Laser operations allow the correction of vision defects. They also allow those who see worse with age to be dispensed with. Dr. Marek Ćwirko, an ophthalmologist, head of the Vision Correction Center at the Spektrum Clinical Ophthalmology Center in Wrocław, which has been performing such procedures for 20 years, talks about new methods of restoring visual acuity.
Who can correct their eyesight surgically?
Basically anyone with a visual impairment and who is bothered by glasses or lenses. The lasers are registered to correct defects from minus 12 diopters to plus 6 diopters. They operate on defects that no longer progress, and this happens after the age of 23. Of course, there are defects that cannot be removed this way, depending on the shape and thickness of the cornea. But most people with visual impairments can put their glasses down afterwards. We also operate on patients whose vision has deteriorated due to illnesses or injuries.
One operation is enough for a child who sees badly to put his glasses down?
Yes. Surgery for both eyes takes 20 to 40 minutes and the patient returns home. The complete healing process takes up to 6 months. The treatment requires prior preparation. Firstly, the examination and qualification of the patient, and secondly, entering the parameters of the cornea, pupil and the defect to be corrected into the laser computer. Before the procedure, the eye is anesthetized with drops, then a special device is put on the eyelids to prevent the eye from closing during surgery. The doctor performs the procedure with a laser, assisted by a nurse and an engineer.
Can people who have never had a visual impairment, but see worse with age, also benefit from this surgery?
So-called presbyopia is when the lens of the eye stiffens and is unable to change its shape so as to adapt its accommodation to near and far vision. Until recently, in such cases, the so-called monovision. This means that as a result of the procedure, one eye saw very well from a distance, and the other one saw very well up close. Thanks to modern lasers, we can now ensure the cooperation of both eyes.
Can you help people with visual impairment, and in addition struggling with presbyopia?
If you have a visual impairment plus three diopters, then in your forties you will need glasses plus 5 diopters to read. If he undergoes surgery and gets rid of his walking glasses as a result of the correction, he needs glasses plus two diopters to read, which is a major difference in the thickness of the lenses. We can also offer patients the PresbyMax treatment that allows them to see without glasses both from a distance and from close.
What is the qualification for laser vision correction?
First, an interview with the patient is carried out in order to exclude diseases that are a contraindication to the procedure and to facilitate the choice of the method of surgery depending on the profession, expectations and financial possibilities. Then, ophthalmological examinations are performed to determine the structure of the cornea and its parameters, such as thickness, diameter and convexity.
The eye is also checked for other medical conditions and the pupils dilate to examine the inside of the eye, especially the retina. Based on the test results, we determine whether the vision defect is suitable for surgery and select the most beneficial and safest method for the patient. Usually it is one visit. During the operation, depending on the method chosen, the doctor uses a laser to correct the shape of the cornea.
What methods do you use?
The method of least interfering with the eye tissue is sanding the outer part of the cornea. After the procedure, you need to put a bandage contact lens on the eye for 3-4 days. The patient may feel pain during this time. After four days, the dressing is removed. The visual acuity is then still impaired. The effect of the operation does not come until 4-6 weeks.
In the FemtoLASIK method, the upper layer of the cornea is incised with a femtosecond laser and after this layer is tilted underneath it, its shape is corrected with an excimer laser. Then the top layer returns to its place. The procedure may seem more invasive, but the patient does not need a bandaged lens. There are no wounds on the outer layer of the cornea and he sees better immediately after the procedure. In the SMILE method, correction is performed by laser incision of two convex surfaces inside the cornea and removal of the microlenses formed in this way. The femtosecond laser guarantees precision, which allows to save the corneal tissue, increasing the safety of treatments.
What to consider when choosing a clinic where we will perform an operation?
The experience of the doctor is important. The quality of the equipment and the standards of postoperative care are also important. The point is that the patient can be sure that after the procedure he can always call the doctor at any time, even on Saturday and Sunday, in the event of malaise or unforeseen consequences.
Patients are also guided by the price. They often compare the prices of treatments with the price of comfortable progressive glasses for glasses, which can cost up to 3. zloty.
In our clinic, depending on the choice of the surgery method, the prices range from PLN 2500 to PLN 5000.
Is interest in these treatments growing?
After surgery, patients often repeat: “I regret that I made up my mind so late. It is the best decision in life ». Recently, the popularity of these treatments has been growing. The pandemic also contributed to this, because when we have a mask on our face, the lenses of the glasses start to evaporate. In addition, glasses make it difficult to practice many sports. Good glasses are not cheap and they are easy to break, scratch or lose. Lenses, although more comfortable than glasses, also have their drawbacks.
They require care, special storage, putting on and taking off. It is forbidden to bathe, swim and sleep in them. They can cause complications such as ulceration or the growth of abnormal vessels into the cornea. The interest in laser surgery is also growing, because we are currently struggling with the epidemic of myopia. This is due to, inter alia, from more and more hours spent in front of the screen of phones and computers and less and less spending time outdoors in natural light.