What is laser eye surgery? - The ABCs…

What is laser eye surgery?

Introduction, history and background

In 1966, Theodore H. Maiman, a physicist at Hughes Aircraft Company in California became the first person to use a process called ... light amplification by the stimulated emmission of radiation or laser light. Lasers have many useful applications such as:

  • Scanners (bar codes in retail shops are scanned to give the price)
  • Digitized data are read by a laser on a compact disk (CD)
  • Lasers are use by law enforcement officers to detect the speed of vehicles.
  • Laser light can be released in pulses or in a continuous beam. In either form, it is so powerful, that it can make precise cuts through metal and can also be used in surgery, as a scalpel - or, to instantly seal broken blood vessels, because it produces such intense heat.
Lasers were originally used in ophthalmology in the early 1960s. Since then, many benefits of laser surgery in ophthalmology have been demonstrated.

What are Lasers?

Lasers are surgical devices that use extremely high-energy light waves to treat tissue. Lasers have produced dramatic surgical benefits that have improved the quality of care for patients. Different types of lasers are used to treat a variety of conditions.

What is Laser Surgery?

Like other surgical procedures, laser surgery alters human tissue. Laser energy can also "activate" drugs to treat disease. Laser surgery is still surgery, but without using a scalpel.

Why is laser eye surgery done?

Eye M.D.s (ophthalmologists) performs laser surgery:

  • to help reduce vision loss from diabetic retinopathy and age-related macular degeneration
  • to restore vision after cataract surgery
  • to reduce high eye pressure for patients with glaucoma
  • to help reduce or eliminate the need for glasses
  • to treat cancerous lesions inside the eye and
  • for cosmetic treatments of the eyelids

Who performs laser eye surgery?

Laser eye surgery should be only done by Eye M.D.s (ophthalmologists) who have been among the main pioneers and innovators in the field of laser surgery. They become experts in laser surgery techniques through residency and fellowship training, continuing educational courses and through performing laser surgery under the guidance of more experienced surgeons.

Who is right for laser eye surgery?

While many individuals are considered good candidates for laser eye surgery, there are some who do not meet the generally accepted medical criteria to ensure a successful laser vision procedure.

The ideal candidate for laser eye surgery includes those who:
  • Are over 18 years of age and have had a stable glasses or contact lens prescription for at least two years.
  • Have sufficient corneal thickness (the cornea is the transparent front part of the eye).
  • A LASIK patient should have a cornea that is thick enough to allow the surgeon to safely create a clean corneal flat of appropriate depth. (Thin corneas may be LASEK candidates), as discussed earlier.
  • Are affected by one of the common types of vision problems or refractive error – myopia (nearsightedness), astigmatism (blurred vision caused by an irregular shaped cornea), hyperopia (farsightedness), or a combination thereof (e.g., myopia with astigmatism).
  • Do not suffer from any disease, vision-related or otherwise, that may reduce the effectiveness of the surgery or the patient's ability to heal properly and quickly.
  • Discuss any concerns during your initial consultation.
  • Are adequately informed about the benefits and risks of the procedure. Candidates should thoroughly discuss the procedure with their physicians.

What are different types or techniques of laser eye surgery?
PRK, LASIK and LASEK are acronyms for three different laser eye surgery techniques or types:

PRK - Photo-refractive keratotomy

LASIK - Laser in-situ keratomileusis

LASEK - Laser in-situ epithelial keratomileusis

LASIK is by far the most popular treatment at present and is normally associated with rapid recovery and improvement of vision. Certain patients may be unsuitable for LASIK or choose not to have it because of some of the complications that may occur. LASEK is essentially a modified form of PRK and may eventually prove to be more popular than LASIK.

How does laser eye surgery work?
Laser vision correction is the most technologically advanced method available today for reducing dependence on glasses and contact lenses. The procedure is performed on an outpatient basis and is effective for treating nearsightedness, farsightedness, and astigmatism.

What are the complications or side effects of laser eye surgery?
Reports of complications range from 1-40% of cases, depending on the source. Many relate to issues of failure to correct the vision exactly to normal, a difference between the two eyes or problems reading. All of these can usually be corrected with re-treatment or glasses. Other problems relate to infection, comfort or sensitivity and tend to settle quite readily. Complications relating to the corneal "flap" in LASIK can often be corrected and serious sight threatening complications are very rare. Complications of an occupational significance include:

Reduced visual acuity:As a rough estimate 3-4% of all treatments will result in a reduction of two lines of best corrected visual acuity on the opticians chart (the best that can be achieved even with glasses or contact lenses). For LASIK, in patients with lesser degrees of short-sightedness this figure is probably closer to 0-1.2% and for LASEK it could be better than that.

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.

Decreased night or low light vision:
Patients may experience difficulty discerning detail in low light or low contrast conditions. Some report problems with halos, glare or starbursts around objects or light sources. These problems are often temporary and recover over a six-week period but in some cases the problem persists. Newer surgical techniques help to minimize this problem.

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