People with problem eyes on our planet a lot - it is believed that every fifth of its inhabitants has or once had myopia or farsightedness. With the development of laser surgery, the correction of many problems in this area has become real. But such operations have certain contraindications. On the pros and cons of laser correction of vision today and will be discussed.
- 1 A brief history. First surgical operation
- 2 Indications for laser correction
- 3 Types of surgical vision correction and their cost
- 4 Preparing for operation
- 5 How is the operation performed?
- 6 Postoperative period
- 7 Contraindications
- 8 Laser vision correction: reviews
A brief history. The first surgical operation
Once the only way to correct vision was wearing glasses. However, ophthalmologists were intensively looking for ways to correct it. In 1939, the Japanese Sato suggested using small incisions to change the curvature of the cornea.
However, due to frequent postoperative complications this method did not take root.
In 1949, Baker suggested that with a change in the direction of the light beam passing through the cornea, a virtually 100 percent correction of vision is possible. This doctor invented and a special device for conducting such operations - microkeratome. A huge contribution to the further development of the method was made by N. Pureskin, who developed the idea and made a detailed description of the process of removing the upper transparent part of the cornea( stroma).
But the first operation of the scientists could be carried out only after the invention of an excimer laser. On a qualitative level, laser correction came only after the improvement of keratotomy techniques by surgeon Svyatoslav Fedorov. It was he who first tested in practice more advanced microscopes and the finest "diamond" tools.
Ironically, the real revolution in eye microsurgery was made by a well-known company IBM, which for the first time used a laser when assembling its computers and engraving chips. It turned out that a beam of light, its depth and area of influence can be fully controlled. Now, due to the high precision of modern devices, the result of the operation became absolutely predictable.
Advice! Laser correction of the cornea of the eye in neglected cases, unfortunately, is impossible. So, it is not performed with myopia -15, hypermetropia above +5 or astigmatism above 3.
Indications for laser correction
It is known that the lens of the eye has the shape of a lens, that is, it is convex on both sides. This form helps him to collect light waves into a beam and then forward to the retina. It is from the properties of the lens that the correct visual perception of the subject largely depends. When its shape is changed,
- can be diagnosed as myopia: pulling the eyeball, because of this shape, the lens transfers the light beam not to the retina, but to the area below it;The image becomes blurred;
- farsightedness( hypermetropia): the size of the eyeball decreases, resulting in the focus being formed not on the retina, but behind it;Very often it develops due to age-related tissue changes, which reduces the curvature of the cornea and increases the density of the lens;
- astigmatism: in most people it is congenital and often accompanies hypermetropia and myopia;Due to changes in the shape of the cornea, the lens and the eyeball itself, the images become vague;Can be accompanied by headaches and pain in the eyes.
In all three cases, after the operation and correction of the shape of the lens, vision is restored.
Tip! With congenital or acquired changes in the retina( inner shell of the eye), laser coagulation is first carried out - electromagnetic stimulation of its tissues, which promotes rapid healing. To laser correction of vision in this case it will be possible to proceed only after half a month.
Types of surgical vision correction and their cost
Unfortunately, insurance companies attribute this procedure to cosmetic, therefore, according to the legislation, they are paid. To date, vision correction is performed using two methods:
- photorefractive keratectomy( PRK): only the outer layer of the cornea is subjected to correction, the internal elements of the eye are not affected, so the cost of such surgery is almost halved - from $ 200 per eye;
- Keratomilez( Lasik): a promising direction in which the upper layer of the cornea is not cut off to gain access to the middle layer of the cornea, but rises in the form of a flap;Damage in the middle layer is also minimal, since it is "evaporated" with the help of a laser;Vision after surgery is restored immediately;With myopia or hypermetropia complicated by astigmatism, this method is recommended.
Which of the methods should be used in a particular case, the ophthalmologist determines after a complete examination. It depends on the thickness of the cornea and the degree of changes in the shape of the eyeball. Each of them, of course, has its pros and cons.
The benefits of PRK include the possibility of carrying it to patients with a thin cornea. However, the healing period, which is more painful than in the case of Lasik, stretches for 4-5 days.
Tip! If vision continues to fall, it is necessary first to achieve stability and stop this process, and only then proceed with laser correction.
Preparing for operation
For an ideal result, the cornea must assume its natural shape. That is why for 2-4 weeks before the operation it is necessary to remove glasses or lenses and try not to strain your eyesight unnecessarily. People who are engaged in intense mental work or working at a computer, it is better to take a vacation and relax your eyes.
For a few days before the operation, alcohol is prohibited and the use of anti-inflammatory drugs and blood thinning medications. At this time, it is not recommended to apply any cosmetic products, especially in the eye area. Undesirable lotions, creams and even perfumes.
You should sleep well before the operation. To avoid unnecessary excitement, the doctor may prescribe soft sedatives.
Advice! Unfortunately, hyperopia can be corrected a little worse than nearsightedness. Only in 80% of patients with hyperopia visual acuity is improved to 0.5 and above. With astigmatism, this percentage is 74-76%.In other cases, there are improvements, but less significant.
How is the operation performed?
Before the operation with the aid of special programs, the most complicated calculations are carried out. For each specific case, depending on the ability of the lens to adapt to external changes and the shape of the eyeball, the residual thickness of the cornea and its optimal curvature are selected.
The very laser correction of vision does not last long - the surgeon needs only 10-15 minutes, most of which is spent preparing for surgery. The time of laser exposure to one eye is only 1-1.5 minutes:
- vision correction is performed under local anesthesia;
- so that the eyeball does not move, it is fixed with a special expander;
- as the laser is able to automatically track even the slightest deviations of the eyeball, in case of its accidental displacement, the device immediately suspends operation;
- at the first stage the cornea is partially cut off and a flap of 150 microns thick is formed from it;
- after its bending for several tens of seconds to give the middle part of the cornea of the desired thickness and shape, its laser evaporation is carried out;
- the separated upper part is laid in place and carefully smoothed, the seams are not superimposed in this case, since the fastening is performed due to the negative pressure occurring inside the cornea itself.
The operation is completely painless. And even during a brief rehabilitation period, the patient does not feel any discomfort or pain. However, in order to promptly restore and prevent the development of complications in the postoperative period, some rules should be observed.
As the eyes are minimally traumatized during the operation, and local anesthesia does not cause side effects, after laser correction of vision there is no need for hospitalization. You can return home on the same day.
The first time after surgery, you will be recommended to wear a special bandage on your eyes even during sleep. To alleviate the condition, only prescribed painkillers are taken. Since at this time too bright light can cause carving, it is better to be in the darkened premises for the first time. When going out, it is recommended to wear sunglasses.
Do not just rub your eyes, but even touch them with your hands should not be - after all, you can accidentally move the cornea that has not yet settled down. All water procedures for the face at the time are also prohibited. Bath and sauna, as well as alcohol, will be banned for another month. At the same time, any, especially intense, physical activity is prohibited.
To prevent infections, special eye drops are prescribed. For the same reason, about 2 weeks should not use any cosmetics. Naturally, contact lenses are strictly forbidden.
Vision at first time can still be clouded. Possible occurrence of halos in those cases when you look at the light sources. But reddening of the eyes and fog disappear within a few days. Only in the most difficult cases for a complete recovery of vision may take up to 3-6 months.
are prescribed to avoid infections. Return to the usual way of life, sports and work should be done only after the doctor's permission. If a second operation is required, it is performed only after complete stabilization of vision.
Advice! If the cornea is too thin, a 100% improvement in vision, unfortunately, will not be possible. Ophthalmologists can only correct it.
According to reviews, the laser vision correction has not only pluses, but also cons. After all, you can not do it all. So, contraindications to it are:
- age to 18 years: since before the onset of this period the eyeball continues to form, it is necessary to wait for the end of this process;
- pregnancy and lactation, as hormonal imbalance can have a significant effect on vision;
- retinal detachment, cataract and glaucoma: an ideal correction of vision in these cases is difficult, therefore before the operation is carried out a preliminary treatment;
- thinning of the cornea( keratotonus): grinding can enhance this process;
- abnormalities in the blood vessels, diabetes mellitus;
- reduced sensitivity of the cornea;
- any inflammatory processes in the body, including non-infectious;
- oncology, AIDS, multiple sclerosis;
- mental illness.
Tip! With a strong initial vision loss, you may need a second operation. It is called pre-correction. It is carried out 3-6 months after the first.
Laser vision correction: reviews
Katerina, 31 year: I did this operation 4 years ago. My eyesight was -3.5.It was very painful, and for several days my eyes were reddish. But now the beauty. Vision unit, I see perfectly. I can not even imagine how I would have lived without her.
Irina, 41 year: It turns out that even at my age such an operation is possible. Once my eyesight was -5.Now I enjoy life and have forgotten about glasses for a long time. Before the operation I questioned a bunch of patients - nobody seemed to complain about the consequences. One woman had a serious loss of vision, so she did not have 1.0, but -1 after surgery. But she is very happy about this - she says that in her case this is an ideal result. Svetlana, 35 years: Of course, it is better not to bring to surgery and save eyes from the youth. But I could not afford such a luxury, unfortunately, because I worked at a computer. I went to the decree, and after the birth I discussed this matter with my husband and decided on the operation. I now see perfectly, and it's great!
Mila, 24 years: After the operation, the sensations are inexpressible. It's just a miracle of some kind - to see for yourself, without lenses and glasses.
Larissa, 39 years old: It is a pity that she did not make a correction earlier - everything could not be decided. The doctor advised Lasik. In 2012, the procedure cost me 30 thousand rubles. The only thing - the eyes somehow became more sensitive, especially to the wind and dust.
Galina, 32 years old: I have one eye once was -5 and -2 on the second. The doctor scared that if I do not wear glasses, strabismus will eventually. Operation for a long time was afraid to do because of a very thin cornea. That's why I had to do not LASIK, but FRC.By the way, in the clinic I honestly warned that the procedure may not be too productive. But fortunately, the vision is still restored. And on all 100!