Major types of eye surgery - A common classification

Major types of eye surgery
While eye surgery can be of many types, the following types or kinds of surgery are the most common and are widely considered as the main types of eye surgery today.

Classification of eye surgery

1-Cataract eye surgery

A cataract can only be removed by surgery. Hence, cataract removal or cataract surgery is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward. It generally involves removing the cloudy lens and replacing it with an artificial lens. There are two types of cataract surgery:

  • i) Phacoemulsification, or phaco: In Phaco, A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery.

  • ii) Extra-capsular surgery: In this type of surgery, your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction

  • iii) Laser cataract surgery

According to the studies, the new image-guided laser for cataract removal has been found to be 10 times better than that obtained with the current standard technique. The revolutionary study also found out that all patients who got the newer laser surgery, reported better vision overall, compared to patients whose surgeries were performed manually by the standard procedure. This new technology based advanced laser procedure is called as capsulotomy.
Benefits of cataract surgery
Although cataract surgery is not risk free, there are significant benefits which make surgery a viable and highly recommended therapy for patients with cataracts. Some of the core benefits associated with cataract surgery include high precision and accuracy, better safety and cheaper costs.

Risks of cataract surgery
As with any surgery, cataract surgery poses risks, such as infection and bleeding. In addition, cataract surgery slightly increases your risk of retinal detachment. Other problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, and swelling), loss of vision, double vision, and high or low eye pressure.

2- Laser eye surgery
Laser surgery can be used for many types of eye disease. A laser is a focused, intense beam of light. When focused through a microscope, a laser can be used to create tiny "explosions" in certain eye tissues, or to make small burns to seal tissues together. How the laser works depends on the kind of laser used and the type of eye tissue that needs to be treated.

While laser eye surgery can be of many types, it can be broadly divided into three main types:

  • i) Photorefractive Keratectomy (PRK): This conventional type of laser eye surgery is best suitable for patients who suffer from certain corneal abnormalities that do not allow them to undergo regular surgery. In PRK, an eye surgeon (ophthalmologist) removes excess corneal tissue from the eye by an excimer laser. However, due to certain associated complications such as pain, longer recovery time and resulting vision problems of haze or blurriness in some patients, PRK is now was being largely replaced by LASIK and other procedures.

  • ii) Laser-Assisted in Situ Keratomileusis (LASIK): It is the most frequently practiced or common type of eye laser. Those people who have a normal cornea that can resist a cut through both the outer and middle layer are good candidates for Lasik. Hence, LASIK uses a blade to create a small flap in the cornea to provide laser access, It is commonly performed to correct farsightedness. LASIK surgery is completed quickly (within 2 minutes) and is relatively less risky as compared to other eye surgeries. The recovery time is usually one to two days.

  • iii) Laser Assisted Sub-Epithelial Keratomileusis (LASEK):
    Those with thin corneas may be better suited LASEK, which combines PRK and LASIK technologies to treat the eye. LASEK also cuts a flap in the eye and reshapes the exposed eye with a laser. There is less risk of hazing and more corneal tissue is preserved. There is also less risk of dry eye syndrome that is sometimes found with LASIK patients. The full recovery time is about six to eight weeks.

Benefits of laser eye surgery
In Phaco, A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called "small incision cataract surgery.

Risks of laser eye surgery
Laser refractive surgery is usually very successful, but there are some risks, just as there are pros and cons to glasses and contact lenses. Some of these risks include infection, pain or discomfort during and / or after the surgery, dry eye, corneal damage due to the thinning of cornea, bleeding and repetition of surgery due to the failure.

3- Lens implantation (Refractive Lens Exchange)
It is a surgical procedure in which Phakic intraocular lenses (IOLs) that resemble contact lenses are placed either behind the iris or between the cornea and the iris. Once they are in place, the patient can't feel them and no maintenance is required. Basically the IOLs function like contacts, except that they are in the eye instead of on top of it. Surgeons may suggest this procedure if the patient has thin corneas or has myopia between -5.00 and -20.00 diopters. Refractive Lens Exchange (RLE) is like cataract surgery. However, instead of removing a cloudy lens, RLE replaces a faulty but clear lens with one that refracts light properly. 

4- Conductive Keratoplasty
This procedure utilizes radio frequency and a small probe (tinier than a strand of human hair) instead of a laser. A circular pattern of spots is placed around the cornea with low energy radio waves. The connective tissue that was hit with the probe then shrinks, effectively tightening up the cornea and making it steeper. The eye surgeon does not remove any tissue and the procedure takes only minutes. It is recommended for those who are older, to reduce their reliance on reading glasses.

5- Vitrectomy
A vitrectomy is an invasive, moderately complicated type of eye surgery that is performed to remove blood, unwanted debris and scar tissue from the eye, and to alleviate pulling on the retina--all of which poorly affect vision. This is also one of the only treatments for severe floaters, which are floating specks in the vision. The clear vitreous gel is removed during this eye surgery, and multiple incisions are made to correct problems caused by retinal detachment, injury, eye bleeding, macular holes and eye infections. Often performed in conjunction with other procedures, recovery time varies from several days to several weeks, depending on the condition treated and outcome of surgery

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