Comprehensive Guide to Refractive Laser Surgery

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What is Refractive Laser Surgery?

‍Refractive laser surgery is a groundbreaking category of eye surgeries designed to correct common vision errors by reshaping the cornea—the clear front part of the eye. This is achieved through the precise application of laser technology, improving how light is focused onto the retina at the back of the eye.

Types of Refractive Laser Surgery

• LASIK (Laser-Assisted In Situ Keratomileusis): The most widely recognized form of refractive surgery which involves creating a thin flap in the cornea, then using an excimer laser to reshape the underlying corneal tissue. This procedure is typically quick, with most patients experiencing substantial improvements in vision almost immediately after surgery.
• PRK (Photorefractive Keratectomy): Before LASIK, there was PRK. It involves reshaping the cornea by removing a small amount of its surface layer to change its curvature. PRK is often recommended for patients with thin corneas who are not ideal candidates for LASIK. PRK is the safest laser refractive procedure but has longer visual recovery.
• LASEK (Laser Epithelial Keratomileusis): Similar to PRK, LASEK treats the corneal epithelium with alcohol to create a flap before reshaping the cornea with a laser. It's suitable for patients with thin corneas or those in professions at risk of eye injuries.
• SMILE (Small Incision Lenticule Extraction): The latest advancement in laser eye surgery, SMILE involves creating a small, lens-shaped bit of tissue within the cornea, which is then removed through a small incision, reshaping the cornea.

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How Does It Correct Vision?

‍Refractive errors like myopia, hyperopia, and astigmatism are corrected by changing the shape of the cornea:

• Myopia (Nearsightedness): The cornea is flattened slightly to reduce the steep curvature, allowing light rays to focus directly on the retina rather than in front of it.
• Hyperopia (Farsightedness): The central part of the cornea is made steeper, helping to focus light rays that would typically converge behind the retina.
• Astigmatism: The laser corrects the uneven curvature of the cornea to a more smooth and regular shape, allowing for better focus.

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What Can Patients Expect?

• Pre-Surgical Assessment: In-depth eye examinations including corneal topography and pachymetry to map the cornea's shape and thickness and ensure precise corrections.
• During the Procedure: Procedures are generally quick, often taking less than 30 minutes. Patients are awake, and anaesthetic drops are used to numb the eye. The actual laser application only lasts for seconds to a few minutes.
• Post-Surgery Recovery: Recovery times vary by procedure type. LASIK patients often see immediate improvements, whereas PRK or LASEK patients might experience a few days of discomfort and slower visual stabilisation. Detailed post-operative care plans include medications to help manage healing and prevent infection.
• Long-Term Outcomes: Most patients achieve excellent vision within a week of surgery, sometimes the next day. However, some might still need glasses for certain activities, especially those over 40 who will develop presbyopia.

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Benefits

Experience Freedom from Glasses and Contacts Refractive laser surgery offers a transformative solution for those looking to correct vision impairments and reduce their reliance on glasses or contact lenses. Here are the key benefits:

• Improved Visual Acuity: Most patients achieve 20/25 vision or better, enabling them to perform most activities without corrective eyewear.
• Quick and Painless Procedures: Surgeries like LASIK involve minimal discomfort and have quick recovery times, with many patients experiencing improved vision almost immediately.
• Long-Lasting Results: After a stabilization period, the improvements in vision are typically permanent, with adjustments rarely needed.
• Enhanced Lifestyle: Freedom from glasses and contacts enhances participation in sports and activities, and can improve confidence and quality of life.
• Reduced Allergy Symptoms: Patients who struggle with eye irritation due to contact lenses often find relief after surgery.
• Cost-Effective: Over time, the cost of surgery may be offset by the savings on glasses, contacts, and associated care products.

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