Laser vision correction the answer to the “myopia pandemic”

Short-sightedness has remained the most common vision defect for years, so it’s no surprise that it was the vision defect that was “taken for granted” when refractive surgery was born in the 1950s.

At that time, a Japanese ophthalmologist (Dr. Sato) performed a series of procedures on volunteers with myopia, and since they were fraught with a large number of post-operative complications, he abandoned the trials, leaving the development of surgical techniques to his successors.

There was no need to wait long. Back in the ’80s, Dr. Theo Seiler performed the first successful laser myopia correction surgeries using the excimer laser. And then came the galloping development of refractive surgery, which continues to this day.

Although nowadays more than just myopia is being operated on with lasers, it is the correction of this visual defect that has the longest history, so any doubts about its effectiveness and safety are unfounded!

Myopia pandemic

A study conducted in early 2020, showed that as many as 90% of Poles aged 18-65 have various eye and vision problems, and more than 60% have a diagnosed visual impairment. 69% of compatriots admit that the increased number of hours spent in front of screens (working and studying remotely!) has worsened the quality of their vision. Ophthalmologists say we now have a true myopia pandemic.

Short-sightedness cannot be cured pharmacologically, nor will it be reversed by wearing even the best-fitting glasses or contact lenses.

Instead, it can worsen, making it necessary to reach for ever stronger glasses or contact lenses. A stabilized visual defect is not worth “growing”. – you can get rid of it with laser vision correction.

Techniques effective for laser myopia correction are:

• LASEK/PRK: The procedure involves either deflecting (LASEK) or removing (PRK) the upper cellular layer of the cornea (epithelium) and then appropriately reshaping the underlying corneal tissue with an excimer laser. The goal of the procedure is to properly model the central surface of the cornea with a laser beam so that it focuses the image precisely on the retinal surface.

• LASIK: a two-step technique; the cornea is incised with a scalpel (microkeratome), and then the corneal surface is modeled so that it can properly focus the image onto the retina.

• Femto-LASIK: using a precise femtosecond laser, the surgeon makes a cut in the cornea, creating a thin flap 0.1 mm thick – a flap. He uses an excimer laser to reshape the previously exposed cornea for a few seconds, then the flap is closed back up; it attaches and forms a protective corneal barrier.

• Trans-PRK smart surFace: The least invasive laser treatment for myopia. Dioptric correction is done in the first stage of the procedure, while the surgeon uses a high-precision excimer laser. PRK used to be the standard method of laser eye treatment, and LASIK replaced it because it involved less pain. However, the LASIK technique failed in patients whose corneas were too thin or irregular. Trans-PRK’s state-of-the-art capabilities helped optimize the procedure at the most important point.

As mentioned, one of the conditions for successful laser intervention is a stabilized visual defect. It is the stabilization of the defect that guarantees that the procedure will not have to be repeated someday, performing a so-called “correction”.

Therefore, if the doctor decides that he can not yet perform laser vision correction – do not push, wait for your time. For that, if he deems that your defect is stabilized and you meet other conditions, allowing laser intervention in the eye – do not hesitate. Laser myopia correction is a safe and effective procedure.

Conditions that absolutely preclude undergoing laser myopia correction

Absolute conditions, i.e. those that indisputably prevent one from undergoing laser vision correction, are few. These are primarily conditions related to the thickness, elasticity and degree of hydration of the cornea, as well as certain corneal lesions (corneal cone, congenital corneal pathologies, dystrophic diseases, corneal scars). Also: the ratio of corrected diopters to corneal thickness.

If the doctor determines that our cornea is too thin, he will not be able to develop the so-called architecture of the procedure, i.e. plan the operation in such a way as to achieve the optimal result for the patient. Programming and carrying out the procedure, even with the most precise lasers, will simply not be possible.

Too high a visual defect (myopia above -10 diopters) also belongs to this group of contraindications – patients cannot undergo laser correction performed by LASIK, but it does not mean that they are doomed to wear glasses or lenses. They can benefit from surface methods with complete removal of the corneal epithelium (PRK, LASEK).

Thin corneas can also undergo laser surgery with any of the newer methods, including EPI-LASIK or EBK, or undergo single, bifocal or trifocal toric intraocular lens implantation, or phakic lens docking or refractive lens replacement.

The laser myopia correction procedure is performed under local anesthesia. None of the laser vision correction methods are associated with pain sensations AFTER the operation, and the discomfort AFTER the operation can be alleviated by taking popular NSAIDs (non-steroidal anti-inflammatory drugs and painkillers, such as those containing ibuprofen or paracetamol).

After laser vision correction, it is imperative to follow the doctor’s recommendations. You can read all about it here.