Laser vision correction

Modern vision correction technologies make it possible to permanently get rid of lenses or glasses in a low-traumatic and highly effective procedure. Laser vision correction (LVC) is the most innovative method of correcting pathologies of the structure of the visual apparatus. The procedure has several variants, recovery periods of varying lengths, and other important features that are best known in advance.

What is LKZ?

The pathology is corrected with high-precision laser equipment. The procedure itself takes 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, at the current stage of development, LKZ is not a panacea for 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 surgeryBefore the correction, be sure to consult your doctor, who will determine the appropriate 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. Choosing the right exposure method depends on the patient's characteristics and financial capabilities.

In general, indications for laser vision correction are the following conditions:

• Farsightedness up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism in the range of -4 and +4 diopters.

Surgery is recommended when the use of contact lenses is not possible, as well as for patients whose vision in only one eye is significantly worse. A preliminary consultation and thorough examination by an ophthalmologist helps 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 hormone levels.
• If vision loss has been observed in the past two years.
• Pathologies of the structure of the cornea, in case of chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Immune deficiency.
• Cataracts and glaucoma.
• Risk of injuries, cracks and retinal detachment.
• Thin cornea (determined by special tests).

Restrictions also affect age - most clinics prefer patients between the ages of 20 and 40. In individual cases, correction is performed after 40 years, but only if the pathology is not accompanied by age-related changes in the cornea. Virtually no laser vision correction is performed before the age of 21. This is due to the fact that the final formation of the eye apparatus ends at this age, which precludes such an intervention. In any case, you should consult an experienced ophthalmologist to assess the possible consequences and level of risk specifically for your body.

Advantages and disadvantages of laser vision correction

Unlike traumatic surgery, laser intervention means minimal impact, high precision and safety of the procedure. The main advantage is that there is no risk of accidental damage to the eye device due to the so-called "human factor". The entire process is carefully controlled by automation, so accidents and mistakes are excluded. Modern laser equipment makes the doctor's work much easier, and the patientenable a quick and effective recovery of 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 without ophthalmic pathology.
• Low morbidity. The rehabilitation period lasts from several hours to a week, which is very short compared to other types of surgical interventions.
• There are no serious restrictions. The preparation for laser vision correction and the rehabilitation period do not require the patient to significantly change their 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 and 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 further 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 appeared, the methods of which show 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 detached with a special device. 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 wing is completely removed and special lenses are used to protect the eyeball. The differences between different methods of laser correction, 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. Although it causes some discomfort to the patient and the recovery period is longer than with other surgeries, PRK is used for medical reasons. Especially if 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 the corneal tissue (laser ablation).
3. After the cornea takes the desired shape, a protective lens is placed on top.

The eye surgeon spends about 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are instilled). Immediately after the procedure, you may experience slight pain, dryness and a burning sensation in the eye, which will subside as the cornea heals.

Special recommendations:

• The light sensitivity of the eyes increases, so during the day it is definitely worth using sunglasses with a suitable degree of ultraviolet protection.
• Rehabilitation takes 3-5 days. Special drops prescribed by a doctor are used, rest is recommended, and spending a long time in front of a computer or smartphone or TV screen is excluded.
• A mechanical effect on the eyes is excluded. Do not rub, press or otherwise touch the damaged area. In case of accidental injury and severe pain, change of perspective or appearance of any visual effects, it is absolutely necessary to consult a doctor.
• If vision in both eyes is restored, the procedure should be performed at intervals of 10-14 days. This will help you 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 proven to be effective.

Laser-assisted 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 case of 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 was published on the success and effectiveness of the procedure.

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 burned with a laser to get the desired shape.
3. Place the flap in its original place and fix it with a bandage lens.

Lenses are selected with high gas permeability for better and faster healing. You 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. Overall, the procedure is less painful than PRK, but has some side effects.

Common adverse symptoms after surgery:

• In the first two days, there is discomfort and the feeling of a foreign body in the eye.
• Increased dry eyes, lasting up to six months. Special moisturizing drops are used to eliminate this.
• "Veil" in front of the eyes, deterioration of twilight vision, blurred vision - all these undesirable manifestations may recur within six months after the correction.

The occurrence of any discomfort or pain should be discussed with your doctor. In order to eliminate unwanted symptoms in time, regular examination and consultation with a qualified ophthalmologist are necessary. After surgery, you must visit your doctor regularly for one year, after which the number of visits will decrease.

Laser-assisted keratomileusis (LASIK)

The LASIK method is the most popular today, it is considered less traumatic and has a high chance of restoring vision. The first operations with this technique have been carried out since 1987, the technology has undergone many changes and has become one of the most popular.

The procedure is as follows:

1. A lobe 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 treated area.

The operation is performed without sutures, the use of contact lenses is not necessary. For the patient, this means a shorter recovery period and return within a few hours after surgery.

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

1. Super Lasik. It is an almost fully automated procedure that allows correction according to the patient's individual parameters. First, a thorough examination of the cornea is performed, the resulting topographic map is loaded into the program, according to which the surgery is performed.
2. Femto-LASIK.To carry out the correction, a special laser device is used - a femtosecond laser. It cuts the wing of the epithelium of the upper layer of the cornea according to specific 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 thin corneas and severe myopia (up to -25 diopters). This type of laser correction is characterized by the fastest possible recovery period - the patient notices an improvement in vision within a few hours after the procedure.
4. Presby LASIK.A specially developed technique for laser vision correction after 40 years. It is prescribed for patients with progressive presbyopia. In this case, the main complaints are that they cannot capture vision on small items up close. If the disease develops against the background of myopia, the patient is forced to use two glasses. During the operation, the cornea is shaped into multifocal lenses, which fully compensates for this visual defect.
5. Epi-LASIK.A rarely used laser correction method, 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 the correction, the damper is replaced and a protective lens with high gas permeability is placed on top. It should be removed after three days at the earliest, which means final healing. It is important that you can literally follow your usual rhythm of life the next day, including sports training. That is why this laser correction method is suitable for active people, as well as for patients whose field of activity is physical activity.

Laser vision correction with 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 amount of damage to the eye is reduced to a minimum, 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. With the help of a special laser, the desired shape of the lens is created directly in the tissues of the cornea. It is called a lenticula, and it is removed by making a minimal (2-4 mm) incision in the upper layer. Rehabilitation after correction takes several hours, vision returns almost immediately after surgery. 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 of laser vision correction in diagnosed dry eye syndrome. This condition is a contraindication to many eye surgeries, including laser vision correction. The disadvantage is 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, it is almost imperceptible to the patient and happens very quickly. The average time of LKZ is 10 minutes per eye. All necessary manipulations are performed with a high-precision laser, and the total exposure time of the laser beam is only a few seconds.

The preparation of the patient before laser correction includes several important points:

1. Avoid wearing soft contact lenses for about a week before your consultation. The rigid contact lenses worn by the patient 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 diagnostics and the calculated trajectory of the laser beam.
2. An ophthalmologist's consultation and examination is mandatory before the operation. It is advisable to choose a clinic immediately and have the necessary tests performed there. At the appointment, a thorough examination of the fundus and visual acuity is checked. If the patient has no contraindications, the doctor will help choose the right type of laser correction, as well as perform a typographic examination of the cornea for the next procedure.
3. It is important to have a general health examination. According to the treatment protocol, the list of necessary procedures is fluorography, blood sugar control, general blood test, HIV, syphilis, hepatitis B and C test.
4. Women should remove eyelash extensions the day before the procedure and refuse to use decorative cosmetics, creams or lotions.

In order to recover better after laser correction, it is advisable to immediately consider the possibility of a mini-vacation. The intervention is typically carried out on a "hospital day", the patient goes home within a few hours after the operation. It is important to solve everyday problems: someone takes them out of the hospital and helps them solve everyday problems. It is important that the patient concentrates on rest, putting aside theusual problems.

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

Most of the fears and anxieties about surgery turn out to be completely unfounded. The total time the patient spends in the operating room does not exceed 10 minutes. The vision correction procedure is performed in a lying position, the eyelids are fixed with a special device that makes it difficult to see freely. In fact, the patient does not feel anything, except for the effect of anesthetic drops and minor discomfort when the ring is placed on the eye. With this tool, you can quickly and accurately remove the desired size cover. The effect of the laser beam can also be felt as a slight warming, but basically all sensations are relieved by the anesthetic effect, and any discomfort is more of a psycho-emotional nature.

Postoperative period: recovery, restrictions, recommendations after correction

Immediately after laser correction, they often complain of dizziness, eye pain, nausea and other unpleasant sensations. Basically, these symptoms are related to psychological stress that inevitably arises in such situations. After the anesthetic drops wear off, painful sensations can become 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't touch your eyes, touch it with your hands, rub it or affect it in any other way. This can lead to displacement of the damper and the need for repeated intervention.
• In some cases, the patient wears special protective lenses for three to four days after surgery. They prevent damage to the eyes, the entry of foreign bodies or dirt.
• In the week after surgery, it is advisable to limit the time spent in front of the TV, computer screen or smartphone.
• In addition, it is advisable to avoid further 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 prolonged bent posture.

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 that hydrates the eye and accelerates the healing process. Thanks to pantothenic acid, the drops help: they stimulate the regeneration of mucous membranes; accelerating cell division and increasing the strength of collagen fibers; provides a regenerating and anti-inflammatory effect. High molecular weight hyaluronic acid retains water and protects the eyes from negative effects, providing effective hydration and comfort.

It is mandatory to consult a doctor during the rehabilitation period following laser correction. Regular vision checks help you see the dynamics of recovery and prevent possible complications.

Possible consequences of laser correction

The small risk of complications can only be minimized by self-control and discipline. It is important to strictly follow all of your doctor's recommendations, use prescribed medications, and follow hygiene and treatment recommendations. In general, the risk of unwanted symptoms with laser vision correction is quite low: 0. 1-1. 2%.

Postoperative complications include:

• Swelling, inflammation and bleeding in the injured area.
• Decreased twilight vision (usually goes away on its own 6-9 months after surgery).
• Wing displacement due to trauma. It is 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 get everything back in place.

If you experience any unusual sensations, pain or discomfort, contact your doctor for advice. Usually, the specialist gives comprehensive recommendations and warns of possible symptoms in advance, even at the pre-operative consultation stage.

Frequently asked questions about LKZ

What happens if I accidentally move my eye during surgery?

Such situations are completely out of the question. 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 deteriorate again after giving birth?

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

Is the efficiency of laser correction not so high?

According to various information, 90. 8% of patients returned to 1. 0 visual acuity. Another 99. 5% boasted an increase in vision in the range of 0. 5-1. 0, and about 1. 2% were dissatisfied with the results of the surgery. 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 way to restore visual function.

After how long can you paint your eyes?

Accidental contact of cosmetics with the eyes can trigger 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 avoid cosmetics and not to do eyelash extensions.

Are sports banned?

It is better to refrain from physical activity the day before surgery. The recovery period depends on the type of intervention. You should forget about contact sports for about a month to avoid the risk of eye injury. In general, there are no special restrictions on playing sports, the main thing is to wait until the harness is restored.

How long will the vision be perfect?

Modern methods are not yet designed to achieve lifelong effects. In general, approximately 45% of PRK patients and 65% of LASIK patients report stable visual quality. The gradual decline is greatly influenced by the diagnosis: in the case of severe myopathy, visual acuity remains in only 25% and 37%, respectively.

Is repeat surgery possible?

Patients with severe myopathy sometimes choose to undergo repeat surgery to slow the decline in visual acuity. This can take place two years after the first intervention, but the actual indications can only be established during a personal examination by an ophthalmologist.

The advent of laser vision correction techniques has enabled millions of people worldwide to stop wearing glasses and contact lenses. This greatly improved the quality of life and allowed us to literally see the world in vivid colors. The characteristics and main differences of the various LKZ techniques, important questions regarding preparation, rehabilitation, and restoration of vision after surgery - all the necessary information on the subject is presented in our review.