Laser vision correction

Modern vision correction technologies make it possible to permanently remove lenses or glasses through a low-trauma 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 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 points are used for pain relief. Laser vision correction is performed for medical reasons and requires prior consultation with a specialist - an ophthalmologist. Unfortunately, LKZ at the current stage of development is not a cure for absolutely all "eye" diseases, it has a small list of contraindications. A few 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 definitely consult your doctor, who will determine the right 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 method of exposure depends on the patient's characteristics, as well as his financial capabilities.

Typically, the 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 a complete examination by an ophthalmologist will help rule out possible contraindications in which such an intervention is not recommended.

In which cases is laser vision correction prohibited:

• During pregnancy and breastfeeding due to unstable hormonal levels.
• If vision loss has been observed during the last two years.
• For pathologies of the structure of the cornea, chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Lack of immunity.
• Cataract and glaucoma.
• Damage, tearing and threat of retinal detachment.
• Thin cornea (determined by special analysis).

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 accompanied by age-related changes in the cornea. Laser vision correction is practically not performed before the age of 21. This is due to the fact that the final formation of the eye apparatus ends around this age, which excludes such an intervention. In any case, you should consult an experienced ophthalmic surgeon to assess the possible consequences and the level of risk specifically for your body.

The 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 eyepiece 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 pathology of the ocular apparatus.
• Low morbidity. The rehabilitation period varies from a few 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 return to work, studies and sports training 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% have experienced complications that require additional medical intervention.

Types of laser vision correction

The first successful operations with laser devices were performed 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 upper layer of the cornea is separated with a special tool. Then, this flap is returned to its place and the time needed to regenerate the damaged tissue 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 various 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 surgeries, 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 vaporize corneal tissue (laser ablation).
3. After the cornea takes the desired shape, a protective lens is placed over it.

The eye surgeon will spend approximately 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are inserted). 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 sensitivity of the eyes to light increases, so during the day you should definitely use sunglasses with an appropriate degree of protection from ultraviolet.
• Rehabilitation lasts from 3 to 5 days. Special points prescribed by the doctor are used, rest is recommended, working at the computer or spending long periods in front of a smartphone or TV screen is excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press or otherwise touch the damaged area. In case of an accidental injury and severe pain, a change in perspective or the appearance of any visual effect 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 recovery after surgery 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, thin cornea and keratoconus. The first corrective operations successfully performed using this method date back to 1999, during which time many statistical data on the success and effectiveness of the procedure have appeared.

How laser correction is performed:

1. The upper layer of the cornea is cut and the lid is moved to the side. In this case, no scalpel or laser is used, but only an alcohol solution that softens the bonds between the lower and upper layers of the corneal epithelium.
2. The bottom layer is laser burned to give the required shape.
3. The cap 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 need to wear them for at least 4 days - during 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 there are some side effects.

Common adverse symptoms after surgery:

• In the first two days there is discomfort and 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, worsening twilight vision, blurred vision - all these unwanted manifestations can recur within 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 consultations with a qualified ophthalmologist are required. You will need to see your doctor regularly for a year after surgery, 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 performed since 1987, the technology has undergone numerous changes, becoming one of the most popular.

The operation progress 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 operation is performed without stitches 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 after surgery.

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

1. Super Lasik. An almost fully automated procedure that allows correction according to individual patient parameters. First, a complete 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.To carry out the correction, a special type of laser equipment is used - a femtosecond laser. He waits for a collision of the epithelium of the upper layer of the cornea according to the 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. It is recommended for patients with thin corneas, 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 few hours after the intervention.
4. Presby LASIK.A specially developed technique for laser vision correction after 40 years. They are prescribed for patients with progressive presbyopia. The main complaints in this case are the inability to adjust the view 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 the operation, the cornea is formed into multifocal lenses, which fully compensate for this vision defect.
5. Epi-LASIK.A laser correction method that is rarely used, it is usually used in 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 corneal epithelium. After correction, the flap is placed in place, and a protective lens with a high degree of gas permeability is attached to the top. It must be removed no earlier than after three days, which requires final recovery. It is important that literally the next day you can stick 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 includes physical activity.

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

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 corneal tissue. It's called the lens, and it's removed through a minimal (2 to 4 mm) incision in the upper layer. Rehabilitation after correction takes a few hours, vision is completely restored almost immediately after 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 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 surgeries, including laser vision correction. The negative side will be the rather high cost and possible difficulties in choosing a clinic and doctor familiar with the specifics of such operations.

Preparation for surgery

Despite all the technical complexity of laser correction, for the patient it will pass almost unnoticed and 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.

Patient preparation before laser correction includes several important points:

1. Avoid wearing soft contact lenses for about a week before the consultation. Rigid contact lenses that the patient has worn for more than a year should be removed three to four weeks before the consultation. Continuous 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 complete fundus examination and visual acuity are checked. If the patient has no contraindications, the doctor will help you choose the right 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, control of blood sugar levels, general blood test, testing for HIV, syphilis, hepatitis B and C.
4. Women will have 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-break for better recovery after laser correction. Typically, the procedure is performed on a "hospital day" basis, with the patient going home within hours of surgery. It is important to decide the day-to-day issues: who will pick you up from the hospital and help you solve everyday problems. It is important for the patient to focus on rest, putting the usual worries aside for a while.

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

Most of the fears and concerns associated with surgery turn 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 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 for the effect of anesthetic drops and slight discomfort during the placement of the ring in the eye. This device allows you to quickly and accurately remove a collision 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 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, which inevitably arises in such situations. After the effect of the anesthetic drops wears off, painful sensations can become really real, but usually on the first day the doctor prescribes periodic pain relief. Antibiotic drops and corneal moisturizing medications are used.

Important nuances of proper rehabilitation after laser correction:

• You can not touch the eyes, touch them with your hands, rub them or affect 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 damage to the eye, foreign bodies or pollutants from entering it.
• During the week after the operation, it is advisable to limit the time spent in front of the TV, computer screen or smartphone.
• It is also advised to avoid additional eye strain, use sunglasses when leaving the house and avoid exposure to frost or strong wind.
• Reduce physical activity, eliminate lifting weights 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 an ophthalmic preventive agent designed to hydrate and accelerate the healing process of the eye. Thanks to pantothenic acid, the drops help: stimulate the regeneration of mucous membranes; accelerating cell division and increasing the strength of collagen fibers; providing regenerative and anti-inflammatory effects. Hyaluronic acid with high molecular weight 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 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 by 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 bleeding in the injured area.
• Decreased vision at dusk (usually goes away on its own 6-9 months after surgery).
• Collision displacement due to trauma. A common consequence of the patient touching the eye on the first day after laser correction. In some cases, a second surgery 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 consultation with the patient before the operation.

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 adjust 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. Loss of vision 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 information, visual acuity 1. 0 was 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. 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 how long can you paint 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.

Banned sport?

It is better to give up physical activity the day before the operation. The recovery period depends on the type of intervention. You will have to forget contact sports for about a month to eliminate the risk of eye damage. In general, there are no special restrictions on 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 eternal effects. Typically, about 45% of PRK patients and 65% of LASIK patients report stable quality of vision. The gradual decline is mainly influenced by the diagnosis: with severe myopathy, visual acuity is preserved in only 25% and 37%, respectively.

Is it possible to repeat the operation?

With a high degree of myopathy, patients sometimes decide to undergo repeated surgery to slow down the decline in visual acuity. This can be done two years after the first intervention, but the current 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. The main characteristics and differences between different LKZ techniques, important questions about preparation, rehabilitation, as well as how much vision is restored after the operation - all the necessary information on the topic is presented in our review.