Laser vision correction surgeries

What are laser vision correction surgeries?

Laser vision correction surgeries, also known as LASIK (Laser-Assisted In Situ Keratomileusis), are specialized medical procedures aimed at correcting refractive errors, specifically vision problems in general. In other words, when there is a refractive error that leads to a disruption in the light’s refraction inside the eye, causing the incoming light rays to not focus correctly on the retina, the most suitable procedure, often involving the use of laser technology, is used to correct this issue. This helps to reposition the light beam correctly onto the retina, resulting in improved visual quality.

Types of refractive errors corrected by laser:

There are four main types of refractive errors that hinder vision and require laser vision correction surgery to address:

1. Hyperopia (Farsightedness): In this condition, the light rays converge behind the retina, making it difficult for individuals with hyperopia to see nearby objects clearly.
2. Myopia (Nearsightedness): In this case, the focal point of light falls in front of the retina, within the posterior segment of the eye. Individuals with myopia struggle to see distant objects clearly.
3. Presbyopia (Age-related farsightedness): This condition occurs with aging when the eye loses its ability to focus on close-up objects and struggles to distinguish between near and far vision. Presbyopia typically sets in at the age of 40 or older.
4. Astigmatism: It is one of the most common eye conditions in which the cornea is shaped irregularly, deviating from its natural spherical form. This leads to blurred or distorted vision and visual doubling.

These refractive errors can be corrected through laser vision correction procedures, such as LASIK or other similar techniques.

Types of vision correction surgeries:

Vision correction surgeries vary greatly, ranging from traditional to modern techniques, utilizing advanced medical equipment and sophisticated technologies. However, they all share a common goal, which is to achieve the best possible visual quality. Here, we will briefly discuss some of the notable types of vision correction surgeries:

Laser Vision Correction:

This procedure relies on laser beams to reshape the cornea for better vision. By reshaping the cornea, light can be directed more effectively onto the retina, improving vision significantly. In this procedure, an ophthalmic surgeon creates a flap on the eye, lifts it temporarily, and then laser beams reshape the cornea. The flap is then repositioned, restoring the eye to its original state. Laser vision correction is suitable for cases of myopia, hyperopia, and astigmatism.

Surface Laser Vision Correction (PRK):

In this type of surgery, the superficial layer of the cornea, including the epithelial cells, is removed and reshaped using laser beams. It is also referred to as “Photorefractive Keratectomy” (PRK). Surface laser vision correction is suitable for cases of mild to moderate myopia, hyperopia, and cases with thin corneas.

Epilasik Vision Correction:

This procedure shares many similarities with the previous surgery and follows similar steps, but the key difference lies in the mechanism. While the entire epithelial layer of the cornea is removed in surface laser vision correction, Epilasik preserves the epithelial layer by lifting it first and then repositioning it after the laser correction and reshaping.

FemtoSmile Vision Correction:

In this procedure, a femtosecond laser is used to direct the laser beam towards the middle layers of the cornea. Additionally, a very thin layer of the cornea is separated without affecting the outermost epithelial layer. The surgical incision in FemtoSmile is much smaller compared to traditional LASIK procedures. This type of surgery is commonly performed for myopia correction.

Conductive Keratoplasty (CK):

CK is a medical procedure that utilizes heat to reshape and adjust the curvature of the cornea. It is an effective method that yields remarkable results.

Conductive keratoplasty is most responsive in cases of mild to moderate hyperopia. It can also be beneficial for vision problems in individuals over the age of 40 and those with presbyopia-related issues.

Intraocular Lens Implantation (IOLs):

In this procedure, a healthy lens is brought in and placed in front of the damaged lens of the eye. This procedure is suitable for individuals with severe vision problems.

Alternative lens implantation is suitable for eye conditions that cannot be corrected with regular or surface laser procedures.

Refractive Lens Exchange (RLE):

High-quality artificial lenses are used to replace the original lens of the eye. The difference between this method and the previous one is that in refractive lens exchange, the new lens is implanted while removing the original lens permanently.

This procedure is beneficial for patients with significant refractive errors who do not respond to any type of surface or regular laser procedures.

Conditions for Laser Vision Correction:

If you are experiencing a vision problem and are considering laser vision correction, there are certain conditions that must be met for you to be eligible for the procedure and to ensure its highest success rate. These conditions include:

1. Age: You should be over 18 years old, as vision stabilizes and the condition can be assessed within a manageable range.
2. No history of eye surgeries, especially heat-based surgeries.
3. Stable vision: If you have recently changed your prescription glasses or contact lenses within approximately one year, it is necessary to wait until your vision stabilizes completely.
4. No conflicting medications or chronic medical conditions that may interfere with the procedure.
5. If you are a married woman, ensure that you are not currently pregnant, and it is preferable to avoid the procedure if you are breastfeeding.
6. Hormonal balance and absence of undisclosed underlying health issues or chronic diseases such as diabetes.
7. The cornea should not be excessively thin, as this type of cornea is more susceptible to injury during the procedure. The ophthalmologist will determine this based on an assessment.

Steps of Laser Vision Correction:

If you are curious and want to know what happens inside the operating room during a laser vision correction procedure, we will take you on a brief tour that begins with the patient lying on the operating bed and ends with their safe exit from Dr. Ammar Nassar’s center. Follow along with us.

1. The patient enters the operating room and sits calmly while a member of the medical staff verifies their personal information and inquires about any recent developments in their condition.
2. After ensuring the patient’s health status and compliance with the preoperative instructions, such as discontinuing medications and getting sufficient rest, the patient lies down on the bed. Above them, there is a complete system of laser devices and accessories, along with a computer to monitor the procedure. Before starting the operation, numbing eye drops are applied, and a few minutes are given for the anesthesia to take effect.
3. The doctor places a device called an eye speculum on the patient’s eye, which keeps it open and prevents it from closing.
4. Now the procedure begins. A suction ring is placed directly above the cornea to create a vacuum and stabilize the eye.
5. A functional artificial glass lens is used to immobilize the eye and flatten the cornea as much as possible.
6. Dr. Ammar Nassar focuses the laser beams on the surgical area.
7. The laser beams create a flap on the corneal surface and enable the suction to be released.
8. The newly created flap is lifted, and the precise excimer laser is used in this step to reshape the cornea and correct refractive errors.
9. As the procedure nears completion, the patient may detect a peculiar smell similar to burning and may hear a clicking sound. These are normal occurrences.
10. Finally, the flap is repositioned back in its original place. If the procedure is Epilasik, a new flap is replaced once the cornea has been reshaped. The cornea gradually heals in its natural position without any visible stitches or sutures.

Contraindications of Laser Vision Correction:

There are exceptional cases or explicit medical conditions that prevent a patient from undergoing laser vision correction surgery. These conditions may result in complications and unwanted side effects. Some of these contraindications include:

• Inflammation or infection of the eyelid.
• Dry eyes and eye irritation.
• Glaucoma (commonly known as “green water”).
• High intraocular pressure. Herpes simplex infection.
• Viral diseases such as herpes zoster.
• Inflammation of the iris.
• Keratoconus.
• Uveitis.

Drawbacks of Laser Vision Correction:

We cannot claim that this procedure is entirely free of drawbacks, as with any other medical procedure, there is a possibility of certain complications and risks. However, it is important to note that the drawbacks are very limited and largely rare. Some of the potential drawbacks include:

• Gradual regression of the effectiveness of laser vision correction over time.
• Temporary double vision after the procedure.
• Occurrence of bothersome dryness in the eye during the six months following the surgery, which can be managed with the use of lubricating eye drops.
• Accumulation of dark bubble-like deposits in the eye, negatively affecting visual quality.
• Transient photophobia or light sensitivity syndrome a few days after the surgery, resulting in issues with light and vision.
• Halos around lights, which is a temporary side effect where the patient sees rainbow-colored rings when looking at white lights.

أهم النصائح قبل وبعد إجراء عملية تصحيح الإبصار بالليزر

هناك مجموعة من النصائح التي يتم توجيهها للمريض عند إجراء عملية تصحيح الإبصار بالليزر سواءاً قبل العملية أو بعدها وتشمل هذه النصائح عدة توجيهات و إرشادات يجب الالتزام بها لضمان سلامة المريض و الحصول على النتائج المنتظرة من العملية و هي:

نصائح قبل إجراء العملية

• يجب على المريض أن يتواصل مع طبيبه و يتعرف على تفاصيل العملية و أنواع الإجراء الطبي وإيجابياته وسلبياته و النتائج المتوقعة بعده.
• في حال اعتماد العدسات اللاصقة الطبية كوسيلة لتحسين الرؤية يجب نزعها لمدة أسبوع إلى 3 أسابيع على الأقل قبل إجراء العملية.
• التأكد من تحديد موعد مع الدكتور عمار نصار قبل يوم من إجراء العملية لعمل فحص شامل لعينيك وتحديد توجهات أشعة الليزر الصحيحة.
• يجب على المريض إحضار مرافق من أجل مساعدته بعد الخروج من العملية حيث تصعب حركته قليلاً لأنه يضع ضماد عيني و لا يمكنه القيادة خلال الساعات الأولى إطلاقاً.

نصائح بعد إجراء العملية

• وضع ضماد العين بشكل متواصل لمدة 48 ساعة أو وفق ما يحدده الطبيب.
• الالتزام بوضع قطرات العين المضادة للالتهابات الفيروسية و الجرثومية.
• تجنب ارتداء العدسات اللاصقة مهما كانت الأسباب.
• الابتعاد عن وضع مستحضرات التجميل و خاصة تلك المساحيق المخصصة للعين.
• تجنب التمارين الرياضية القاسية و كذلك السباحة و الساونا لمدة 3 أسابيع بعد العملية على الأقل.
• زيارة طبيب العيون بشكل دوري و منتظم للتأكد من صحة العين و سير النتائج الإيجابية بعد عملية تصحيح الإبصار.

إيجابيات و سلبيات عملية تصحيح الإبصار بالليزر

إليكم أبرز مزايا ومساوئ هذه العملية والتي تم نقلها عن فئة كبيرة من المرضى الذي أجروا عملية تصحيح الإبصار بالليزر.

إيجابيات العملية

لاحظ معظم المرضى أن عملية تصحيح الإبصار بالليزر هي أكثر عملية آمنة و فعالة بين العمليات الطبية الأخرى. وقد تم خلالها تصحيح كافة مشاكل الإبصار و استعادة الرؤية الطبيعية وذكر معظم المرضى الذين قاموا بها أنهم أصبحوا يروا الأمور على حقيقتها بعد سنوات طويلة من تشوش الرؤية و ضبابيتها. بالإضافة إلى ذلك فقد تخلصوا من وسائل تصحيح الإبصار المزعجة مثل النظارات الطبية التي تحتاج إلى تغيير دائم و اهتمام مستمر وكذلك من العدسات الطبية اللاصقة التي تتعب العين و تحتاج إلى عناية يومية.

سلبيات العملية

تكاد سلبيات هذه العملية لا تذكر. فعند سؤال المرضى عنها وضّحوا أن الجانب السلبي الوحيد بعد إجراء العملية كان احمرار العين الذي استمر لعدة أيام بعدها. إضافةً إلى ذلك فقد ذكر البعض أنهم عانوا من جفاف العين لفترة طويلة امتدت حتى 6 أشهر من إجراء العملية لكن تم التخلص من هذه المشكلة بواسطة القطرات العينية المرطبة المتاحة بدون وصفة طبية.