Possible complications of laser vision correction. Possible consequences of laser vision correction
LASIK surgery is the most widely advertised and widely performed vision correction for astigmatism and other diseases. Millions of surgeries are performed every year around the world.
Much has been said about its benefits, but the possible complications are not often covered. After LASIK, complications of one kind or another varying degrees severity is observed in approximately 5% of cases. Serious consequences, significantly reducing visual acuity, occur in less than 1% of cases. Most of them can only be gotten rid of by additional treatment or operations.
The operation is performed using an excimer laser. It allows you to correct astigmatism up to 3 diopters (myopic, hyperopic or mixed). It can also be used to correct myopia up to 15 diopters and farsightedness up to 4 diopters.
The surgeon uses a microkeratome tool to cut the top of the cornea. This is the so-called flap. One end remains attached to the cornea. The flap is turned to the side and access to the middle layer of the cornea is opened.
The laser then evaporates a microscopic portion of the tissue in this layer. This is how a new, more regular shape of the cornea is formed so that light rays are focused precisely on the retina. This improves the patient's vision.
The procedure is fully computer controlled, fast and painless. Once completed, the flap is returned to its place. In a few minutes it adheres firmly and no stitches are required.
Consequences of LASIK
The most common (about 5% of cases) are the consequences of LASIK, which complicate or lengthen the recovery period, but do not significantly affect vision. They can be called side effects. They are usually part of the normal post-operative recovery process.
As a rule, they are temporary and are observed for 6-12 months after surgery while the corneal flap is healing. However, in some cases they can become a permanent occurrence and create some discomfort.
Side effects that do not cause a decrease in visual acuity include:
It must be remembered that LASIK is an irreversible procedure that has its own contraindications. It involves changing the shape of the cornea of the eye, and after it is performed, it is impossible to return vision to its original state.
If the correction results in complications or dissatisfaction with the result, the patient's ability to improve vision is limited. In some cases, repeated laser correction or other operations will be required.
Complications of laser vision correction using LASIK technology. Analysis of 12,500 transactions
Refractive lamellar corneal surgery dates back to the late 1940s with the work of Dr. Jose I. Barraquer, who first recognized that the optical power of the eye could be altered by removing or adding corneal tissue1. The term "keratomileusis" comes from two Greek words "keras" - cornea and "smileusis" - to cut. The surgical technique itself, instruments and devices for these operations have undergone significant evolution since those years. From the manual technique of excision of part of the cornea to the use of freezing of the corneal disc with its subsequent treatment for myopic keratomileusis (MCM)2.
Then the transition to techniques that do not require tissue freezing, and therefore reduce the risk of opacities and the formation of irregular astigmatism, providing a faster and more comfortable recovery period for the patient 3,4,5. A huge contribution to the development of lamellar keratoplasty, understanding of its histological, physiological, optical and other mechanisms was made by the work of Professor V.V. Belyaev. and his schools6. Dr. Luis Ruiz proposed in situ keratomileusis, first using a manual keratome, and in the 1980s an automated microkeratome - Automated Lamellar Keratomileusis (ALK).
The first clinical results of ALK showed the advantages of this operation: simplicity, rapid restoration of vision, stability of results and effectiveness in the correction of high myopes. However, the disadvantages included the relatively high percentage of irregular astigmatism (2%) and the predictability of results within 2 diopters7. Trokel et al8 proposed photorefractive keratectomy in 1983 (25). However, it quickly became clear that with high degrees of myopia, the risk of central opacities, regression of the refractive effect of the operation significantly increases, and the predictability of results decreases. Pallikaris I. et al. 10, combining these two methods into one and using (according to the authors themselves) the idea of Pureskin N. (1966) 9, cutting out a corneal pocket on a pedicle, proposed an operation that they called LASIK - Laser in situ keratomileusis. In 1992 Buratto L. 11 and in 1994 Medvedev I.B. 12 published their variants of the surgical technique. Since 1997, LASIK has gained more and more attention, both from refractive surgeons and from patients themselves.
The number of operations performed each year already amounts to millions. However, with the increase in the number of operations and surgeons performing these operations, with the expansion of indications, the number of works devoted to complications increases. In this article we wanted to analyze the structure and frequency of complications LASIK operations based on 12,500 operations performed in Excimer clinics in the cities of Moscow, St. Petersburg, Novosibirsk and Kiev for the period from July 1998 to March 2000. 9,600 operations (76.8%) were performed for myopia and myopic astigmatism hypermetropia, hyperopic astigmatism and mixed astigmatism - 800 (6.4%), corrections of ammetropia in previously operated eyes (after Radial keratotomy, PRK, Through corneal transplantation, Thermokeratocoagulation, Keratomileusis, pseudophakia and some others) - 2100 (16.8%).
All operations under consideration were performed on a NIDEK EC 5000 excimer laser, optical zone - 5.5-6.5 mm, transition zone - 7.0-7.5 mm, and multi-zone ablation at high levels. Three types of microkeratomes were used: 1) Moria LSK-Evolution 2 - keratome head 130/150 microns, vacuum rings from - 1 to + 2, manual horizontal cut (72% of all operations), mechanical rotational cut (23.6%) 2 ) Hansatom Baush&Lomb - 500 operations (4%) 3) Nidek MK 2000 - 50 operations (0.4%). As a rule, all LASIK operations (more than 90%) were performed simultaneously bilaterally. Topical anesthesia, postoperative treatment- local antibiotic, steroid for 4 - 7 days, artificial tear according to indications.
Refractive results correspond to world literature data and depend on the initial degree of myopia and astigmatism. George O. Warning III proposes to evaluate the results of refractive surgery according to four parameters: effectiveness, predictability, stability and safety 13. Efficiency refers to the ratio of postoperative uncorrected visual acuity to preoperative best-corrected visual acuity. For example, if postoperative visual acuity without correction is 0.9, and before surgery with maximum correction the patient saw 1.2, then the effectiveness is 0.9/1.2 = 0.75. And vice versa, if before the operation the maximum vision was 0.6, and after the operation the patient sees 0.7, then the effectiveness is 0.7/0.6 = 1.17. Predictability is the ratio of the planned refraction to the received one.
Safety is the ratio of maximum visual acuity after surgery to this indicator before surgery, i.e. A safe operation is when before and after surgery the maximum visual acuity is 1.0 (1/1=1). If this coefficient decreases, then the risk of the operation increases. Stability determines the change in refractive outcome over time.
In our study, the largest group was patients with myopia and myopic astigmatism. Myopia from - 0.75 to - 18.0 D, average: - 7.71 D. Observation period from 3 months. up to 24 months Maximum visual acuity before surgery was more than 0.5 in 97.3%. Astigmatism from - 0.5 to - 6.0 D, average - 2.2 D. Average postoperative refraction - 0.87 D (from -3.5 to + 2.0), patients after 40 years were planned to have residual myopia. Predictability (* 1 D, from the planned refraction) - 92.7%. Average Astigmatism 0.5 D (from 0 to 3.5 D). Uncorrected visual acuity was 0.5 or higher in 89.6% of patients, 1.0 or higher in 78.9% of patients. Loss of 1 or more lines of maximum visual acuity - 9.79%. The results are presented in Table 1.
Table 1. Results of LASIK surgery in patients with myopia and myopic astigmatism with a follow-up period of 3 months. or more (out of 9600 cases, it was possible to trace the results in 9400, i.e. in 97.9%)
Complications after laser vision correction using LASIK
Floor: not specified
Age: not specified
Chronic diseases: not specified
Hello! Please tell me what complications can occur after laser vision correction using the LASIK method?
They say that the consequences can be not only immediately after the operation, but also long-term, several years later. Which?
Tags: laser vision correction, CVS, laser correction, lasik vision correction, lasik method, lasik, corneal erosion, diffuse lamellar kerati, rubbing the eye after correction, eye erosion after surgery, rubbing the eye after lasik
Possible complications after laser vision correction
Keratoconus is a protrusion of the cornea in the form of a cone, formed as a result of thinning of the cornea and intraocular pressure.
Iatrogenic keratectasia develops gradually. Over time, corneal tissue softens and weakens, vision deteriorates, and the cornea becomes deformed. In severe cases, a donor cornea transplant is performed.
Insufficient vision correction (hypocorrection). In the case of residual myopia, when a person reaches the age of 40-45 years, this deficiency is corrected by developing presbyopia. If, as a result of the operation, the resulting quality of vision does not satisfy the patient, repeated correction is possible using the same method or using additional techniques. More often, hypocorrection occurs in people with a high degree of myopia or farsightedness.
Overcorrection is excessively enhanced vision. The phenomenon is quite rare and often goes away on its own in about a month. Sometimes wearing weak glasses is required. But with significant values of hypercorrection, additional laser exposure is required.
Induced astigmatism sometimes appears in patients after LASIK surgery and is eliminated by laser treatment.
“Dry eye” syndrome - dryness in the eyes, a feeling of the presence of a foreign body in the eye, sticking of the eyelid to the eyeball. The tear does not properly wet the sclera and flows out of the eye. "Yugo eye syndrome" is the most a common complication after LASIK. It usually goes away 1-2 weeks after surgery, thanks to special drops. If the symptoms do not go away for a long time, it is possible to eliminate this defect by closing the tear ducts with plugs so that the tears linger in the eye and wash it well.
Hayes occurs mainly after the PRK procedure. Clouding of the cornea is the result of a reaction of healing cells. They produce a secret. which affects the transparency of the cornea. Drops are used to eliminate the defect. sometimes laser intervention.
Corneal erosions can form due to accidental scratches during surgery. At correct implementation postoperative procedures heal quickly.
Deterioration of night vision occurs more often in patients with too wide pupils. Bright sudden flashes of light, the appearance of halos around objects, and illumination of objects of vision occur when the pupil dilates to an area larger than the laser exposure area. Interferes with driving a car dark time days. These phenomena can be smoothed out by wearing glasses with small diopters and instilling drops that narrow the pupils.
Complications during the formation and restoration of the valve may arise due to the fault of the surgeon. The valve may turn out thin, uneven, short, or cut off to the end (this happens extremely rarely). If folds form on the flap, it is possible to reorient the flap immediately after surgery or subsequent laser resurfacing. Unfortunately, people who have undergone surgery remain forever in danger zone traumatism Under extreme mechanical stress, flap detachment is possible. If the flap disappears completely, it cannot be reattached. Therefore, it is necessary to strictly observe the rules of postoperative behavior.
Epithelial ingrowth. Sometimes fusion of epithelial cells from the surface layer of the cornea with the cells located under the flap occurs. When the phenomenon is pronounced, such cells are removed surgically.
"Sahara syndrome" or diffuse lamellar keratitis. When foreign microparticles get under the valve, inflammation occurs there. The image before your eyes becomes blurry. Corticosteroid drops are prescribed for treatment. If such a complication is quickly identified, the doctor washes the operated surface after lifting the valve.
Regression. When correcting large degrees of myopia and hypermetropia, it is possible to quickly return the patient's vision to the level that he had before the operation. If the cornea maintains its proper thickness, a repeat correction procedure is performed.
Draw definitive conclusions about positive and negative aspects It’s too early for laser vision correction. It will be possible to talk about the stability of the results when all the statistics on the condition of people operated on 30-40 years ago are processed. Laser technologies are constantly being improved, making it possible to eliminate some of the defects of previous level operations. And it is the patient, not the doctor, who should decide on laser vision correction. The doctor only has to correctly convey information about the types and methods of correction and its consequences.
It often happens that the patient is not satisfied with the results of the correction. Expecting to get 100% vision and not receiving it, a person falls into a depressed state and needs the help of a psychologist. A person's eye changes with age, and by the age of 40-45 he develops presbyopia and has to wear glasses for reading and near work.
This is interesting
In the USA, laser vision correction can be done not only in ophthalmological clinics. Small points equipped for carrying out operations are located near beauty salons or in large shopping and entertainment complexes. Anyone can undergo a diagnostic examination, based on the results of which the doctor will perform vision correction.
For the treatment of hypermetropia (farsightedness) up to +0.75 to +2.5 D and astigmatism up to 1.0 D, the LTK (laser thermal keratoplasty) method has been developed. The advantages of this method of vision correction are that during the operation no surgical intervention is performed in the eye tissue. The patient undergoes a preoperative examination, and before the operation anesthetic drops are instilled into him.
Special pulsed holmium laser infrared radiation The tissue is annealed on the periphery of the cornea at 8 points with a diameter of 6 mm, the burned tissue shrinks. Then this procedure is repeated at the next 8 points with a diameter of 7 mm. Collagen fibers of the corneal tissue in places of thermal influence are compressed, and the central
Due to tension, the part becomes more convex, and the focus shifts forward to the retina. The greater the power supplied laser beam, the more intense the compression of the peripheral part of the cornea and the stronger the degree of refraction. The computer built into the laser, based on the data from a preliminary examination of the patient’s eye, automatically calculates the parameters of the operation. The laser only lasts about 3 seconds. The person does not experience any unpleasant sensations, except for a slight tingling sensation. The eyelid expander is not immediately removed from the eye so that the collagen has time to shrink well. Afterwards the operation is repeated on the second eye. Then a soft lens is placed on the eye for 1-2 days, antibiotics and anti-inflammatory drops are instilled for 7 days.
Immediately after the operation, the patient develops photophobia and a feeling of sand in the eye. These phenomena quickly disappear.
Restorative processes begin in the eye and the refractive effect gradually smoothes out. Therefore, the operation is performed with a “reserve”, leaving the patient weak degree myopia down to -2.5 D. After approximately 3 months, the process of returning vision ends and the person returns to normal vision. Over the course of 2 years, vision does not change, but the effect of the operation lasts for 3-5 years.
Currently, vision correction using the LTK method is also recommended for presbyopia ( age-related deterioration vision). People aged 40-45 years often experience the appearance of farsightedness, when small objects and printed fonts become difficult to distinguish. This happens due to the fact that the steel frame loses its elasticity over the years. The muscles that support it also weaken.
To reduce vision regression based on the LTK method, a technique with a longer-lasting effect of thermal keratoplasty has been developed: diode thermokeratoplasty (DTC). Used for DTK diode laser constant action, in which the energy of the laser beam remains constant, annealing points can be applied arbitrarily. Thus, it is possible to regulate the depth and location of coagulants, which affects the duration of healing of the corneal tissue and, accordingly, the duration of action of DTC. Also, with a large degree of hypermetropia, a combination of LASIK and DTK methods is performed. The disadvantage of DTC is the possibility of astigmatism and slight pain on the first day of surgery.
Complications after LASIK
and her safety
As we know, LASIK surgery may seem scary at first, but in fact, Opti LASIK ® laser vision correction is fast, safe, and almost immediately afterward, you will finally have the vision you've always dreamed of!
Safety of LASIK eye surgery
Corrective laser surgery is considered one of the most common procedures of choice today. Those who passed it are very happy about it. Results of a survey of patients who underwent LASIK surgery. showed that a whopping 97 percent of them (that's impressive!) said they would recommend the procedure to their friends.
Based on the results of controlled clinical trials conducted in the United States to evaluate the safety and effectiveness of the operation, FDA FDA: Abbreviation for Food and Drug Administration, a federal agency within the U.S. Department of Health and Human Services that responsible for determining safety and effectiveness medicines and products medical purposes. approved LASIK for use in 1999, and since then, LASIK has become the most widely accepted form of laser vision correction today, benefiting approximately 400,000 Americans each year. 1 In 93 percent of cases, patients' vision after LASIK is at least 20/20 or better. The impressive thing is that this operation takes only a few minutes and is almost painless.
Of course, as with any other surgical procedure, there are some safety considerations and complications that you may encounter. Take a quick look at the potential complications of LASIK before making any decisions.
Complications after LASIK
Laser technology and surgeons' skills have advanced significantly over the past 20 years since LASIK was first approved by the FDA in 1999, but no one can accurately predict how an eye will heal after surgery. As with any surgical procedure, there are risks associated with LASIK. In addition to the short-term side effects that some patients experience after surgery (see After LASIK Eye Surgery), some people may experience conditions that last longer due to differences in the healing process between individuals.
Listed below are some LASIK complications that you should discuss with your surgeon if they occur after surgery.
The FDA does not monitor the conditions of each surgery and does not inspect doctors' offices. However, the government requires surgeons to be licensed through state and local agencies and regulates medical supplies and equipment by requiring clinical trials, which prove the safety and effectiveness of each laser.
To read the supporting material the right choice doctor continue to the next section.
Comments on the review
Andrey June 6, 2012 Anything is possible! I know for sure that a lawsuit is now being prepared against AILAZ, due to the negligence of doctors.
Oksana Sergeevna Averyanova, AILAZ center September 14, 2012 I called and did not specifically find out the name of the patient - the “victim”, or the circumstances of the case. The answer was supposedly from a “representative” of the “affected person.” There have been no calls to our clinic from the court.
Laser vision correction
Messages: 2072 Registered: Sat Mar 26, 2005 04:40 From: Barnaul
My husband recently did this. Seems happy
the postoperative period is three days, the second is the most difficult, because the eyes water and hurt, increased irritability into the light and everything bright, but even that is not scary. Unpleasant sensations less during lasik surgery, when the epithelial layer is incised and then put back in place (rather than burned out and then a new one grows), but they explained to us that with lasik there is a greater risk that something will go wrong.
As I understand it, there are no special guarantees that vision will not begin to deteriorate again, this is a minus. On the other hand, for those who do not tolerate lenses well, this is still a solution, even if only for a few years.
I think I will also have surgery on myself, but only after I give birth for the second time, although they say that surgery is not a contraindication for natural childbirth, it’s still scary after giving birth; I personally had red eyes, you never know.
I am collecting reviews about laser vision correction.
If it’s not difficult, I ask those who have undergone laser vision correction to unsubscribe here!
If possible, indicate the degree of myopia (astigmatism, farsightedness), the method of laser correction and when it happened, the sensations during the operation, etc. You can indicate the clinic - what if this helps someone?
The most important thing is the result.
Although PRK, LASIK and its modifications are performed in outpatient setting and is carried out using a laser, the rays of which do not penetrate deep into the eyeball; vision correction refers to operations. In this regard, like any surgical intervention, laser vision correction has complications that can arise in the perioperative period.
Most often, complications that arise after refractive surgery are quite easy to correct.
Before starting the operation, the doctor is obliged to warn the patient about all possible troubles. There are also a number of serious complications leading to decreased visual acuity. Such changes occur extremely rarely (less than 1% of patients), but they should not be forgotten either.
Complications of PRK
Depending on the degree of impact on vision, all complications with PRK can be divided into:
1. Complications that affect (increase discomfort, prolong) the recovery period. However, the final result does not change.
- Corneal edema;
- Filamentous epitheliokeratopathy;
- Slowing down the rate of re-epithelialization;
- Short-term drooping of the upper eyelid;
- Mild dry eye syndrome;
- Allergy to medications.
2. The second group includes complications that need to be treated quite intensively. Sometimes a repeat operation is required.
- Exacerbation of keratitis associated with herpes;
- Decreased corneal transparency (mild subepithelial fibroplasia);
- Bacterial keratitis;
- Severe manifestations of dry eye syndrome.
3. The third group includes complications that require repeated surgery to eliminate:
- Ablation zone displacement;
- Incomplete removal of the epithelium;
- Undercorrection;
- Regression of the refractive effect;
- Hypercorrection for myopia;
- Severe corneal opacity.
Complications of LASIK
Complications of LASIK can be divided into several groups:
1. Complications that affect the course of the postoperative period, but the result laser treatment don't change.
- Temporary ptosis;
- Damage to the superficial layers of the cornea when applying an eyelid speculum or during marking;
- Debris, which occurs when part of the evaporated corneal tissue remains under the surface flap. It is usually not noticeable to the patient and resolves over time;
- Damage to the epithelial layer during flap formation;
- Staining of the subflap area during marking or toxic effects of the dye;
- Mild form of dry eye syndrome;
- Keratomalacia (complete or partial resorption) of the flap;
- Ingrowth of the epithelial layer under the corneal flap.
2. Complications that require drug therapy.
- Keratitis.
3. A group of complications that require repeated intervention to eliminate:
- Undercorrection or overcorrection;
- Incorrect position of the flap;
- Folding the edge of the flap;
- Decentration of the optical region during laser ablation;
- Flap displacement;
- Debris located in the central zone and affecting the total visual acuity;
- Ingrown epithelial tissue under the flap, which leads to severe discomfort and decreased visual function.
4. Group of complications that require alternative methods treatment.
- Errors in flap formation (incomplete, torn, decentered, thin, insufficient size, complete cut of the epithelial cover, flap with striae).
Complications that require repeat surgery are described in more detail below.
Debris
When laser evaporation of corneal tissue, very small particles are formed, which most often become airborne. However, a small amount of tiny particles settles on the corneal tissue. Despite the fact that after laser operation the surface of the cornea is washed, postoperative wound Particles of talc, evaporated cells, and discharge of the meibomian glands may remain. All this falls under the corneal flap. This so-called garbage is called debris.
Usually it does not affect visual function and does not cause discomfort. Subsequently, gradual resorption of debris occurs. If particles are under the flap big size and are located in the central zone, then the wound surface should be washed again, because otherwise the patient will perceive them as a stain. A similar procedure is performed when epithelial cells grow under the flap.
Incorrect placement, displacement, tucking of the edge of the flap
If the surgeon is not experienced enough, such complications may occur. Accidental touching of the flap also leads to displacement. Re-installation will help correct such complications.
Low quality of the flap itself
If the quality of the flap is poor, but the wound surface is sufficient, the procedure is carried out as usual. If the wound surface is insufficient, then the flap is placed in place, and only after 3-6 months a repeat operation is performed.
Undercorrection or overcorrection
Sometimes there is a discrepancy between actual and expected results. This occurs extremely rarely. In this case, if necessary, a second stage of laser correction can be performed.
Keratitis
Keratitis is accompanied by inflammation of the cornea, painful sensations, decreased visual function, lacrimation, photophobia. Any infection can lead to the development of keratitis, since during surgery a vulnerable wound surface is formed. It is important to identify signs of inflammation in time and carry out treatment. Therefore, it is necessary to undergo a complete preoperative examination, which includes consultation with a dentist and ENT specialist in order to identify foci of infection. In the case of a sluggish inflammatory process, the ophthalmologist should be notified and preventive therapy should be carried out.
If keratitis occurs immediately after surgery, then drops and tablets can be used. The consequences for vision in this case are minimal, but there are exceptions.
This concerns herpetic infection. In case of keratitis caused by the herpes virus, it is necessary to undergo treatment before laser vision correction surgery. This is due to the fact that the herpes virus is most often present in the body in a latent form. Under any favorable conditions for the virus, it again shows activity and can lead to the development of repeated herpetic keratitis. This disease is dangerous and often leads to decreased vision.
Doctor's video on the topic
LASIK complications that significantly affect the quality of vision
Further we'll talk about those complications of laser correction that can irreversibly and seriously affect the quality of vision. The likelihood of developing such complications is very small (tenths or hundredths of a percent), but it is necessary to remember such possibilities.
Traumatic flap injury
Flap damage due to trauma is not common. Typically, patients follow all recommendations in the postoperative period and behave very carefully, including not touching the eye.
However, the literature describes cases of corneal flap loss due to trauma. If the patient has lost a flap, he should be hospitalized immediately, since such an extensive wound surface will take a long time to heal. This whole process is always accompanied by severe pain.
Despite healing, the patient's vision will significantly change in the positive direction (iatrogenic hypermetropia). The quality of vision also suffers. This situation can be corrected by implantation of phakic or aphakic artificial lenses. Such intraocular lenses are selected taking into account the individual structural features of the eye, which allows eliminating all signs of iatrogenic farsightedness. The same operation is performed on patients with cataracts. Although this intervention is abdominal surgery, there is no other way out.
Diffuse lamellar keratitis
Diffuse lamellar keratitis is classified as separate group because he is very cunning. No one can say for sure what causes the development of DLK, so this disease cannot be prevented or predicted. 2-4 days after LASIK surgery, the patient experiences discomfort, decreased vision, and fog in one eye. Then these symptoms gradually progress.
If diffuse lamellar keratitis is not treated with intensive courses hormone therapy, then vision may deteriorate by several diopters. Also, clouding in the central zone of the cornea, located under the flap, is very difficult to remove.
Standard therapy for DLK is prednisolone or dexamethasone drops, which need to be instilled at least 4-6 times a day (sometimes every hour). In some cases, systemic therapy is additionally administered. hormonal agents. A single rinse of the subflap space with dexamethasone solution may be useful.
Laser correction is one of the most popular and effective techniques fight against various diseases in ophthalmology. It allows you to quickly and painlessly eliminate some pathologies and restore absolute vision to a person. So that you can decide on such a procedure, let’s figure out what it is, in what cases it can be prescribed, what stages of implementation it has, and what therapeutic effect can give.
Method Definition
Laser vision correction is a procedure that aims to change the shape of the cornea. Due to this, it is possible to eliminate various refractive errors, including and. During laser correction, the laser itself evaporates according to a certain principle. certain part cornea, due to which the desired effect is achieved.
Unlike other methods of treatment in ophthalmology, laser is almost painless for the patient, it leaves no scars or stitches, and the percentage of complications with this technique is minimal. That is why it is recommended to so many patients who want to get 100% vision and forget about contact lenses or glasses forever.
Application area
Laser vision correction can be used for people aged 18 to 55 years in various clinical cases. Among them:
less commonly, this manipulation is used to eliminate some other pathologies, for example, retinal detachment. It will be especially effective on early stages similar diseases.
Kinds
There are several popular types of laser vision correction. This:
the choice of one procedure or another depends on the technical support of the clinic and the patient’s indications. However, none of the presented methods can be considered universal and are not suitable for all patients.
Treatment
Laser vision correction involves the sequential implementation of several important stages: preparation, the manipulation itself, as well as the rehabilitation period. Let's look at them in more detail.
Patient preparation
Before undergoing laser vision correction, the patient must be examined by an ophthalmologist to determine the type of correction and the category of its complexity. If a person has retinal changes, he needs to undergo PPLKS (prophylactic peripheral). There should be at least two weeks between this procedure and vision correction. Also, before vision correction, a person should:
Also, women a day before such a procedure should stop using cosmetics, both decorative and medicinal. It is recommended to stop taking certain medications as recommended by your doctor.
Carrying out the procedure
Laser vision correction is carried out in several successive stages. This:
After this procedure, a person does not have any scars on the eye. There is absolutely no need to be afraid of such complications.
Rehabilitation period
The presented manipulation does not have a long rehabilitation period. Discomfortable sensations after such manipulation are usually observed only during the first 2-3 hours. At this time, the patient may experience increased lacrimation, pain, and photophobia. Vision may be blurry and foggy. Usually these symptoms disappear within a few hours after the procedure.
During the same period, the patient must undergo a follow-up examination with a doctor, after which the specialist can send him home. The patient does not need to drive, as he will not be able to fully monitor the situation on the road. It's best to call a taxi.
In the first few days after surgery, the patient may be advised to use eye drops antimicrobials or drops such as artificial tears, which will promote full recovery cornea. A week after the manipulation, the person will also need to go to the clinic and undergo a follow-up examination to make sure that the procedure was successful.
results
In 98% of cases, laser correction is successful, and the person receives full recovery vision. If a person followed all the doctor’s recommendations during preparatory and recovery period after surgery, the risk of complications does not exceed 0.05%.
In order for laser correction to be successful, patients need to follow several general recommendations. These recommendations include:
The patient also needs to monitor his health in the first days after vision correction. If during this period he develops any pain, increased lacrimation, photophobia, etc. unpleasant symptoms, he needs to see a doctor immediately. Otherwise, he may have vision problems.
Video
conclusions
As you can see, laser correction is one of the most effective manipulations in ophthalmology, which can save the patient from various pathologies, including myopia and astigmatism. To get the expected effect from similar procedure, the patient needs to take a very responsible approach to choosing a doctor and the clinic in which it will be performed, and also follow all the doctor’s recommendations for the preparatory and rehabilitation period after such manipulation. And then you can get maximum result from this treatment method.
Also read about the features of conducting and.
Laser eye microsurgery is one of the most modern methods of vision correction. However, despite the innovation of technology, this is still an operation, which means, like any operation, it has its rehabilitation period and consequences.
As for the consequences, they can be very different, both positive and negative.
Does everyone really need correction?
Laser correction helps restore visual ability and eliminate the use of glasses and contacts.
The essence of the procedure is that the excimer laser beam changes the curvature of the outer cornea of the eye, as a result of which the light from the image begins to focus not in front or behind the retina, but directly on it, which is necessary for good vision.
There are a number of professions where good vision is essential, but the specific nature of the work makes it difficult to use glasses. For example, firefighters, due to working conditions ( high temperatures, urgency of action, smoke) wearing glasses seems simply impossible. What can we say about test pilots or, say, artists. Are there many dancers wearing glasses? Of course not.
In this case, contact lenses come to the rescue, depriving a person of the need to worry about them all the time. Most people find them convenient and comfortable, especially if they manage to choose the right ones for themselves that do not cause irritation and are not felt on the eyes.
By taking off glasses and putting on contact lenses, people begin to feel more active and mobile, and more self-confident. Wearing lenses opens the way to various kinds of extreme entertainment, where glasses are simply unacceptable (rock climbing or rafting on mountain rivers, for example). However, the use of lenses is also not acceptable in all professions. So, firefighters cannot wear not only glasses, but also contact lenses. Because under their working conditions, wearing lenses is simply impossible.
It would seem that lenses are an excellent solution, but recently statistics show that wearing lenses also has its consequences. Moreover, not everyone has such a fortunate opportunity to choose suitable lenses simply due to individual intolerance. And here the following options are usually considered: laser surgery– as a newer and more modern method of vision correction in the 21st century.
Indications for laser correction
As with any operation, laser correction requires medical indications, in addition to the patient’s wishes:
- Persistent myopia (to exclude the possibility of temporary deterioration) up to 10.0 diopters;
- Farsightedness for a long time up to +6.0 diopters;
- Astigmatism up to 4.0 diopters is allowed;
- Individual situations (partial vision correction is possible);
- Inability to use glasses or contact lenses (due to the specific nature of the work, for example, firefighters).
Contraindications to the procedure
There are a number of contraindications to surgery.
These include:
Consequences and rehabilitation period
Of course, any medical intervention, be it medicinal or surgical, has its consequences. Today clinics providing this procedure to restore the functionality of the eyes, they announce the probability of complications during the rehabilitation period in the region of 1%.
To the main reasons causing Negative consequences include the following:
- Insufficient calibration of equipment needed for the operation. Interruptions in the operation of the vacuum system;
- Incorrectly selected size for the procedure (depends on the level of experience and professionalism of the doctor performing the operation);
- Making an excessively thin or split cut.
All of the above reasons relate to the human factor (lack of professionalism) and interruptions in the operation of equipment.
Unfortunately, even if all of the above reasons are absent, the vacuum system works correctly, without interruptions, the doctor has extensive experience, even with successful implementation surgery, there may be consequences that appear already in the postoperative period. They are usually associated with individual characteristics of a person and are often extremely difficult to predict.
The following complications may occur:
- Various types of inflammatory processes;
- Tissue swelling, redness;
- Retinal disinsertion;
- Complications such as a feeling of “sand” in the eye;
- The need to repeat the operation due to insufficient recovery;
- Deterioration of vision;
- A complication in the form of converting diopters from minus to plus.
Even some time after the operation, months and years, undesirable consequences may appear due to the unpredictability of the human body and its individual reaction to the intervention:
It is important not to plan pregnancy for the rehabilitation period throughout the year.
Because in connection with the expectation of a child, the female body’s immunity, which is necessary for the healing of the cornea after surgery, greatly decreases.
It is also important to understand that myopia, farsightedness, and astigmatism are progressive diseases. With age, vision still deteriorates, it all depends on how quickly it happens. And it is already in the hands of man - to slow down this process by all available means.
Considering that laser surgery in this case will help to correct vision rather than cure the eyes, this means that sooner or later vision will still deteriorate, and another correction may be required. It all depends on the quality of the operation performed and the individual characteristics of the patient’s body.
The right to choose
When choosing only the best for yourself, it is important to take seriously the issue of the need for laser correction. You should carefully weigh the need for surgery and the impossibility of solving a vision problem by wearing glasses or contact lenses. Also known traditional methods to improve vision.
Still, laser correction is surgical intervention into the internal device human eye, and what the body’s reaction to this will be is difficult to say. You need to understand whether laser correction is really necessary in each specific situation. Having made a positive decision, it is important to remember what the consequences may be.
However, technology does not stand still. A medical technology progress every year. Only in the last 20 years have opportunities appeared that were not even dreamed of in the middle of the last century.
Surely in the near future even that small percentage negative consequences will be reduced to zero. In the meantime, an informed decision, good experienced doctor and unconditional strict adherence to recommendations for the postoperative period will help improve vision modern methods laser surgery.
Over all the years of using laser vision correction, not a single case of irreversible vision loss or significant deterioration as a result of this operation has been identified. However, sometimes small problems may occur. They may be caused by non-compliance with recommendations for the postoperative period. After laser vision correction, active sports and physical labor are contraindicated for patients, especially in the first three months.
For 2 weeks, you should not rub your eyes; it is advisable to avoid exposure to direct bright light, hypothermia, and direct exposure to cool air into the eyes. You cannot swim in, visit the bathhouse, sauna, or use cosmetics for eyelashes and eyelids. In the first summer after surgery, sunglasses and sunbathing are not recommended. After laser vision correction, you cannot plan a pregnancy for at least three months. Even simple rubbing of the eyes can cause complications and deterioration of vision, and if they are injured during this period, you can even lose your vision.
Possible side effects of laser vision correction
TO side effects Laser vision correction includes the appearance of circles and “spots” before the eyes, and excessive dryness of the eyes. After surgery, inflammatory processes, conjunctivitis, swelling, epithelial ingrowth, and hemorrhages may develop. The reason for their appearance is the individual characteristics of the body.
In the first time after surgery, contrast sensitivity decreases; patients have difficulty distinguishing the boundaries of objects and the boundaries of colors, so driving at night and in the dark is undesirable. A side effect of laser vision correction is the development of vitamin D deficiency due to sensitivity to the sun and its avoidance, and fluctuations in visual acuity. Sometimes bright artificial light causes blurry vision to appear in the eyes. At night, the pupil may dilate, becoming larger than the flap and causing vision distortion.
Patients may experience ghost images (double vision), striae (“wrinkles” on the flap), growth or foreign bodies under the flap, irritation of the eyelid, cornea, induced astigmatism, separation of the posterior vitreous, epithelial erosion, spotty hole, glare. There is also the possibility of “undercorrection” - residual. It is removed by repeated laser correction after two months and becomes an additional burden on weakened eyes. Side effects include long-term laser vision correction. They are not yet studied as it becomes difficult to determine their occurrences.
