To able to see clearly, the cornea and the lens must bend or refract the light rays to focus on the retina which is a layer of light-sensing cells that line the back of the eye. If the light rays don’t focus on the retina, you begin to see everything blurry. This is called a refractive error. Basic types of refractive errors are nearsightedness (myopia), farsightedness (hyperopia), astigmatism or presbyopia. The aim of glasses, contact lenses, and refractive surgeries is to eliminate these errors by making light rays focus on the retina.
Refractive surgeries are generally done with two techniques, which are either reshaping the cornea with laser or implanting a lens inside the eye.
If you have an appropriate refractive error, want to decrease your dependence on glasses or contact lenses and accept the potential side effects of the procedure, refractive surgery is a good option for you. If you are suitable and also considering refractive surgery, you and your ophthalmologist can determine the most proper procedure for you by discussing your lifestyle and vision needs.
Let's take a look at the types of eye surgery which are generally improving the quality of life by giving the ability to see the images clearly.
Laser-Assisted in Situ Keratomileusis (LASIK) is one of the most commonly performed laser eye surgery designed to treat hyperopia, myopia, and astigmatism. LASIK is a 15-minute procedure in which the eye surgeon treats vision disorders by making a minimal cut on the cornea, making a flap of it and then applying excimer laser to reshape the cornea by using either a mechanical surgical tool called a microkeratome or a femtosecond laser.
Although there are instructions you to follow during recovery, the procedure does not require significant aftercare because the results can be seen in 24 hours. LASIK cost varies depending on several factors, such as the country. For example, while you are supposed to pay €3000 per eye for LASIK in Germany, at a price of €1600 you can undergo a quite successful surgery in Turkey, along with memorable recovery time.
In bladeless LASIK eye surgery, the bladed instrument (microkeratome) is not used; instead, the eye surgeon uses two types of lasers during the procedure. First, an ultra-fast femtosecond laser is used to create a thin flap in the cornea, and then an excimer laser is used to reshape the underlying corneal tissue to correct your vision. Lastly, the flap is returned to its original position.
Bladeless LASIK is also called as blade-free LASIK, all-laser LASIK, femto LASIK, Intralase LASIK, IntraLASIK.
Epi-LASIK is another eye surgery with laser procedure, and it is quite similar to LASIK surgery in that a flap is made with a keratome or mechanical device. But the flap with Epi-LASIK is much thinner, and this procedure may be more appropriate for patients with thin corneas than being a candidate for a regular LASIK.
Laser Assisted Sub-Epithelial Keratectomy (LASEK), is a laser eye surgery which is generally recommended for patients who have a more sensitive and vulnerable characteristic of the eye. LASEK eye surgery is similar to LASIK, but the difference between them is that only one laser is used in LASEK while there are two laser procedures are performed in LASIK eye surgery. LASIK recovery time is generally around 24 hours whereas LASEK recovery time is around a week.
Photorefractive Keratectomy (PRK)
PRK is also a laser eye surgery used to correct farsightedness, nearsightedness, or astigmatism. Similar to the LASIK procedure, the eye surgeon uses excimer laser to reshape the cornea. But the difference from LASIK is that a flap of the cornea is not made; instead, the surface of the cornea is completely removed. Although local anesthesia for eye surgery is more popular, there will always be a need for general anesthesia, as well. Some patients may refuse local anesthesia, because of not be sure that they will keep still or will lie flat for the duration of surgery. Likewise, both young children and those with the allergy to local anesthetic need general anesthesia.
PRK procedure is generally recommended for patients who have thin cornea and are not able to have LASIK because of this condition.
Conductive Keratoplasty (CK)
Conductive keratoplasty (CK) is basically a corneal steepening procedure for both the correction of hyperopia and the management of presbyopia. During the CK procedure, the eye surgeon uses surgical equipment that contains a tiny probe to apply low-level radio frequency (RF) to specific spots.
Corneal Cross-Linking (CXL)
Corneal cross-linking (CXL), also called corneal crosslinking or corneal collagen crosslinking is an in-office eye procedure in which the cornea is strengthened. CXL procedure is generally performed on patients who have weakened cornea because of keratoconus condition (progressive eye disease which causes distorted vision).
Refractive Lens Exchange (RLE)
The surgical technique of refractive lens exchange (RLE) is used as a variation of conventional cataract surgery. The eye doctor makes a small incision at the edge of the cornea, removes the eye’s natural lens completely and replaces it with an artificial lens. RLE is used to correct extreme myopia or hyperopia. This procedure is generally recommended for patients with thin corneas or dry eyes.
Which Option Is Best for Me?
Which type of vision correction surgery to choose depends greatly on some important factors such as your age, your corneal thickness, the humidity level of your eye and your health condition. For example, according to studies, laser eye surgeries may be performed safely in patients with diabetes.
But if you have glaucoma, you may not be able to undergo LASIK surgery.
In a nutshell, there is no single “best” method for correcting refractive errors. You should decide the best option for you after a thorough examination and discussion with your ophthalmologist.
This content is edited by Flymedi Medical Editors in April 2019.