Corrective Eye Surgery

Corrective Eye Surgery-

The emergence of contact lens during the 1950's turned out to be an extraordinary story. Before that, no other arsenal was available except eye glasses for correcting refractive vision errors and the glasses did not provide the answer in all the situations. But innovations have their own dynamics and hence today, we have many ways for corrective eye surgery including laser reshaping of the surface of the eye through LASIK and PRK and insertion of artificial lenses through surgery.

LASIK,  PRK and other procedures of the same type use laser energy for reshaping of the curvature of the cornea so that the way of the light rays entering the eye is altered suitably.  Similarly, surgical methods are adopted for inserting artificial lenses into the eye for sharpening the vision.

During the 1980's, a procedure called Radial Keratotomy was being conducted to flatten the eye's surface to correct myopia.  But surgeons got reports of certain annoying and dubious side effects like glare, regression, fluctuating vision, etc. from a few patients.  The side effects also included night vision problems in patients with high prescription strengths.  These over-riding considerations forced eye surgeons think of better options and this procedure was relegated into obsolescence.

Photorefractive Keratectomy or surface ablation procedure that followed, involved laser correction for removing the tissue on the eye' surface to change the curvature of the eye. But this procedure soon made way for LASIK procedure.  But it is a curious twist that in recent times, surgeons prefer to go back to photorefractive keratectomy procedure because it is found to help nerve regeneration much faster than LASIK and  to reduce dryness in eye and some other complications that may arise in the healing process.

Some eye surgeons prefer PRK procedure for persons with a thin cornea because creating a thin, hinged flap on the eye's surface is not involved in this and hence the question of surgical flap complications do not arise.  

Laser-Assisted in situ Keratomileusis (LASIK)  and PRK are almost similar except that a thin, hinged flap is made in the eye's surface in LASIK.  Further, in LASIK, for applying laser energy underneath the eye for the sake of reshaping, the flap is lifted.  The flap, when replaced to its original position, will start functioning as a natural bandage.

The technology used for measuring accurate readings of vision errors in LASIK is called wavefront technology.  The main advantage in LASIK is that the patient will not feel the discomfort during or after the procedure and within hours, clear vision is restored.  How the flap is created forms the basis of difference between different forms of LASIK procedure.

In LASEK procedure, an ultra-thin flap is created on the outer covering of the eye or epithelium and floating the flap away from the eye's surface with alcohol, the eye is reshaped with laser.

Epi-LASIK is similar to LASIK and the only difference is for lifting the flap, a special cutting tool is used.  In a bladeless, blade-free or all-laser LASIK,  another laser does the job of the mechanical cutting tool in creating the flap.  IntraLase Corp. were the original makers of this laser and hence all-laser Lasik is also called as intraLASIK.   There are quite a few bladeless LASIK brands available now.

Wavefront LASIK uses wavefront, an ultra-modern technique, for measuring how light travels through the eye.  Excimer lasers come with a built-in wavefront to detect and adjust subtle vision errors during the process of reshaping the cornea.  Wavefront-guided LASIK reduces chances of night glares that may occur post-LASIK surgery and maintains contrast sensitivity.

For people with far-sighted vision, conductive Keratoplasty is done using a tiny probe and low heat radio waves to apply "spots" around the eye's front surface.  With this non-invasive method, the cornea is steepened and this problem corrected.  Even presbyopia can be corrected to improve near vision to those who undergo LASIK or cataract surgery.

Yet another option for vision correction surgery for higher levels of nearsightedness are Implantable lenses.  

For eliminating high degree of farsightedness, refractive Lens Exchange which is another non-laser procedure, is used.  The eye's clear natural lens is removed and replaced with an artificial lens of a different shape so that farsightedness is eliminated.  This can be used for nearsightedness also.  But it may lead to certain complications and hence is used only in rare cases that need correction of severe vision problems.

Cataract surgery may also be categorized as another corrective eye surgery.  Multifocal IOLs or accommodating IOLs are used effectively not only for correcting near and farsightedness but for partial restoration of a person's near vision.

Some of the corrective eye surgeries that work very well for young adults may not suit older folks.  Children under 18 and pregnant ladies are not suitable for laser vision correction.  For people who have diabetes, PRK and LASIK are more suitable than some of the types of LASIK.  For persons with thin corneas, PRK, LASIK. implantation of the Visian ICL or Verisyse lens are more suitable than LASIK.

In general, persons of age between 20s and 30s are most suitable for laser vision correction, LASIK, PRK and Visian ICL.

It is the basic philosophy of most eye surgeons that  any vision correction procedure is not a permanent thing and you will have to opt for enhanced surgical corrections as you grow older.  It should also be remembered that all corrective eye surgeries come with a slight risk element and also side effects.  Hence the sane advice is that you should discuss all these things with the eye surgeon before deciding.