The Future of Vision? Laser Eye Surgery, the positives and negatives

11 November 2024

As we advance into an age dominated by technological innovations, the world of vision correction is undergoing a remarkable transformation. Laser eye surgery has emerged as a leading solution for those seeking freedom from glasses and contact lenses. In this blog, we will explore the various types of laser eye surgeries, including LASIK and LASEK, while highlighting their benefits and why they are essential options in the modern optometry landscape.

Understanding Laser Eye Surgery

Laser eye surgery encompasses several procedures that utilize laser technology to reshape the cornea, thereby improving vision. The most common types of laser eye surgery include:

1. LASIK (Laser-Assisted In Situ Keratomileusis)

LASIK is perhaps the most well-known laser eye surgery. This outpatient procedure involves creating a thin flap in the cornea, which is lifted to allow the laser to reshape the underlying tissue. The flap is then repositioned, enabling quick recovery and minimal discomfort.

Benefits of LASIK:

• Quick Recovery: Most patients notice a significant improvement in vision within a day, allowing them to return to daily activities almost immediately.
• Minimal Discomfort: Due to the numbing drops used during the procedure, discomfort is generally minimal, and the eye heals rapidly.
• Long-Lasting Results: LASIK can provide a long-lasting solution for most commonly short-sightedness and astigmatism.

2. LASEK (Laser-Epithelial Keratomileusis)

LASEK has similarities to LASIK but involves a different approach to the corneal surface. In LASEK, the outer layer of the cornea is softened with alcohol and gently pushed aside, allowing the laser to reshape the underlying tissue.

Benefits of LASEK:

• Ideal for Thin Corneas: LASEK is often recommended for patients with thinner corneas, where LASIK may not be suitable.
• Reduced Risk of Complications: With LASEK, there’s typically a lower risk of flap-related complications since the procedure does not involve creating a permanent flap.

3. SMILE (Small Incision Lenticule Extraction)

SMILE is a newer, less invasive procedure. Small Incision Lenticule Extraction (SMILE) is a type of laser eye surgery to correct refractive errors such as near-sightedness (myopia) and/or astigmatism. The procedure is performed just beneath the corneal surface and unlike LASIK, there is no need to create a flap on the cornea. Instead, the surgeon operates through a keyhole, which makes the surgery minimally invasive reducing the risk of potential side effects.

Benefits of SMILE:

• Minimally Invasive: With no flap created, SMILE reduces the risk of corneal complications and promotes faster healing.
• Less Dry Eye Risk: Patients often experience fewer incidents of dry eye compared to other laser procedures.

The Advantages of Laser Eye Surgery

Beyond the specific benefits of each procedure, laser eye surgery collectively offers numerous advantages for those considering vision correction:

• Enhanced Quality of Life: Many patients report a dramatic improvement in their quality of life. They can participate in activities without the hassle of glasses or contact lenses.
• Cost-Effective Over Time: While the initial investment in laser eye surgery may be higher than the cost of glasses or contacts, over time, patients may save money as they eliminate the need for prescriptions, lenses, and regular eye exams.
• Customized Treatment: Modern laser eye surgeries are highly customizable, allowing for tailored solutions based on the unique needs of each patient’s eyes, resulting in optimal visual outcomes.

Contraindications

When considering laser eye surgery, it’s important to be aware of certain contraindications that may prevent individuals from being suitable candidates for the procedure. These contraindications can include:

1. Unstable Vision: Significant changes in vision prescription over the past year may indicate that the eyes are not stable enough for surgery.
2. Age: Generally, candidates should be at least 18 years old, as younger patients’ eyes may still be developing.
3. Pregnancy and Nursing: Hormonal changes during pregnancy or breastfeeding can affect vision stability, making laser surgery less predictable.
4. Corneal Thickness: Patients with thin corneas may not be ideal candidates, particularly for LASIK, as the procedure involves creating a flap in the cornea.
5. Eye Conditions: Certain eye conditions, including:
   • Keratoconus (a progressive thinning of the cornea)
   •  Dry eye syndrome
   • Corneal scarring
   • Glaucoma
   • Retinal diseases
6. Systemic Conditions: Some medical conditions, such as autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus), uncontrolled diabetes, or certain conditions that affect the healing process, can be contraindications.
7. Medications: Certain medications that affect healing or the immune response, such as long-term use of steroids, may impact candidacy.
8. History of Eye Surgery: Previous eye surgeries or procedures may influence the suitability for laser eye surgery.
9. Severe Allergies: Individuals with severe allergies that cause significant eye irritation may wish to defer surgery until their condition is stable.
10. Other Eye Surgeries: Previous surgeries like cataract surgery or retinal repair may complicate the outcomes of laser vision correction procedures.

It is crucial to have a comprehensive evaluation by an experienced eye care professional to determine individual candidacy for laser eye surgery. They will assess your specific circumstances and provide guidance on the best options for your vision correction needs.

Potential Complications

• Dry Eyes
  • Many patients experience dryness post-surgery. This can last weeks to months.
  • Use prescribed eye drops for relief.
• Visual Disturbances
  • Some patients see halos or glare around lights, especially at night.
  • These symptoms may improve over time, but not always.
• Infection
  • Though rare, infections can occur.
  • Follow your surgeon’s aftercare instructions closely.
• Under or Overcorrection
  • Your vision may not improve as expected or might worsen.
  • Sometimes, touch-up procedures are necessary.
• Flap Complications
  • If you have LASIK, the corneal flap can create issues.
  • Flaps may not reattach properly, leading to discomfort or visual problems.

Recovery Considerations

• Initial Recovery: Expect some discomfort.
• Follow-ups: Attend all scheduled appointments to monitor your healing.
• Activity Restrictions: Avoid swimming and strenuous activities for a while.

Conclusion

As technology continues to evolve, the future of vision correction looks promising. Laser eye surgery, including LASIK, LASEK, and SMILE, offers patients remarkable benefits, from immediate visual improvement to enhanced lifestyle freedom. If you are considering laser eye surgery, consult with an experienced optician to discuss your options and determine the best procedure for your individual needs.