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 correcting pathologies of the structure of the visual apparatus. 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 for pain relief. Laser vision correction is carried out for medical reasons and requires prior consultation with a specialist – an ophthalmologist. Unfortunately, LKZ at the present stage of development is not a panacea for absolutely all "eye" ailments; it has a small list of contraindications. Several years after the correction, vision may deteriorate somewhat, 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 provide the elimination of such pathologies as myopia, farsightedness (not all types of MCL), astigmatism. The choice of the appropriate method of exposure depends on the characteristics of the patient, as well as his financial capabilities.

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

• Farsightedness up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism in the range from -4 to +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 thorough examination by an ophthalmologist will help to exclude possible contraindications in which such intervention is not recommended.

In what cases is laser vision correction prohibited:

• During pregnancy and breastfeeding due to unstable hormonal levels.
• If vision loss has been observed over the past two years.
• For pathologies of the cornea structure, chronic inflammatory or infectious diseases of the ocular apparatus.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, ruptures 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, 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 the final formation of the ocular apparatus ends around this age, which precludes such an intervention. In any case, you need to consult with an experienced ophthalmologist surgeon to assess the possible consequences and level of risk specifically 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 about 100%, which is rarely determined even in people who do not have any pathologies of the ocular apparatus.
• Low morbidity. The rehabilitation period ranges 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 their usual life. After the intervention, you can almost immediately return 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 requiring 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 have 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. Subsequently, this flap is 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 methods of laser correction, 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 discomfort for the patient 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 surface layer of the cornea is removed.
2. A laser is used to evaporate corneal tissue (laser ablation).
3. After 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 intervention, you may experience mild pain, dryness and a burning sensation in the eye, which becomes weaker as the cornea heals.

Special recommendations:

• The light sensitivity of the eyes increases, so during the daytime you should definitely use sunglasses with a suitable degree of ultraviolet protection.
• Rehabilitation lasts from 3 to 5 days. Special drops prescribed by a doctor are used, rest is recommended, work at the computer, or spending long periods of time in front of a smartphone or TV screen are excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press or in any other way impact the damaged area. In the event of an accidental injury and severe pain, a shift in perspective, or the appearance of any visual effects in 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 avoid severe pain.

After excimer laser correction, vision returns gradually, 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 has proven effectiveness.

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, thinned cornea, and keratoconus. The first successfully performed correction operations using this method date back to 1999, during which time a lot of statistical data has appeared on the success and effectiveness of the procedure.

How is laser correction performed:

1. The top layer of the cornea is cut off and the flap is moved to the side. In this case, a scalpel or laser is not 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 the required shape.
3. The flap is placed in its original place and fixed with a bandage lens.

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 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 undesirable symptoms after surgery:

• In the first two days there is discomfort and sensations 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.
• 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 required. You will have to see your doctor regularly 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, 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, 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 a bandage lens is not required. For the patient, this means a shorter recovery period, as well as the return of vision within a few 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 for correction according to the patient’s individual 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. He cuts off a flap of the epithelium of 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 the fastest possible recovery period - the patient notices an improvement in vision within 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 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 compensates for this vision defect.
5. Epi-LASIK.A rarely used laser correction method, it is usually used at the initial or middle stages of myopia or farsightedness. The shape of the cornea in such cases is flatter, which makes it possible to cut the flap along the natural edge - the section of the epithelium of the cornea. After correction, the flap is put in place, and a protective lens with a high degree of gas permeability is attached on top. It must be removed no earlier than after three days, which takes the final 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.

Carrying out laser vision correction using this technique can improve visual acuity 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 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 required 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 on the top layer. Rehabilitation after correction takes several hours, vision returns completely almost immediately after the end of the operation. There is practically no information on possible complications, because this method has been actively used over 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 cost and possible difficulties in choosing a clinic and doctor 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 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 about a week before your consultation. Rigid 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 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. At 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 perform 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, checking 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 also refuse to use any 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 a "hospital day" basis, with the patient going home within a few hours after surgery. It is important to resolve everyday issues: who will pick you up from the hospital and help in solving everyday problems. It is important for the patient to focus on rest, putting aside the usual worries for a while.

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

Most fears and concerns associated with the operation turn out to be completely unconfirmed. The total time that the patient will spend in the operating room is no more than 10 minutes. The vision correction procedure is carried out in a 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 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 may be felt as a slight heating, but basically all sensations are relieved by the action of an anesthetic drug, and possible discomfort is more of a psycho-emotional nature.

Postoperative period: recovery, restrictions, recommendations after correction

Immediately after laser correction, there are often complaints of dizziness, pain in the eyes, 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 can indeed 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 lead to displacement of the flap and the need for repeated intervention.
• In some cases, the patient will wear special protective lenses for three to four days after surgery. They prevent injury to the eye, foreign bodies or contaminants from entering it.
• During the week after surgery, it is advisable to limit the time spent in front of the TV, computer screen, or smartphone.
• It is also advisable to avoid additional strain on the eyes, use sunglasses when leaving the house, and avoid exposure to frost or strong wind.
• Reduce physical activity, eliminate heavy lifting, and staying 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, drops help: stimulate the regeneration of mucous membranes; accelerating cell division and increasing 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 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 be minimized only 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: from 0. 1 to 1. 2%.

Postoperative complications include:

• Swelling, inflammation and hemorrhages in the damaged area.
• Decreased twilight vision (usually goes away on its own 6-9 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 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 and warn about possible symptoms in advance, even at the stage of consulting the patient 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 in the desired angle.

Will my vision decrease again after childbirth?

A common myth that has no statistical evidence. Loss of vision at the time of childbirth may be associated with high blood pressure, pathologies of the ocular 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 information, 1. 0 visual acuity returned to 90. 8% of patients. Another 99. 5% can boast of an increase in vision within the range of 0. 5 - 1. 0, and about 1. 2% were dissatisfied 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 eye 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 better to give up 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 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 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 decline is largely influenced by the diagnosis: with severe myopathy, visual acuity is preserved in only 25% and 37%, respectively.

Is repeat surgery possible?

With a high degree of myopathy, patients sometimes decide to undergo repeat surgery to slow down 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 bright colors. Features and key differences between various LKZ techniques, 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.