LASIK (Laser Assisted In-Situ Keratomileusis) surgery is one of the most common and popular refractive surgery procedures performed today. It uses a laser to reshape the cornea to correct vision. During LASIK surgery, the surgeon will:
- Create a thin flap in the cornea using a laser or microkeratome. This flap is gently folded back to expose the inner corneal layer.
- Use an excimer laser to remove tiny amounts of corneal tissue from the inner corneal layer. This reshapes the cornea to correct nearsightedness (myopia), farsightedness (hyperopia) or astigmatism.
- Replace the corneal flap and allow it to heal back in place. The corneal flap procedure allows for very rapid healing with minimal discomfort for patients.
LASIK provides very good visual outcomes for most patients. Results are usually immediate though fine tuning may be needed in the first few months after surgery. The main risks include dry eyes, visual halos or glare conditions at night. However, the risk of serious complications is low when performed by experienced surgeons.
Photorefractive Keratectomy (PRK)
PRK was one of the first corneal refractive procedures developed but is now less common than LASIK. Instead of using a corneal flap, the surface layer of the cornea is removed during PRK. The excimer laser is then used to reshape the stroma, or middle corneal layer:
- The epithelial layer on the front surface of the cornea is painlessly removed using a solution or laser.
- The excimer laser then reshapes the underlying stroma in a similar way as LASIK to correct vision.
- A bandage contact lens is used until the epithelium heals, which usually takes 5-7 days.
While results are good, recovery after PRK tends to be more painful and take longer than LASIK due to removing the corneal surface cells. Vision may also be more blurry initially. However, PRK does not require generation of a corneal flap.
Lens Replacements: Phakic IOLs and Clear Lens Extraction
For some patients who are not candidates for the cornea-based surgeries above, lens replacement procedures may be an option. Refractive surgery are artificial lenses that can be placed inside the eye behind the iris to correct refractive errors, without removing the natural lens:
- Implantation of a phakic IOL requires an operation under general anesthetic to create a small incision and place the lens inside the eye behind the iris.
- Various lens powers and optic designs are available to treat myopia, hyperopia or astigmatism while keeping the natural lens intact.
- Risks include cataracts, glaucoma and possible later need to remove the natural lens. Close post-op monitoring is required.
For patients with significant refractive errors, clear lens extraction (CLE) may be recommended. This involves removing the clear natural lens and replacing it with an IOL. Outcomes tend to be very reliable and predictable for correcting vision, though risks include increased risk of postoperative cataracts later in life without the natural lens.
Refractive Lens Exchange
Refractive lens exchange (RLE) is a procedure to improve both distance and reading vision by removing the aged natural lens and replacing it with a modern multifocal IOL. The main steps are:
- Performing small incisions and removing the clear natural lens using phacoemulsification.
- Implanting a toric, extended depth of focus or multifocal IOL calculated to provide both distance and near/intermediate vision without glasses.
- A short recovery and most patients experience good quality vision without glasses within 1-2 weeks.
While the procedure eliminates dependency on reading glasses after surgery, some visual side effects may occur with multifocal lenses like halos or double vision. RLE provides a permanent 'all-in-one' vision correction solution but is not reversible once the natural lens is removed.
refractive surgery has advanced significantly in the past few decades. Procedures like LASIK, PRK, lens implants and lens replacements now allow safe and effective vision correction for millions worldwide. Continued research aims to further improve outcomes, expand the number of treatable patients and provide even more personalized vision solutions. For those seeking freedom from glasses or contact lenses, modern refractive surgery presents numerous life-enhancing options.
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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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