Eye Surgery – All Aspects
Lasik Eye Surgery
LASIK stands for Laser-Assisted In Situ Keratomileusis. Lasik eye surgery is a procedure that permanently changes the shape of the cornea, the clear covering of the front of the eye, using an excimer laser.
During Lasik Eye Surgery
The Lasik eye surgery should take less than 30 minutes. In lasik eye surgery, you will lie on your back in a reclining chair in an exam room containing the laser system. The laser system in lasik eye surgery includes a large machine with a microscope attached to it and a computer screen. A drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will hold your eyelids open. A ring will be placed on your eye and very high pressures will be applied to create suction to the cornea. Your vision will dim while the suction ring is on and you may feel the pressure and experience some discomfort during this part of Lasik eye surgery procedure. The microkeratome, a cutting instrument, is attached to the suction ring. Your doctor will use the blade of the microkeratome to cut a flap in your cornea. The microkeratome and the suction ring are then removed. You will be able to see, but you will experience fluctuating degrees of blurred vision during the rest of the procedure. The doctor will then lift the flap and fold it back on its hinge, and dry the exposed tissue.
During lasik eye surgery, the laser will be positioned over your eye and you will be asked to stare at a light. This is not the laser used to remove tissue from the cornea. This light during lasik eye surgery is to help you keep your eye fixed on one spot once the laser comes on. If you cannot stare at a fixed object for at least 60 seconds, you may not be a good candidate for this surgery. When your eye is in the correct position, your doctor will start the laser. As the laser removes corneal tissue, some people have reported a smell similar to burning hair. A computer controls the amount of laser energy delivered to your eye. Before the start of lasik eye surgery, your doctor will have programmed the computer to vaporize a particular amount of tissue based on the measurements taken at your initial evaluation. After the pulses of laser energy vaporize the corneal tissue, the flap is put back into position. A shield should be placed over your eye at the end of the lasik eye surgery procedure as protection.
What Is Laser Eye Surgery And How Can It Help You?
Laser eye surgery is the most prevalent corrective eye surgery. Scads of people have undergone laser eye surgery with a high success rate, often resulting in a significant improvement in vision. Laser eye surgery wields superlative technology and provides excellent results more often than not. Peruse this article to have a clear understanding of how this fabulous technology could help you.
The corneal tissue plays a major role in providing you crystal clear vision. Basically, light rays are refracted (bent) by the cornea so that they fall on the retina (a layer of light-sensing cells). In a patient with a refractive error, these light rays don’t exactly converge on the retina, and hence the patient’s view is rather blurry. Depending on how the rays are refracted, a person may suffer from nearsightedness or farsightedness.
Now, laser eye surgery aims to correct this error by carving the corneal tissue with the aid of a high-precision laser, the Excimer. After reshaping the cornea, the light rays fall on the retina and the patient can again experience crystal clear vision.
Laser eye surgery is the preferred choice for correcting several types of vision impairments. Since the surgery has gained popularity, you could easily find an experienced laser eye surgeon in your vicinity.
Laser eye surgery, like any other surgical procedure, does have its complications. However, unlike other surgeries, laser eye surgery has a minimal complication rate – a mere 5%. Therefore, laser eye surgery is a relatively safe and technologically advanced procedure.
Laser eye surgery does have a few side effects, such as eye irritation, under-correction, over-correction, and other minor complications. These normally wear off within a few weeks, and crystal clear vision is restored. Although rare, a few patients might require enhancement surgeries to accomplish accurate vision. All in all, laser eye surgery presents itself as a safe procedure, and is the choice of many.
After all, who wouldn’t want to throw away those awkward looking spectacles?
Is Laser Eye Surgery Safe?
In most cases laser eye surgery is safe. But, like any other surgical procedure there are certain risks that need to be addressed. A large number of patients have been able to stop wearing glasses after surgery and have achieved 20/40 vision, or better, that have been cases where patients have a decreased vision after surgery. There are some things that need to be taken into account before choosing a “safe” laser eye surgery.
This is a common side effect of laser eye surgery, but usually fades with time, although not always. It can’t be corrected with contact lenses or glasses, but only a further surgery procedure to treat scarring, such as CustomVue WaveFront.
Decreased 20/20 Vision
Many types of laser eye surgery can leave scarred tissue, resulting in a 20/20 vision lower than the one the patient used to experience before treatment. Over corrected or under corrected vision is also a common side effect of laser eye surgery. In such cases, glasses or contact lenses may still be needed or the patient may be recommended a second surgery for more effectiveness.
Laser surgery procedures which use a microkeratome blade to cut a flap involve the risk of cutting it off instead of leaving it hinged. If the flap is damaged, the patient may suffer vision loss. Successful procedures that use a blade can still leave small imperfections that can result in blurred vision.
Post Operative Infections
Choosing a skilled and experienced surgeon is certainly helpful to make laser eye surgery safe, but there’s always the risk of post operative infection. This risk is higher in PRK and LASEK than LASIK. In most cases, these infections can be treated with medication and usually don’t turn into long-term problems. However, more sever complications ca result into temporary vision loss or even worse. The healing process is longer for PRK and LASEK than LASIK.
It is important to not have extremely high expectations about laser eye surgery, This treatment may not be suitable for some people. There are some things to consider, such as “Is laser eye surgery safe?”, “are your expectations reasonable?”, and “Is laser eye surgery safe for you?” In order to answer these questions you have to learn more about what to expect from each type of laser eye surgery. You should know the positives and negatives of them all, and talk to your doctor about what is best for you.
Laser eye surgery is not a good choice for everyone. Pregnant women, people who suffer from diabetes, patients who have problems with binocular visions, thin corneas, dry eyes or large pupils may not be good candidates for this type of treatment.
Why You Might Consider Enhancement After LASIK Laser Eye Surgery
Undoubtedly every patient and eye surgeon would want to accomplish the desired visual correction in the very first refractive surgery procedure. Surgeons typically conduct a comprehensive preoperative examination to determine whether the patient is a viable surgery candidate, and in order to predict the results of the refractive surgery. But unfortunately, it is difficult to accurately predict results in the case of higher refractive errors. Things gone awry during the preoperative examination or during the surgery itself may necessitate an enhancement surgery.
On certain occasions, the patient could well do without an enhancement surgery. Minor undercorrection and overcorrection can be treated through a technique called CLAPIKS (Contact Lens Assisted Pharmacologically Induced Kerato Steepening), which uses Rigid Gas Permeable (RGP) contact lenses to reshape the cornea and eye drops to make the cornea more malleable. However, other major issues may typically require enhancement surgery.
Even if your eye surgeon gives you the slightest hint of the requirement of an enhancement surgery, it is advised that you don’t hastily demand enhancement re-treatment. You must wait for the eyes to settle down to a fixed refraction, before you decide on having an enhancement. Most enhancements are carried out between 3 and 6 months after the first eye surgery. This is because it is common for the eye to regress back to a fixed refractive error, and enhancement should not be performed until the regression has resolved.
A hyperopic patient is more difficult to predictably correct via surgery when compared with a myopic patient. And therefore, a hyperopic patent is more likely to require an enhancement surgery. If your initial eye surgery was LASIK or IntraLASIK, the surgeon would typically lift the existing flap and cut out the corneal surface at the location of the original flap. Though the LASIK flap adheres to the stroma, it can still be lifted, thereby averting the need to create a new flap.
With the advances in laser technology and an increase in the experience of eye surgeons, enhancement cases have significantly dropped. However, some cases might still occur that necessitate enhancement surgery.
Enhancement surgery is not something to be anxious about, since an enhancement surgery would typically accomplish the desired results, which were somehow missed during the first surgery.
If you find a LASIK surgeon that you are confident with, you will be able to get more information about eye enhancement surgery.
Laser Eye Surgery – Expectations vs. Reality
Laser Eye Surgery – What are your expectations?
The success of laser eye surgery (as with any elective surgery), is measured by how the outcome matches your before-surgery expectations. Are your expectations realistic? Can your expectations be met by laser eye surgery? It’s your surgeon’s job to help you consider all aspects of good vision prior to your laser eye surgery. Laser eye surgery can greatly improve your vision but no procedure can promise ‘perfect vision’ to every patient. When asked, most people say they expect to have 20/20 vision following laser eye surgery. In truth, most will be satisfied with 20/25 or 20/30 vision.
Laser eye surgery can give mild to moderately nearsighted (distant objects are not clear) patients a 90% chance to be able to drive during the day without glasses. Many of these patients will still need to wear glasses for night driving but most consider this a vast improvement to their vision before surgery. Extremely nearsighted patients who view the world through thick glasses are often not able to be fitted with contacts to correct their vision. For these patients, laser eye surgery can be a life saver and they are some of the most satisfied patients following eye surgery. These patients say that their ability to see without having to wear thick glasses is a life changing event. Many claim they feel more attractive and feel free to play sports for the first time since childhood.
It’s important to realize that good vision is more than being able to read the 20/20 line on your doctor’s eye chart. Having good vision means you also need to consider all the elements of vision:
• depth of field – can you see clearly from near to far
• night vision – can you see clearly in low light conditions
• color vision – are you able to distinguish red from green
• contrast sensitivity – can you distinguish different shades of gray
• bi-ocular vision – do your eyes work together
Will you be happy with your results following laser eye surgery? The best way to insure your happiness is to discuss your expectations with your surgeon. Will you only be happy with ‘perfect’ vision or are you prepared to have slightly less than perfect vision if it means you won’t need to wear contacts or glasses on a daily basis?
Laser eye surgery and the epithelium
Often times called ophthalmic surgery, eye surgery, is a surgical procedure that is preformed on the eye or eye region. This type of surgery, due to it’s nature, is typically performed by an ophthalmatolgist; hence the original name ophthalmic surgery.
There is several different types of eye surgery. The most common are described below:
PRK (PhotoRefractive Keratectomy):
PRK surgery is when the most oustide layer of the cornea is scraped away manually and an excimer laser is used to reshape the tissues located underneath the surface of the cornea. After the corrective eye surgery is done the outer layer must be grown back, in order for the eye to be protected again. Due to this, PRK is known for having a large recovery time. There as some advanced methods avaiable today that use a different excimer laser which vaporizes the epthithelium, however it is not widely used.
LASEK (Laser Assisted Sub-Epithelial Keratomileusis)
LASEK is advanced form of PRK(see below) that uses an alcholic solution on the epithelium which softens the surface before it is removed. With this procedure the epithelium can be replaces once the surgery is finished.
Epi-LASEK is similar to LASEK however it uses a type of barrier to preserve the epithelium layer, which is then replaced after the surgery. The reason for this extra step is to try and help cut down post surgery discomfort, and increase the amount of time required for healing.
As you can see their is several different methods of laser eye surgery; These aren’t even all of them! If you think that eye surgery might be right for you, or are interested in obtaining more information it is recommended to consult with your local physician and eye doctor.
Lasik Eye Surgery Complications
What are some of the possible complications of Lasik eye surgery?
Undercorrection – this occurs when the expected vision correction falls short of the desired outcome. This occurs more commonly with patients who have a high degree of nearsightedness (only objects close up are clear), farsightedness (only objects far away are clear) or astigmatism (images both far and near are distorted). Why? There is more laser corneal sculpting that needs to occur with patients having higher degrees of vision imperfection. When choosing your Lasik eye surgeon, it’s important to ask them what percentage of their patients need retreatment for undercorrection. This should be something that they are willing to freely discuss with you. If not, walk away! This is not to be confused with a planned slight undercorrection for nearsighted patients over forty years old which aids their reading vision. But this is something that you and your Lasik eye surgeon would have discussed before your surgery.
Overcorrection – this complication occurs less frequently than undercorrection and results when the amount of correction (corneal laser sculpting) exceeds what is planned. Slight overcorrection can be temporary and may resolve itself in the first month following Lasik eye surgery. Patients can manage slight overcorrections by wearing glasses until their vision resolves. Some patients with overcorrection may need additional Lasik eye surgery 3 to 6 months following their first surgery.
Dry Eye – many Lasik eye surgery patients may experience the feeling of ‘grittiness’ in their eyes following surgery. This condition usually resolves itself in 3 to 6 months and may be helped by using lubricating eye drops. Patients using birth control pills and patients going through menopause may experience this condition more often. If ‘dry eye’ continues beyond 6 months, your Lasik eye surgeon may recommend blocking your tear ducts with tiny silicon plugs to prevent tears from draining away too quickly.
Corneal abrasion – a small percentage of Lasik eye surgery patients may develop a small corneal abrasion (scrape) caused by the microkeratome (instrument used to create corneal flap) used during surgery. This abrasion is generally not serious and will heal quickly. Your Lasik eye surgeon may temporarily place a thin bandage contact lens on your eye to promote healing. While your abrasion is healing, your vision will be blurry.
Night glare – this annoying condition may not affect your vision clarity but patients may see halos or ghosting of images at night during the first month following surgery. Night glare generally improves in 3 months and often disappears within 6 months. Patients with large pupils and more severe vision impairment may be more prone to night glare.
Corneal flap complication – this occurs when the corneal flap is too small, too thin or is an irregular shape. In some cases the corneal flap may shift slightly following surgery if a patient rubs their eyes during the first 6 hours after surgery. If the flap does shift, ‘wrinkles’ can form causing distorted vision. A second procedure may be necessary to ‘smooth out’ the wrinkles and improve vision.
Infection – although this is the most feared complication of Lasik eye surgery patients, it is extremely rare. If your eye is going to become infected, chances are it will happen in the first 72 hours following surgery and will be treated with antibiotic eye drops. For this reason it is very important to avoid eye makeup, hot tubs and swimming pools for at least the first week following Lasik eye surgery.
The risks of Lasik eye surgery are low with an experienced Lasik eye surgeon but you need to be aware of possible complications prior to surgery. Your Lasik eye surgeon should freely discuss all possible complications of Lasik eye surgery prior to surgery. Do everything you can to put your eyes in the best possible hands.
7 Commonly Asked Questions About Laser Eye Surgery
Lasik and other forms of laser eye surgery have become so common and effective that many health plans around the country may soon begin paying for them as acceptable forms of eye surgery. And if they don’t, they should. The success rate with lasik eye surgery and laser eye surgery, in general, has made the procedure a household name, and made it also more affordable, so many more people can actually consider the procedure.
But no matter how many people have lasik eye surgery or laser eye surgery, you may still have your reservations. After all, they are slicing into your eyes, two of the most important organs you have, with a white-hot laser. So don’t be afraid to ask any questions that you may have, and do as much research as necessary to make yourself comfortable with the procedure. Hopefully, we can get a jumpstart for you here with this article – and the answers to the 7 most commonly asked questions about laser eye surgery.
#1: What exactly is laser eye surgery? Lasik is one form of laser eye surgery, whose sole job is to make you not dependent on your glasses or contacts anymore. Lasik stands for Laser-Assisted In Situ Keratomileusis.
#2: How does lasik work to correct vision? You sure you want to know the answer to this one? Kidding aside, laser eye surgery works because it actually changes the shape of your cornea, or the clear lens of your eye that allows light to enter your eye. Doctors use a microkeratome, a knife, to create a flap in your cornea. This is then folded back and a laser, called an excimer laser, is used to “shave” off the cornea until it’s the proper shape. Of course, there are other types of laser eye surgery out there, some of which you may have already heard about, like intralase surgery.
#3: How do I know if lasik is right for me? There are a lot of considerations to make before you get the laser eye surgery. First, you have to ask yourself whether or not you can afford the procedure, or whether or not your work and health insurance will pick it up.
#4: Are there other medical conditions that could interfere with the surgery? Yes, you should be aware of any medications that you may be taking that can slow down your healing, such as steroids. You should make sure you don’t suffer from a condition that could slow your healing, such as an autoimmune condition.
#5: Are all eyes able to be “shaved”? No, some eyes, especially those with other conditions, such as dry eye, thin corneas, or pupil disorders, do not make good candidates for laser eye surgery. If your prescription is still in flux – if you’ve changed prescriptions in the last year or two – you should probably hold off on the lasik eye surgery as well.
#6: Does laser eye surgery work 100 percent of the time? No, sometimes the results are not permanent. In that case, repeated procedures may be needed down the road. You could also suffer side effects such as dry eyes, contrast sensitivity, or even blindness.
#7: How do I find a doctor? Ask around your friends, family, colleagues, and other doctors. The best laser eye surgery doctors should be experienced, have the latest equipment, be able to explain everything about the procedure to your heart’s content, and offer care down the road.
The Different Types Of Eye Sugery
Types of Eye Surgery
Eye surgery, also referred to as ophthalmic or ocular surgery, is a type of surgical procedure that is performed on the eye or the surrounding tissues. There are a number of different types of eye surgeries including refractive surgery, corneal surgery, glaucoma surgery, cataract surgery, and oculoplastic (cosmetic) surgery.
The goal of refractive surgery is to improve a patient’s vision. An individual who is either nearsighted or farsighted has a refractive error in the interior of their eye. Light entering the eye does not properly focus on the retina, instead focusing in front of the retina in nearsighted individuals or behind the retina in farsighted individuals. The result is that viewed images appear blurry and out of focus. Refractive surgery corrects this error, allowing light to focus directly on the retina, thereby improving vision and eliminating the need for corrective lenses.
There are numerous methods of refractive surgery, the most popular of which are LASIK (laser assisted in-situ keratomileusis), LASEK (laser assisted sub-epithelial keratomileusis) as known as Epi-LASIK, PRK (Photorefractive keratectomy), CK (conductive keratoplasty), and ICRs or Intacs (Intracorneal rings).
Corneal surgery is any surgery that involves manipulation of the cornea of the eye. This encompasses nearly all types of refractive surgeries since the cornea is modified in order to improve the individual’s vision. It also includes corneal transplant surgery, a procedure by which a damaged or diseased cornea is removed and replaced with a clear cornea from an organ donor. Other types of corneal surgery are PK (penetrating keratoplasty), PTK (phototherapeutic keratectomy), and Pterygium excession.
Glaucoma is a disease that attacks the optic nerve, resulting in loss of vision and a rise in intraocular pressure. Glaucoma surgeries assist in combating the disease by lowering intraocular pressure. This may be accomplished by decreasing the amount of aqueous produced in the eye or by encouraging the release of excess aqueous humor from the eye.
Cataract extraction is the most common eye surgery performed. Age, illness, or trauma to the eye can sometimes cause the crystalline lens of the eye to become cloudy and opaque. This cloudiness, called a cataract, interferes with the eye’s ability to focus a clear image on the retina, resulting in loss of vision. The presence of significant cataracts requires the removal and replacement of the lens through cataract surgery. Although there are a number of different types of cataract extraction, the two most popular procedures are called ICCE (intracapsular cataract extraction) and ECCE (extracapsular cataract extraction).
Oculoplastic surgery is a type of eye surgery that concerns the reconstruction of the eye and its surrounding structures. Eyelid surgery, or blepharoplasty, removes excessive fat, muscle and skin from the eyelid to correct sagging or puffy eyes. Browplasty, often referred to as a brow lift, is the reconstruction of the forehead and brow bone. Oculoplastic surgery can also involve the removal of the eye itself. Enucleation involves the removal of the eye itself, leaving the muscles surrounding the eye and all orbital contents in place. Evisceration occurs when the eye and all of its contents are removed, leaving just the shell of the sclera in place. Finally, exenteration involves the removal of the entire orbital content. This includes the removal of the eye itself, any extraocular muscles, surrounding fat, and all connective tissues.
Cataract Eye Surgery
Cataract eye surgery is one of the world’s most common surgery procedures and it is also the most effective and safest surgery performed. Cataract eye surgery is done by removing the cloudy lens of the eye and replacing it with a substitute eye lens that has the same functions as the original lens. The replacement lens are called “intraocular lens”. There are two kinds of intraocular lenses. These are the “monofocal intraocular lenses” and the “multifocal intraocular lenses”. Monofocal intraocular lenses are lens that provide a clear vision at one distance only. Majority of individuals who undergo cataract eye surgery choose to see well far and correct their near vision with a pair of eye glasses or contact lenses. Multifocal intraocular lenses were introduced on 1997 with the approval of the FDA for use in cataract eye surgery. Multifocal intraocular lens provides the patient with near and far vision (the far vision is however much clearer than the near vision). On the other hand, not all patients are eligible for this type of intraocular lens. The doctor will evaluate the patient before deciding if the patient is eligible for multifocal intraocular lenses. The patient is considered a good candidate for cataract eye surgery if the cataract has decreased the patient’s quality of life.
The individual who wants to undergo cataract eye surgery must arrive at least two hours after the scheduled surgery time. This is to prepare the patient for surgery, the patient needs to have some eye drops administered and then is explained on how the cataract eye surgery is done. The patient is then settled down in a comfortable position ready for cataract eye surgery. The span of the cataract eye surgery lasts no more than half an hour. Most patients are conscious throughout the surgery procedure. However there are some patients that needed to be sedated because of anxiety and fear. A mild sedative is sometimes used to administer in the patient.
There are two kinds of cataract eye surgery procedure. These are the phacoemulsification procedure and the extracapsular procedure. Phacoemulsification is the most common type of procedure. It is done by making a small incision on the side of the cornea (the clear and dome shaped that covers the front of the eyes). A tiny probe that emits an ultrasound is then used to break the cloudy lens. The lens is then removed by suction and an intraocular lens is then inserted. In extracapsular procedure, the incision is longer in order to remove the hard center of the lens and the remainder of the lens is then removed through suction.
If the cataract is present on both eyes, it can not be operated at the same time. The surgeon will perform separate surgery on one eye and the other eye on a later date.
After cataract surgery
A cataract surgery procedure frequently lasts not more than an hour. It is usually painless. Most of the time, individuals who undergo cataract surgery choose to be awake during the procedure, although there are some who would rather be put to sleep for a short time. On the other hand, if the patient chooses to be awake, the patient will be given an anesthetic to numb the nerves that surround the eyes. A “lid speculum” will then hold the patient’s eye. The procedure is usually not uncomfortable. In after cataract surgery the patient will be given an eye shield to be placed over the eye. In some after cataract surgery effects, the patient will experience some increase sensitivity to light and a small amount of fluid will sometimes discharge from the eye. The fluid discharge is also common in after cataract surgery. After cataract surgery the patient may experience slight discomfort but this will decrease and disappear completely within the next few days. Itching and mild discomfort is normal. Most patients usually go home right away after the surgery procedure although the patient is restricted from driving.
Immediately after surgery the doctor will schedule the patient for exams to follow up on the patient’s progress. The patient is then prescribed with some eye drops or antibiotics to help increase the healing process. Once the dressing on the eye is removed the patient is advised to wear the eye shield when sleeping to protect the eye from injuries and damages.
Here are some guidelines for the patients to follow after the cataract surgery procedure:
* Avoid strenuous exercises for two to three weeks after cataract surgery procedure.
* Avoid manual labor two weeks after cataract surgery.
* Avoid vigorous sports two weeks after undergoing cataract surgery. Swimming is safe a month after the cataract procedure.
Follow these guidelines and you will improve you vision with less complications. Although some patients still need glasses or contact lenses despite the development of their vision.
The most common after cataract surgery problems are increased pressure, inflammation, blurring of vision because of swelling, pain, redness and bleeding. The most serious (but rare) after cataract surgery problems are infection, loss of vision and light flashes. The patient should contact their doctor if they experience increasing pain and progressive worsening of vision after the cataract surgery. All these complications can be treated if given prompt medical attention.
It is important to remember not to put your fingers in your eye after the cataract operation. Do not lift heavy objects because it increases the pressure in the eye. Have a good rest. And most importantly you should take your medications exactly as the doctor has prescribed. See your doctor if you are experiencing any problems.