Laser vision correction

Modern vision correction technologies make it possible to permanently eliminate 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 varying lengths, as well as other important characteristics that are best known in advance.

What is LKZ

Correction of the pathology is carried out using high-precision laser equipment. The procedure itself takes just 10 to 15 minutes and special pain relief drops are used. 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" diseases, it has a small list of contraindications. Several years after 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 consult 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. Choosing the appropriate exposure method depends on the patient's characteristics, as well as their financial capacity.

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 wear 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 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 hormone levels.
• If vision loss has been observed within the last two years.
• For pathologies of the structure of the cornea, chronic inflammatory or infectious diseases of the ocular apparatus.
• Diabetes.
• Immunodeficiency.
• Cataracts 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 carried out 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 makes such intervention impossible. In any case, you need to consult an experienced ophthalmologist surgeon to assess the possible consequences and the 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, avoiding accidents and oversights. Modern laser equipment significantly facilitates the doctor's work, and for the patient they become 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 around 100%, which is rarely determined even in people who do not have pathologies of the ocular system.
• 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 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% have had complications that required additional medical intervention.

Types of laser vision correction

The first successful operations using laser equipment were carried out in the 80s. 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 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 needed to regenerate the injured 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 the different laser correction methods, as well as some 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. Especially when the patient has a thin cornea and large pupils.

The procedure takes place in several steps:

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 ophthalmologist 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 your eyes, which weakens as the cornea heals.

Special recommendations:

• The sensitivity of the eyes to light increases, therefore, during the day you should definitely wear sunglasses with an adequate degree of ultraviolet protection.
• Rehabilitation lasts 3 to 5 days. Special eye drops prescribed by the doctor are used, rest, working on the computer or spending long periods in front of the smartphone or TV screen are recommended.
• 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 of 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 carried out at intervals of 10 to 14 days. This helps to better deal with post-operative recovery and avoid intense pain.

After excimer laser correction, vision returns gradually, the process takes a month or more. If you follow your 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 least traumatic LASEK method. The main advantage is the possibility of use in patients with dry eye syndrome, thin cornea and keratoconus. The first correction operations successfully carried out using this method date back to 1999, during which time a lot of statistical data on the success and effectiveness of the procedure emerged.

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 bonds between the lower and upper layers of the corneal epithelium.
2. The bottom layer is burned with a laser to give the desired 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 have to wear them for at least 4 days - the entire recovery period after the correction. Visual acuity returns more quickly, in about a week. Overall, 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.
• A "veil" before the eyes, deterioration of twilight vision, blurred vision - all these undesirable manifestations can reappear six months after correction.

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

Laser-assisted keratomileusis (LASIK)

The LASIK method is today the most popular, considered less traumatic, with a great chance of restoring vision. The first operations using this technique were carried out in 1987, the technology has undergone numerous changes, becoming one of the most popular.

The course of 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 replaced in its place, covering the operated area.

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

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

1. SuperLasik.Almost fully automated procedure that allows correction according to the patient's individual parameters. First, a thorough examination of the cornea is carried out, 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 from 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. FemtoSuper 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 a few hours after the intervention.
4. Presby LASIK.A technique specially developed for laser vision correction after 40 years. Prescribed for patients with progressive presbyopia. The main complaints in this case are the inability to fix the view on small elements at close range. If the disease develops against a background of myopia, the patient is forced to wear 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 in the early or intermediate 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 attached on top. It should not be removed earlier than three days, which leads to final recovery. It is important that literally the next day you can maintain 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

Innovative ReLEx SMILE technology eliminates the need to create or remove a corneal flap. Using a special laser, a lens of the desired 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 returns completely almost immediately after the end of the operation. There is practically no information about possible complications, since this method has been actively used for the last 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 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 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 carried out with a high-precision laser, and the total exposure time of the laser beam is just a few seconds.

Patient preparation before laser correction includes several important points:

1. Avoid wearing soft contact lenses for 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 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 consultation, a thorough examination of the fundus and visual acuity is checked. If the patient has no contraindications, the doctor will help him choose the appropriate type of laser correction, as well as carry out 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, tests for HIV, syphilis, hepatitis B and C.
4. Women will need to remove eyelash extensions the day before the procedure and will also refuse to use decorative cosmetics, creams or lotions.

It is advisable to immediately consider the mini-vacation option for better recovery after laser correction. Typically, the procedure is performed on "hospital day, " with the patient going home a few hours after surgery. It is important to resolve everyday issues: who will pick you up from the hospital and help with solving everyday problems. It is important for the patient to focus on rest, putting aside their 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 turned out to be completely unconfirmed. The total time 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 makes it difficult to see freely. In fact, the patient will not feel anything other than the effect of the anesthetic eye drops and a small 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, and the possible discomfort is more of a psycho-emotional nature.

Post-operative: 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 these situations. After the effect of the anesthetic drops wears off, the painful sensations can really become real, but usually on the first day the doctor prescribes periodic painkillers. Antibiotic eye drops and corneal moisturizers 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 flap displacement and the need for repeated interventions.
• In some cases, the patient will wear special protective lenses for three to four days after surgery. They prevent eye injuries, entry of foreign bodies or contaminants.
• 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 your eyes, wear sunglasses when leaving the house and avoid exposure to ice or strong wind.
• Reduce physical activity, eliminate heavy lifting and remaining 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 - a preventive ophthalmic agent designed to moisturize and accelerate the healing process of the eye. Thanks to pantothenic acid, the eye drops help: to 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 a 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 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 twilight vision (usually goes away on its own 6 to 9 months after surgery).
• Flap displacement due to trauma. 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 place.

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

LKZ Frequently Asked Questions

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 decrease again after giving birth?

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

Is the effectiveness of laser correction not so high?

According to various reports, visual acuity 1. 0 returned in 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 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 how long can you paint your eyes?

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

Forbidden 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 damage. In general, there are no special restrictions for playing sports, the main thing is to wait for the epithelium to restore.

How long will the vision be perfect?

Modern methods are not yet designed to achieve lasting 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: in 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 have repeat surgery to slow 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 living colors. Features and main 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.