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 optical device. The process has many varieties, recovery periods of varying length, as well as other important features that are better known in advance.

What is LKZ?

Correction of the 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 performed for medical reasons and requires prior consultation with an ophthalmologist. Unfortunately, LKZ at the current stage of development is not a panacea for all "eye" ailments, it has a small list of contraindications. Several years after correction, vision may deteriorate somewhat, usually due to age-related changes in the optical apparatus. At the same time, the decrease in visual acuity occurs much more slowly than without surgery. Before the correction, you should definitely 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, hypermetropia (not all types of MCL), astigmatism. The choice of the appropriate exposure method 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 the use of contact lenses is impossible, as well as in patients whose vision is significantly worse in only one eye. A preliminary consultation and thorough examination by an ophthalmologist will help rule out possible contraindications in which such intervention is not recommended.

In which cases laser vision correction is prohibited:

• During pregnancy and breastfeeding due to unstable hormonal levels.
• If vision loss has occurred in the past two years.
• For pathologies of the corneal structure, chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, tears and threat of retinal detachment.
• Thin cornea (identified 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 eye apparatus ends around this age, which precludes such an intervention. In any case, you should consult an experienced ophthalmic surgeon to assess the potential consequences and level of risk specific to your body.

Advantages and disadvantages of laser vision correction

Unlike traumatic surgery, laser surgery 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 device due to the so-called "human factor". The whole process is carefully controlled by automation, so accidents and omissions are excluded. Modern laser equipment greatly 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 result after the procedure. Visual acuity will be about 100%, which is rarely determined even in people who do not have pathologies of the eye apparatus.
• Low morbidity. The recovery period ranges from several hours to a week, which is very short compared to other types of surgery.
• No serious restrictions. Preparation for laser vision correction, as well as the recovery period, do not require the patient to significantly change his usual life. After the intervention, you can almost immediately return to work, studies 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, approximately 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 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 according to the specified parameters. First, the upper layer of the cornea is separated with a special tool. This flap is then moved back into place and the time it takes for the damaged tissue to regenerate 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 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 procedures, PRK is used for medical reasons. In particular, when the patient has a thin cornea and large pupils.

The process takes place in several stages:

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

The ophthalmologist will spend about 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are instilled). Immediately after the procedure, you may feel 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 UV protection.
• Recovery takes from 3 to 5 days. Special drops prescribed by a doctor are used, rest is recommended, computer work or prolonged time in front of a smartphone or TV screen is excluded.
• Mechanical impact on the eyes is excluded. Do not rub, squeeze or otherwise hit the damaged area. In case of accidental injury and severe pain, a change in the angle of vision or the appearance of visual effects on the 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 postoperative 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 subepithelial keratomileusis (LASEK)

A variant 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 successful corrections carried out using this method date back to 1999, during which many statistical data on the success and effectiveness of the procedure appeared.

How laser correction is done:

1. The upper 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 alcohol solution that softens the connections between the lower and upper layers of the corneal epithelium.
2. The bottom layer is laser burned to give the desired shape.
3. The flap is placed in its original position and secured with a bandage lens.

Lenses are selected with a high degree of gas permeability for better and faster healing. You should 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 adverse 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. Special moisturizing drops are used to eliminate it.
• A "veil" in front of the eyes, worsening 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 the timely elimination of unwanted symptoms, regular examinations and consultation with a qualified ophthalmologist are required. You should see your doctor regularly for a year after surgery, after which the number of visits will decrease.

Laser Assisted Keratoplasty (LASIK)

The LASIK method is now the most popular, it is considered less traumatic, with great chances of restoring vision. The first operations with this technique were carried out since 1987, the technology has undergone many 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 returns to its position, covering the surgical area.

The operation is performed without stitches, and the use of a bandage lens is not required. For the patient this means a shorter recovery period, as well as a return of vision within a few hours after the operation.

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

1. Super Lasik.An almost fully automated process that allows correction according to individual patient parameters. First, a thorough 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. It cuts a flap of the epithelium of the upper layer of the cornea according to defined parameters, which greatly facilitates the patient's recovery period. It is characterized by a high cost 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.A specially developed technique for laser vision correction after 40 years. It is prescribed to patients with progressive presbyopia. The main complaints in this case are the inability to stabilize vision on small objects 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 shaped into multifocal lenses, which fully compensate for this vision defect.
5. Epi-LASIKA rarely used method of laser correction, it is usually used in the early or middle stages of nearsightedness 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 part of the corneal epithelium. After correction, the flap is placed in place and a protective lens with a high degree of gas permeability is placed over it. It must be removed no earlier than after three days, which requires the final recovery. It is important that literally the next day you can adhere to the usual rhythm of your 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.

Laser vision correction using this technique can improve visual acuity up to 100%, as well as increase clarity of vision in twilight. 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's called the lenticule, and it's removed through a small (2 to 4 mm) incision in the upper layer. Recovery after correction takes several hours, vision is completely restored almost immediately after the end of 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 evaluate the prospects.

The main advantage is the possibility of laser vision correction for diagnosed dry eye syndrome. This condition is a contraindication for many eye procedures, 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.

Preparation for surgery

Despite the technical complexity of laser correction, for the patient it will pass almost unnoticed and very quickly. 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 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 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 good to immediately choose a clinic and undergo the necessary tests there. At the appointment, a thorough fundus examination 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 X-ray, blood sugar control, general blood test, test for HIV, syphilis, hepatitis B and C.
4. Women should remove eyelash extensions the day before the procedure and also refuse to use decorative cosmetics, creams or lotions.

It is recommended to immediately consider the option of mini vacations for better recovery after laser correction. Typically, the procedure is performed on a "hospital day, " with the patient returning home within hours of the operation. It is important to solve everyday 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 aside the usual worries for a while.

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

Most of the fears and anxieties associated with the operation turn out to be completely unfounded. The total time the patient will spend in the operating room does not exceed 10 minutes. The vision correction procedure is performed 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 slight discomfort when applying the ring to the eye. This device allows you to quickly and accurately remove a fin of the required size. The impact of the laser beam can be felt as a slight heating, but basically all the senses 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, eye pain, nausea and other discomforts. Basically, these symptoms are associated with psychological stress, which inevitably arises in such situations. After the effect of anesthetic drops wears off, painful sensations may indeed become real, but usually on the first day the doctor prescribes periodic pain relief. Antibiotic drops and medications are used to hydrate the cornea.

Important nuances of correct recovery after laser correction:

• You can not touch your eyes, touch them with your hands, rub them or affect them in any other way. This can lead to flap displacement and the need for repeat surgery.
• 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 dirt from entering it.
• During the week after surgery, it is recommended that you limit the time you spend in front of the TV, computer screen or smartphone.
• It is also good to avoid extra eye strain, use sunglasses when leaving the house and avoid exposure to frost or strong wind.
• Reduce physical activity, eliminate heavy lifting and stay in a bent position for long periods of time.

During the recovery period after laser vision correction, it is recommended to use eye drops with pantothenic and hyaluronic acid - this is a preventive eye agent designed to moisturize and accelerate the healing process of the eye. Thanks to pantothenic acid, the drops help: they stimulate the regeneration of mucous membranes. accelerating cell division and increasing the strength of collagen fibers. providing regenerative and anti-inflammatory action. Hyaluronic acid of high molecular weight retains water and protects the eyes from negative effects, providing effective hydration and comfort.

It is mandatory to visit your doctor during the recovery 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 by self-control and discipline. It is important to strictly follow all the doctor's recommendations, using prescription drugs, as well as follow the hygiene and regimen recommendations. In general, the risk of unwanted symptoms with laser vision correction is quite low: from 0. 1 to 1. 2%.

Post-operative complications include:

• Swelling, inflammation and bleeding in the damaged area.
• Decreased twilight vision (usually resolves 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 needed to put everything back in place.

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

Frequently asked questions about LKZ

What happens if I accidentally move my eyes during the procedure?

Such situations are completely excluded. During laser vision correction, special devices are used that reliably stabilize 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 statistics. Loss of vision at the time of delivery can be associated with high blood pressure, pathologies of the eye apparatus and other conditions. After laser correction, there is no reason to postpone pregnancy planning and there is no reason to worry about vision loss during childbirth.

The effectiveness of laser correction is not so high?

According to various reports, visual acuity of 1. 0 returned in 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 visual function restoration.

After how long can you paint your eyes?

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

Are 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 should forget about contact sports for about a month to eliminate the risk of eye injury. In general, there are no special restrictions for 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 results. Typically, about 45% of PRK patients and 65% of LASIK patients report stable quality of vision. The gradual decrease is greatly affected by the diagnosis: with severe myopathy, visual acuity is preserved at only 25% and 37%, respectively.

Is repeat surgery possible?

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 real indications can only be determined by an ophthalmologist during 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. This greatly improved the quality of life and made it possible to see the world literally in bright colors. Features and main differences between various LKZ techniques, important questions about preparation, recovery, as well as how much vision is restored after the operation - all the necessary information on the subject is presented in our review.