What is laser vision correction
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Laser vision correction is a procedure utilizing methods and techniques of laser refractive surgery. It is currently the safest method, offering the greatest possibilities for intervening with the eye. It involves laser-shaping the anterior surface of the cornea.
What is laser vision correction?
Laser vision correction is a procedure utilizing methods and techniques of laser refractive surgery. It is currently the safest method, offering the greatest possibilities for intervening with the eye. It involves laser-shaping the anterior surface of the cornea. The result is an improvement in visual acuity for patients with myopia, hyperopia (farsightedness), and astigmatism.
Is it safe?
Laser eye correction is a maximally safe procedure (the complication rate is below 1% of cases), painless, and allows for an almost immediate return to normal daily functioning. It is a permanent and effective alternative to contact lenses and traditional corrective glasses.
Laser correction of myopia involves flattening the cornea in the center of the eye to reduce the refractive power of light rays – this is a refractive error where parallel light rays entering the eye refract not on the retina, but in front of it.
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Methods of laser correction for myopia
LASEK/PRK
The procedure involves either lifting (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 precisely reshape the central corneal surface with a laser beam so that it focuses the image accurately onto the retina.
Femto-LASIK
Using a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is then used to reshape the exposed cornea for a few seconds, after which the flap is repositioned; it adheres and forms a protective barrier for the cornea.
LASIK
Two-stage technique: the cornea is incised with a scalpel (microkeratome), and then the corneal surface is reshaped so that it can properly focus the image onto the retina.
Trans-PRK smart surFace
The least invasive method of laser treatment for myopia. Diopter correction takes place in the first stage of the procedure, while the surgeon uses a high-precision excimer laser. PRK was once the standard method of laser eye treatment, but LASIK replaced it due to less pain. However, the LASIK technique failed in patients whose corneas were too thin or irregular. Modern Trans-PRK capabilities have optimized the procedure at its most critical point.
EBKTM (Epithelial Bowman’s Keratectomy)
This is a modification of the LASEK and PRK methods. The epithelium is precisely removed with an Epi-Clear knife, which gently and in a fully controlled manner prepares the cornea for the procedure, leaving its deeper layers intact. Compared to other surface methods, after EBK, the epithelium regenerates up to twice as fast, and the regeneration process is milder than in other surface methods. The EBK method is the first choice for a relatively small group of patients. The range of correctable defects is small: from -8 D to +3 D, astigmatism up to 5 D, with the procedure primarily dedicated to individuals with thin but healthy corneas. EBK can be used in individuals for whom there is a clear contraindication to LASIK-type procedures (LASIK, FEMTOLASIK, VLASIK®).
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Laser correction for hyperopia
During laser correction for hyperopia, a greater corneal curvature is created, which increases the eye’s refractive power, thereby improving comfort and visual acuity.
LASIK
Two-stage technique: the cornea is incised with a scalpel (microkeratome), and then the corneal surface is reshaped so that it can properly focus the image onto the retina.
Femto-LASIK
Using a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is then used to reshape the exposed cornea for a few seconds, after which the flap is repositioned; it adheres and forms a protective barrier for the cornea.
EBKTM (Epithelial Bowman’s Keratectomy)
This is a modification of the LASEK and PRK methods. The epithelium is precisely removed with an Epi-Clear knife, which gently and in a fully controlled manner prepares the cornea for the procedure, leaving its deeper layers intact. Compared to other surface methods, after EBK, the epithelium regenerates up to twice as fast, and the regeneration process is milder than in other surface methods. The EBK method is the first choice for a relatively small group of patients. The range of correctable defects is small: from -8 D to +3 D, astigmatism up to 5 D, with the procedure primarily dedicated to individuals with thin but healthy corneas. EBK can be used in individuals for whom there is a clear contraindication to LASIK-type procedures (LASIK, FEMTOLASIK, VLASIK®).
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Laser correction for astigmatism
Astigmatism often accompanies myopia. Parallel light rays entering the eye refract in two different planes (e.g., vertical and horizontal), resulting in a lack of image sharpness, distortion, waviness, and poor contrast. The latest surgical technologies enable laser correction of astigmatism concurrently – i.e., during the same procedure – with laser correction of myopia.
Femto-LASIK (All-Laser-LASIK)
Using a precise femtosecond laser, the surgeon makes an incision in the cornea, creating a thin flap 0.1 mm thick. An excimer laser is then used to reshape the exposed cornea for a few seconds, after which the flap is repositioned; it adheres and forms a protective barrier for the cornea.
LASIK
Two-stage technique: the cornea is incised with a scalpel (microkeratome), and then the corneal surface is reshaped so that it can properly focus the image onto the retina.
LASEK/PRK
The procedure involves either lifting (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 precisely reshape the central corneal surface with a laser beam so that it focuses the image accurately onto the retina.
Qualification for laser vision correction
Qualification for laser eye surgery includes:
- corneal topography
- patient interview
- computerized vision examination (autorefractometry)
- keratometry (corneal curvature measurement)
- pachymetry (corneal thickness measurement)
How laser vision correction is performed
Laser vision correction is performed under local anesthesia in an outpatient setting. Depending on the chosen method, the patient may experience minor or greater, but short-lived, discomfort. None of the laser vision correction methods involve pain DURING the operation.
First phase of laser vision correction:
precise preparation of the surgical area: the patient’s face is cleansed with a special antiseptic, and their eyes are anesthetized with eye drops
immobilization of the patient’s eyelids with special speculums
Further procedure depends on the chosen method.
Modern laser devices have an eye-tracking function (e.g., Eye Tracker 6D or 7D system), making them very precise, so the patient does not have to worry that a slight movement of their eye will cause the procedure to fail.
Laser vision correction takes from several to a dozen minutes – shorter than the preparation for it. During the procedure, the surgeon is in constant contact with you and can explain, step by step, what they are doing and what is happening with your eyes.
Post-operative recommendations for laser vision correction
- Do not drive – it is advisable to come to the laser vision correction procedure with a friend who can drive you home.
- You may return to light activity at home, but be careful not to perform any actions that could lead to touching or rubbing your eyes.
- To prevent eye strain and ensure a quick recovery, avoid all screens – televisions, smartphones, tablets, computers, e-readers – and any activities such as reading books.
- Wear sunglasses.
- It is recommended to take a bath instead of a shower to avoid eye irritation from soap and water.
- Remember that air conditioning can dry out your eyes. Use moisturizing drops with sodium hyaluronate (so-called artificial tears).
- Avoid contact with people suffering from infections such as colds, flu, or contagious diseases. After surgery, like any other organ in our body in a similar situation, the eye requires complete healing in the safest possible conditions.
Contraindications for laser vision correction
Absolute contraindications
These determine that the refractive error cannot be corrected by laser. Therefore, there is no point in forcibly seeking a surgeon who, ignoring the results of our tests, would break procedures and perform the operation anyway.
- certain corneal changes (keratoconus, congenital corneal pathologies, dystrophic diseases, corneal scars) and corneal thickness, elasticity, and hydration level
- glaucoma
- Cataracts
- ratio of corrected diopters to corneal thickness
- too high a refractive error: if the laser is not sufficient for correction, a phakic lens can be implanted or refractive lens exchange can be performed
- complicated form of astigmatism coexisting with another refractive error and/or eye disease
- tendency to form keloids
Relative contraindications
These are temporary contraindications. This means that once the objective obstacles to performing the procedure disappear, it can be carried out. It is only necessary to create appropriate conditions, wait for the right moment, e.g., reaching the appropriate age or a chronic disease entering remission.
- too young an age (which is related to the ongoing progression of the refractive error) or too advanced an age (concerning corneal thickness, hydration level, and elasticity, as well as the patient’s general health)
- unstable refractive error
- autoimmune diseases, e.g., Hashimoto’s disease, type 1 diabetes, rheumatoid arthritis (RA), as well as allergies and atopy
- pregnancy and breastfeeding
- taking certain medications, e.g., steroids, which increase the likelihood of ocular complications such as glaucoma and steroid-induced cataracts.
