What is Refractive surgery?
Refractive surgery is an elective eye surgery procedure that is done to correct or improve vision problems like nearsightedness, farsightedness, and astigmatism by altering the shape of the cornea or replacing the eye’s natural lens. It reduces or completely takes away the need for glasses and contact lenses.
For a human being to see clearly, light must pass through the cornea and lens and focus accurately on the retina. For people with refractive errors, the light focuses incorrectly that resulting in vision problems. Refractive surgery corrects vision problems by using any one of the following two approaches. One method is by reshaping the cornea with the help of a laser. This allows the light to clearly focus on the retina. The other method is by replacing the eye’s natural lens, where the surgeon implants an artificial lens inside the eye to correct the vision.
Types of refractive surgery
The most common type of refractive surgery falls into two main categories, with ideal treatment depending on the patient’s unique vision health, age, and eye health
Laser-based (Cornea-reshaping) Procedures
- LASIK (Laser-Assisted In-situ Keratomileusis) is a procedure where a surgeon uses a laser or blade to create a thin, hinged flap in the cornea. The flap is lifted, and an excimer laser reshapes the underlying corneal tissue, and then the flap is put back into place to act as a natural bandage. It is best for patients with stable prescriptions and sufficient corneal thickness. Recovery is very fast, with most patients experiencing improved vision within a day or two and minimal discomfort.
- PRK (Photorefractive keratotomy) is a procedure where, instead of creating a flap, the surgeon removes the cornea’s outermost layer before using an excimer laser to reshape the cornea surface. A bandage contact lens is then worn for a few days while the epithelium regrows. It is best for patients with thin corneas, irregular corneas, or who participate in contact sports or other activities that could risk a flap injury. Longer and more uncomfortable than LASIK, with blurred vision and discomfort for several days or weeks.
- SMILE (Small incision lenticule extraction) uses a femtosecond laser; the surgeon creates a small, disc-shaped piece of tissue inside the cornea. This lenticule is then removed through a very small, keyhole-sized incision to reshape the cornea. It is best for correcting nearsightedness (myopia) and astigmatism. Recovery has quicker healing than PRK (Photorefractive keratotomy), with fewer dry eye symptoms than LASIK.
Lens-based procedures
- Phakic Intraocular Lenses (ICL) are a biocompatible artificial lens that is permanently implanted inside the eye without removing the eye’s natural lens. It is placed either in front of or behind the iris. It is best for patients with moderate to high myopia, dry eye concerns, or thin corneas who are not good candidates for laser surgery.
- The refractive lens exchange (RLE) procedure is similar to cataract surgery, but is performed on a clear lens rather than a cloudy one. The natural lens is removed and replaced with an artificial intraocular lens (IOL). It is best for individuals over 40 who have age-related focusing issues (presbyopia), as well as those with high refractive errors.
| Procedure Name | Refractive Surgery |
|---|---|
| Type of Surgery | Minor minimally invasive procedures |
| Type of Anesthesia | Local anesthesia |
| Procedure Duration | 10-15 minutes |
| Recovery Duration | 24-48 hours |
Refractive Surgery: Pre-Op & Post-Op Care
Refractive surgery, such as LASIK or PRK, has a standard process that includes a complete pre-operative examination, a precise intra-operative procedure, and a careful post-operative recovery.
Pre-operative: Preparation for surgery
This phase focuses on a thorough evaluation of the patient’s eye and preparing them for the procedure. The ophthalmologist examines the general health and family eye history, along with performing specialized tests. Measurements are taken of your eye pressure, corneal thickness, and pupil size.
Preparation involves several crucial steps; the patient will be instructed to stop wearing contact lenses for a period to ensure the cornea returns to its natural shape for accurate measurements. The patient must avoid using eye makeup, perfumes, and lotions in the days leading up to surgery to minimize the risk.
Intra-operative: The surgical procedure
On the day of the procedure, the patient will be given numbing eye drops to keep comfortable. A device is used to hold the eyelids open to prevent blinking. Specific types depend on the type of surgery.
LASIK is a thin corneal flap that is created using a laser or blade and folded back. An excimer laser then reshapes the underlying cornea based on your unique measurements. The flap is then placed back, where it naturally adheres. The entire procedure is quick, often taking less than 30 minutes for both eyes.
PRK (Photorefractive keratotomy). Unlike LASIK, PRK does not involve creating a flap. The surgeon removes the outer layer of the cornea before using the laser to reshape the cornea. A protective corneal lens is then placed over the eye to heal.
Post-operative: Recovery and follow-up
After the surgery, proper care is essential for smooth recovery and optimal results, which involves protecting the eye, where there will be a protective eye shield to wear, particularly while sleeping, to prevent rubbing.
Prescribed eye drops must be used to prevent infection and inflammation.
Swimming, hot tubs, and heavy exercises should be avoided for several weeks.
Follow-up appointments are crucial to monitor the healing.
Benefits of Refractive Surgery at Yashoda Hospitals
- Less dependence on glasses and contact lenses
- Enhanced lifestyle
- Improved convenience
- Sharper vision
- High success rate
- Long-lasting results
- Quick recovery
- Precise and Safe
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