Myopia is not just the most common refractive error today—it is a genuine civilizational challenge that ophthalmologists openly call a “pandemic.” At Swisslaser, both in Warsaw and Krakow, we change patients’ lives every day by eliminating the need to wear glasses and contact lenses. How do we know that laser correction is so effective and safe? Its history spans several decades of innovation. We invite you on a journey into the world of refractive surgery, which has evolved from uncertain beginnings to ultra-precise procedures, giving sharp vision to thousands of Poles.
What will you learn from the text below?
- Is the idea of surgically correcting refractive errors new? No, the history of refractive surgery dates back to the 1950s, though the breakthrough came with the excimer laser in the 1980s.
- How widespread is the problem of myopia today? In Poland, over 60% of adults have a diagnosed refractive error, and increased screen time is deepening this problem.
- What are the key differences between the most popular correction methods? You will learn about surface methods (such as Trans-PRK) and flap-based methods (such as Femto-LASIK), understanding their advantages.
- What is the most important condition for a laser procedure to be permanent and effective? The key is refractive stability, which ensures that a so-called enhancement will not be needed in the future.
- Does an excessively high refractive error or thin cornea completely disqualify a patient? No, although it precludes LASIK, alternatives such as surface methods (PRK/LASEK) or intraocular lenses remain available.
Laser Vision Correction: The Answer to the “Myopia Pandemic”
A Brief History of Refractive Surgery
Today’s laser precision did not appear out of nowhere. It is the result of hard work by pioneers. As early as the 1950s, when refractive surgery was being born, Japanese ophthalmologist Dr. Sato conducted the first attempts to correct myopia. Although his techniques carried too great a risk of complications and were ultimately abandoned, they opened the door to further exploration. The real breakthrough came in the 1980s, when Dr. Theo Seiler used the excimer laser for the first time to successfully correct myopia. This moment initiated the dynamic development of techniques that continues to this day, making laser myopia correction one of the safest procedures in the world.
- Birth and early attempts (Dr. Sato). The first surgical interventions, though unsuccessful, initiated the era of refractive surgery in the 1950s.
- Breakthrough and development of excimer lasers (Dr. Theo Seiler). The 1980s brought the use of the excimer laser, which became the foundation of modern, safe procedures.
The Scale of Vision Problems in Poland
Myopia has long ceased to be a niche problem. Almost all of us know someone struggling with this refractive error.
The Myopia “Pandemic” – Data and Facts
Studies from 2020 revealed the scale of the problem: as many as 90% of Poles aged 18–65 report various vision problems, and over 60% have a diagnosed refractive error. The situation has been dramatically worsened by lifestyle changes. As many as 69% of compatriots admitted that increased hours spent in front of screens (remote work and learning) have affected the quality of their vision. From here, it is only a short step to describing the situation as a myopia pandemic.
- Percentage of Poles with vision problems and diagnosed refractive errors. More than half of Poles require correction, which demonstrates the mass nature of the refractive error.
- Impact of screens on vision quality (remote work and learning). Prolonged screen viewing has become a risk factor for deepening myopia.
- Why can’t myopia be cured pharmacologically? Myopia is a structural defect (shape of the eye/cornea) that cannot be reversed with tablets or glasses—it can only be corrected optically or its architecture changed surgically.
Effective Techniques in Laser Myopia Correction
The goal of all methods is the same: to appropriately reshape the central corneal surface so that the image focuses precisely on the retina. However, they differ in the way they access this tissue.
Surface (Ablative) Methods
These methods involve the excimer laser working directly beneath the corneal epithelium.
- LASEK/PRK: What it involves and what it uses (excimer laser). In PRK, the surgeon removes the epithelium; in LASEK, it is displaced. The laser then reshapes the tissue.
- Trans-PRK Smart SurFace: The least invasive option. This is an enhancement of PRK, where epithelial removal and diopter correction occur in a single stage using the excimer laser—maximally shortening the intervention time.
- EPI-LASIK and EBK (alternatives for thin corneas). These are newer surface techniques that allow safe correction even with a thinner cornea, where LASIK is contraindicated.
Deep (Flap-Based) Methods
These methods are characterized by very rapid recovery, because the deeper corneal tissue is protected by a flap, which returns to its place after the procedure.
- LASIK: Classic two-stage technique (microkeratome). The flap is created using a surgical blade (microkeratome). Although this was the dominant method for years, it is now giving way to Femto-LASIK.
- Femto-LASIK: Precise technique using a femtosecond laser. This is the gold standard. The femtosecond laser creates an ultra-thin, precise corneal flap approximately 0.1 mm thick, minimizing risk and maximizing patient safety.
Safety and Conditions for Procedure Success
At Swisslaser, we prioritize safety, which is why patients must meet specific criteria for the procedure to be effective and permanent for years.
Key Condition – Refractive Stability
- Why is stable refractive error a guarantee of effectiveness? The laser corrects what is currently present—if the refractive error is still progressing (we are talking about a change of more than 0.5 diopters per year), the procedure’s results might not be permanent, which would lead to the need for enhancement.
- What are the risks of lack of stability (risk of enhancement)? Performing the procedure too early means that in a few years the patient may need another intervention.
Expert Statement and Case Study
Dr. Victor Derhartunian (Swisslaser, Warsaw and Krakow) emphasizes the role of qualification:
“Many people push to have their refractive error corrected immediately, but we do not compromise on safety. We must be certain that the corneal architecture and refractive stability are optimal. Precise examination of corneal thickness, elasticity, and hydration is decisive. It is these data, not just diopters, that determine which method—whether Trans-PRK or Femto-LASIK—we will choose so that the patient enjoys sharp vision for life.”
Absolute Contraindications
Although technology is advancing, there are criteria that absolutely preclude laser correction:
- Cornea-related factors (thickness, pathologies, scars). For example, keratoconus, congenital pathologies, or scars.
- Contraindications arising from the ratio of diopters to corneal thickness. A cornea that is too thin does not allow the physician to safely plan the procedure.
Limitations for the Highest Refractive Errors (above -10 diopters)
- Non-recommended methods (e.g., LASIK). With very high myopia (above -10 D), classic LASIK laser correction is excluded due to the excessive amount of tissue that would need to be removed.
- Alternative solutions: Surface methods and intraocular lenses (phakic, toric). These patients can, however, successfully benefit from surface methods (PRK, LASEK) or modern intraocular implants (phakic lenses), which completely eliminate the need to wear glasses.
Procedure and Recovery
Procedure Comfort
Fears of pain are unfounded! The entire laser myopia correction procedure is performed under local anesthesia (eye drops).
- No pain during the operation. None of the methods involve pain during the laser intervention.
Post-Operative Management
Discomfort is usually temporary.
- Alleviating discomfort with NSAIDs. Any mild pain, burning, or photophobia (more common with surface methods) can be easily managed with common analgesics (e.g., ibuprofen).
- The necessity of strictly following the physician’s instructions. Drops, avoiding exertion and swimming pools—discipline during recovery is the guarantee of rapid and complete return to sharpness.
FAQ – Frequently Asked Questions
1. How long does the laser vision correction procedure take?
The laser procedure itself on one eye typically lasts several to several dozen seconds. The entire procedure, including preparation and time spent in the operating room, usually takes no longer than 15-30 minutes.
2. Is there a risk that the refractive error will return after laser correction?
If the refractive error was stable before the procedure (which is a qualification requirement), the risk of the refractive error returning is very small. A slight regression is possible in the first months, but it is rarely significant enough to require enhancement.
3. What is the optimal age limit for undergoing the procedure?
Laser correction can typically be performed from the age of 18, provided there is refractive stability. There is no upper age limit, as long as the patient meets all medical criteria and does not have cataracts or other contraindications.
4. Is the Femto-LASIK procedure safer than LASIK?
Yes. Femto-LASIK, using a femtosecond laser to create the flap, is significantly more precise and predictable than classic LASIK with a microkeratome (blade). As a result, the risk of flap-related complications is minimized.
