Refractive eye surgery, or vision correction surgery, are surgical procedures used to fix or improve the refractive state of the eye. It is a simple and safe alternative to glasses or contact lenses. There are various methods of this surgery, including surgical remodeling of the cornea, lens implantation, or lens replacement. Today, the most common method is using excimer lasers to reshape the curvature of the cornea. The cornea is the clear front part of the eye that lets light travel through and focus properly on your retina. Most of the refractive eye surgery can treat a range of very common vision problems, such as nearsightedness (myopia), farsightedness (hyperopia), as well as astigmatism.
Refractive eye surgery is not for everyone. In general, this procedure is appropriate for people with a moderate degree of refractive error and no unusual vision problems. The best candidate for this procedure is people who are at least 18 years of age and not pregnant or nursing. You should also make sure that you have a stable vision over the past year and have no history of active corneal disease or significant medical problems (such as corneal ulcers, diabetic retinopathy, and glaucoma). In some cases, a number of patients will still need to wear sunglasses in certain situations, for example when driving at night. To decide if this procedure is right for you and to determine which technique is most suitable for your condition, your eye surgeon will ask you detailed questions.
There are some cases in which refractive eye surgery is performed on children, usually on children who are cognitive or visual development is failing due to refractive error. Some examples where children will need refractive eye surgery are a bilateral high refractive error, anisometric amblyopia, anisometropia, or accommodative esotropia. However, refractive eye surgery for children involves other risks than for adults.
There are several types of refractive eye surgery. The following are some of the more common types.
- LASIK or laser in-situ keratomileusis is a procedure for people who have myopia, hyperopia, and astigmatism. During this procedure, your surgeon uses a microkeratome or a femtosecond laser to cut a flap of your corneal tissue. Then, the tissue underneath your cornea is reshaped so it can focus light properly.
- RLE or refractive lens exchange is similar to cataract surgery. Your surgeon makes a small cut at the edge of your cornea, removes your natural lens, and replaces it with a plastic lens implant. It can correct extreme myopia and hyperopia. It also works well with people who have thin corneas, dry eyes, or other minor cornea conditions. Sometimes, this type of procedure is combined with LASIK to correct astigmatism.
- PRELEX stands for PREsbyopic lens exchange and it can treat presbyopia or a loss of flexibility in your eye. This procedure is performed by removing your lens and replacing it with a multifocal lens.
- An aphakic intraocular lens (PIOL) is suitable for people who are too nearsighted for LASIK. Your surgeon makes a small incision at the edge of your cornea. Then, the implant lens is attached to your iris or inserted behind your pupil and your natural lens stays in its original place.
- PRK stands for photorefractive keratectomy is a procedure to correct mild to moderate myopia, hyperopia, and astigmatism. It is similar to LASIK as a laser is used to reshape the cornea. The difference between PRK and LASIK is that PRK only affects the cornea’s surface and not the tissue underneath.
- LRI or limbal relaxing incisions is a surgical procedure to correct astigmatism. Your surgeon will make one or two incisions at the sharpest part of your cornea to help it relax and to make it more rounded.
In general, you are given either local anesthesia in the form of eye drops or general anesthesia. If you are given local anesthesia and you fear that you will be nervous, you can request a mild sedative to help you relax. Pediatric refractive eye surgery requires general anesthesia in order to avoid risks due to involuntary movement.
Length of Stay in Destination
After the procedure, you need to stay in the hospital for a few hours to be monitored. You may go back to your hotel on the same day once the effects of the anesthesia wear off. Some procedures such as LASIK will only require you to stay in the area for 2 days, but other procedures will take longer, sometimes up to 7 days.
The recovery period is different depending on which type of procedure is being performed. For LASIK, a full recovery can take up to 6 months. However, you should be able to return to work within a few days. The recovery time for PRK may be longer than that. In general, the recovery time is painless and quick with only slight discomfort. It is common to feel some soreness and your eyes may feel a little watery. Most people can immediately see significant positive results after the first few days after the procedure.
Follow-up checkups are very important because it allows your surgeon to determine your eye health and when you will be able to drive or use gadgets. Your surgeon will likely give you detailed aftercare instructions and there might be several restrictions that you must obey during your recovery period. Try to avoid having a shower immediately after the procedure. You will also need to reduce the chances of exposing your eyes to irritation for the first week. Do not apply any products around your eye, get soap or water in your eyes or wear eye makeup. Avoid being around people who smoke as smoke can irritate your eyes. You should also avoid rubbing your eyes as it can cause severe discomfort and increase the risk of complications. It is advised to do some exercise within three days of your surgery, but you should avoid yoga, aerobics, as well as strenuous exercises and sports such as weight lifting, football, or tennis.
The success rate for refractive eye surgery is exceptionally high and your result depends on several factors, including your refractive error. People with mild nearsightedness usually have the most success, while people with a high degree of nearsightedness, farsightedness, or astigmatism have less predictable results. According to studies, 95% of nearsighted patients who undergo LASIK achieve improved vision after recovery.
It is important to be aware that refractive eye surgery also possesses some potential risks and complications, including under correction or overcorrection, excess corneal haze, regression, halo effect, flap damage or loss, worse vision, as well as infection and delayed healing.
Alternatives to Refractive Eye Surgery Procedure
Refractive eye surgery is still the best way to treat common vision problems. Nevertheless, people who do not want to undergo surgery can have conventional reading glasses, varifocals, multifocal, or bifocals to focus the top half of the glasses for distance and the lower half for reading. Contact lenses can also be used to create a multifocal cornea.
For an in-depth analysis of the Refractive Eye Surgery Procedure, watch this short video.
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