LASER EYE SURGERY

There are some refractive errors or eye issues that could impair your vision, such as:

• Myopia (short-sightedness): inability to see distant objects clearly.
• Hyperopia (long-sightedness): inability to see close objects clearly.
• Astigmatism: blurry vision due to an irregular eye shape.

Myopia and hyperopia are the most common refractive eye errors. They are caused by eye abnormalities that affect the ability to focus light on the back part of the eye called the retina.

Light is bent (refracted) by the cornea, the clear surface at the front of your eye, and the crystalline lens inside it. Then, it ends up back at the retina, a fine layer of light-sensitive cells.

When the light doesn’t focus correctly or hit the retina properly, our brain interprets a blurred image.

Myopia is the most common refractive eye problem worldwide. If you suffer from short sight, you will have difficulty seeing distant objects clearly but will be able to perform close-up tasks, such as reading and using the computer.

Myopia occurs when the eyeball is too long. It causes light rays to focus in front of the retina instead of directly on the surface.

Short sight can also be caused by the cornea being too curved for the length of the eyeball.

Conversely, hyperopia is better known as far-sightedness and is the opposite of myopia. The eyeball is too short, causing light rays to be refracted behind it.

If you’re shortsighted, the first number on your eyeglasses prescription is preceded by a minus sign (–). The opposite applies to hyperopia.

Both refractive errors can be corrected using eyeglasses, contact lenses, or having refractive surgery. The latter includes laser eye surgery and lens surgery.

Laser eye surgery changes the cornea’s curvature, altering the way the light bends to ensure it is focused correctly. There are two main types of laser eye surgery.

Laser-assisted in situ keratomileusis (LASIK surgery) and Photorefractive keratectomy (PRK/LASEK) are the two laser techniques used to solve refractive problems (myopia, hyperopia, and astigmatism).

Both PRK and LASIK surgery modify and reshape the cornea surface. However, the surgical procedures are performed differently.

With PRK, your eye surgeon removes the thin external layer of the cornea (epithelium) to get access. Your surgeon then uses lasers to reshape the layers of the exposed cornea and fix any irregular curvature in your eye to achieve the required correction.

Conversely, in LASIK surgery — the most common refractive procedure — the surgeon uses a laser to separate the corneal epithelium and create a corneal flap. This flap is raised up, and your surgeon uses the laser to reshape and remove part of the corneal tissue. Then, the flap is lowered back down, and the cornea should repair itself over the next few months without using stitches.

Ultimately, the choice of technique depends on the results of the eye tests during the first preoperative consultation. It should be the specialist in laser eye surgery who personally evaluates you and has the last word on the best technique for your particular case.

Laser eye surgery is highly effective and safe to correct low to moderately high cases of myopia, long-sightedness, and astigmatism.

Corneal refractive surgery with laser is highly safe. According to the Royal College of Ophthalmologists, flap complications with LASIK surgery arise in less than 5% of cases and can usually be corrected with little or no vision loss.

Also, some patients have a problem with dry eyes in the months after surgery, and artificial tear supplements may be needed long term.

Many patients have experienced glare or halo effects when night driving the first months.

During the first 6 hours, you should keep both eyes closed as much as possible. This reduces the discomfort and helps the patient’s recovery. Before leaving the hospital, specialists will give you the necessary instructions and aftercare medication.

You must protect the eyes with protective glasses even when at home to avoid rubbing them or involuntary knocks.

Also, after the surgery, you may note a burning or itching sensation or the feeling that there is something in your eye. In most cases, this feeling doesn’t last more than 6 hours. The doctor may prescribe medication for mild pain and a sedative to ease any discomfort.

Vision is generally blurred or cloudy the same day of the operation, but this blurriness will improve the following days. Although visual recovery is quick, it is recommended to have a few days of rest and off work. However, this process is longer with LASEK surgery, and the first 24 hours can be slightly painful.

Is the postoperative period very complicated?

The procedures require very little postoperative medication: some eye drops and artificial tears that have to be used briefly.

How long will it take me to resume my normal activity?

After an intervention with laser, the patient’s visual recovery is very fast. In most cases, normal activities can be resumed the day after the surgery. The final result is usually achieved after a week.

If I am not a candidate for laser eye surgery, what alternative is there to remove my vision problem?

Suppose specialists decide that a patient cannot be treated with laser refractive surgery because of high myopia or special eye conditions. In that case, the alternative could be the implantation of an intraocular lens.

Is laser eye surgery permanent?

Surgery is permanent, but it won’t prevent aging of the eyes. Hence, a very small percentage of patients might need additional minor adjustments, aka follow-up surgery.

What happens if I move my eye during the intervention?

It is necessary to understand that the patient must not move the head or body as it is a microsurgical operation. However, during the laser application, the system has a device that can correct small eye movements.

I am pregnant; can I have laser surgery?

No. It is necessary to wait until after childbirth and the breastfeeding period. During pregnancy, there could be slight changes in eye strength. Also, there is a risk that the postoperative medication could get into the breast milk during the breastfeeding period.

Can you have laser eye surgery twice?

In some cases, due to natural aging, a second surgery might be required. However, each patient is different. A second surgery can be performed depending on several factors as patient’s cornea and its thickness.

Lasek Vs Lasik: Which One Is Better? Pros & Cons, Procedure & Aftercare.

Phakic intraocular lenses: Recent advances and innovations. Martínez-Plaza E, López-Miguel A, Holgueras A,Barraquer RI, Alió JL, Maldonado MJ.Arch Soc Esp Oftalmol. 2020 Apr;

Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy. Vargas V, Alió JL,Barraquer RI, D’ Antin JC, García C, Duch F, Balgos J, Alió Del Barrio JL.Eye Vis (Lond). 2020 Jul 1