A View on Vision Surgery
By Emily Stewart.
Published on September 11th, 2018
It wasn't until the 1950s that people with poor eyesight could wear anything other than the eyeglasses - those funny facial contraptions have dominated our eyesight experience for the past seven centuries! Thanks to the fast pace of new medical technology, laser eye surgery and other non-laser technologies are replacing contacts and glasses as the preferred method of corrective eye technology. There are cost-effective solutions for people suffering from nearsightedness to astigmatism, cataracts to farsightedness, and everything in between. Many solutions eliminate the need for eyewear. “For the first time, I could actually see when I opened my eyes in the morning,” said Nancy, a LASIK recipient. “It changed my life. I felt more safe and confident than I had in years!” Clever marketing has made LASIK the most discussed type of surgery. However, other laser and non-laser surgeries may be suited to your particular needs.
You do You
While eye surgeries provide life-changing vision correction, your eyes will still change with time (like the rest of the body). Many patients end up wearing glasses or booking follow-up surgeries years after their first procedure. For this reason, people aged 20-30 years old are great candidates-- their eyes have plateaued for the time being. People with severe eye issues are also great candidates, simply because the need is identifiable and urgent. If you’re already dependent on glasses and contacts, get rid of those pesky glasses and book a procedure!
Consider your unique lifestyle. The body is a fantastic thing - it will adapt to your needs. If you’re a seamstress who’s served well by nearsightedness, allow the doctor to correct your eye to the level that best serves you.
Just like some of us are taller than others, so do some of us have larger pupils than others. The bigger the pupils, the better suited you are for LASIK! Weird, but true.
If you’re over the age of 40 years old and have severe vision problems, there are a few extra considerations. Monovision is common ailment: one eye can see distance, the other can see close-in. In this case, contact lenses are often a better solution. Anyone over 40 will most likely require several types of eye corrections, at once and again over time, as eyes further degrade.
People with diabetes should consider photo refractive keratectomy, a.k.a. PRK, instead of LASIK, as studies show that the surface of the eye regenerates with greater ease. Unfortunately, pregnant women and people with glaucoma are not eligible for LASIK.
Unless you get corrective eye surgery for major health reasons, you will book with a private health care provider and pay for the cost out of pocket - something like €1,500 - €2,500. Great! - you’ll save thousands over the years in eyewear. Not to mention the miracle of waking up with nearly perfect vision!
An optometrist is the person you’ve been seeing for your basic visions needs. If they suspect that you have an eye disease, or would greatly benefit from eye surgery, they’ll refer you to an ophthalmologist for treatment. Optometrists are limited in their diagnostic and treatment options, whereas opthamologists are highly trained to diagnose and treat eye illnesses.
Types and Competencies
Whether your eye surgery uses laser or not, the name for any type of surgical procedure that corrects common vision problems is housed under the umbrella of refractive surgery. There are many kinds of refractive surgery. There is a numbing agent used in all surgeries, most often numbing eye drops.
Thanks to clever marketing tactics, the most commonly recognised form of corrective eye surgery is LASIK. LASIK eye surgery uses laser energy to reshape the curvature of the front surface of the eye - the cornea - to alter the way the light rays.
The biggest benefit to LASIK surgery is that vision often clears in hours, or a few days, with little discomfort. Additional types of the technology offer slight variations adapted to individual needs (like multiple eye problems or sensitive anatomies). One, LASEK, creates a super thin flap in the cornea. Another, Epi-LASIK uses a special cutting tool. Bladeless LASIK uses a laser to both cut and re-shape the eye.
The most common side effect of LASIK surgeries are dry, burning, itching eyes. Luckily, this is easily treated with antibiotic and steroid eye drops a few times daily for a week or so. While most people experience a shortened recovery time with LASIK, some people experience light sensitivity and vision oddities, like glare, “halos,” and “starbursts”. Because these eye issues most often occur at night, it’s recommended not to drive for 3-6 days afterward.
While most people find that LASIK surgery corrects major eye issues, in 3% of cases the surgery is not totally successful or creates secondary eye conditions. Some patients therefore book a secondary surgery. One example is the case of presbyopia, middle aged farsightedness due to loss of elasticity in the eye. This ailment is difficult to cure with LASIK, so those people may get LASIK first and Conductive keratoplasty second.
Conductive keratoplasty (CK)
For farsighted people, “CK” is the best solution. Rather than use laser, CK uses a tiny probe and low heat radio waves to apply “spots” to the eye’s front surface periphery.
Refractive lens exchange
This surgery that serves farsightedness and presbyopia well. It replaces the eye’s natural lens with a completely new, man-made one to sharpen focus. Instead of wearing those bifocals on your nose, they’re inserted directly into your eyes!
PRK (Photo refractive keratectomy)
This predecessor to LASIK eye surgery changes the curvature of the eye by removing tissues directly from the cornea - hence the reason it’s also called surface ablation. Because there is no hinged, thin flap on the eye’s surface, people with thin corneas and really all patients report a faster recovery time with less dry eyes.
Intraocular lenses This procedure is a total alternative to LASIK because it replaces the eye’s natural lens with an artificial one. Surgically implanting the lens helps the eye to refocus and sharpens vision. If you’re unwilling and unable to approve the removal of your natural lens, there is a version of the procedure that implants a lens directly over the natural one, although such a lens can cause depth perception issues and night vision problems.
Refractive lens exchange The perfect non-laser answer to cataract problems, this surgery removes the natural lens that's grown cloudy and replaces it with a lens of a different shape entirely. This procedure is replacing most traditional cataract surgery because it not only removes the issue but can completely restore a person’s vision and correct issues like nearsightedness and farsightedness. In the past, many people suffered from astigmatism after their cataracts were removed. With the insertion of multifocal IOLS and toric IOLS, astigmatism may be prevented.
At the end of the horizon, the only person qualified to tell you the best type of surgery for your needs is your doctor. Come to their table with a background understanding of the topic, and you’ll set yourself up for a whole new view of the world. Literally!
About the author
Emily Stewart calls herself a “Pi-Fit-Yogi,” teaching yoga, Pilates, and blended classes all around the world. You can reach her at ahumandoing.org