Laser vision correction

Modern vision correction technologies allow you to get rid of lenses or glasses forever 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 duration, as well as other important features that it is best to know 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 to relieve pain. Laser vision correction is performed according to medical indications and requires prior consultation with an ophthalmologist. Unfortunately, LKZ at the current stage of development is not a panacea for absolutely all "eye" diseases, there is a small list of contraindications. A few years after correction, vision may deteriorate slightly, 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 appropriate type of laser intervention.

Indications and contraindications for laser vision correction

The capabilities of laser surgery ensure the elimination of such pathologies as myopia, farsightedness (not all types of MCL), astigmatism. The choice of an appropriate method of exposure depends on the characteristics of the patient, as well as on his financial capabilities.

Common 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 to +4 diopters.

The operation is recommended when it is impossible to use contact lenses, as well as for patients whose vision is significantly impaired in only one eye. Preliminary consultation and a thorough examination by an ophthalmologist will help to rule out possible contraindications in which such an 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 occurred in the past two years.
• In pathologies of the structure of the cornea, chronic inflammatory or infectious diseases of the eye apparatus.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, tears 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 related to age-related changes in the cornea. 21 years ago, laser vision correction was practically not performed. This is due to the fact that around this age the final formation of the eye apparatus ends, which precludes such an intervention. In any case, you should consult an experienced ophthalmic surgeon to assess the possible consequences and degree 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 lack of risk of accidental damage to the eye apparatus due to the so-called "human factor". The entire process is carefully controlled by automation, so accidents and omissions are excluded. Modern laser equipment greatly facilitates the work of the doctor, and for the patient it becomesin the possibility of 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 who do not have any pathologies of the eye 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. The preparation for laser vision correction, as well as 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.

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 were not satisfied with the results of vision correction, and 0. 1% had complications requiring additional medical intervention.

Types of laser vision correction

The first successful operations with laser equipment were performed in the 1980s. During this time, 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 set parameters. First, the upper layer of the cornea is separated with a special tool. Subsequently, this flap is returned to its place, and the time required to regenerate the damaged tissue is the patient's recovery period. In some cases, the excised lid is removed completely and special lenses are used to protect the eyeball. The differences between the various 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 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 the corneal tissue (laser ablation).
3. After the cornea takes the desired shape, a protective lens is fitted on top.

The eye surgeon will spend approximately 10 minutes on each eye. The patient is under local anesthesia (anesthetic drops are applied). Immediately after the intervention, you may feel a slight pain, dryness and burning sensation in the eye, which subsides as the cornea heals.

Special recommendations:

• The light sensitivity of the eyes increases, so during the day you should definitely use sunglasses with an appropriate degree of ultraviolet protection.
• Rehabilitation lasts from 3 to 5 days. Special drops prescribed by a doctor are used, rest is recommended, working on a computer or spending a long time in front of a smartphone or TV screen is excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press or otherwise affect the damaged area. In case of accidental injury and severe pain, change in perspective or appearance of any visual effects in 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 the 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, 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 correction operations using this method date back to 1999, during which time numerous statistical data on the success and effectiveness of the procedure appeared.

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 give the required 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 need to wear them for at least 4 days - the entire recovery period after correction. Visual acuity returns faster, in about a week. The procedure is generally less painful than PRK, but there are some side effects.

Common adverse symptoms after surgery:

• During the first two days there is discomfort and a feeling of a foreign body in the eye.
• Increased dryness of the eyes lasting up to six months. Special moisturizing drops are used to remove it.
• "Veil" before the eyes, deterioration of twilight, blurred vision - all these undesirable manifestations can reappear within six months after the correction.

Any discomfort or pain should be discussed with your doctor. Regular examinations and consultation with a qualified ophthalmologist are necessary for timely removal of unwanted symptoms. 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, it is considered less traumatic, with a high chance of restoring vision. The first operations using this technique have been performed since 1987, the technology has undergone numerous 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 set 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 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 a few hours after the operation.

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

1. Super crawler.An almost fully automated procedure that allows correction according to the individual parameters of the patient. 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. He cuts a flap from 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 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 fix the vision on small elements at a close distance. 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 that completely compensate for this visual defect.
5. Epi-LASIK.A rarely used method of laser correction, it is usually used in the initial or middle stage of myopia or farsightedness. The shape of the cornea in such cases is flatter, which allows the flap to be cut along the natural edge - the 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 fixed on top. It must be removed no earlier than three days, which takes the 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 for patients whose field of activity is related to physical activity.

Performing laser vision correction using this technique can improve visual acuity up to 100%, as well as increase the 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 cap. With the help of 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 is done through a minimal (2 to 4 mm) incision 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 past five years, which is not enough to assess the prospects.

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

Preparation 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 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 the consultation. Hard contact lenses that the patient has worn 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 trajectory of the laser beam.
2. Mandatory consultation and examination by an ophthalmologist before surgery. It is recommended to immediately choose a clinic and undergo the necessary examinations there. At the appointment, a thorough 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 undergo a general health examination. According to the treatment protocol, the list of necessary procedures includes fluorography, checking 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 decorative cosmetics, creams or lotions.

It is recommended that you immediately consider the possibility of a mini-vacation for better recovery after laser correction. Usually, the procedure is done on a "hospital day" basis, with the patient going 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 solve everyday problems. It is important that the patientto focus on rest, putting aside the usual worries for a while.

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

Most fears and apprehensions related to surgery turn out to be completely unfounded. 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 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 the ring is placed in the eye. This device allows you to quickly and accurately remove the flap of the required size. The impact of the laser beam can be felt as a slight heating, but basically all sensations are relieved by the effect of anesthesia, and the possible discomfort is more of a psycho-emotional nature.

Postoperative period: recovery, limitations, recommendations after correction

Complaints of dizziness, eye pain, nausea and other discomfort often appear immediately after laser correction. Basically, these symptoms are related to psychological stress that inevitably arises in such situations. After the effect of the anesthetic drops wears off, painful sensations can really become real, but usually on the first day, the doctor prescribes periodic anesthesia. Antibiotic drops and medications are used to moisten the cornea.

Important nuances of proper rehabilitation after laser correction:

• You can not touch your eyes, touch them with your hands, rub them or otherwise affect them. This can lead to flap displacement and the need for reintervention.
• 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 contaminants from entering it.
• During the week after the operation, it is recommended to limit the time spent in front of the TV, computer screen or smartphone.
• It is also recommended to avoid additional strain on the eyes, use sunglasses when leaving the house and avoid exposure to cold or strong wind.
• Reduce physical activity, eliminate heavy lifting 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 a preventive ophthalmic agent designed to moisturize 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; provides a regenerative and anti-inflammatory effect. Hyaluronic acid with a high molecular weight retains water and protects the eyes from negative influences, providing effective hydration and comfort.

During the rehabilitation period after laser correction, it is mandatory to visit your doctor. Regular eye examinations will help you see the dynamics of recovery and prevent possible complications.

Possible consequences of laser correction

Even so, the small risks of complications can be minimized with self-control and discipline alone. It is important to strictly follow all the doctor's recommendations, use prescribed 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%.

Postoperative complications include:

• Swelling, inflammation and bleeding in the damaged area.
• Decreased twilight vision (usually disappears on its own 6-9 months after surgery).
• Valve 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 feel unusual sensations, pain or discomfort, you should consult your doctor for advice. Usually, the specialist will give comprehensive recommendations and warn about possible symptoms in advance, even at the stage of counseling 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 that has 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 effectiveness of laser correction is not so high?

According to different information, visual acuity 1. 0 returned in 90. 8% of patients. Another 99. 5% can boast of an increase in vision within 0. 5 - 1. 0, and about 1. 2% are 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 must be avoided at all costs. Until the cornea is completely healed, which takes 4-7 days, it is recommended to completely give up cosmetics and not undergo eyelash extensions.

Sports banned?

It is better to refrain from 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 principle, there are no special restrictions on sports, the main thing is to wait for the restoration of the epithelium.

How long will 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 decrease is largely influenced by the diagnosis: in severe myopathy, visual acuity is preserved in only 25% and 37%, respectively.

Is re-operation possible?

With a high degree of myopathy, patients sometimes decide to undergo reoperation to slow the decline in visual acuity. This can be done two years after the first intervention, but the actual readings can only be established 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 greatly improved the quality of life and made it possible to literally see the world in bright colors. Features and key 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.