The ability to see has to be one of our most cherished senses. It allows us to enjoy the world around us, however many of us have to rely on glasses or contact lenses to for our vision to function properly.
According to the Vision Council, more than 190 million people in the USA wear glasses today. If you have been using glasses for a long time, you will know about all the irritations associated with it. How they fog up when you are ready to hit that winning birdie putt, how they always have fatty fingerprints on them, how you struggle to find them in the middle of the night. And if you haven’t sat on your glasses at least once in your life, you probably haven’t had them for long.
Having to wear glasses or contact lenses means that you may have considered eye surgery at some stage. The most important thing is to make sure that you go to a reputable eye specialist for a consultation, but a little self-education on how it works will most certainly be advantageous.
The cornea (lens) is a part of the eye that helps to focus light so that an image is created on the retina, similar to the way that a camera lens works to generate an image on film. The bending and focusing of light is known as refraction. In a perfect world, the cornea will have a perfect shape and we will all have twenty-twenty vision. Unfortunately, this is not the case and it leaves us with blurred or distorted vision.
There are three main types of refractive errors: myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. If you are suffering from nearsightedness, it means that you have more difficulty seeing distant objects as clearly as near objects. Persons with farsightedness, have more difficulty seeing near objects as clearly as distant objects. Astigmatism is a distortion of the image on the retina caused by irregularities in the cornea. Glasses or contact lenses are intended to compensate for the these imperfections. Surgical procedures aimed at improving the focusing power of the eye are called refractive surgery.
The idea of having to go through an invasive process like eye surgery makes most people gulp at least a few times, especially since false rumors like “you could end up blind”, “it hurts”, “it doesn’t last long” float around on the internet. The truth is that all surgery has risks, but those in refractive surgery are really minimal. Make sure you understand the risks and benefits when you consult your eye surgeon. Most types of vision correction surgery is focused on either reshaping your cornea or replacing the lens in your eye.
LASIK and LASEK
LASIK (Laser-assisted in-situ keratomileusis) and LASEK (Laser-assisted subepithelial keratomileusis ) is the most common and most popular refractive surgical procedures today. In LASIK. your eye surgeon will alter the shape of your cornea by cutting out a thin, circular flap after which he or she will use a laser to remove or flatten some of the inner layers. After that, the flap is repositioned and you are ready to tackle your new world within a few days. In LASEK, the flap is made in the protective layer that covers your cornea. The procedure is similar to LASIK after that. Both types of surgery is over in a few minutes and not too expensive.
PRK, or photorefractive keratectomy, can correct near – and farsightedness as well as astigmatism. It also changes the shape of your cornea, using laser technology, but unlike LASEK and LASIK it only affects the cornea’s exterior, not the soft tissue below. The eye surgeon removes the whole epithelium (outside layer of the cornea), reconfigures the cornea and then allows it to grow back by itself over time. This surgery is the oldest of all the current techniques used but is not as popular as LASIK or LASEK due to the longer recovery times. Pricewise it is similar to the other two.
Small Incision Lenticule Extraction (SMILE), also known as keyhole laser eye surgery, is the latest innovation in laser surgery. It is much less invasive and more effective in correcting higher myopic (nearsighted) prescriptions to come out of the eye care industry. It uses 3D technology to send a series of precise pulses to the center of the cornea with extreme precision. These pulses “illuminate” the areas that need to be removed, so that the surgeon knows exactly where the problems are. The tissue is removed through a tiny hole created by the laser, meaning faster healing time for the patient.
It truly is life-changing and is bound to shape the industry in years to come as it grows in popularity. Glasses shops; watch your backs!
Conductive Keratoplasty (CK)
CK uses a small uses a tiny probe that submits low heat radio waves to the border of the eye's clear front surface. This relatively non-intrusive application changes the cornea, providing vision corrections for farsighted people.
Implantable lenses first received FDA approval in 2004. It requires surgery to implant lenses and is mainly for patients with high levels of myopia. Your eye's natural lens is left in place when implantable lenses are used.
Refractive Lens Exchange RLE
RLE or PRELEX, clear lens exchange CLE and reflective lens replacement RLR are basically all the same thing. These procedures have higher risk complications compared to the other types of surgery. It is very similar to cataract surgery. A small cut is made at the edge of the cornea and the natural lens is removed and replaced with a silicone or plastic lens.
Astigmatic keratotomy AK or LRI
This procedure is used to correct astigmatism. The eye shape of people afflicted with astigmatism is not round like normal people’s but is more shaped like a football. The doctor makes a few small cuts at the steepest part of the cornea to help it relax so that it becomes more rounded. This procedure can be done alone or in combination with other laser eye surgeries like PRK, LASIK, or RK.
Intacs are also known as intra-corneal ring segments or ICR. Two-minute incisions are made in the cornea so that two crescent-shaped plastic rings can be placed at its periphery. The rings flatten the cornea so that entering light is focused to the retina in a different way, improving vision.
Our eyes change as we get older. This implies that the types of vision correction required might also change. Generally, procedures that are inappropriate for older individuals, might be very good for younger ones and vice versa. There are a few ground rules though. If you are younger than 18 years, you will probably not be considered as your eyes still change at a very rapid pace. Also, if you are pregnant or breastfeeding, you should not be getting eye surgery. The reason for this is mainly that pregnant and breastfeeding women have fluctuating hormonal levels which can affect vision and healing.
According to the official website of the FDA, there are several things to consider and that your doctor should check before deciding to operate. If you have diseases like diabetes, uncontrolled glaucoma or shingles in the area of the eye, your doctor will not operate on you. Other diseases like collagen vascular disease, rheumatoid arthritis, or lupus will also diminish your chances for surgery.
It is not just your body that has to be healthy – your eyes must be in good condition too. For example, if you have keratoconus, a condition that causes your cornea to be too thin for reshaping, you will miss the boat. Then there is blepharitis, inflammation of the eyelids accompanied with crusting of the eyelashes. This will increase infection risks after your operation. If you had refractive surgery (e.g., RK, PRK, and LASIK) before, you may be advised against doing one more. Lastly, dry eyes are normally aggravated by LASEK surgery, so you will have to consult your doctor.
It is advised that you wait at least three days before doing non-contact sports and depending on your doctor’s advice. Participation in contact sports should be avoided for at least four months since any bumps could seriously damage your eyes. If you want to give your eyes the best chance to heal without getting affected, stop using eye creams, lotions, make-up a day or two before the operation and at least two weeks after. Swimming and hot tubs are also not allowed.
Eyecare Leaders is a co-managing partner with the Eye Center of Texas regarding all LASIK procedures to correct vision conditions such as of myopia, hyperopia, astigmatism and presbyopia. Eyecare Leaders is at the front-lines gathering critical information, diagnosing the condition and guiding our patient’s decision as to when to undergo surgery.
Once a surgical referral is made, Eyecare Leaders’ involvement with the patient’s care continues. We take responsibility for all aspects of the care from start to finish. For any questions regarding LASIK, please do not hesitate to ask any of our doctors.
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