What is laser eye surgery?

Laser eye surgery is a new advance in surgical procedures that removes the use of the traditional spectacles.

Laser eye surgery works by directing a laser onto the cornea; the cornea is the clear structure covering the iris (the colored part of the eye around the pupil). The laser works by reducing the thickness of the cornea to a point where the eye can bring images into focus correctly.

In total there are three types of laser surgery available, LASIK, LASEK and EPIFLAP.

LASIK eye surgery

LASIK eye surgery is the newest of the three surgeries and works by slicing a thin layer of the cornea off so it forms a flap so the laser can target the tissue underneath. The flap is then put back to where it was sliced from, and the body naturally repairs it causing vision to be improved almost instantly.

LASEK or EPIFLAP eye surgery

These treatments involve partially removing the epithelium, the outer layers of the cells on the eye, so the cornea is revealed. A laser then reshapes the cornea; the eye is bought back to its normal position where it repairs within days.

Treatment safety

The medical world is divided over the safety of newer treatments but these treatments have been approved and used in many surgeries throughout the western world with nothing but success.

Like many treatments there is a small percentage of risk involved and there have been instances where surgery has caused issues and the patient has required cornea transplants after the surgery.

Who can have laser eye surgery?

Not everyone is suitable for laser eye surgery, only healthy adults can be considered because a child’s eye has not fully formed and performing surgery on an unhealthy adult can increase the risk of complications.

Eye surgery popularity

Laser eye surgery has become very popular in recent years because the price of eye surgery when set against the cost of spectacles over a few years looks appealing; also a lot of people are becoming more knowledgeable on the treatments available as it becomes widely available.

Sir Elton John is one of many stars that’s has admitted to thinking about getting rid of their spectacles once and for all and plunge for laser eye surgery.

The future of laser eye surgery

Laser eye surgery keeps improving all the time, with advances in technology happening constantly in medicine it is only a matter of time before a new, improved surgery is found.

If you have been thinking about improving your eyesight through laser eye surgery it may be worth reading more information about the different surgeries and finding recommended consultants in your area who carry out the procedure before deciding it is definitely what you want.

Laser peripheral Iridotomy surgery involves creating a small hole in the peripheral iris. This allows the fluid to flow from behind the iris directly to the outer chamber of the eye. This normally will take care of the bowed iris. This surgery is easily done in the office of the surgeon, or as an outpatient procedure. The pupil is normally constricted with special eye drops, the head is positioned, and the procedure completed with a laser beam. Normally this does not require any sedation. Topical anesthetic drops may be applied to better control the laser beam. This procedure takes only minutes to complete. Eye drops may be needed to keep the eye from becoming inflamed after surgery. You will normally stop using these eye drops after a few days.

There have been questions about this surgery and if it’s good for reversing glaucoma. It is not a procedure that will do that. It may be used to help treat the symptoms of glaucoma but will not cure the problem. The goal of this procedure may be to prevent developing glaucoma; the surgeon will make the decision on whether this surgery will be helpful for glaucoma patients.

The surgery is normally not painful. A topical anesthetic is used but the iris of the eye is not numbed. There may be some mild discomfort when the laser beam touches the iris. Normally there are just brief moments of slight discomfort and no discomfort after the surgery in most of the cases. As with any surgery there are some risks involved. Inflammation and infection, bleeding in the eye, and inflammation may occur. Any potential complications may be treated with eye drops the surgeon will prescribe.

Our eyes are an important part of our lives. We should do everything we can to protect them, treat them, and wear prescription glasses or contact lenses when necessary. Patients with eye problems need to have their eyes examined yearly and at the bare minimum every two years. With the exam, you may be asked if you want to be tested for glaucoma. This test may add a little more cost to your exam but well worth it. Glaucoma that is detected early will have a better chance of responding to treatment.

Laser peripheral Iridotomy is a useful tool in treating glaucoma and other related drainage problems in the eye. Your eye doctor will help you decide if this surgery will be worthwhile to you and your vision problems.

Conductive Keratoplasty (CK) is a form of surgery that uses very mild heat from radio waves to round out the cornea. It changes the overall shape of the cornea by shrinking collagen in the periphery of the cornea. This procedure is a simple procedure that only takes about five minutes per eye.

Another popular form of corrective eye surgery is the Implantable Contact Lens. This procedure can correct both nearsightedness and farsightedness and usually takes between six to twenty minutes for each eye. This procedure will treat severe forms of nearsightedness and farsightedness. This reversible procedure places the contact lens behind the iris and in front of your eye’s natural lens. These implantable lenses do not need any maintenance and you cannot feel the lenses in your eyes.

Intraocular Lenses are normally implanted during regular cataract surgery. The eye’s natural lens is replaced by the implants. Cataracts caused the eye’s natural lens to be cloudy and weaken vision. This technique has been used for several decades. Formerly this surgery would be used to provide distance vision and glasses were also needed for any close reading or handwork.

New IOLs have since been introduced that allows your vision to be corrected so it is possible to see near, medium, and far distances without the aid of extra glasses. The new surgery allows the lens to move around in the eye and is limited to those who need cataracts removed. Researchers hope to gain FDA approval to use this new surgery to correct myopia, hyperopia, and presbyopia. Some surgeons will use this corrective surgery to provide other vision corrections in some circumstances.

Intacs are inserts made of plastic and were once used to treat mild nearsightedness and astigmatisms. These inserts are now mainly used to correct bulging corneas. The inserts are placed in different parts of the cornea to flatten it. This treatment is meant to be permanent but can be removed if necessary. This procedure takes about fifteen minutes and has been approved by the FDA in 2004.

Laser Thermal Keratoplasty is another corrective surgery that uses a mild heat to shrink the collagen at the edge of the cornea. This surgery will correct farsightedness and presbyopia and takes about three seconds.

Scleral Expansion Bands are new and are used to treat presbyopia. The FDA has not approved this corrective surgery and the surgery takes about 30 minutes. The surgeon places four pieces just below the white surface of the eye.

Research is still going on to refine and improve corrective eye surgeries. If you feel you cannot be helped by corrective surgery now, you may be a good candidate for surgery in the future as technology advances. Scientists and researchers continue to look for new and better ways to correct faulty eyesight.

Another common form of eye surgery is to correct glaucoma problems.  Glaucoma is a group of diseases that result in vision loss because they affect the optic nerve.  There are various glaucoma surgeries and sometimes a surgeon will use a combination of several surgeries to lower intraocular pressure.  These surgeries will either help the eye to release excess aqueous humor from the eye or to lower the production of that material.  An excess of aqueous humor raises intraocular pressure and causes glaucoma.  There are various surgeries that will correct the excess of aqueous humor.  A few of them are:

• Laser Trabeculoplasty
• Iridotomy
• Iridectomy
• Anterior Sclerotomy

There are many other methods used to reduce intraocular pressure.  Your surgeon will be able to decide which method is best for your needs.

Corneal surgery is another common form of eye surgery and includes corneal transplant surgery, penetrating Keratoplasty, phototherapeutic Keratectomy, and pterygium excession.  The corneal transplant surgery involves removing a cloudy or diseased cornea and replacing it with a donor corneal.

Vitreo-retinal surgery includes many different procedures to correct eye problems.  Of the many procedures associated with vitreo-retinal surgery is the repair of a retinal detachment.  Retinal detachment can be caused by several incidents but one of the most common reasons for this condition is a blow to the eye.  A tear to the retina can be repaired with a laser photocoagulation.  Other procedures include ignipuncture, which is no longer widely used, pneumatic retinopexy, macular hole repair and vitrectomy.

The third most common eye surgery is eye muscle surgery.  This surgery corrects strabisumus, myectomy, myotomy, tenectomy, and tenotomy for loosening the eye muscles.  The procedures done for tightening or strengthening the eye muscles include resection, tucking, and placing the eye muscle in a different location to achieve better eye control.

Oculoplastic surgery deals with surgeries that will reconstruct the eye and those structures that are associated with the eye.  A few of the operations that are associated with oculoplastic surgery are:

• Canthectomy-the surgical removal of tissue at the meeting of the upper and lower eyelids.
• Cantholysis-surgical division of the canthus.
• Canthoplasty-Plastic surgery of the canthus.
• Canthotomy-surgical division of the outer canthus

There are many other forms of oculoplastic surgeries that deal with the reconstruction of the eye.  Your eye doctor and surgeon will help you decide which surgery is needed for your particular eye problem.

If someone has a refractive error in the eye this means they have an abnormal shaped eye or cornea, or they have a hardened lens. By having one of these conditions, it means they suffer with visual impairment because the lights rays do not reached the retina at the correct state that a normal healthy eye would let light in. There are various names for the these conditions because it affects people in different ways, these are

* Astigmatism (abnormal shaped cornea)
* Myopia (being near sighted)
* Hyperopia (being far sighted)
* Prebyopia (the hardening of the eyes lens)

Treatments available

In total there are 5 different surgical treatments available for refractive eye surgery, which you can see below.

Laser Assisted In-Situ Keratomileusis (LASIK)

LASIK is a laser eye treatment where the surgeon cuts a flap in the corneal tissue and uses an excimer laser in the tissue underneath to remove the damaged tissue near the corneal stroma.

Laser Assisted Sub-Epithelium Keratomileusis (LASEK)

LASEK is another laser treatment, but this treatment uses the laser to permanently remove small pieces of damaged tissue, changing the shape of the cornea.

Photorefractive keratectomy (PRK)

This is a less invasive surgery than LASEK or LASIK eye surgeries and is normally carried out with local anesthetic, which is given in the form of eye drops. The process involves using an excimer laser to remove the smallest amounts of tissue from the external surface of the cornea.

Radial keratotomy

Radial keratotomy and its new surgical variants involve making incisions to the cornea in the shape bicycle spokes using a diamond knife. These incisions alter the shape of the cornea and are effective against myopia.

Thermal Keratoplasty

Thermal Kertoplasty involves making eight to sixteen burn marks around the pupil and inserting a ring of collagen constriction making the cornea steeper in angle. This procedure is a good surgery for some astigmatism patients.

Risks involved

Refractive eye surgery is very safe, but like anything in life there is a risk even if it is only a small percentage.

Delayed healing due to infection can cause discomfort but will generally not last any longer than four year and only affects one patient out of every one thousand plus surgeries.

Under correcting or over correcting the problem in the eye is another slight risk. The surgeon will know what is wrong with your eye and know what needs to be done to correct it, but like anything in life the surgeon cannot predict exactly how your eyes will respond to the treatment meaning some patients need a second surgery or still need some form of corrective lenses.

Because this is a surgical procedure the more common risk is to have sore, dry, eyes that give you pain post surgery.

Some patients also have a slight haze or halo affect when looking at lights; this doesn’t affect their vision normally unless they are driving during the night.

The final risk involves high altitudes. When you venture to higher ground it is believed that you may have slight corneal swelling due to the change in oxygen levels, although this is not painful some patients have said their vision changes and becomes poorer.

Complications resulting from LASIK surgery are rare.  LASIK candidates are carefully screened before the surgery and only those with a reasonable expectation of improved vision are good candidates.  Reports indicate only one percent of those who have LASIK surgery report any complications.  Any complications that may occur can easily be corrected with re-treatments with the laser or other enhancements to the eye.  It is rare for complications causing permanent damage to the eye or vision loss.

One complication is an irregular astigmatism.  This will result in a cornea surface that is not smooth and will result in the laser beam not being centered on the eye.  Ghost images and double vision are caused by swelling in the cornea but will sometimes disappear without needing further treatment.  If treatment is needed, a re-treatment or an enhancement may be needed.  Sometimes these vision problems will disappear when the healing process is complete.

There are certain complications to consider when undergoing LASIK flap surgery.  They are associated with cutting a hinged flap in the cornea, lifting it for corrective surgery, then replacing the flap to form a natural bandage.  New technology and advances in procedures have improved accuracy and fewer complications are found with LASIK flap surgery.  The newest technology is called IntraLase.  It is an improvement on the former procedure but also costs more.  The patient is given a choice of having the more expensive procedure or they want the traditional, less expensive LASIK.

Another choice is custom LASIK that can treat vision errors that were not once noticed and higher order aberrations.  Custom LASIK uses a mapping of the cornea to locate the areas that need to be reshaped to enhance vision.

If the flap is not cut correctly, it may not stick to the surface of the eye.  It can be cut too thin or too thick and when placed back over the cornea it could wrinkle and cause complications.  These wrinkles could lead to vision distortions caused by irregular astigmatism.

Other complications that could arise after LASIK surgery are haziness in vision, dry eye problems, and infections.  Other visual aberrations include glare, halos, double vision, and loss of sensitivity to contrast.  Problems with night vision or low light situations may also occur.  Most of these complications or risks can easily be corrected with another laser treatment, eye drops or oral medications.  With a one percent risk of complications, LASIK eye surgery is a great option for correcting vision problems.  Most surgeons believe any risks involved in LASIK surgery are outweighed by the benefits

The extraocular muscles are attached to sclera, which is the outer protective layer covering the eyeball.  They are found in different places and the other ends are attached to the eye socket in the skull.  This is what allows the eyeballs to move up, down, and to both sides and any angle between.  This allows the eyeball to “track” together.

Normally both eyes would move together and give you a clear picture of what you are looking at.  If the eyes do not move together, the brain receives two separate images and will either show a double vision or suppress one of the images.  The main purpose is to adjust the eye muscles to straighten eye alignment.  The surgery may need to be performed on one eye or both.  Muscles may be weakened, or tightened to make the eyes align with each other for a clear 3-dimensional picture.

Eye muscle surgery will also have a cosmetic benefit.  It can be disconcerting to talk to someone who has an eye out of alignment.  It is hard to know which eye to be looking into while you are talking.  Other eye disorder that eye muscle surgery can correct is Nystagmus.  This is a condition when one or both eyes move rapidly or oscillate.  Duane syndrome is another disorder that can be helped by eye surgery.  This condition is when there is little horizontal eye movement.  Normally, muscles will be weakened to relieve the symptoms and allow more movement horizontally.

The surgery itself can be performed to weaken muscles, tighten them or reposition them.  The procedure is designed for each individual and the correction that is needed for each patient.  Small children may have this done around the age of two to correct any eye problems that is recognized.  Many years ago, placing a patch on one eye and doing exercises, or reading or watching TV to strengthen the muscles in one eye treated a “wandering” eye.  Now we have sophisticated surgery that easily corrects these problems in small children.

Patients should make their doctor aware if they are taking any medication, even over-the-counter medications.  Especially tell your doctor if you are taking any blood-thinner medications.  If you are, you will need to stop this medication for ten days before surgery.  You should not eat or drink anything after midnight before this surgery.

Once the surgery is completed, the eye may feel scratchy but not painful.  The eyes will be red and watery and there might be a little blood in the eye for a couple of days.  This is just a bruise like one that would appear on your skin if you run into a door or piece of furniture.   This surgery improves eye alignment for cosmetic purposes and for improved version.

The mind is an amazing jigsaw of thoughts and processes that help define the people we are, but it can also bring out our fears about future events. The fact that people become nervous or even feel anxiety about surgery is normal, but it can increase further when it comes to eye surgery.

What does eye surgery entail?

It depends on your eye condition; some surgeries involve simple procedures while others involve full corneal transplants using the corneas of a deceased donor.

There are so many different surgeries available that its difficult to explain what they all entail, one thing that can be said is that most of them entail some form of incision to the eye itself.

Why is eye surgery so scary?

Eye surgery may not have high risk factors involved but a lot of people feel the strain at the thought of a surgeon using surgical instruments to make precise incisions to their eyes. If you think about it, this is your sight the surgeons are working with, if something goes wrong it could cost your vision so it is understandable why people have this fear.

There is no reason for people to be so scared of eye surgery, as mentioned the risk factors are very low and the technology available for eye surgery today is second to none. If you think about the amount of people that have cataract or laser eye surgery every year, only a small fraction ever have an issue.

Combating the fear of surgery

Talking to your surgeon to find out all possible information about the surgery can help in some circumstances, as the lack of knowledge can be one of the big reasons why people are so scared.

If talking to a surgeon does not help, then visiting a psychologist can also have a big impact on your fears. Psychologists are trained to work through fear, anxiety and emotional stress so they may be able to resolve your wall of emotions at the prospect of eye surgery.

The importance of your surgery

It is important to have the surgery your medical consultant has requested as a treatment. It may not be life threatening but if surgery to your eye is the treatment needed to resolve your condition then you need to work through your fear.

If you think about it, if surgery was not important a doctor would not request for you to have this as a treatment.

Summary

Its natural to feel scared at the prospect a having a surgeon working on your eyes, after all you only get two of them for your whole lifetime. Many of us neglect our eyesight without realizing it, be honest, when was the last time you went and had your eyes tested? A long time ago I am sure.

Remember to look after your eyes, you never know when the doctor may come knocking on your door telling you surgery is the only answer.

People who have a common vision problem such as nearsightedness (myopia) are finding a correction surgery that involves implantable lenses. Implantable lenses may be another choice for correcting your vision problems. An implant that resembles contact lenses are placed between the iris and the cornea, or just behind the iris.

This is an alternative to the LASIK surgery but LASIK uses light rays to remove tissue from the eye to change the shape; the implantable lenses are more like glasses or contact lenses. The difference is they correct your vision inside the eye. This procedure does not need tissue to be removed; they are added to the eye. The implantable lens is similar to what is used in simple cataract surgery but the lens not replaced but placed inside the eye.

Cataract surgery involves removing the lens surgically before another lens is placed in the eye.

If other surgical procedures are not an option a doctor may consider implantable lenses to correct eye problems such as thin corneas. Implants may also be used to supplement or refine other vision correction procedures.

The Food and Drug Administration has approved implantable lenses for use in the United States. They are Verisyse and Visian ICL. Both companies are based in the state of California.

Verisyse was approved to correct nearsightedness in moderate to severe ranges. The patient must be 21 years old or older. It is made of plastic known as PMMA. This plastic was developed in Europe.

The second company with FDA approval is Visian ICL. Their lens is made from biocompatible material known as collagen. It is easier to insert because it is foldable, which means a smaller incision and shorter recovery times. The approval from the FDA covers patients over 21 who have moderate to severe nearsightedness. This vision correction method has been marketed in Europe for many years.

Clinical trials continue for both of these products and procedures to decide if they can be used to correct farsightedness (hyperopia) and higher levels of astigmatism. Those patients who have a high-level of astigmatism may find help in resolving their problem with the use of implantable lenses. Many times, patients with high astigmatism are not eligible for contact lenses. This new procedure, if it is approved for astigmatism, may give them freedom from the glasses they may have worn all of their life.

Immediately after the lens implantation, you eye may feel scratchy. Patients are asked to rest at home the day of the surgery and return the next day for a postoperative checkup. Most patients are able to drive and resume their work schedule the next day. Follow-up visits are made to the eye doctor to ensure the implants are functioning, as they should.

Once the lenses are inserted, the patient is unable to feel them. They are made to be permanently added to the eye and never need removal for cleaning.

Complications are always a risk as with any other surgery including the chance of retinal detachment or loss of cells in the cornea. Inflammation, infection, and cataracts are also risks that should be looked at before choosing this vision correction surgery.
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Cataract surgery is one of the most common eye surgery performed in the United States.  The success rate of cataract surgery is over 98 percent.  Cataracts appear as a clouding of the lens and affects vision as a person ages.  Surgery is performed to give the aging patient better vision.  Cataract surgery is done as an outpatient surgery and you do not have to remain in the hospital.  Normally a surgeon will not do both eyes at the same time. The cataract in the other eye will be removed during a second surgery.

The process for removing a cataract is fairly simple.  During the surgery the affected lens will be removed.  One way that is done is by using high frequency sound waves to break the lens into small pieces that is suctioned out of the eye through a small incision.  There are many other ways to remove the lens and remove the cataract; this one is the most common way.  Once the lens has been removed it is replaced with a manufactured lens called “intraocular lens.”  The entire procedure is called “intraocular lens implantation.”  The manufactured lens is chosen to fit your eye and will help restore your vision to normal.  Normally a new prescription for glasses is needed after cataract surgery.

As with all surgeries, there is a risk involved but the success rate of cataract surgery is high.  As with any operation there is always a risk of inflammation and infection.  You will want to talk to your doctor about other risks common to this surgery.  It is normal to feel some mild discomfort and your eye may itch.  Eye doctors normally recommend an over-the-counter pain reliever.  There may be a temporary fluid discharge and your eye could be sensitive to light.  These minor problems are just that, minor and the results of the eye surgery and well worth a few days discomfort.

After surgery, you will need to use medicated eye drops to prevent infection and promote healing.  This medication will also help control the pressure inside your eye.  Heavy lifting and strenuous activities should be avoided for a short time.  Normal routines may be resumed immediately.  Your doctor will be able to tell you if you will need any special limits after your cataract surgery.

Your vision will improve the day after you have cataract surgery.  You will not notice maximum improvements until nearly a month after surgery.  You also will need a new eyeglass prescription.

Cataract surgery and intraocular lens implants will last for the life of the patient.  They rarely need to be replaced.  A small percentage of cataract patients may have a clouding on the lens after a few months or even years after the surgery was completed.  This is unusual but will sometimes occur in some patients.

Although cataracts are problems that normally appear, as we get older, it can happen in some younger people.  This vision problem is easily taken care of and is 98 percent successful.