Refractive surgery

Refractive surgery or vision correction-complex ophthalmic surgery to remove refractive defects, such as myopia, hyperopia, astigmatism and presbyopia or hyperopia, in order to achieve good quality of vision and independence from glasses or contact lenses.

Methods used in refractive surgery may be divided into two main groups: the superficial, which works on the cornea, and the intraocular, which introduces the lens inside the eye.

Refractive surgery aims to change the curvature of the cornea in order to focus the light more precisely on the retina. The objective of refractive surgery is to reduce dependence on glasses or contact lenses. The majority of people who have undergone refractive surgery have achieved this goal; nearly 95 per cent of individuals do not need to follow up with remote vision corrective lenses.

Ideal candidates for refractive surgery are healthy people aged 18 and over who are not satisfied with glasses or contact lenses and who do not have any other eye pathology.

Contraindications to refractive surgery include:

  • Acute eye diseases , including severe dry eyes.         
  • Autoimmune disease or connective tissue disease, which can impair wound healing.        
  • Taking isotretinoin or amiodarone.         

Refraction must be stable for at least the last year before surgery. After surgery, the herpes simplex latent virus may reactivate, so patients should be appropriately aware of this.

Side effects of refractive surgery include temporary symptoms such as:

  • Foreign body sensation;         
  • Sensitivity to light;         
  • Ghosting around light sources;         
  • Dryness;         
  • Sometimes these symptoms persist.         

Possible complications

Conducting excimer - laser procedures, involving superficial stroma layers, can lead to the appearance of turbidity. If infection, abnormal astigmatism, or the formation of opacities leads to permanent changes in the central part of the cornea, the maximum corrected vision may be lost. In the absence of contraindications to refractive surgery, the risk of complications is low and the chance of vision loss is less than 1%.

Types of Refractive Surgery

The two most common procedures in refractive surgery are :

  • Laser keratomileusis (LASIK);         
  • Photorefractive keratectomy (PRK).         

Other types of refractive surgery include:

  • Extraction of the lenticular through a small incision (SMILE);         
  • Phakic intraocular lenses (IOL);         
  • Lenses-in-ear;         
  • Extraction of a transparent lens;         
  • Intrathoracic annular segments (INTACS);         
  • Radial keratotomy;         
  • Astigmatic keratotomy.         
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