods 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 tool. The flap is then put back into place and the time required for the damaged tissue to regenerate is the patient's recovery period. In some cases, the cut lid is completely removed and special lenses are used to protect the eyeball. The differences between different methods of laser correction, as well as some nuances of the procedures, are discussed below.

Photorefractive keratectomy (PRK)

This laser is the oldest method of vision correction and is still relevant today. Despite some discomfort for the patient and a longer recovery time than other surgeries, PRK is used for medical reasons. Especially if the patient has a thin cornea and large pupils.

The procedure takes place in several stages:

1. The corneal surface layer is removed.
2. A laser is used to vaporize corneal tissue (laser ablation).
3. After the cornea takes the desired shape, a protective lens is placed on it.

The eye surgeon will spend about 10 minutes on each eye. The patient is under local anesthesia (anesthesia drops are dripped). Immediately after the intervention, a slight pain, dryness and burning sensation may appear in the eye, which subsides as the cornea heals.

Special recommendations:

• The sensitivity of the eyes to light increases, so during the day you should definitely use sunglasses with adequate protection against ultraviolet rays.
• Rehabilitation lasts from 3 to 5 days. Special drops prescribed by the doctor are used, rest is recommended, working at the computer, staying in front of the smartphone or TV screen for a long time is excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press, or otherwise affect the affected area. In case of accidental injury and severe pain, change in perspective or any visual effects on vision, you should definitely consult a doctor.
• If it is necessary to restore vision in both eyes, the intervention is carried out at intervals of 10-14 days. This helps to better cope with post-operative recovery and prevent severe pain.

After excimer laser correction, vision gradually returns, the process takes 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 proven to be effective.

Laser-assisted subepithelial keratomileusis (LASEK)

A variation of PRK, a laser correction technology, is a 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 correctional operations using this method date back to 1999, and during this time many statistics have emerged about the success and effectiveness of the procedure.

How laser correction is performed:

1. The upper layer of the cornea is cut and the flap is moved to the side. In this case, a scalpel or laser is not used, but 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 cap 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 have 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 has some side effects.

Common unwanted symptoms after surgery:

• In the first two days, there is discomfort and the feeling of a foreign body in the eye.
• Increased dry eye lasting up to six months. To eliminate it, special moisturizing drops are used.
• A "curtain" before the eyes, blurred vision, blurred vision - all these undesirable manifestations can be repeated within six months after the correction.

Any discomfort or pain should be discussed with your doctor. Regular examinations and consultations with a qualified ophthalmologist are required for timely elimination of unwanted symptoms. After the operation, you will have to visit the doctor regularly for a year, after which the number of visits will decrease.

Laser-assisted keratomileusis (LASIK)

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

The process of operation is as follows:

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

The operation is performed without sutures and does not require the use of a bandage lens. For the patient, this means a shorter recovery time, as well as recovery of vision within hours of surgery.

LASIK laser vision correction technique is divided into the following groups:

1. Super Lasik.An almost completely automated procedure that allows for adjustments according to the patient's individual parameters. First, a comprehensive examination of the cornea is performed, the resulting topographic map is loaded into the program, and the operation is performed accordingly.
2. Femto-LASIK.To carry out the correction, a special type of laser equipment is used - a femtosecond laser. According to the specified parameters, it cuts the cap of the epithelium of the upper layer of the cornea, which greatly facilitates the recovery period of the patient. It is characterized by a high price and a low risk of complications (about 0. 1%).
3. Femto Super LASIK.The technology combines all the advantages of Super Lasik and Femto-LASIK. It is recommended for patients with a thin cornea, as well as for severe myopia (up to -25 diopters). This type of laser correction is characterized by the fastest possible recovery period - the patient notices an improvement in vision within a few hours after the intervention.
4. Presby LASIK.A specially developed technique for laser vision correction after 40 years. It is prescribed to patients with progressive presbyopia. In this case, the main complaints are the inability to determine the ability to see 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 the operation, the cornea is transformed into multifocal lenses that 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 farsightedness. In such cases, the shape of the cornea is more flat, which allows cutting the flap along the natural edge - along the section of the corneal epithelium. After correction, the cap is put in place and a protective lens with high gas permeability is put on top. It should be removed no later than three days, which requires the final restoration. It is important that you can follow your usual rhythm of life, including sports training, the next day. Therefore, this method of laser correction is suitable for active people, as well as patients whose field of activity is related to physical activity.

Performing laser vision correction using this technique can improve visual acuity up to 100%, as well as improve the clarity of twilight vision. Due to the use of high-precision laser equipment during the operation, the degree of damage to the eye is minimized, which virtually eliminates postoperative complications.

Femtosecond laser vision correction ReLEx SMILE

The innovative ReLEx SMILE technology eliminates the need to create or remove a corneal flap. Using a special laser, a lens of the right shape is formed directly in the tissues of the cornea. It is called a lenticule, and its removal occurs through a minimal (2 to 4 mm) incision in the upper layer. After correction, rehabilitation takes a few hours, vision returns completely immediately after the operation. There is practically no information about possible complications, since this method has been actively used for the past five years, which is not enough to assess the prospects.

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

Preparation for surgery

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

Preparing the patient before laser correction includes several important points:

1. Avoid wearing soft contact lenses for about a week before your consultation. Hard contact lenses that the patient has been wearing for more than a year should be removed three to four weeks before the consultation. Regular use slightly changes the shape of the cornea, which can cause errors in vision diagnosis, as well as in the calculated trajectory 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. During the appointment, a thorough examination of the fundus and visual acuity are checked. If the patient has no contraindications, the doctor will help you choose the appropriate 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, blood sugar level control, general blood test, tests for HIV, syphilis, hepatitis B and C.
4. Women should remove eyelash extensions the day before the procedure, as well as refuse to use any decorative cosmetics, creams or lotions.

For better recovery after laser correction, it is advisable to immediately consider the option of a mini-vacation. Typically, the procedure is performed on a "hospital day" basis, with the patient going home within hours of the operation. It is important to solve everyday problems: who will pick you up from the hospital and help you solve everyday problems. It is important for the patient to put aside his usual worries for a while and focus on rest.

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

Most fears and anxieties about surgery are completely unfounded. The total time the patient will spend in the operating room is no more than 10 minutes. The vision correction procedure is performed in a lying 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 slight discomfort when applying the ring to the eye. This device allows you to quickly and accurately remove a cap of the required size. The effect of the laser beam may be felt as a slight fever, but basically all sensations are removed by the effect of the anesthetic drug, and the possible discomfort is more psycho-emotional in nature.

Postoperative period: recovery, limitations, recommendations after correction

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

Important nuances of correct rehabilitation after laser correction:

• You can not touch your eyes, touch them with your hands, rub them or otherwise affect them. This can lead to flap displacement and the need for reintervention.
• In some cases, the patient will wear special protective lenses for three to four days after surgery. They prevent damage to the eye, foreign bodies or pollutants from entering it.
• During the week after the operation, it is recommended to limit the time spent in front of the TV, computer screen or smartphone.
• It is also recommended not to strain the eyes, to use sunglasses when leaving the house, and not to be exposed to frost or strong wind.
• Reduce physical activity, lift heavy loads and do not stay bent over for a long 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 the eye and accelerate the healing process. Thanks to pantothenic acid, the drops help: stimulate the regeneration of mucous membranes; accelerate cell division and increase the strength of collagen fibers; has a restorative and anti-inflammatory effect. High molecular hyaluronic acid retains water and protects the eyes from negative effects, providing effective hydration and comfort.

It is mandatory to consult a doctor during the rehabilitation period after laser correction. Regular visual inspections will help to see the dynamics of recovery and prevent possible complications.

Possible results of laser correction

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

Postoperative complications include:

• Swelling, inflammation and bleeding in the injured area.
• Decreased twilight vision (usually disappears by itself 6-9 months after surgery).
• Displacement of the valve due to trauma. The general result of touching the patient's eye on the first day after laser correction. In some cases, a second operation will be required 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 even at the stage of consultation with the patient before the operation and will warn in advance about possible symptoms.

Frequently asked questions about LKZ

What if I accidentally move my eyes during surgery?

Such cases are completely excluded. During laser vision correction, special devices are used that reliably fix the position of the patient's eyes at any angle.

Will my vision decrease again after giving birth?

A common myth without any statistical evidence. Vision loss at birth can be associated with high blood pressure, pathologies of the eye apparatus 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.

The effectiveness of laser correction is not so high?

According to various reports, 90. 8% of patients returned to 1. 0 visual acuity. Another 99. 5% can boast of an increase in vision in the range of 0. 5 - 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 visual function restoration.

After what time can you paint your eyes?

Accidental contact of cosmetics with the eye can cause an inflammatory process, which should be avoided at all costs. Until the cornea is completely healed, which lasts 4-7 days, it is advisable to completely refuse cosmetics and not to extend eyelashes.

Sports banned?

It is better to refrain from physical activity the day before the operation. Recovery time depends on the type of intervention. You will need to avoid contact sports for about a month to eliminate the risk of eye damage. In general, there are no special restrictions for playing sports, the main thing is to wait for the restoration of the epithelium.

How perfect will the vision be?

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

Is a repeat operation possible?

Patients with a high degree of myopathy sometimes decide to undergo reoperation to slow down the decline in visual acuity. This can be done two years after the first intervention, but the actual indicators can only be determined by an ophthalmologist during a personal examination.

The emergence of laser vision correction methods has enabled millions of people around the world to stop using glasses and contact lenses. This significantly improved the quality of life and allowed us to see the world in bright colors. Features and main differences between various LKZ methods, important questions about preparation, rehabilitation, as well as how much vision is restored after surgery - all the necessary information on the topic is presented in our review.