Laser-assisted in situ keratomileusis (LASIK)
LASIK is one of the most common and effective types of refractive surgery. It uses a laser to reshape the cornea to correct vision. During the procedure, a flap is first created on the front surface of the cornea using a laser. Then another laser is used to remove a small amount of corneal tissue to change its curvature. This reshapes the cornea to focus light accurately onto the retina. The corneal flap is then placed back into position. LASIK provides rapid visual improvement and the risk of complications is low when performed by an experienced surgeon. One drawback is that it does not work for people with very high amounts of nearsightedness, farsightedness or astigmatism.
Laser Epithelial Keratomileusis (LASEK)
LASEK is similar to LASIK but does not create a flap in the cornea. A thin layer of the outermost corneal cells called epithelium is scraped off instead of making a flap. Then the laser is used to reshape the corneal surface underneath. The scraped epithelial cells heal and grow back within a few days. LASEK provides good outcomes but recovery may take slightly longer than LASIK. It is generally considered a safer alternative for thinner corneas that cannot undergo LASIK.
Photorefractive Keratectomy (PRK)
In PRK, the outermost layer of the cornea called epithelium is removed mechanically before excimer laser is used to reshape the corneal bed. This makes it a non-flap procedure like LASEK. However, unlike LASEK where epithelial cells naturally regrow, in Refractive surgery may take a few days longer as sterile bandage contact lenses are worn for protection during healing. Though not as comfortable as LASIK initially, PRK allows treatment of thinner corneas and high amounts of refractive error. Risk of haze or regression of effects is also lower with PRK.
Lens Implantation
For people who are not candidates for laser vision correction, refractive lenses can be implanted to compensate for vision problems. Two main types are phakic intraocular lenses (IOLs) and refractive lens exchange. In phakic IOL implantation, a lens is placed inside the eye behind the iris but in front of the natural lens. This shifts the focal point of light entering the eye to correct nearsightedness, farsightedness or astigmatism. Refractive lens exchange involves removing the natural lens and replacing it with an artificial lens matched to the eye's refractive error. Both procedures are highly effective but carry risks of cataracts, glaucoma, infections and loss of best-corrected vision.
Pre-procedure Consultation and Screening
A comprehensive eye exam and suitability screening is essential before scheduling refractive surgery. The ophthalmologist needs to ensure the eyes and overall health status are appropriate. Factors like refractive error magnitude, corneal thickness, shape of the cornea and lens, dry eye or other ocular surface conditions, diabetes and general medical conditions are evaluated. Stable refraction, no previous eye injuries or surgeries, and no retinal issues are some key criteria. Sometimes pre-surgery contact lens wear is advised to accurately measure the refractive error.
During the Procedure
For laser procedures like LASIK, LASEK or PRK, temporary blurry vision and mild discomfort is common during treatment as the lasers reshapes the cornea precisely. For advanced procedures involving lens implantation, anesthesia is used and minor surgical incisions are made for insertion of lens or replacement of natural lens. The entire procedure takes about 20-30 minutes depending on the technique used.
Post-procedure Care and Recovery
Following refractive surgery, topical antibiotic eye drops and steroids are usually prescribed for couple weeks. Protective eye shields maybe required during initial healing days. Recovery time varies - LASIK allows return to work next day but light activity only for 1 week. For surface ablations like LASEK/PRK, use of bandage contact lenses and longer healing of few weeks is needed. Mild blurry vision, halos or starbursts around lights at night are common in early days but gradually improve. Best corrected vision takes 4-6 weeks to stabilize. Long-term follow up checks are advised to monitor vision and eye health.
Risks and Complications
Though largely safe, complications do occur in less than 5% of refractive surgeries. Undercorrection or overcorrection leading to residual refractive error is the most common risk. Haze, infections, dry eyes, and regression of effect over time are other potential issues. More rarely, significant loss of best corrected vision, double vision or need for enhancement surgery can arise. Thorough counseling on success rates versus risks based on one's individual examination helps decide the most suitable procedure. Careful selection of surgeons with subspecialty training in refractive surgery can help minimize complications.
Overall, refractive surgeries provide a safe and effective option for patients to gain freedom from dependence on glasses or contact lenses when performed by experienced ophthalmologists. The benefits of improved quality of life and independence far outweigh the minimal risks in vast majority of cases. Continued technological advancements are also making vision correction increasingly more precise and predictable. Pursuing a consultation from a retinal specialist can help one determine if they are a suitable candidate for this life-changing treatment.
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Alice Mutum is a seasoned senior content editor at Coherent Market Insights, leveraging extensive expertise gained from her previous role as a content writer. With seven years in content development, Alice masterfully employs SEO best practices and cutting-edge digital marketing strategies to craft high-ranking, impactful content. As an editor, she meticulously ensures flawless grammar and punctuation, precise data accuracy, and perfect alignment with audience needs in every research report. Alice's dedication to excellence and her strategic approach to content make her an invaluable asset in the world of market insights.
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