The laser eye for the correction of refractive defects such as myopia, astigmatism and farsightedness, is an operation that is often performed due to its:
- relative safety,
- Effectiveness
- short recovery time.
Like other types of refractive surgery, the LASIK procedure alters the refractive power of the cornea so that the light entering the eye hits the retina correctly. In this way, vision is improved.
Various types of surgical interventions to correct vision are possible, such as:
- PRK (photorefractive keratectomy),
- LASEK (laser epithelial keratomileusis),
- LASIK procedure (“laser-in-situ—keratomileusis”).
It makes no difference whether the eye color is light, brown or dark, everyone can have surgery and the results show no differences.
The ophthalmologist determines whether refractive surgery is suitable for the patient and which procedure is the best.
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Who are the ideal candidates for LASIK eye surgery?
The most suitable candidates for LASIK eye surgery are people with healthy eyes who have not had previous eye surgery and wish to be corrected by:
- Myopia
- Farsightedness
- Astigmatism.
Patients should have stable vision for at least a year, because if they are prone to deterioration, the laser result may not be satisfactory over time.
The minimum age for the procedure is 18 – 20 years of age, but an age between 25 – 40 years would be preferable.
People with certain medical conditions and those taking certain medications cannot receive LASIK treatment.
Some people with thin calluses may be more suitable for other procedures of refractive surgery, for example PRK.
How much does the operation cost?
The costs range from 1,800 to 3,000 euros.
Before LASIK surgery
The ophthalmologist will perform a close examination of the eye to make sure the eyes are healthy enough for treatment. In doing so, it determines:
- shape and thickness of the cornea;
- pupil size;
- refractive defects (nearsightedness, farsightedness and astigmatism);
- all other eye diseases.
The doctor also evaluates:
- lubrication of the eyes; he may advise preventive treatment to reduce the risk of developing dry eyes after LASIK surgery.
- Typically, a corneal topography is performed on the eye to measure the curvature of the anterior surface of the eye and to create a “map” of the cornea.
- The ophthalmologist must also assess the overall clinical history and any medications taken to determine whether the patient is suitable for the LASIK procedure.
Contact lenses must be removed for a period of time recommended by the doctor (usually two weeks) before the ophthalmological examination and LASIK procedure are performed, as the contact lenses can change the natural shape of the cornea.
How does the LASIK procedure work?
LASIK is performed while the patient is under the surgical device, called an excimer laser.
- The procedure is performed on an outpatient basis.
- First, the eye is anesthetized with a few drops of a local anesthetic.
- An eyelid holder (blepharostat) is placed between the eyelids to keep the eyelids open and prevent the patient from blinking.
- A suction ring placed on the eye helps to keep the eye in position.
The patient can feel the pressure of the eyelid holder and the suction ring, which resembles a finger pressing on the eyelid.
As long as the suction ring is placed on and until it is removed again, the view appears cloudy or everything turns black. - If the cornea is flattened, the surgeon uses an automatic microsurgical device (microkeratome) or a laser to cut a tab out of the cornea and lift it.
- This corneal flap is lifted and bent backwards.
Then the laser excimer is centered on the eye to be operated. - The surgeon makes sure that the laser is positioned correctly.
- The patient looks into a special light, the so-called fixing light or target light, while the excimer laser models the tissue of the cornea.
- The surgeon then closes the folded corneal flap again and smoothes the edges.
The corneal valve adheres to the cornea within two to five minutes, a suture is not required.
How long does the procedure take?
The LASIK procedure takes a few minutes, while recovery times vary from a few days to a few weeks.
After LASIK surgery
The doctor lets the patient rest for a while and usually you can go home immediately.
Convalescence
The patient should have someone to accompany him who will take him home after the procedure and relax there.
- After the procedure, neither glasses nor bandages are needed.
- The surgeon prescribes eye drops to speed up healing and prevent dryness.
- You may feel a temporary burning sensation or itching in your eyes immediately after surgery.
- It is normal if vision is a little blurred immediately after surgery; however, visual acuity should improve the following morning.
- Vision should stabilize and continue to improve in a few days, although in rare cases it may take a few weeks or more.
- Most people immediately have better vision.
Although you may be able to go back to work the following day, many doctors recommend taking a few rest days. - In addition, you should refrain from physical activities for at least 2 -3 weeks, because the eye can be traumatized and the result impaired.
- As a rule, you should visit the ophthalmologist or LASIK surgeon again the day after surgery. During the first check-up, the doctor examines your vision and makes sure that you can drive without glasses or contact lenses.
- As with any other surgery, one should always follow the surgeon’s instructions and take prescribed medications.
- In any case, you should refrain from rubbing the eyes, as there is a small possibility of opening the corneal flap.
Risks and side effects of laser surgery
Development of a new visual disorder
- Undercorrection. If the laser removes too little tissue from the eye, you do not get the hoped-for clear vision.
Lack of correction is a common complication in nearsighted people.
Another refractive operation may be required. - Overcorrection. It is possible that the laser removes too much tissue from the eye, usually a result of human error.
An overcorrection can be more difficult to restore than an undercorrection.
Scar. A corneal scar may form, which clouds the vision; further intervention may be necessary for correction.
thinning of the cornea. Ectasia is a deformation of the cornea caused by excessive thinning after surgery. It can cause serious vision problems and require invasive surgery.
Astigmatism. Astigmatism can be caused by irregular tissue removal.
Glare, halos and double vision. After the procedure, difficulties in night vision can be noted.
The following can be observed:
- Dazzle
- Halos in the vicinity of light sources
- Diplopia (double vision)
Sometimes such problems can be treated with eye drops containing a type of cortisone, but a second operation may also be required.
Even if a good visual result is achieved by standards, vision in low light (such as twilight or fog) may be reduced after surgery.
Dry eye. The LASIK procedure causes a temporary reduction in lacrimation.
In the first six months after surgery, the eyes may be unusually dry.
The ophthalmologist could prescribe the use of eye drops for this time.
If a highly dry eye develops, another procedure to insert a tab into the tear duct may be considered to prevent the tears from being drained from the surface of the eye.
Problems with the corneal tissue valve. Because the corneal tissue valve at the front of the eye is bent or removed during surgery, complications may occur, including:
- Infections
- excessive lacrimation,
- eye swelling,
- the outermost layer of corneal tissue (epithelium) may grow abnormally under the valve during the healing process.
Some diseases can increase the risks associated with LASIK or make the outcome less predictable.
These include:
- autoimmune diseases such as rheumatoid arthritis,
- immunodeficiency caused by immunosuppressants or HIV,
- Eye disorders: cataract, too thin cornea, ocular malformations, persistent eye dryness, keratoconus,
- pregnancy,
- unstable vision,
- Diabetes.
For some people with presbyopia, the outcome may get worse with age.
The LASIK procedure is not recommended for:
- sufficiently good eyesight,
- severe myopia.
