Restoring vision using Lasik surgery. Vision correction using Lasik method Laser keratomileusis

Thanks to the constant development of modern ophthalmology, the use of a scalpel is relegated to the background. It is being replaced by a high-tech method of laser eye correction.

Surgery using the Lasik technique (laser keratomileusis) eliminates many eye pathologies (,), which allows most people to regain visual acuity and stop wearing glasses or contact lenses.

With the development of eye pathology, a violation of the light focus occurs, which is not displayed on the retina of the eye, due to which the visible picture becomes unclear and acquires blurred contours.

Laser correction is based on a mechanical effect on the cornea, modeling its shape, the display of visible images is concentrated on the center of the retina. This creates the opportunity to completely restore visual acuity.

Indications for surgery

Contraindications for surgery

There are situations when Lasik surgery is not performed.

Absolute contraindications

The occurrence of the following diseases in a patient is an absolute contraindication:

Relative contraindications

In addition, relative contraindications are identified; if they occur, the operation is undesirable; it is better to carry it out when the following pathological conditions are eliminated:

The essence of laser surgery

During the operation, the main goal is to achieve a clear location of displayed objects on the retina.

For this, an excimer laser beam is used, which gives the cornea the desired shape:

Types of Lasik surgery

Depending on the eye pathology, the ophthalmologist may choose a laser therapy technique.

There are three types of laser vision correction:

1. PRK. By exposure to an excimer laser, a mechanical change occurs in the surface layer of the cornea, followed by the formation of a corneal flap. This technique involves an increased rehabilitation process. It can last up to 1 month. In this case, the patient may experience discomfort in the form of pain, pain, and increased lacrimation.
2. IFL. The essence of this technique comes down to the implantation of an implant - a phakic lens. The implant is inserted in front of the iris of the eye, or directly behind it. This type of operation is performed for advanced forms of eye diseases (myopia, hypermetropia, astigmatism).
3. Lasik. This operation is carried out using an excimer laser, which is used to remove the surface layer of the cornea to eliminate abnormalities in the inner layers. After this, the removed epithelial layer returns to its place. The main advantage of this surgical intervention is that the rehabilitation period occurs within a few days.

Recently, this technique has been diversified into new directions:

This technique is the latest achievement in the field of ophthalmology, which allows, in most cases, to return 100 percent vision. But due to its high cost, it has not yet found widespread use in the Russian Federation and the CIS.

Devices for laser correction

To carry out laser vision correction, the following devices are used:

• Excimer laser system VISX Star S4 IR (USA). When using this device, a high degree of formation of a smooth surface of the corneal layer is achieved. This increases the healing of the wound surface and minimizes the postoperative period.
• Femto - IntraLase FS60 laser. Separates the surface layer of the cornea at the molecular level.
• Microkeratome Moria Evolution 3. Through the introduction of innovations, this device adapts to the individual characteristics of the patient's eyeball.

Basic principles of Lasik surgery

This type of surgical intervention is based on the following basic principles:

It is very important that performing this type of operation does not cause the patient a feeling of fear or psycho-emotional disorder. The absence of pain does not cause psychological trauma.

Preparing for surgery

Laser vision correction using the Lasik method does not require special preparation, which is necessary when performing abdominal operations. There are some nuances that you should pay attention to.

Before starting the operation you must:

Operation stages

has three stages:

• First stage involves the formation of a flap from the superficial layer of the cornea. This can be done in two ways:
  • Using a microkeratome. The epithelial layer of the cornea is cut with high precision, which ensures a smooth surface.
  • Application of femto laser. This technique has not yet been widely used due to its high cost. However, its use requires an individual approach to the patient, taking into account the anatomical characteristics of the eyeball. At this stage, a vacuum ring is used to achieve complete immobility of the eyeball. Pain is excluded, the patient may notice that vision disappears for a few seconds. This stage of the operation is considered completed after the creation of a corneal flap.
• Second phase. The formed corneal flap is moved to the side. After which the necessary areas of the cornea are evaporated. In more complex forms of eye pathology, this stage of the operation requires more time. The patient, throughout this stage, must observe the luminous point.
• Third stage. The ophthalmologist places the flap in its original position. Due to the action of adhesive forces, fixation is carried out independently. This makes it possible not to use suture material. In some cases, it is possible to install a contact lens to make the eyeball more protected.

The duration of the Lasik operation does not exceed 10 minutes.

Postoperative period

Immediately after the operation, the patient is transferred to the ward and his condition is monitored for 2 - 3 hours. If his condition is stable and there are no visible complications, he is allowed to go home (especially good if he has an accompanying person).

The ophthalmologist prescribes strict implementation of the following recommendations:

Immediately after the operation, the patient may experience:

• Fear of sunlight or bright light.
• Sensation reminiscent of sand getting into the eyes.
• A burning sensation and increased secretion of tear fluid.

Such manifestations are considered natural, since they are the body’s response to mechanical stimuli.

A follow-up examination is performed the next day after laser eye correction. Throughout the next week, visual acuity may differ (it all depends on the healing process of the corneal tissue).

Repeat visits to the clinic where the operation was performed occur:

• On day 4.
• After 7 days.
• In 30 days.
• After six months.
• Moreover, each subsequent year requires a visit to the ophthalmologist at least once.

It should be borne in mind that complex forms of myopia and hypermetropia, even after Lasik surgery, sometimes do not make it possible to refuse to wear glasses or contact lenses.

This surgical method of eliminating visual dysfunction is performed using advanced technologies, but sometimes situations arise that complicate the rehabilitation process.

Early complications

Early forms of complications include:

• Increased tear production.
• The occurrence of cutting or pain when blinking the eye.
• The appearance of unbearable itching.
• Increase or decrease in visual perception on the first day after surgery.
• When viewing a bright light source, glare is observed.

Such symptoms are a reason to visit an ophthalmologist. After the examination, he will prescribe eye drops that will reduce the negative consequences.

Late complications

They may develop after some time, accompanied by the following symptoms:

Operation efficiency

This type of operation is characterized by a high degree of safety; it is not only atraumatic for the eye tissue, but also does not allow depression of the mental state of the sick person. This is due to the fact that during its implementation there is practically no pain.

The use of this technique occurs under the control of a computer system, which in most cases eliminates the possibility of a medical error. Achieving 100% vision is possible in 90% of all operations.

Sometimes, vision may decrease due to the progression of myopia. Repeated laser eye correction will help eliminate this problem.

Price

Lasik surgery is considered a type of plastic surgery, and therefore the full cost is paid by the patient. But sometimes there are exceptions for the military. It is produced in Moscow and St. Petersburg at the Department of Ophthalmology of the Military Medical Academy.

The price for this type of operation depends on:

Conclusion

Laser surgery using the Lasik technique in most cases helps to achieve full visual acuity and allows a person to feel like a full-fledged member of society.

And also stop wearing glasses or contact lenses.

The patient must remember that at the age of 40 he may need glasses.

This should not be frightened, because this is a physiological process called presbyopia, in which the image of objects in the distance has clear outlines, and visual work at a close distance will be accompanied by difficulties, since objects will be blurry and cloudy.

The period after surgery must be accompanied by compliance with all requirements and recommendations of the ophthalmologist. Self-prescription of drugs and the use of traditional medicine recipes are completely excluded.

Any patient who has undergone Lasik surgery should remember that it primarily removes the symptoms of the disease and does not affect the causes of its occurrence. Therefore, over time, the disease may progress and visual dysfunction may increase.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

It is difficult to imagine a modern person who has never heard of laser vision restoration methods. They are as widely used as they are advertised in the media. One of them is LASIK (LASIK), a laser correction operation for the shape of the cornea.

The name of the operation comes from the abbreviation “LASIK”, which in medical language means “laser keratomileusis”, that is, separation of a flap of the cornea, correction of the underlying layers and restoration of the integrity of the outer shell of the eye.

Most adults on the planet have vision problems; they are also widespread in children. The blame for this lies not only with heredity, acquired eye diseases or individual characteristics of the development of the organ of vision. The enormous load when using a computer, watching TV, or doing paperwork makes a huge negative contribution to the progressive deterioration of vision for many people.

Advertising promises a quick and painless restoration of vision to almost normal parameters, but not everything is so simple. Of course, laser correction is highly effective and in many ways safer than other surgical treatment methods, but it has a lot of contraindications, does not exclude the possibility of complications and does not always give the expected result.

In order for the treatment process to be as comfortable and effective as possible, you need to carefully choose a clinic and specialists who can be entrusted with one of the most important organs of our body - the eyes. In this case, cost is not always the determining factor. A patient can pay a significant amount of money at a private medical center, but a good result is not guaranteed if the ophthalmologist was not sufficiently qualified or the equipment was already outdated.

When choosing a place of treatment, you cannot blindly trust the reviews of patients, because the lack of success for one does not always mean that the correction was carried out poorly. We will try to understand the pros and cons, indications and possible obstacles to laser vision correction.

Indications and contraindications for LASIK surgery

Laser vision correction through LASIK surgery is performed for:

• Farsightedness +6 diopters;
• Myopia up to – 15 diopters;
• Astigmatism up to ±3 diopters.

Indications for treatment are limited to visual impairment and therefore few in number, while there are many more contraindications to the procedure. It is not performed on persons under the age of majority, as well as on pregnant women and nursing mothers.

Absolute contraindications include:

1. Autoimmune diseases that impede normal corneal regeneration;
2. Pathology of immunity;
3. Systemic connective tissue diseases;
4. Absence of one eye (they will not do LASIK on the only one that is intact);
5. Increased intraocular pressure;
6. Keratoconus;
7. Small thickness of the cornea (less than 450 microns);
8. Clouding of the cornea (cataract);
9. Progression of myopia;
10. Retinal detachment, which was treated surgically;
11. Viral eye infection (herpes).

There are also relative contraindications to LASIK surgery. These are some common diseases - diabetes, acute mental disorders, presence of a pacemaker. Pregnancy and breastfeeding may be a temporary obstacle, since hormonal imbalance can disrupt normal corneal regeneration.

Laser vision correction cannot be performed for acute inflammatory eye diseases. They must be treated. Retinal pathology may require preliminary laser coagulation, after which LASIK is already possible. Corneal scars can be a relative obstacle to the procedure.

Benefits of LASIK

Vision correction using a laser beam has many advantages compared to surgical techniques, which makes this particular procedure very attractive for a wide range of patients:

• Short rehabilitation period - you can leave the clinic on the day of treatment and safely begin work the next day;
• Possibility of outpatient treatment;
• Painless and quick procedure;
• No damage to the upper layer of the cornea;
• Local anesthesia in the form of drops is safe and well tolerated;
• It is possible to treat both eyes at once;
• Minimal risk of complications;
• Restoration of vision on the day of the procedure;
• Persistent positive result;
• Availability.

The principle of laser vision correction method

The cornea is a transparent light-refracting shell of the eye, the features of which, like the lens and other components of the organ of vision, determine whether the image will fall on the retina or outside it. The principle of LASIK is based on changing the shape of the cornea at the front of the eye, through which the image is focused onto the retina.

Treatment of vision pathology using a laser beam has been practiced since the end of the last century, and now both the technique itself and the installations used for this have changed significantly. The laser has become more accurate and faster, and preoperative diagnostics have improved. The device for the procedure successfully combines a radiation source, an operating microscope and a microkeratome.

Standard LASIK surgery involves the action of an ultraviolet beam aimed at the deep layers of the cornea. At the same time, the cells heat up, their layers evaporate, and the cornea changes its shape. An indispensable condition is the use of a microkeratome, capable of separating the thinnest upper layer of the cornea.

Femto LASIK is a more modern procedure in which correction occurs non-contactly and does not require the use of a microkeratome. The infrared laser beam itself is capable of creating a thin and neat cut of the cornea, it can be directed to the desired depth of the eye shell, it is very accurate, and the treatment process is controlled at all stages, taking into account the individual characteristics of a particular patient. With femto LASIK manipulation, it is possible to obtain ideal corneal characteristics, thereby achieving the best treatment results and shortening the recovery period.

The only significant drawback of the femtosecond laser is its high cost, which is why the equipment is not very common in clinics in Russia and neighboring countries. For the same reason, the operation itself is much more expensive than LASIK.

In popular publications and advertising you can find the term “super LASIK”, which is not used in the scientific literature and among manufacturers of surgical equipment. It means the same LASIK operation, and the prefix “super” is a common advertising ploy designed to attract more patients.

An obstacle to LASIK surgery can be an excessively thin cornea, which cannot be safely cut with a microkeratome. Designed for such cases Epi LASIK technique, when only the upper corneal layer is peeled off using an epithelial keratome, then it is returned to its place and covered with a protective lens for several days to accelerate corneal regeneration. Otherwise, the operation is no different from the LASIK technique.

Despite the filigree of the Epi LASIK operation, it is considered very safe. There is not a single case recorded in the world in which the cornea was perforated or clouded as a result of such treatment. 9 out of 10 patients were ready to return to work the next day after treatment.

Video: laser correction of myopia femto lasik

Planning and preparation for laser vision correction

LASIK does not involve the kind of preparation that would be needed for, say, abdominal surgery. In this case, everything is much simpler, but there are many nuances that the patient simply must know.

The use of contact lenses is widespread among people with low vision. They help you feel comfortable without glasses, but when planning laser correction, you will have to give them up and return to regular glasses. The minimum period of refusal from lenses is a week, depending on their characteristics.

The need to switch to glasses is dictated by the fact that the lens, when worn for a long time, changes the shape of the cornea, which immediately before the operation does not have time to return to its original state, which means the result of the operation may be unpredictable and negative.

When wearing soft lenses, it is recommended to remove them at least a week before the start of pre-operative examinations. Fixed soft lenses are removed two weeks before treatment, and hard lenses two or even three weeks before the start of preoperative examinations.

When planning an operation, you need to tell the ophthalmologist in detail about your health, the state of your vision, previous treatment and its results, preferably supported by appropriate documentation. You should inform your doctor about all medications you are currently taking. There is no need to be shy about asking in detail about the essence of the treatment, possible consequences, and the feasibility of its implementation.

Immediately before LASIK and the day before, you should avoid using any cosmetics, including creams and lotions. It is advisable to ensure that one of your friends or relatives helps you get home after treatment. Car owners should know that it is better not to drive in the coming days after treatment.

Stages of LASIK

The laser treatment process includes several stages:

1. The patient is seated in a special chair, the eyes are cleaned, anesthetic drops are instilled, after which an eyelid dilator is placed to prevent blinking during the procedure;
2. To fix the eye while cutting the corneal flap, a special suction ring is installed; it may cause a feeling of pressure or pain - this is normal;
3. The patient, who, naturally, in consciousness, focuses his vision on the luminous point - this is how the organ is installed in the desired position;
4. Using a microkeratome (microsurgical instrument), a corneal flap up to 150 microns thick is separated, moved to the side and opened for the laser beam, then the ring and microkeratome are removed;
5. The main therapeutic manipulation is the action of the laser on the deep layer of the cornea, which heats up, then water evaporates (similar to laser vaporization in other parts of the body), and the configuration of the cornea changes;
6. The flap of the upper corneal layer is returned to its original place after correcting its shape;
7. The eye is washed with a special solution, and anti-inflammatory drugs are instilled.

stages of the operation

If necessary, you can immediately begin treatment of the second eye; manipulations are carried out in the same sequence. The operation takes about 20 minutes on both eyes.

After treatment, the patient may feel some discomfort in the eyes, but this does not in any way affect the general well-being and functioning. The discomfort disappears within a few days at most. After about 1-2 hours, vision begins to improve, and by 3-5 days it is restored to the planned value.

The LASIK method is used on an outpatient basis and does not imply hospitalization or any preparation, except in cases of contraindications that require additional examination or treatment. On the day of correction, the patient goes home, having received the necessary instructions from the attending physician.

Video: laser vision correction method, operation progress

Postoperative period and possible complications

Vision after laser correction is restored quite quickly, but in the early stages after treatment some inconvenience is possible. The eyes may become watery, there may be a foreign body sensation and even pain, which the ophthalmologist will warn you about before treatment. Glare, blurred vision, redness of the eyes, excessive sensitivity to light are a natural reaction to the laser, so there is no need to panic when they appear.

Under no circumstances should you rub your eyes after surgery, even if the feeling of itching or something extra persists! Any mechanical impact on the eyeball can provoke displacement of the corneal flap, and then you will have to go to the doctor again for additional treatment.

It is advisable to plan the next few days after the correction so that there is no strain on the eyes; if possible, refuse to work for this period. When the discomfort, lacrimation, and redness go away, you can safely go about your usual activities. For some time after treatment, sunglasses are recommended to protect not only from excess light, but also from possible mechanical influences.

In the early postoperative period, you should closely monitor your feelings. If severe and sudden pain occurs in the eyes, vision begins to “decay”, and symptoms of discomfort progress, then you should immediately contact the clinic where the correction was made.

The day after the correction you will need to visit an ophthalmologist, then, during the first three months, consultations with a doctor are carried out to analyze the clarity of vision. Even if it has not completely recovered, you cannot use lenses or glasses again without consulting a doctor.

For the first week after treatment, you should not use cosmetics or creams. For a month you should refrain from taking a hot bath, visiting a bathhouse, sauna, swimming pool, or playing sports that have a high risk of injury. If possible, you should protect your eyes from all types of influences so as not to cause infection and not to move the corneal flap.

After the operation, the patient may immediately notice an improvement in vision, but during the first few months and up to six months there will be a stabilization process with gradual improvement. During this period, there may be difficulties when driving a car in the dark, a feeling of glare.

Complications with laser vision correction are quite rare, but still not excluded. Among them are:

• Keratoconus, when the cornea takes on a conical shape, occurs several years after treatment;
• Dry eye syndrome;
• Insufficiently accurate vision correction;
• Sensitivity to light, double vision;
• Displacement of the corneal flap, folds, accumulation of fluid under the flap;
• Astigmatism.

Possible long-term consequences - glare, blurred vision - may be irreversible, but occur quite rarely.

Laser vision correction is not a life-saving operation; rather, it is a field of plastic surgery, so all over the world such treatment is provided for a fee, and insurance companies do not cover its cost. In Russia and neighboring countries, this procedure is also carried out at the patient’s expense, although there are exceptions - military personnel at the Military Medical Academy of St. Petersburg are operated on free of charge; in Krasnodar, City Hospital No. 1 offers this service to residents of the region. You should find out about the possibility of free treatment from specialists in your locality.

The price of paid laser vision correction using the LASIK method varies greatly depending on the chosen clinic, the qualifications of the surgeon, the equipment used and the complexity of the operation itself. On average, the cost of LASIK ranges from 15 to 35 thousand rubles, femto LASIK will cost much more - up to 55 thousand in Moscow clinics.

The most popular method of laser vision correction in the world, with several million operations performed annually.

What is LASIK?

LASIK (LASIK, LESIK, LASIK) is the most popular method of laser vision correction in the world, with several million operations performed annually. LASIK is an abbreviation of the full name of the operation “Laser Assisted In Situ Keratomileusis”, proposed by the Greek doctor Pallikaris back in 1990.
Today, LASIK is the safest, high-tech and time-tested method of laser vision correction, allowing to obtain high visual acuity and stable results. LASIK is used to correct nearsightedness, farsightedness and astigmatism, allowing patients to avoid wearing glasses and contact lenses.
Why has this technique become so popular?
LASIK has several advantages over other refractive surgeries. Namely:

• Rapid vision recovery
• No pain
• Short operation time
• No seams or scars
• Stability of results

The essence of the LASIK method is to use the “cold” ultraviolet beam of an excimer laser to change the optical power of the cornea. Changing the refraction of the cornea allows for precise focusing of light rays on the retina of the eye, which determines high visual acuity. Patients with nearsightedness have a very steep cornea, and the goal of LASIK is to flatten it. Patients with farsightedness, on the contrary, need to give the cornea a steeper shape. With astigmatism, the cornea is given a regular spherical shape.
The latest modification of this technique is called Super LASIK or personalized vision correction. The difference from the standard LASIK technique is that the individual structural features of the patient’s cornea are used to correct vision. A special device - a corneotopograph - scans the cornea of ​​the eye at several thousand points, creating an accurate map of its surface and refractive power. These data are transferred to the excimer laser program and vision restoration occurs according to the individual parameters of each patient. The result is the highest quality vision with high clarity and contrast, especially in the evening, as well as visual acuity, often exceeding 100%.
LASIK surgery consists of 3 main stages:

• Creation of a corneal flap
• Carrying out laser correction
• Returning the corneal flap to its original position

One of the most important stages of the entire operation is the creation of a corneal flap. Today there are two ways to create it:

• Classic technique using a microkeratome
• A more modern technique using a femtosecond laser

The LASIK operation was created using mechanical microkeratomes, which have an ideal cut surface quality for the corneal flap. Femtosecond lasers have only recently begun to approach mechanical microkeratomes in these parameters, but due to their high cost they are not yet widely used in Russia. When using a femtosecond laser, the operation is called Femto LASIK and can be performed either according to a standard correction program or personalized based on the topographic data of the cornea.

Before LASIK surgery

If you are going to get rid of glasses and contact lenses by doing laser vision correction using the LASIK method, then the first step should be choosing a professional ophthalmology clinic and a refractive surgeon. This is undoubtedly one of the most important steps depending on the patient.
To determine whether you are a good candidate for LASIK, your eye doctor will perform a complete diagnostic examination to evaluate your eye health, rule out contraindications, and determine a vision correction program. During the consultation, you will be able to assess the predicted result of the operation, which will correspond to your visual acuity with full correction with glasses or contact lenses. The doctor will also carefully ask you about any common diseases you have and medications you are taking, which may completely exclude the possibility of surgery or postpone it for a certain period of time.
Your doctor may prescribe a variety of prophylactic eye drops, for example, to reduce post-LASIK dry eye syndrome, which is common in patients who have undergone refractive surgery.
If the clinic has the appropriate equipment, you may be offered a correction using the Super LASIK program. In this case, you will be examined on a special topographer, the information obtained will be stored in the excimer laser computer to carry out a personalized operation.
If it turns out that LASIK is contraindicated for you for some reason, the doctor will suggest alternative, safer in your case, methods of vision correction, such as PRK, LASEK or Epi-LASIK. There are also a number of vision correction techniques without the use of a laser, for example, implantation of phakic lenses.
For more information about whether you are a good candidate for LASIK, please read the article “Is LASIK Right for Me?”

What happens during LASIK surgery?

LASIK is an outpatient procedure, and you will leave the clinic some time after it is performed. Be sure to ask someone to accompany you, as you will not be able to drive on your own.
When concluding an agreement with the clinic for the provision of medical services, you will be asked to sign a voluntary informed consent for LASIK surgery.
Despite the refinement of LASIK technology, it requires very delicate execution, which is only possible in a professional clinic and an experienced surgeon.
Before surgery, your doctor will perform an eye exam, and some patients may be asked to take sedatives. Then you will be taken to the surgical department of the clinic and changed into operating clothes.
First, anesthetic drops will be placed in your eyes several times, and you will feel no pain during the entire operation. You will be placed on the excimer laser operating table and the surgeon will accurately align your eye with the laser. As a rule, the operation is performed on both eyes, first on the right, then on the left. A special spacer will be installed in the operated eye, which will not allow it to blink; the other eye can do this calmly.
Next comes the stage of forming a corneal flap. Regardless of the instrument used - microkeratome or femtosecond laser, a fixation vacuum ring will be installed on the eye, ensuring correct position and absence of eye movement to eliminate problems with the quality of the flap. While the microkeratome is operating, a slight buzzing noise or buzzer is heard, the patient's image completely disappears for 20-30 seconds, then the light returns. As a result, a thin pedunculated flap with a thickness of about 0.1 mm is created on the surface of the cornea, its structure reminiscent of an antique watch with a lid. The surgeon carefully moves the flap to one side.
The excimer laser stage is the active part of the operation, when the laser beam evaporates a given amount of corneal tissue according to the patient’s correction program. The greater the number of diopters that the laser must eliminate, the longer its operation will last. While the laser is operating, the patient looks at the luminous mark from several seconds to a minute, which depends on the amount of correction and the parameters of the excimer laser. The more modern the excimer laser installation, the less time the laser lasts, which greatly facilitates the patient’s task and reduces psychological stress. The patient may also smell a peculiar odor from ultraviolet radiation.
After the laser correction stage, the surgeon carefully returns the corneal flap to its place, which is fixed to the cornea due to adhesion forces without sutures. In some cases, a contact lens may be inserted for added safety.

The entire operation takes 5-7 minutes per eye.

The entire operation takes 5-7 minutes per eye. LASIK is usually performed on both eyes at the same time, although some patients choose to take a week off.
After completion of the procedure, the patient remains in the room for 1-2 hours under the supervision of staff, after which the doctor conducts a follow-up examination, gives all recommendations and sends him home until the next day. The patient may be bothered by lacrimation, pain and a feeling of sand in the eyes. Bright light can intensify these sensations, so it is necessary to protect your eyes with dark glasses. For 24 hours after surgery, you should avoid any touching of the eye so as not to displace the corneal flap. A prerequisite for a successful outcome of the operation is strict adherence to all restrictions and prescriptions of the attending physician. The patient receives a detailed treatment regimen of 2-3 types of drops for the entire postoperative period.

After LASIK

The next day after the operation, the patient comes for a follow-up examination. In most cases, by this time, visual acuity is as close as possible to predicted, but without glasses or contact lenses. Visual acuity may fluctuate and vary slightly over several days or weeks while the healing process is active, depending on the individual patient.

The patient can begin their work or school the very next day after LASIK surgery.

LASIK is a cosmetic procedure and most clinics do not provide sick leave. In principle, the patient can begin his work or study the very next day after the operation, if it does not conflict with the restrictions. Of course, the ideal option would be to spend 2-3 days at home before the second follow-up examination. A visit to the doctor is also necessary on the 4th day after surgery, after 1 week and 1 month. Follow-up examinations are usually carried out after 6 months and 1 year.
For successful recovery and achievement of maximum results after laser vision correction, it is necessary to observe a number of restrictions in the postoperative period. The clinic will give you instructions on how to behave after LASIK surgery. The number and duration of restrictions may vary in different clinics and among different doctors.

LASIK results

Most people achieve 100% visual acuity after LASIK, and sometimes more. Do not forget that the main goal of LASIK is to relieve the patient from wearing glasses and contact lenses, so visual acuity of less than 100% is also considered a good result.
Sometimes, especially if high myopia has been corrected, the patient will still need contact lenses or glasses for full correction, but they will be significantly weaker than the original ones. In rare cases, having achieved high visual acuity after surgery, patients may notice a gradual deterioration of vision in the long term, the so-called “regression”. This may be due to progressive myopia, where the eyeball is still growing in length. This issue can be discussed with the surgeon to determine whether additional correction with repeat LASIK is possible.
Even if you have excellent vision after LASIK, by age 40 you may still need reading glasses or multifocal contact lenses. This is a normal physiological process called presbyopia. Your distance vision will remain clear, but you will struggle when working at close range.
With proper selection of candidates for surgery and careful examination, postoperative complications occur in less than 1% of cases. These include eye infection, dry eye syndrome, rainbow circles from bright light sources, etc. Most of them respond well to treatment or significantly reduce their symptoms over time. Read more about this in the article “Risks and Complications of LASIK.”

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Deterioration in the quality of vision, even gradual, will eventually lead to the fact that a person will be forced to start wearing glasses or contact lenses. Neither one nor the other method of vision correction is absolutely convenient - both have their pros and cons, and, unfortunately, there are many more disadvantages. They are especially acutely felt by those who have experienced severe visual impairment. However, medicine does not stand still, and now professional clinics perform various operations to help correct vision and restore almost 100% accuracy. For example, Lasik is an eye surgery that is performed very quickly, and a person begins to see after it without the help of glasses or lenses.

What kind of operation is this?

Many people have heard about this operation, especially often those who have poor eyesight and are unable to even get out of the house without corrective means are interested in it. Operation Lasik or Lasik, also sometimes read as Laysik, is now perhaps the most popular, but at the same time the safest operation that allows a person to see well again. The operation is high-tech and is performed in a short time on an outpatient basis, but immediately after it the person can already see with his own eyes, throwing his glasses into the trash.

“Lasik” is an acronym derived from the abbreviated full name of the procedure – Laser Assisted in Situ Keratomileusis. If you translate this into Russian, you get laser keratomileusis. This is a method of correcting the quality of vision using laser technology. Lasik is performed with a special excimer laser, capable of creating fairly powerful ultraviolet radiation, which affects the layers of the cornea of ​​the eye located deep in the organ of vision.

On a note! Today, Lasik is performed in 45 countries around the world by various medical institutions. And over the past 5 years, more than 5,000,000 operations have been performed in the world. Now Lasik has become such a familiar and widespread method of restoring vision that in the USA or Japan it is done not even in clinics, but in ordinary small offices rented in shopping centers.

Indications for this operation are:

• myopia up to -15 diopters;
• farsightedness up to +6 diopters;
• astigmatism up to + or – 3 diopters.

The operation is allowed for people aged 18 to 45 years who want to restore their vision and do not have any contraindications.

History of operations to correct vision defects

The history of vision correction operations is quite rich. The first Lasik surgery was performed in 1989. But the very first steps towards the possibility of correcting the quality of vision using this method were made back in 1950. Then a Spanish ophthalmologist working in Colombia was able to come up with and develop a special technology for surgical intervention in the ocular system, which makes it possible to make a very thin section of the cornea of ​​the eye, and then change its shape. It was this process that the doctor called keratomileusis.

Further, the ideas of this specialist began to be developed by the Soviet academician S. Fedorov, who developed and introduced the so-called radial keratotomy in the 70-80s of the twentieth century. And the first excimer laser was created by scientists at the University of California in 1968; in 1980 it was improved to ultraviolet.

In the 80s, radial laser keratotomy was mastered. And the first operation to eliminate refractive errors was carried out in 1987. A patent for a method for changing the curvature of the cornea with the help of it was issued to Golam Peyman from the USA in 1989. However, the very first operation using Lasik technology was performed in 1988 in Novosibirsk. But few people know about this.

Now Lasik is performed in almost all cities of Russia. Technologies do not stand still, and this operation is becoming more and more perfect, allowing people to regain their vision even in extremely difficult cases.

Table. Types of Lasik surgery.

Type	Description
	The method was developed in 2003 by the Greeks. During the operation, a special instrument is used - an epikeratome, which allows you to separate the upper layer of the cornea along the line of the natural division of the layers. Then the shape of the cornea is changed to the required state and the upper layer of the cornea is returned to its rightful place. The technology is not suitable for all patients (only 40%), provided that they did not wear contact lenses.
	In this operation, which is more delicate than Epi-Lasik, the upper layer of the cornea is separated using a femtolaser. Next comes the same excimer laser, which acts directly on the deep layers of the cornea and changes it. The operation is completed by placing the cut piece of cornea in place. Very precise and less traumatic operation.
	This is the most advanced type of Lasik surgery. If previous operations are carried out according to a strictly refined algorithm, then Super-Lasik is carried out in accordance with the individual characteristics of the patient’s eye structure. To determine all parameters, the cornea is scanned using an aberrometer, which provides very accurate data. Super Lasik allows you to achieve the best possible results.

Advantages of the technique

Lasik has a lot of advantages, for which it is appreciated by both patients and doctors themselves. The main advantages of this method of vision correction:

• the ability to return to work or study as soon as possible;
• the operation is performed on an outpatient basis and there is no need to stay in the hospital;
• no seams;
• Local anesthesia is used during surgery, which patients usually tolerate well;
• the ability to cope with even the most complex cases of visual impairment;
• fast rehabilitation times;
• the ability to stop wearing glasses on the first day after surgery;
• high efficiency and minimal risks;
• simplicity and high speed, accessibility.

On a note! Lasik is not as wonderful as it seems. The main disadvantage of the operation is its rather high cost.

How is Lasik performed?

Lasik surgery is performed in a fairly short time. However, before the patient goes to the operating room, he will have to undergo the necessary examination to determine the condition of the eyes. Diagnostics will enable doctors to determine the most appropriate type of operation, as well as to make tentative predictions for its outcome. Diagnostics are performed using high-precision computerized equipment. You may also need to take blood tests for hepatitis B and C, HIV and a complete blood count.

Of course, Lasik must be performed by a highly qualified surgeon with experience in performing such operations. But overall, Lasik is safe now, and there is no need to worry about possible vision loss. The operation is carried out like this.

1. First of all, drops that have an anesthetic effect are injected into the eyes. They will allow the patient to feel nothing. Next, an eyelid expander is inserted into the eye, which will stop reflex blinking. At the same time, the patient begins to look at the luminous point - the eye is centered.
2. Next, using a microkeratome instrument or a femtosecond laser, a flap is created on the corneal layer of the eye. The diameter of the flap is about 8 mm. It is not completely cut out; one part of it remains attached to the cornea. The patient will not feel anything. The flap is bent to the side and allows access to other layers of the cornea.
3. Then the laser correction itself occurs. The excimer laser acts on the cornea, correcting it in such a way that after the operation, light rays passing through the eye can be reflected on the retina - the person will be able to see well.
4. The operation is completed - the corneal flap is returned to its place and fixed independently on the eye due to adhesion, no sutures are applied.
5. The operation is repeated on the second eye.

Video - How is Lasik performed?

Rehabilitation

After the Lasik surgery is completed, the patient spends a couple of hours in the clinic under the supervision of doctors. As soon as vision stabilizes a little, the person can go home. The next day he will need to see a doctor. At first, you may feel sand in your eyes and a large amount of tears are released.

Important! You should not come to the operation in your own car. It is better to ask someone to accompany you, since you should not drive after such an intervention.

Unfortunately, not all clinics issue sick leave. Therefore, if you want to relax after surgery, it is better to plan it during your vacation. In general, the maximum period for which disability may last, depending on the degree of eye injury, is 5-30 days. In the postoperative period, it is very important to follow all the doctor’s recommendations - use the right drops, properly care for your eyes, etc.

At first, it is also recommended to reduce visual stress - read less and sit at the computer. Although in general, after Lasik surgery, patients return to normal life within a couple of days. Exceptions are difficult sports that should be temporarily excluded from your life for now.

Restrictions and contraindications

Unfortunately, not everyone can undergo Lasik surgery. But it actually doesn’t have as many contraindications as it might seem. So, the restrictions for performing the operation are age under 18 or more than 45 years, as well as pregnancy and the lactation period. Among the absolute contraindications are:

• a number of autoimmune diseases;
• having only one eye;
• thin cornea;
• glaucoma, cataract;
• progressive myopia;
• operated

If a person has progressive myopia, then first he will have to undergo scleroplasty, which will stop the process of vision deterioration. After this, you can safely do Lasik. Lately, by the way, scleroplasty is rarely used.

A number of relative contraindications include diabetes mellitus, a number of nervous disorders, the presence of a pacemaker, and inflammatory processes occurring in the eye area.

Complications

Complications after Lasik surgery are not uncommon. According to statistics, they can appear in 46% of cases. The patient may receive diplopia, glare in front of the eyes and other visual effects as a gift. However, a number of complications arise either due to incorrect preliminary calculations or due to improper eye care after surgery.

Attention! Lasik is irreversible, and nothing can be done back.

Sometimes after Lasik there are fluctuations in the quality of vision, dry eye syndrome, postoperative astigmatism and other problems. However, this does not stop people with vision problems from visiting a surgeon, because Lasik is an opportunity to see well again.

What to do after surgery?

Step 1. It is important not to forget to get general recommendations from your doctor and a prescription for purchasing the necessary medications at the pharmacy before leaving the clinic. It is also worth reminding about issuing an invitation to the next appointment after the operation.

Step 2. It is necessary to ask someone to accompany the patient home. It is not always possible for a person to get to the apartment on his own after surgery.

Step 3. The first day after surgery should be devoted to rest without eye strain. At the same time, it is important to ensure that you do not close your eyes and move them as little as possible. Under no circumstances should you rub your eyelids.

Step 4. The doctor will prescribe the use of a number of medications - they must be purchased at the pharmacy and used as prescribed. It is important to wash your hands thoroughly with soap and water before each injection of drops into your eyes, and during instillation, make sure that the dropper of the bottle does not touch your eyes.

Step 5. It is important to use clean gauze soaked in water to clean the area around the eyes. You cannot wash your face using any products.

Step 6. In case of any troubles, it is important to call your doctor and get advice on how to behave.

Laser vision correction is a modern and effective method that helps to cope with such serious pathologies as astigmatism, myopia, hypermetropia. Mild ophthalmological disorders can be corrected with glasses and lenses, but there is always a risk that these diseases will manifest themselves with renewed vigor over time. With laser correction, this likelihood is minimized. However, such operations also have negative sides. Which ones exactly? We'll talk about all this in our article.

What it is?

The cornea is a light-refracting element of the visual apparatus, which is responsible for the clarity of vision of objects. When the cornea is deformed, these functions are lost, and Lasik eye surgery is used to restore them.

Previously, the shape of the cornea was restored through surgery, but this was associated with high traumatism. And there were also high risks of unsuccessful completion of the procedure. As statistics showed, positive results were not observed in all patients.

Unlike traditional surgery, a laser beam can be called a thinner instrument. It has a highly precise effect on certain tissues, without affecting healthy areas of the cornea.

IMPORTANT! The essence of laser vision correction using the lasik method is to change the shape of the cornea so that the image of objects accurately falls on the retina of the eye.

During the procedure, the deep structures of the cornea are heated and certain layers are evaporated. First, the specialist makes microsurgical incisions, after which the upper portion of the cornea is bent to provide access to the deep tissues.

Indications and contraindications

• astigmatism;
• myopia;
• farsightedness.

The procedure also has an impressive list of contraindications:

• minor patients;
• age over forty-five years;
• pregnancy period;
• lactation;
• cataract;
• glaucoma;
• keratoconus;
• lens spasm;
• tumor processes of the eye;
• inflammatory diseases of the eye;
• retinal detachment;
• diabetes;
• optic nerve atrophy;
• rheumatism, rheumatoid arthritis;
• Presbyopia – age-related farsightedness.

ATTENTION! Laser correction cannot be performed if there has been a sharp decrease in vision over the past year.

There is no point in carrying out correction for ophthalmological diseases such as glaucoma, cataracts or optic atrophy. In all these cases, vision loss is not associated with refractive error, so laser correction will not bring positive results.

And you should also not perform surgery for skin diseases such as eczema, psoriasis, and neurodermatitis. All these pathological processes are characterized by the formation of keloid scars. There is a high probability that scar changes will also affect the tissues of the eye after surgery, and this can lead to complete loss of vision.

Severe neurological or psychological abnormalities are contraindications to laser correction. The patient may have an inadequate reaction both during the operation and during the rehabilitation period.

Relative contraindications include colds accompanied by a runny nose and cough. After a preliminary examination, the ophthalmologist can identify individual contraindications to the procedure.

Advantages and disadvantages

Every year, several million laser vision correction operations are performed around the world. The procedure has proven its effectiveness and safety.

Laser correction Lasik has an impressive list of advantages:

• Minimal risks of relapse.
• Maximum security.
• Can be used for all types of visual impairment.
• No pain at all stages of the operation. Before the procedure, drops with an anesthetic are instilled into the eyes. The patient only feels touch and pressure.
• Fast results. Within a few hours after the procedure, the patient will notice the first results. During the first week, visual function will stabilize.
• Stability of results. After correction, the shape of the cornea is maintained for life.
• Conducted on an outpatient basis. There is no need for the patient to stay in the hospital. A few hours after visual correction, he can go home.
• There is no need for general anesthesia.
• Minimal risks of medical error, since the participation of a specialist in the procedure is minimal.
• The operation is bloodless and does not require stitches.
• Possibility of performing the procedure on both eyes at once.
• No side effects. Of course, provided there are no contraindications and compliance with medical recommendations during the rehabilitation period.

The patient does not experience pain during the procedure

IMPORTANT! In cases of high myopia, laser correction will be useless.

Still, you don’t need to reassure yourself with the thought that laser correction is an ideal technique. It must be admitted that the procedure has a number of objective disadvantages, namely:

• It is not always possible to get rid of visual dysfunction.
• Some restrictions in the recovery period. This includes working at the computer, reading books, and physical activity.
• The stabilization period for visual function is up to a year.
• Presence of medical contraindications.
• High price.
• There may be inaccuracies in diagnosis and calculations, which can lead to insufficient correction.
• The procedure cannot prevent the appearance of new visual disturbances.

Basic methods

Currently, there are several methods of laser vision correction. They all have common basic features, but may differ in the following parameters:

• implementation algorithm;
• technologies used;
• material.

Let's talk about the most common types of such operations:

• Lasik. The technique is very popular. It is considered one of the safest and most affordable. The laser beam changes the shape of the cornea and helps separate the iris.
• Photorefractive keratectomy. This is an old technique that has only been slightly improved. Specialists use it if there are contraindications to laser correction. PRK has many disadvantages. During the operation, the surface layer of the cornea is completely removed, so the procedure is very traumatic. At the end of the procedure, a protective lens is applied, under which a new corneal layer is formed, after which it is removed. PRK is considered a painful operation with a high risk of dangerous complications.
• Epi-lasik. Before using the laser, chemicals are used to remove the dense outer layers.
• Femtolasic. During the procedure, a special type of laser is used, which is capable of separating the necessary layers at any given depth. The only difference is that the procedure is performed using a femto laser.

femto-LASIK

The peculiarity of this procedure is that the cornea is incised using a femtosecond laser beam. It is not used in all ophthalmological clinics in Russia, since the treatment costs a lot. In terms of effectiveness and morbidity, the procedure is not much, but it exceeds the standard operation.

IMPORTANT! The femtolasik procedure is an improved modification of the LASIK procedure.

When using femto-assisted correction, the corneal valve is formed not with a mechanical instrument, but by tissue dissection. During the manipulation, a beam of infrared light is used. This allows treatment of patients with corneal abnormalities, dry eye syndrome, and thinning of the cornea.

super-LASIK

Superlasik is not a separate technique, but only a commercial name for the LASIK procedure. It is the latest advance in the field of refractive surgery. The manipulation is performed according to the individual parameters of the patient's eyes.

Superlasik costs much more than standard correction, but does not have any special advantages or differences. Using this technique, the parameters of laser exposure are calculated on a wavefront analyzer. This data is then transferred to the laser computer.

epi-LASIK

Developed by Greek specialists back in 2003. The procedure is performed using an epikeratome, a medical instrument. The epithelium is separated along the natural division line of the layers.

Next, under the action of laser beams, evaporation occurs, due to which the shape of the cornea changes, after which the epithelial flap returns. It is worth noting that the technique is not suitable for everyone. According to statistics, it suits forty percent of patients who have not previously used contact lenses.

Preparation and planning

The main goal of preparation is to eliminate contraindications to excimer laser correction. At least a week before a planned operation, patients who use contact lenses must abandon such optics. This is due to the fact that corrective devices have a mechanical effect on the cornea. To determine the parameters of the cornea as accurately as possible, time is required for its adaptation.

It is better to notify an ophthalmologist about the presence of existing chronic processes. Immediately before the procedure, you should not apply makeup or use any cosmetic products.

You will need to take sunglasses with you to the clinic, as there will be increased sensitivity to light in the first few days. Motorists should take into account the fact that they will not be able to drive for several days after the operation. Traveling by public transport is also not recommended due to the risk of infection.

Features of the event

The operation will not take much time for the patient. It usually lasts within ten minutes. The manipulation is carried out in stages:

1. The patient is given eye drops containing an anesthetic.
2. To prevent blinking, a speculum is inserted between the eyelids.
3. For subsequent extension of the flap, a suction ring is installed on the cornea area.
4. The patient is asked to focus his gaze on the luminous point. This allows you to fix the eye in the desired position.
5. Using a keratome, the layer of the cornea is separated, after which it is bent to the side.
6. The laser beam acts on the exposed surface of the cornea.
7. At the end, the bent part of the cornea returns to its original place.
8. A rinsing solution and anti-inflammatory drops are instilled into the eyes.

There is no pain during the procedure itself, but patients may experience minor pain after the operation. If discomfort interferes with leading a full life, the doctor may prescribe anesthetic drops.

The operation is carried out using modern equipment

Rehabilitation period

Despite the fact that laser vision correction is a safe and painless procedure, after it is performed, patients are forced to adhere to certain restrictions. This will prevent the development of complications and dangerous consequences.

There are myths regarding restrictions after laser treatment. Despite the fact that such operations have been carried out for many years, some patients are wary of them, all because of common false claims.

Is it true that after laser correction it will no longer be possible to play sports? Some patients are absolutely sure of this. They think that after surgery, the blood vessels and tissues of the eye may be damaged due to physical activity. Actually, this is not true!

Restrictions on physical activity exist, but no more than a month. Patients are prohibited from lifting weights or intensely exercising. After the recovery period and in the absence of complications, patients can return to their usual rhythm of life.

And it is also believed that after the procedure you will have to watch less TV, read and work on the computer. Is it so? In the first days after visual correction, of course, it is better to take care of your eyes and not overwork them. There are no restrictions on watching TV in the future, it is only important to follow the correct mode. Don't forget about breaks. Moderation is a quality that is important in everything, including visual stress.

It is also worth noting another opinion, the essence of which is that if laser correction is carried out at a young age, then after forty years the cornea will begin to deteriorate due to the effects of the laser. This assumption has no scientific basis. Experts say that the excised and subsequently healed cornea is no different from other eye tissues that have not been subject to surgery.

There are also official restrictions that will help avoid unwanted problems in the future. Doctors recommend not washing your face at all during the first days. Do not rub your eyes or touch them at all. During the first week, visiting saunas and baths is strictly prohibited.

During the first week, it is recommended to sleep on your back. Lying on your side or stomach increases blood flow to your eyes. You should not apply decorative cosmetics to your face during the first week, or use hairsprays or hair sprays.

Consequences

The likelihood of unwanted complications after laser correction is negligible. Moreover, the consequences can be diverse and numerous. Most often, adverse reactions develop due to the fault of the patient himself. In most cases, if a person ignores medical recommendations regarding limiting physical activity during the rehabilitation period and maintaining personal hygiene, then problems arise. If alarming symptoms appear, it is better to consult a doctor.

A negligent attitude towards your health can result in the following complications:

• photophobia;
• dry keratoconjunctivitis;
• keratoconus;
• deterioration of visual acuity;
• destructive changes in the vitreous body;
• corneal ectasia.