What Patients Are Eligible For Excimer Laser Operations?
Laser eye surgery is approved for correction of nearsightedness, farsightedness and astigmatism. A suitable candidate for a laser eye surgery:
- is over 18 years of age;
- has had a stable glasses or contact lens prescription for at least 12 months;
- has no conditions that may preclude the patient from being a candidate for a laser eye surgery, such as pregnancy, nursing or some systemic diseases (rheumatoid arthritis and other);
- does not suffer from any eye or other disease that may reduce the effectiveness of the surgery and affect wound healing.
A full eye examination is done during preoperative consultation.
When the laser eye surgery is recommended?
- Laser vision correction gives most patients the freedom to enjoy their normal daily activities without the dependence on corrective lenses and glasses. Patients who need excellent vision for their carriers may also benefit from refractive surgery.
- There are medical indications for refractive surgery. Sometimes refractive error between the eyes differs greatly. In such case, refractive error cannot be properly corrected with glasses.
Laser eye surgery not only improves unaided vision, but also offers new and better quality of life and confidence.
Are there any other options to treat refractive error?
Clinical research shows, that no drops or vision therapy exercises can treat underlying refractive error. Myopia can be corrected with glasses or contact lenses, or refractive surgery. Patients with low and medium degree of myopia can be corrected with glasses rather well, achieving good quality of vision. However, patients with higher degrees of myopia cannot always be corrected properly because of optical properties of thick glass lens. Prolonged contact lens wearing may result in an allergy and discomfort; time is required to put them in the eye and take out and they are rather expensive.
What result can I expect after surgery?
The goal of the surgery is to eliminate refractive error. Most patients have the same visual acuity after the operation as they had with appropriately selected glasses before the surgery. Those patients with high myopia have a lesser chance of achieving that result, but their vision will be markedly improved. The final result depends on the degree of refractive error and individual healing respond of the patient.
What conditions can influence the operation results?
Laser eye surgery is performed with a computer controlled laser system with an accuracy of 0,25 microns. However, the operation result can be influenced by individual healing process. There are some conditions that may aggravate the healing process and lead to a poorer final result. Because of this reason, laser eye surgery is not performed for pregnant or nursing women and for patients who have diseases of autoimmune origin.
Are the operations with excimer laser safe?
Experience and studies have shown that excimer laser correction procedures are safe and effective. Operation proceeds on the surface of the eye, without any manipulation inside the eyeball, so there is no risk of damaging or infecting the inner eye structures.
All procedures are carried out with excimer laser, under computer control with accuracy of 0.25 microns. Eye tracking system helps to avoid any mistakes because of involuntary eye movement. The procedure and laser can be stopped at any stage of the operation. The laser equipment is periodically tested and undergoes prophylactic service.
Is the correction permanent?
LASIK and PRK are surgical procedures that permanently remove corneal tissue to reshape the cornea and improve refraction. Physical results are permanent, but the eyes can still change with time after the operation. The refractive surgical procedure does not affect other components of the eye (lens, retina) or visual conditions that may occur with the age, for example presbyopia.
What are long term results of these operations?
Refractive corneal surgery has been developed more than 15 years ago. Laser technology and surgical technique have been refined and advanced. The studies have shown that excimer laser correction is safe and effective procedure.
What are complications of the procedure?
Like all surgical procedures, LASIK and PRK have risks and potential complications, but serious complications are very rare. Most of the complications occur immediately after the procedure and resolve with the time. For example:
- Light sensitivity may occur during the healing period and is more often experienced after PRK;
- Eye pain and discomfort usually resolve within 3 days after PRK, within several hours after LASIK. The actual laser treatment itself is painless;
- Blurred vision. Sometimes it takes several weeks to achieve clear vision after PRK. Patients after LASIK usually achieve good vision the next day after the surgery;
- Overcorrection, undercorrection, regression. It is common to be slightly temporarily overcorrected for the first few weeks following treatment. Temporary overcorrection may cause difficulty for the treated eye in focusing near for about few days to several weeks. Every eye heals differently. The surgical plan is based upon an average healing response, but sometimes patients heal more aggressively, or slower. These are the reasons of overcorrection, undercorrection or regression of the effect. This complication is more usual for patients with high degree of myopia or hyperopia. If surgeon suggests, enhancement procedure may be performed. However, eyes with very thin corneas, may not be eligible for the enhancement procedure.
Permanent complications may occur:
- The haze of the cornea sometimes occurs after PRK procedure. Studies showed that scar formalion doesn‘t appear after LASIK operation. Usually haze disappears within 6-12 months, and most patients are unaware that they have ever developed any such haze and it is not visible to the naked eye. It rarely causes a visual problem. Haze may lead to a slight loss of effect of the laser with a "myopic shift". As it clears, the refraction gets better. In the higher myopes, the risk of haze causing a visual problem is greater;
- Glare and halos, especially in diminished light condition and at night are sometimes experienced after LASIK. About 10% of operated patients experience blurred night visions, sometimes with glare and halos. Symptoms decrease during 4-6 weeks after operation. Possible causes may be residual refractive error, the amount of refractive error have been corrected, large pupils. There is no method to determine in advance who will experience this symptom;
- Dryness – this is rather common complaint after an operation, experienced by 14-15% of the patients. Dryness usually resolves within 3 to 6 months. Risk factors for dryness are: prolonged contact lens wearing before an operation, medications used after the procedure, hormonal changes during menopause, birth control pills, decreased sensitivity of the cornea. Preservative free artificial tears are recommended to help the symptoms.
How long does it take to do an operation?
It takes about 20 minutes for PRK and 30 minutes for LASIK. The excimer laser itself is used approximately for a minute.
Does laser surgery hurt?
The surgery is painless and is performed under anaesthetic eye drops. Sometimes sedatives are administered to help patient to relax before an operation. After PRK , patient experiences light sensitivity, foreign body sensation, tearing, discomfort for about 3 days. Eye drops are prescribed to reduce these symptoms.
During LASIK surgery, discomfort can be felt when suction ring is put on the eye with a pressure, but it doesn‘t hurt. Several hours some discomfort can be experienced in the operated eye. Short snooze is advised to help the symptoms.
Can both eyes be done with LASIK or PRK at the same time?
Nearsightedness is usually corrected on the same day in both eyes despite LASIK or PRK procedure is performed. Farsightedness is corrected in one eye first and then in another after about 2 months.
How long will I be out of work after having laser surgery?
It depends on type of surgery and job. Most people return to work and most activities within a few days. Faster after LASIK - within about 3 days, slower- after PRK within 7 days.
How long will it take before I can see well?
Visual recovery good enough for most daily activities is achieved within 3 to 7 days, most patients achieve good vision on next day after LASIK. However, vision can continue to improve and best vision can still take one to three months to occur. Patients who undergo LASIK for high degree of myopia or hyperopia often need to wait longer to achieve final visual acuity.
Can I drive immediately after having LASIK?
Patients experience some discomfort, blurred vision for a few hours after LASIK, and for about several days after PRK. You should not plan to drive the day of the surgery and even several days after, until visual acuity for driving is not achieved enough. Most patients are able to drive within 2-3 days after LASIK and 1 week after PRK.
Can I play sports after laser surgery?
Patients can resume most sport activities after a week. Depending on vision correction type, kind of sport, condition of the eyes, doctor will suggest individually.
What is the appointment schedule after an operation?
The first appointment after LASIK surgery is on the next day, after PRK on the third day after surgery, when contact lens is removed off the eye. Then all patients are seen after 10 days, 1, 3, 6 months. Sometimes appointment schedule may be corrected when healing is delayed or problems occur. The eye examination is available in our clinic in Kaunas and Vilnius.
What are LASIK advantages over PRK?
LASIK provides some advantages over PRK. These include:
- Less postoperative discomfort - as the cornea is only slightly disturbed it is rare for the LASIK patient to experience discomfort. Minimal irritation is expected initially for about first 4-5 hours;
- Faster visual recovery (as the epithelium is only minimally disturbed during the procedure, the recovery is usually very fast with the majority of patients returning to most activities on the next day);
- Corneal haze has almost been eliminated as a long term complication in LASIK;
- Contact lens is not used after operation.
What should not I do after an operation?
After an operation:
- You may experience light sensitivity, burning, foreign body sensation, itching. Do not rub your eyes. Go nowhere without sunglasses. If you have lost contact lens after PRK, don‘t put it on the eye by yourself, but call the doctor;
- If you experience unusual side effects, any worsening symptoms at any time after surgery, immediately call for your doctor;
- Always wash your hands before you install eye drops;
- Avoid water come into your eyes, don‘t use make-up for a 1-2 weeks;
- Avoid sauna, swimming pool, solarium for a 2-4 weeks;
- Try to stay away from smoky rooms, dusty environments or areas with chemical vapours;
- Do not drive until your vision has not improved to drive;
- You should wait for about 1-2 weeks, before beginning any non-contact sports. You should discuss about the possibility to resume contact sports with the doctor individually.
What does laser surgery cost?
The treatment is affordable for most patients. We offer some payment options - cash, credit cards, or monthly payments. The price is determined by expensiveness of excimer laser, it‘s servicing, medications that are used during an operation.
The fee includes an operation, medications that are used after the procedure and Office visits that are required. If necessary, enhancement procedures are free of charge.