Laser vision correction

Modern vision correction technologies enable the permanent removal 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 variants, recovery periods of different lengths, as well as other important features that are known in advance.

What is LKZ?

Pathology correction is carried out using high-precision laser equipment. The procedure itself lasts only 10-15 minutes, and special drops are used to relieve pain. Laser vision correction is performed for medical reasons and requires prior consultation with a specialist - ophthalmologist. Unfortunately, LKZ in 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 reduction 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 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, the indications for laser vision correction are the following conditions:

• Farsightedness up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism ranging 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. Preliminary consultation and a detailed examination by an ophthalmologist will help to 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 in the last two years.
• For pathologies of the structure of the cornea, chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, ruptures and risk 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 related to 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 eye apparatus ends around this age, which makes such intervention impossible. In any case, you need to consult with an experienced ophthalmic surgeon in order to assess the possible consequences and the level of risk especially for your organism.

Advantages and disadvantages 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 eye apparatus due to the so-called "human factor". The entire process is carefully controlled by automation, so that 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 efficiently 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 eye apparatus.
• Low morbidity. The rehabilitation period ranges from a few hours to a week, which is very short compared to other types of surgical interventions.
• There are 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, study 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% had complications that required additional medical intervention.

Types of laser vision correction

The first successful operations with laser equipment were performed in the 80s. During that time, several types of laser correction appeared, the methods of which have significant differences. The essence of all procedures is the correction of 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. After that, this flap is returned to its place, and the time required for the regeneration of the damaged tissue is the patient's recovery period. In some cases, the cut lobe is completely removed, 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 current today. Despite some discomfort for the patient and a longer recovery period than other surgeries, PRK is used for medical reasons. Especially 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 on top.

The eye surgeon will spend approximately 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are dripped). Immediately after the intervention, you may feel slight pain, dryness and burning 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 level of protection against ultraviolet radiation.
• Rehabilitation lasts from 3 to 5 days. Special drops prescribed by the doctor are used, rest, work at the computer or prolonged time in front of a smartphone or TV screen are excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press or otherwise strike the damaged area. In case of accidental injury and severe pain, shift in perspective or appearance of any visual effects in vision, be sure to 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 postoperative recovery and avoid severe pain.

After excimer laser correction, vision gradually returns, the process lasts 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 effective.

Laser-assisted subepithelial keratomileusis (LASEK)

A variation of PRK, 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 corrections using this method date back to 1999, and during that time a lot of statistical data appeared on the success and effectiveness of the procedure.

How laser correction is performed:

1. The top layer of the cornea is cut away and the flap is moved to the side. In this case, no scalpel or laser is 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 obtain the desired shape.
3. The cover is placed in its original place and fixed with a screw lens.

Lenses are chosen 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 has some side effects.

Common side effects after surgery:

• In the first two days, there is discomfort and the 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.
• "Veil" before the eyes, deterioration of vision at dusk, blurred vision - all these undesirable manifestations can be repeated within six months after correction.

The occurrence of any discomfort or pain should be discussed with your doctor. Regular examinations and consultations with a qualified ophthalmologist are necessary for timely elimination of unwanted symptoms. You will need to see your doctor regularly for a year after surgery, after which the number of visits will decrease.

Laser-assisted keratomileusis (LASIK)

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

The operation flow 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 goes back into place, covering the operated area.

The operation is performed without stitches, and the use of a contact 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 the operation.

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

1. Super Lasik. An almost fully automated procedure that enables correction according to the individual parameters of the patient. First, a detailed examination of the cornea is performed, the obtained topographic map is loaded into the program according to which the operation is performed.
2. Femto-LASIK.A special type of laser equipment - a femtosecond laser - is used to perform the correction. He cuts the flap of the epithelium of the upper layer of the cornea according to certain parameters, which greatly facilitates the patient's recovery period. 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). 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.Specially developed laser vision correction technique after 40 years. It is prescribed to patients with progressive presbyopia. The main complaints in this case are the inability to fix vision on small elements from 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 shaped into multifocal lenses, which fully compensate for this form of vision.
5. Epi-LASIK.A rarely used method of laser correction, it is usually used in the initial or intermediate 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 cross section of the corneal epithelium. After correction, the valve is placed in place, and a protective lens with a high degree of gas permeability is attached on top. It must be removed after three days at the earliest, which requires a final recovery. It is important that literally the next day you can follow 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 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 the operation, thanks to the use of high-precision laser equipment, the degree of damage to the eye is minimized, which practically 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 in the upper layer. Rehabilitation after correction takes a few hours, vision is completely restored almost immediately after the end of the operation. There is practically no data on possible complications, as this method has been actively used for the past five years, which is not enough to assess the outlook.

The main advantage is the possibility of performing laser vision correction for diagnosed dry eye syndrome. This condition is a contraindication for many ophthalmic surgeries, including laser vision correction. The disadvantage will be a rather high price and possible difficulties in choosing a clinic and a doctor who is familiar with the specifics of such operations.

Preparation for surgery

Regardless of all the technical complexity of laser correction, it will go almost unnoticed for the patient and very quickly. The average time for LKZ is 10 minutes per eye. All the necessary manipulations are performed 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 your consultation. Hard contact lenses worn by the patient 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 diagnostics, as well as in the calculated path of the laser beam.
2. Mandatory consultation and examination by an ophthalmologist before surgery. It is recommended to immediately choose a clinic and have the necessary examinations there. When scheduling an examination, a detailed examination of the fundus and visual acuity is performed. 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 have a general health examination. According to the treatment protocol, the list of necessary procedures includes fluorography, blood sugar control, 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 will also refuse to use any decorative cosmetics, creams or lotions.

It is recommended to immediately consider the option of a mini vacation for better recovery after laser correction. Usually, the procedure is performed on a "hospital day" basis, and the patient goes home within a few hours after 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 that the patient focuses on rest, leaving for a while the usual worries.

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 is no more than 10 minutes. The vision correction procedure is carried out 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 feel nothing but the effect of anesthetic drops and less discomfort when putting the ring on the eye. This device allows you to quickly and precisely remove flaps of the required size. The effect of the laser beam can be felt as a slight warming, but basically all feelings are alleviated by the action of the anesthetic, and the possible discomfort is more psycho-emotional in nature.

Postoperative period: recovery, limitations, recommendations after correction

Immediately after laser correction, complaints of dizziness, eye pain, nausea and other complaints often occur. Basically, these symptoms are related to psychological stress, which inevitably occurs in such situations. After the effect of anesthetic drops wears off, painful sensations can really become real, but usually on the first day, the doctor prescribes periodic pain relief. Antibiotic drops and medicines are used to moisten the cornea.

Important nuances of proper rehabilitation after laser correction:

• You can't 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 injuries to the eye, the entry of foreign bodies or pollutants into it.
• During the week after surgery, it is recommended 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 lifting heavy loads and staying in a bent position 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 intended to moisten and accelerate the healing process of the eye. Thanks to pantothenic acid, the drops help: stimulate the regeneration of the mucous membrane; accelerating cell division and increasing the strength of collagen fibers; provides regenerative and anti-inflammatory action. Hyaluronic acid of high molecular weight retains water and protects the eyes from negative influences, providing effective hydration and comfort.

A visit to the doctor is mandatory 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, use the prescribed medicines, as well as adhere to 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 damaged area.
• Decreased twilight vision (usually resolves on its own 6-9 months after surgery).
• Flap 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 operation will be needed to put everything back in place.

If you experience any unusual sensations, pain or discomfort, contact your doctor for advice. The specialist will usually give extensive recommendations and warn in advance of possible symptoms, 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 fix the position of the patient's eyes at the desired angle.

Will my vision decrease again after giving birth?

A common myth for which there is no statistical evidence. Loss of vision during childbirth can be associated with high blood pressure, pathologies of the eye apparatus and other conditions. After laser correction, there is no need to delay pregnancy planning, and there is no need to worry about vision loss during childbirth.

The efficiency of laser correction is not so high?

According to various information, visual acuity of 1. 0 returned in 90. 8% of patients. Another 99. 5% can boast of an increase in vision in 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 form 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 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 the operation. 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 the 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 quality of vision. 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 undergo reoperation 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 through a personal examination.

The advent of laser vision correction techniques has enabled millions of people around the world to stop wearing glasses and contact lenses. It significantly improved the quality of life and made it possible to literally see the world in bright colors. Features and key differences between different 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.