Although it is an extraocular and ambulatory operation, we must not forget that ocular laser surgery is an operation and therefore carries a certain level of risk, however minimal. For this reason it is important to emphasize the importance of the first pre-operative consultation, since it allows the ophthalmologist to establish the medical criteria that prevent the operation of the laser eye comes associated with unnecessary and avoidable risks.
Lasik surgery: What does it consist of?
Although there are other laser techniques, most surgeons are supporters of Lasik refractive surgery for their efficacy, safety and minimal risks. For this surgical procedure a last generation Excímer laser is used with which the corneal tissue is remodeling, and thus correct the defects that cause a poor vision. As a preliminary stage, the surgeon lifts a thin layer of corneal tissue to apply the laser. Once the intervention is finished, that layer of cornea tissue is repositioned without the need for stitches. This is the point that differentiates Lasik from other procedures such as surface techniques (PRK/Lasek).
What are the advantages?
Faced with the possible risks associated with all types of ocular laser surgery, Lasik technique, a surgery that adapts to the characteristics of each eye and the needs of each patient, has the following advantages:
- It is fast (approximately 10 minutes long) and both eyes are operated on the same day.
- It is a practically painless operation in which the surgeon uses topical anaesthesia administered in the form of drops.
- It is an outpatient procedure, which does not require hospital admission and the patient returns home after the intervention.
- This technique is a very safe method, tested and scientifically endorsed, which does not entail excessive complications, being very uncommon.
- The normalization of the vision after the intervention is usually very fast and the reincorporation to the working life is, usually, immediate.
Who can be a candidate for lasik surgery?
The patient who wants to say goodbye to his glasses and lenses with Lasik technique should go to a first consultation in the clinic with his ophthalmologist so that this values your case taking into account the results obtained from simple tests consisting basically , in the graduation of the sight, the taking of the intraocular tension and the assessment of the state and thickness of its cornea. Generally speaking, patients are usually discarded:
- They’re under the age of 18.
- Whose graduation has increased more than one diopter over the past year.
- Have other visual problems associated with refraction defects (myopia, hyperopia, presbyopia, and/or astigmatism), such as glaucoma or some retinal problems.
In the event that the patient cannot be operated with this technique, the doctor may opt for other laser surgery techniques or for intraocular surgery for the lens implant.
Frequent complications and their solutions
In addition to the risks associated with each patient in a particular way, and of which the specialist will inform you in a totally personalized way, Lasik surgery has some very rare complications and that occur with a low frequency:
- Dry eye. It is an alteration also known as dry eye syndrome that occurs on the surface of the cornea and conjunctiva by a scant production of tear, or because it is of poor quality. It may appear as a side effect to an intervention and, although annoying, this problem does not usually produce greater symptoms than mild eye discomfort such as: irritation, blurred vision, itching or redness. With the proper treatment (usually the use of artificial tears) it usually disappears completely within a few days. For this reason, during the first consultation, a detailed examination of the tear (both of its quality and the amount of tear production) is performed to see if the intervention is viable. In cases of very severe dryness, one can choose to change the type of technique that is going to be applied in the intervention that is performed with the laser, or to pre-treat the patient for a few months to be intervened if it produces an improvement of the dry eye picture.
- There is a possibility that a small residual defect of the refractive problem is maintained or that a small regression occurs over time (a small defect may appear). On most occasions, it is possible to repeat the operation without increased risk.
- Less frequent problems may also result in a slight loss of visual acuity.
- Very rarely are inflammations or infections that can be treated with certain medications.
- Appearance of night halos or glare in low-light situations. These types of problems are usually experienced by patients who have been involved with ancient laser systems.
Very rare complications
- Injury or loss of the part of the corneal epithelium removed to apply the laser, which may cause opacity and/or irregularity of the cornea.
- Upper eyelid drooping.
- Decreased visual capacity in dim light situations (Dark places)
- Allergic reactions to the anesthetic or medication administered.
In any case, the specialist will explain to the patient all these possible problems and solve all possible doubts.
What are the limitations of this technique?
The main limitation of Lasik technique is that, although most, not all patients are suitable candidates for this type of intervention, as there are certain factors that discourage it and can generate risks associated with this operation of eyesight:
- Have scarring on the cornea.
- Have suffered an infection or eye injury in the past year.
- Have a history of herpes or autoimmune disorders, such as Sjogren’s syndrome or lupus.
At Clínica Bavaria about 15% of patients who go through a first pre-op visit are considered “unfit” for ocular laser surgery. In these cases, our ophthalmologists propose alternative surgical treatments or simply explain that they should continue to use glasses and/or lenses to avoid risks associated with refractive surgery.
As far as expectations are concerned, it is important for the patient to be aware that the maximum vision he or she is going to achieve with laser surgery is usually the same as that achieved with their glasses and lenses if they are properly graduated. Therefore, if the patient has a lower visual acuity than normal, the most frequent is that he/she does not recover with the intervention, although its execution and result are completely satisfactory.
On the other hand, it is important to consider that the laser treatment does not influence the evolution of the rest of visual alterations that can suffer the patient like: retinal detachments, hemorrhages, macular atrophy or changes of graduation during the pregnancy .