Laser Eye Surgery

Posts Tagged ‘Epithelium’

Good vision and eyesight can make or mar the quality of a person’s life. The conventional method of correcting vision is through spectacles or contact lenses. In recent times, however, laser surgery has become a much-sought-after alternative. The laser is aimed at the cornea, the outer circular structure that shields the colored part of the eye (otherwise known as the iris), and the pupil. In correcting myopia, for instance, the laser is set to decrease the thickness of the cornea. This makes it possible for the eye to bring images into focus accurately.

There are essentially three different types of laser eye surgery. The latest and most prevalent type of laser surgery is called ‘Lasik’. This process involves creating a flap by cutting off a thin layer of the cornea, which further enables the laser to aim for the tissue beneath. The flap is merely placed back, and regenerates naturally. The results are almost immediate – vision is restored in no time.

The second most popular type of laser surgery is called ‘Epiflap’ or ‘Lasek’ surgery. This method involves the fractional removal of the epithelium to reveal the cornea. The cornea is then firmed or reshaped by a laser. Furthermore, the outer layer of cells is pushed back, and the eye heals shortly after.

PRK was the prevailing laser eye surgery method for years. It involved the entire removal of the epithelial cells on the eye. While Lasik is used to treat severe hyperopia or myopia, Lasek is only used to correct mild to average myopia.

These treatments are generally considered safe. However, the medical community is divided in its opinion over some of the latest advances in eye surgery and treatments. This is largely due to the newness of the technology and a lack of research on the long-term effects of some of these treatments. Moreover, like any surgery, eye surgery poses its own set of risks, and doctors are expected to educate their patients on the matter. It is not unusual for patients to suffer complications, even to the extent of having to have their cornea transplanted. Laser eye surgery should only be done on a healthy adult. Mild eyesight issues are not considered legitimate enough to warrant laser surgery. Conditions such as pregnancy, diabetes and illnesses involving the bone and joint can also rule out the possibility of laser treatments.

Eye surgery is carried out typically, to enhance the refractive state of the eye and to reduce the reliance on glasses or contact lenses. Most eye surgeries today use lasers that help remodel the cornea and hence, are known as laser eye surgery.

LASIK or Laser Assisted In-Situ Keratomileusis is the latest development in this field and is highly popular. In the year 2005, most of the eye surgery procedures were performed using this technique. In this technique, the surgeon uses an instrument known as microkeratome to cut a flap of the corneal tissue to get an entry into the cornea. This procedure is typically carried out for correcting nearsightedness. It is a common method used in the surgery and involves cutting a flap in the cornea so as to get to the tissue below.

LASEK or Laser Assisted Sub-Epithelium Keratomileusis is known to permanently change the shape of the cornea. It uses an excimer laser to ablate some amount of tissue from the frontage of the eye. EPI-LASIK is a recent technique that is quite akin to LASEK and uses an epi-keratome instrument to take out the top layer of the cornea.

Photo refractive keratectomy (PRK) is a procedure that is performed under local anesthesia. Eye drops are used to anesthetize the eyes. This is a type of refractive surgery, which requires destroying of microscopic amounts of the outer eye tissue. It reshapes the cornea by the use of cool UV light that is controlled by means of a computer.

Refractive surgery has become quite common and popular in the recent years. However, it is not advisable in case of slow healers and people who are afflicted with glaucoma or diabetes. It is also not recommended in case of people who are suffering from vascular diseases, autoimmune diseases and pregnant women.

It is seen that even in case of normal healthy individuals, there is a certain amount of risk involved. They could be exposed to infection and also delay the healing procedure as well. In the long run, this problem is generally sorted out with the right treatment. Other complaints include regression as also halo effect that are typical of eye surgery.

Photorefractive Keratectomy (PRK) laser eye surgery has been existent for over 12 years and is considered to be quite a safe procedure. It is the forerunner of the Lasik procedure. There is no concrete evidence to suggest that PRK laser eye surgery harms the vision or eyes of a patient in the long run. The procedure is used less, unlike Laser and Lasik treatment.

About the Procedure:

If a patient has an unusually thin cornea or sometimes, a large pupil, a surgeon might recommend PRK laser eye surgery for the patient. Lasik and Laser treatment are considered complicated under these conditions.

Preparations:

The eye area of the patient is cleaned and the eyelid is held intact, using a metal ring. Anesthetic drops that are administered ensure that the eyes are numb. This prevents discomfort when the laser is used. In other laser eye treatments, the eye’s shape is reformed, beneath the surface of cornea. But in PRK procedure, the cornea is reshaped by removing thin layer of cells, with a laser examiner, from the eye’s surface. The epithelium tends to naturally grow back and side effects are less.

Downside:

Unlike newer and advanced laser eye surgeries, PRK laser eye surgery needs a longer recovery time. The patients, after the surgical procedure, experience greater discomfort and greater pain. The vision can be blurred and hazy in the patients of PRK, for nearly two months. The complete result of the surgery is apparent only after a few months.

Risks Involved:

Like all other surgeries, this surgery has a few risks involved. They are:

o Dry eyes:

This is a common side effect and eye drops are used for lubricating the eyes and staying away from infections.

o Poorer night vision:

The daytime vision of a patient will improve after PRK and this will help the patients to carry out their daily routine, without the help of contact lenses and glasses. Night vision sometimes will be poorer than that of the vision that existed before surgery. This ensues in the patients- seeing halo or glare around the lights. Driving in night is not advised for a few months and glasses become necessary for driving during the night time.

Conclusion:

Results have proven that more than 80% of people who choose this procedure do not use corrective lenses or glasses. This is exciting news for people with defective eyesight that needs to be rectified. PRK surgery has many advantages and is reputed as a safe procedure with an impressive success rate.