Laser vision correction

Modern vision correction technologies make it possible to permanently get rid of lenses or glasses thanks to a low-traumatic and very 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 varieties, recovery periods of varying duration, as well as other important features that are best known in advance.

What is LKZ

Correction of pathology is carried out using high-precision laser equipment. The procedure itself only takes 10 to 15 minutes; special drops are used to relieve pain. Laser vision correction is carried out for medical reasons and requires prior consultation with a specialist – an ophthalmologist. Unfortunately, LKZ, at the current stage of development, is not a panacea for absolutely all "eye" diseases, it has a small list of contraindications. Several 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 without surgical intervention. 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 possibilities of laser surgery make it possible to eliminate pathologies such as myopia, hyperopia (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:

• Hyperopia up to +6 diopters.
• Myopia up to -12 diopters.
• Astigmatism between -4 and +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. A preliminary consultation and a thorough examination by an ophthalmologist will make it possible to exclude 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 hormonal levels.
• If vision loss has been observed in the last two years.
• For pathologies of the corneal structure, chronic inflammatory or infectious diseases of the ocular system.
• Diabetes.
• Immunodeficiency.
• Cataract and glaucoma.
• Damage, ruptures 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 associated with age-related changes in the cornea. Before the age of 21, laser vision correction is practically not carried out. This is due to the fact that the definitive formation of the ocular apparatus ends around this age, which excludes such intervention. In any case, you should consult an experienced eye surgeon to assess the possible consequences and the level of risk specifically for your body.

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 risk of accidental damage to the ocular apparatus due to the "human factor". The entire process is carefully controlled by automation, so that accidents and oversights are excluded. Modern laser equipment significantly facilitates the work of the doctor and becomes an opportunity for the patient to quickly and effectively restore visual acuity.

The main advantages of laser vision correction:

• Excellent effect after the procedure. Visual acuity will be approximately 100%, which is rarely determined even in people without any pathologies of the ocular 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. Preparation for laser vision correction, as well as the rehabilitation period, do not require the patient to significantly change his usual life. After the procedure, you can return to work, study and sports training almost immediately.

The disadvantages include the fairly high cost of laser correction, as well as a low risk of complications. According to various statistics, about 1. 2% of patients are dissatisfied with the results of vision correction, and 0. 1% have experienced complications requiring additional medical intervention.

Types of laser vision correction

The first successful operations with laser equipment were carried out in the 80s. During this period, 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 specified parameters. First, the upper layer of the cornea is separated using a special tool. Subsequently, this flap is returned to its place, and the time required for the regeneration of the damaged tissue corresponds to the patient's recovery period. In some cases, the cut flap is completely removed and special lenses are used to protect the eyeball. The differences between different laser correction methods, 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 used today. Despite some discomfort for the patient and a longer recovery period than other operations, PRK is used for medical reasons. Particularly 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 evaporate the corneal tissue (laser ablation).
3. After the cornea has taken the desired shape, a protective lens is installed on top.

The eye surgeon will spend approximately 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 burning in the eye, which will weaken as the cornea heals.

Special Recommendations:

• The sensitivity of the eyes to light increases, so during the day you should definitely use sunglasses that provide an appropriate degree of protection against ultraviolet rays.
• Rehabilitation lasts 3 to 5 days. Special drops prescribed by a doctor are used, rest is recommended, working on a computer or spending long periods in front of a smartphone or TV screen are excluded.
• Mechanical impact on the eyes is excluded. Do not rub, press, or otherwise impact the damaged area. In case of accidental injury and severe pain, change in perspective or the appearance of visual effects on vision, you must definitely consult a doctor.
• If it is necessary to restore vision in both eyes, the procedure is carried out at intervals of 10-14 days. This makes it possible to better manage postoperative recovery and avoid intense 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 to be effective.

Laser-assisted subepithelial keratomileusis (LASEK)

A variation of PRK, a laser correction technology, is the popular and less traumatic LASEK method. The main advantage is the possibility of use in patients suffering from dry eye syndrome, corneal thinning and keratoconus. The first successful correction operations carried out using this method date back to 1999, during which time a lot of statistical data appeared on the success and effectiveness of the procedure.

How laser correction is carried out:

1. The top 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 required shape.
3. The flap is placed in its original place and secured with a bandage lens.

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 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:

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

The occurrence of any discomfort or pain should be discussed with your doctor. To quickly eliminate unwanted symptoms, regular examinations and consultation with a qualified ophthalmologist are necessary. You will need to see your doctor regularly for a year after the operation, after which the number of visits will be reduced.

Laser-assisted keratomileusia (LASIK)

The LASIK method is the most popular today, considered less traumatic, with a high chance of restoring vision. The first operations using this technique were carried out since 1987, the technology has undergone numerous developments, becoming one of the most popular.

The procedure 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 is returned to its place, covering the operated area.

The surgical procedure 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 surgery.

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

1. Great Lasik.An almost completely automated procedure that allows correction based on individual patient parameters. A thorough examination of the cornea is first carried out, 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 specified parameters, which greatly facilitates the patient's recovery period. It is characterized by a high cost and a low risk of complications (approximately 0. 1%).
3. Femto Super LASIK.The technology combines all the advantages of Super Lasik and Femto-LASIK. 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 his vision a few hours after the procedure.
4. Presbyian LASIK.A technique specially developed for laser vision correction after the age of 40. Prescribed to patients with progressive presbyopia. The main complaints in this case are the inability to fix vision on small elements at close range. If the disease develops against the background of myopia, the patient is forced to use two pairs of glasses. During surgery, the cornea is transformed into multifocal lenses, which completely compensates for this vision defect.
5. Epi-LASIK.A rarely used laser correction method, it is generally used in the initial or intermediate stages of myopia or hyperopia. In such cases, the shape of the cornea is flatter, which allows the flap to be cut along the natural edge - the section of the corneal epithelium. After correction, the flap is put in place and a protective lens with a high degree of gas permeability is attached on top. It must be removed no earlier than after three days, which takes definitive recovery. It is important that from the next day you can adhere 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 patients whose field of activity involves physical activity.

Laser vision correction using this technique can improve visual acuity by up to 100%, as well as increase the clarity of twilight vision. 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.

ReLEx SMILE femtosecond laser vision correction

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. This is called a lenticule and its removal is done through a minimal incision (2 to 4 mm) on 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 on possible complications, since this method has been actively used over 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 constitutes a contraindication to many ophthalmological operations, including laser vision correction. The disadvantage will be the rather high cost and possible difficulties in choosing a clinic and a doctor who knows the specifics of such operations.

Preparing for surgery

Despite all the technical complexity of laser correction, for the patient it will go almost unnoticed and very quickly. The average duration of 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.

Patient preparation before laser correction includes several important points:

1. Avoid wearing soft contact lenses about a week before your consultation. Hard contact lenses that the patient has worn for more than a year must 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 diagnosis, as well as in the calculated trajectory of the laser beam.
2. Mandatory consultation and examination by an ophthalmologist before surgical intervention. It is advisable to immediately choose a clinic and undergo the necessary examinations there. During the appointment, a thorough fundus examination and visual acuity is checked. If the patient has no contraindications, the doctor will help you choose the appropriate type of laser correction and will perform a typographic examination of the cornea for the upcoming intervention.
3. It is important to have a general health exam. According to the treatment protocol, the list of necessary procedures includes fluorography, blood sugar check, general blood test, screening for HIV, syphilis, hepatitis B and C.
4. Women will need to remove eyelash extensions the day before the procedure and also refuse to use decorative cosmetic products, creams or lotions.

It is advisable to immediately consider the mini-vacation option for better recovery after laser correction. Typically, the procedure is performed on an "inpatient day" basis, with the patient returning home a few hours after surgery. It is important to solve everyday problems: 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 concerns surrounding the operation turn out to be completely unconfirmed. The total time that the patient will spend in the operating room is no more than 10 minutes. The vision correction procedure is carried out while lying down, the eyelids are fixed with a special device that will make it difficult to see freely. In fact, the patient will feel nothing other than the effect of the anesthetic drops and slight discomfort when applying the ring to the eye. This device allows you to quickly and precisely remove a 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 action of an anesthetic drug and the possible discomfort is rather of a psycho-emotional nature.

Postoperative period: recovery, restrictions, 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 the anesthetic drops wears off, painful sensations may actually 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 good rehabilitation after laser correction:

• You cannot touch your eyes, touch them with your hands, rub them or influence them in any other way. This can cause the flap to move and require repeated procedures.
• In some cases, the patient will wear special protective lenses for three to four days after surgery. They prevent eye injuries, foreign bodies or contaminants from entering.
• During the week following surgery, it is advisable to limit the time spent in front of the television, computer screen or smartphone.
• It is also advisable to avoid additional 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 rehabilitation period after laser vision correction, it is recommended to use eye drops containing pantothenic and hyaluronic acid - this is a preventive ophthalmic agent designed to moisturize and accelerate the process ofhealing of the eye. Thanks to pantothenic acid, the drops help to: stimulate the regeneration of mucous membranes; accelerate cell division and increase the strength of collagen fibers; providing regenerative and anti-inflammatory effects. High molecular weight hyaluronic acid retains water and protects the eyes from negative influences, providing effective hydration and comfort.

It is obligatory to consult your doctor during the rehabilitation period after laser correction. Regular visual checks will help you see the dynamics of recovery and prevent possible complications.

Possible consequences of laser correction

The risks of complications, already low, can only be minimized with self-control and discipline. It is important to strictly follow all doctor's recommendations, use prescribed medications, as well as follow hygiene and diet recommendations. In general, the risk of adverse symptoms with laser vision correction is quite low: 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).
• 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 necessary to put everything back in place.

If you experience any unusual sensations, pain or discomfort, you should consult your doctor for advice. As a rule, a specialist will give comprehensive recommendations and warn in advance about possible symptoms, even at the stage of consulting the patient before surgical intervention.

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 to reliably fix the position of the patient's eyes at the desired angle.

Will my vision further diminish after giving birth?

A common myth that has no statistical proof. Loss of vision at the time of childbirth can be associated with high blood pressure, pathologies of the eye apparatus and other conditions. After laser correction, there is no need to postpone planning a pregnancy and there is no need to worry about vision loss during childbirth.

Isn't the efficiency of laser correction 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 between 0. 5 and 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 remains the most effective and successful type of restoration of visual function.

After what time can you dye your eyes?

Accidental contact of cosmetic products with the eyes can cause an inflammatory process that should be avoided at all costs. Until the cornea is completely healed, which takes 4-7 days, it is advisable to completely abandon cosmetic products and not undergo eyelash extensions.

Sports banned?

It is best to abandon physical activity the day before surgery. 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 injuries. In general, there are no special restrictions for playing sports, the main thing is to wait until the epithelium is restored.

How long will vision be perfect?

Modern methods are not yet designed to produce lasting effects. Typically, approximately 45% of PRK patients and 65% of LASIK patients report stable vision quality. The progressive decline is largely influenced by the diagnosis: in cases of severe myopathy, visual acuity is preserved in only 25% and 37%, respectively.

Is further surgery possible?

With a high degree of myopathy, patients sometimes decide to undergo further surgery to slow the decline in visual acuity. This can be done two years after the first procedure, but the actual indications can only be determined by an ophthalmologist during a personal examination.

The advent of laser vision correction techniques has allowed millions of people around the world to stop wearing glasses and contact lenses. This significantly improved the quality of life and made it possible to literally see the world in vivid colors. Key features and differences between different LKZ techniques, important questions about preparation, rehabilitation, as well as the degree of restoration of vision after surgery - all the necessary information on the topic is presented in our review.