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Laser Correction: Is It Possible To Return Perfect Vision Once And For All

VISUAL PROBLEMS ARE CONCERNING MILLIONS of people around the world. We rarely think about how to keep our eyes healthy, and we only sound the alarm when violations interfere with a normal life. The usual optical glasses or contact lenses in this sense seem to solve the problem, but for many, these measures are associated with great physical and psychological discomfort.    

Laser vision correction is increasingly becoming an alternative solution to the problem, but not everyone is ready to believe in the effectiveness of this procedure because of the fears and myths associated with it. We talked with an ophthalmologist, head of the ophthalmological department of the LRKTs of the Ministry of Defense of the Russian Federation, Alexei Schekaturov, and found out how this procedure is carried out, how safe it is, and is it true that it should not be done by those who are planning children in the future.

How much will the “new” eyes cost? 

Oddly enough, laser vision correction in medicine is considered a cosmetic operation – that is, there is no medical indication for it. It helps to correct congenital or acquired ailments: myopia, hyperopia or astigmatism, the so-called refractive errors . Traditional means – glasses or lenses – cope with this task just as successfully, but they have an obvious drawback – they need to be worn. Glasses are not always comfortable, some of them make it seem as if there is something superfluous on the face, and contact lenses can cause dry eyes and require careful hygiene , which not everyone can observe.  

The price of vision correction products also matters: according to the estimates of the American Academy of Ophthalmology, residents of the country spend more than $ 15 million annually on glasses and lenses. Of course, the cost of laser correction is also high and is usually not covered by insurance, but this procedure is performed only once. Perhaps that is why, in the same USA, the demand for it does not decrease: every year more than 700 thousand operations are performed there.     

In Russia, the price range in the capital alone can vary from 30–40 to 80–100 thousand rubles for one or both eyes. Much depends on the choice of clinic, doctor, as well as on the type of correction itself. “When you have poor vision from the age of ten,” says Anna D., “the opportunity to gain normal vision, and not to suffer with glasses and lenses, is priceless. I had myopia, about minus eight. I am absolutely happy with the result of the correction, I can say that it is worth the money spent. A couple of days after the operation, my visual acuity was almost one – this is about 95%, and after a week both eyes were already 100% visible ”.

How is the procedure carried out

Both myopia and farsightedness are associated with the fact that light rays, passing through the cornea, lens and vitreous humor, focus not on the retina, but behind it or in front of it. This can be caused by the anatomical features of the eye (too short or elongated eyeball), and the gradual loss of the ability to accommodate. In this case, the lens and the muscles supporting it become less elastic; the lens ceases to easily adapt to the resulting image, changing its shape – and the focus shifts, and the image becomes indistinct. There are also operations to replace the lens – but with laser correction, they do it easier, changing the shape of the cornea, the very surface layer of the eye, and achieving focusing of the image in the right place. The task is not to thin the cornea, but to change its shape, that is, to make it flatter or, conversely, convex.

Technically, the operation is not very difficult and takes only a couple of minutes: with the help of a laser beam, several layers of the cornea (the most convex part of the eye) are “evaporated” so that the image can again be focused on the retina, as it should be. Today, there are many types of procedures, but it is fundamentally important to determine one feature – whether the correction will be patchwork or flapless. In the first case, for example, when using the LASIK (Laser-Assisted in Situ Keratomileusis) method, at the initial stage of the operation, a flap is made on the cornea (it can also be called “flap” – from the English “flap”), which is then thrown back like a page of a book to the side. On the opened area, the shape of the cornea is corrected with a laser according to individual parameters calculated by a special program even at the stage of examination. At the end of the procedure, the flap is applied back. Vision is restored within two hours after the operation; photophobia immediately disappears, lacrimation decreases, the feeling of a “speck in the eye” disappears. A person sees clearly without any aids and can get behind the wheel on the same day (although doctors recommend playing it safe and asking loved ones to pick you up from the clinic).  

“I had myopia, minus 6.5,” says Polina. – I wore lenses, but really wanted to do laser correction. The procedure lasted approximately seven minutes. As soon as I got up from the operating table, I began to see perfectly, although at first everything was in a slight fog (this is a normal symptom, they warn about it). After the procedure, the discomfort is associated only with the fact that the anesthesia passes: the eyes are watery, tingling is felt. But in no case should you touch them at this moment ! By the evening, everything was finally restored, as if nothing had happened. “

With a flapless correction, the so-called PRK (photorefractive keratectomy), the doctor does not form a flap. Before the operation, the surface layer of the cornea is removed mechanically (this is called scarification), and then a laser is used on the “cleaned” area. Since the flap is not used, the eyes after such a procedure are very vulnerable and they need additional protection from external stimuli: light, dust and others. In this case, the patient will not be able to immediately go home: two or three days will have to be spent in the clinic until the surface layer of the cornea is restored.  

Are there any restrictions?

The choice of the method depends not only on the wishes and financial capabilities of the patient, but also on a number of medical factors – the decision must be made only after a thorough ophthalmological examination and consultation with a specialist. In some cases, the operation has to be abandoned altogether.

“My situation was quite specific,” says Alexandra, “I have a genetic disease, cystic fibrosis. Because my lungs don’t work very well, I often cough. After the examination, the doctors at the clinic said that “it’s possible to do it” – and this “kind of” alerted me. In the evening before the correction, I went online and watched a video on how exactly this is done. And I got scared: during the operation I have to lie still, and if I suddenly start coughing, it might ruin everything, and I will be left without eyes. In general, I decided to play it safe and still live with minus 3.5 and minus 5.5. “

In general, laser vision correction is relatively safe, if some contraindications are excluded. Simple and common LASIK allows you to return to your daily activities almost immediately, but there are situations when you need to do PRK surgery. So, for example, if the cornea of ​​the eye is rather thin (on average it should be about 550-600 microns), the doctor may recommend flapless correction. For professions and sports where there is a risk of mechanical damage to the eyes, PRK is also better suited. But it is important to understand that any type of laser correction implies a reduction of the cornea by 100-130 microns, so you need to weigh the pros and cons again if your values ​​are, say, below 500. Severe thinning of the cornea can lead to the appearance of holes ( perforation ) in it. and other unpleasant consequences that will have to be treated.

Another serious contraindication for laser correction is progressive myopia, that is, vision impairment by one diopter or more per year. In this case, you should wait until the “minus” stops on its own, or carry out a series of strengthening operations to stabilize. If, with a regular check with an ophthalmologist every six months or a year, your indicators do not change for some time, and there are no other contraindications, then you can safely perform the operation.  

At what age do the correction be made and will it interfere in the future? 

“I have been thinking about laser vision correction for a long time, but I still can’t make up my mind,” Nastya shares her fears, “contradictory opinions interfere. I’ve been talking about the operation for eight years now, and all this time some have been frightening by the fact that the correction cannot be done in youth (I am 22 years old) – supposedly the vision then falls again. Others believe that the operation should not be done before giving birth, because later there may be problems during childbirth. When I talked about this with the doctor, she also dismissed it – still young ”. In fact, according to Alexey Shchekaturov, any adult can have laser correction, regardless of their age at the time of the procedure. Eye growth is completed during adolescence; if after the operation there is a deterioration in vision, this is not due to age, but, for example, to the fact that the progressive myopia was not stopped before the correction. Of course, as with any operation, it is impossible to completely eliminate the risk, and even an experienced specialist cannot guarantee that everything will always be fine after laser vision correction. At the same time, the overall percentage of complications after surgery is extremely low , and many of them can be successfully eliminated at the stage of rehabilitation.   

The absence of children is also not a cause for concern. Laser correction performed before pregnancy will not in any way affect its course and the health of the child, and the condition of the eyes after childbirth will not worsen. Much more serious is the presence of undiagnosed and uncorrected fundus changes that can manifest themselves later. Therefore, before pregnancy, you should check with an ophthalmologist – as with other specialists – and try to improve your overall health. The operation is not performed during pregnancy and is generally recommended to be postponed until the end of breastfeeding.     

Is it possible to make a correction after 40 years?

“I have astigmatism, the doctor prescribed glasses for me, which I wore for about two years,” says Anya E., “they had a headache all the time, and it was hard to carry them. I thought the lenses were better and asked my parents for them as a New Year’s present, but my dad suggested laser correction. He made it himself more than ten years ago and is very pleased. At first I doubted – the word “operation” scares me. Then I looked at the clinic’s website, read the reviews. But most of all, I was convinced by a visit to the clinic, where I was examined for more than two hours. I was sure that this correction is being stamped there for everyone – with and without indications, but this is not the case. Mom was not allowed to have the operation because of her age, they said that after forty it is no longer possible.

Laser correction, according to Alexei Schekaturov, is not contraindicated after forty years and can improve vision even with age-related changes (presbyopia), although a few years ago this was not possible. This, however, does not mean that the eyes will stop aging; the procedure will not save you from further presbyopia, and after a while your vision may deteriorate again. In addition, cataracts and other diseases often develop in old age , in which laser vision correction is not done. And yet, the main reason for the ban on surgery is the presence of contraindications, and not a certain age.     

How to care for your eyes after surgery

If you talked to a specialist, did all the examinations and realized that laser correction is right for you, you just have to not worry about the pain. The operation is performed under local anesthesia, so the maximum that you can feel is some inconvenience. “There was a moment,” says Anna D., “when you seemed to go blind for a while: your eyes were open, but you did not see anything – it’s a little unpleasant psychologically. They also put a kind of suction cup on the eye to fix the pupil – the sensations are also so-so. “

Rehabilitation lasts about two weeks. During this time, the doctor prescribes ophthalmic antibiotics, anti-inflammatory drugs to reduce swelling, as well as so-called tear substitutes, which may be needed for a while after the rest of the medications are canceled. While the eyes are recovering, it is worth refusing to visit the pool, sauna or bath. Correction can be done in summer, when the sun is most active, but then in no case should you neglect sunglasses , since direct exposure to ultraviolet radiation after surgery is much more dangerous. Otherwise, the lifestyle will not change in any way, and visual stress, if, for example, you read a lot or work at the computer, is not contraindicated. 

“The operation itself takes no more than five minutes,” says Anya E., “everything was quick and calm. After that, they put on protective lenses (they used to give funny bandages). The next day you come, everything is filmed, and then a new life begins. I went to the subway and thought: “Why did I have new eyes, now I see all the shortcomings”. I returned home and happily threw my glasses on the top shelf. Now more than two years have passed, I can see well. From time to time I start to panic when my eyes hurt – I’m afraid that I will check my vision and it turns out that it has worsened. But in fact, this is due to the strong tension, and it is simply worth sitting less at the computer and phone less. “

Laser vision correction can make life much easier for those who suffer from glasses and contact lenses. Of course, it is more rational to think about it when the eyes see very badly. Among other things, this is exactly the case when the principle of “measure seven times, one – cut off” should be followed almost literally: an illiterate consultation will not only negate the effect of the procedure, but also cause a lot of health problems. Statistics , however, show that 90% of patients are satisfied with the results of laser correction. According to Alexei Schekaturov, in our time, such an operation makes it easy, safe and, as a rule, to get rid of vision problems forever . You will have to decide whether you personally need it after consulting a doctor – although a couple of reviews from friends and recommendations of loved ones will definitely not be superfluous. 

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