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Laser correction of diopters is a surgery practiced for over 40 years, chosen by over 50 million people worldwide to correct refractive eye anomalies. If you asked some of these patients today, a vast majority would agree that they mark the time before and after the surgery, at least regarding their vision quality.
There’s no need for fear, as all techniques of this surgical procedure are computer-controlled with the help of precise software programs. This computer precision, combined with our doctors’ experience, guarantees a safe surgical procedure.
Today’s lasers can correct diopters from -9 to +5, and ±5 diopters of astigmatism, meaning that practically 95% of people with refractive eye anomalies are candidates for surgery. For patients with higher diopters, a method of implanting phakic intraocular lenses has been developed, with results as good as laser diopter correction (often even better for people with high diopters because lenses improve image quality).
Techniques of laser diopter correction
In the last 20 and more years, a lot of work has been done to improve techniques for laser diopter correction surgeries. Of all of them, PRK and LASIK have remained the most popular due to procedure evolution, numerous scientific research, and technological advancements, with Femto LASIK added to them.
Photorefractive Keratectomy (PRK) is actually the first technique of laser diopter correction. This method is based on removing the epithelium (the cornea’s surface) with a laser (Transepithelial PRK; T-PRK) and correcting diopters by ablating (micron remodeling) the eye’s corneal stroma.
This method is suitable for corrections up to -4 diopters of the cylinder and up to -1.50 diopters of the cylinder, while it is not recommended for + diopter corrections. It is primarily advised for patients who have thin corneal tissue and for whom other methods of diopter correction are not recommended.
The downside of this method is a slightly longer postoperative recovery. Namely, the regeneration of the corneal epithelium, removed during the operation, lasts up to 10 days, which can cause a feeling of blurred vision, eye scratching, and tearing in the patient.
The most popular and frequently used method of laser diopter correction currently is Laser-Assisted In Situ Keratomileusis (LASIK). This method corrects diopters in over 95% of cases, making it irreplaceable in refractive eye surgery.
Unlike the PRK method, the LASIK method does not damage the epithelium but instead creates a so-called flap, or “lid,” on the cornea’s surface with a cut. The flap is lifted from the cornea, the stroma is remodeled with a laser for diopter correction, and the flap is put back in its place.
Because of this way of correcting diopters, LASIK can correct minus diopters all the way to -9, plus up to +5, and astigmatism up to ±5 diopters.
Another advantage is significantly faster postoperative progress. Namely, patients can return to most of their life activities 1-2 days after the procedure, and there’s practically no pain, blurred vision, or tearing of the eye.
During the LASIK method, as mentioned earlier, a flap or lid is created on the surface of the eye’s cornea. The difference between LASIK and Femto LASIK is precisely in the way the flap is created.
With the LASIK method, the flap is created with a cut using a so-called microkeratome blade. On the other hand, in Femto LASIK, the flap is created with a laser cut. There’s still a lot of debate about whether there’s a significant difference between the LASIK and Femto LASIK methods. Whichever method is chosen, in the hands of an experienced surgeon, each will undoubtedly be safe and efficient.
Preoperative examination and consultations
Before each laser diopter correction surgery, a detailed examination of the front and back of the eye is conducted, with particular attention to the cornea’s state. The exact visual acuity and refractive anomaly of the eye are determined, and a review of the cornea, ocular lens, and ocular fundus is conducted. The cornea’s thickness, curvature, any irregularities, and scars that may affect the decision about the operation are analyzed in detail with special diagnostics.
After all these exams, the patient is informed about the condition of both eyes, correction possibilities, and the course of the operation and postoperative recovery are explained. The decision about the operation is always a joint one.
A course of the operation
Before the operation itself, the eyes are anesthetized by dripping anesthetic drops. This is the only anesthetic needed. The patient is advised to focus their sight on the eye where the diopter is being corrected on the light they see. They should also be as calm as possible, not squeeze the eye, and not move the head. Even if the eye moves during the operation, modern lasers have a so-called tracking system that tracks even the slightest eye movements, completely eliminating the possibility that the laser remodels part of the corneal stroma that is not intended for it.
First, the right eye is operated on, followed immediately by the left eye. The operation is entirely painless.
Immediately after the procedure, the patient goes home, with advice for a little longer rest that day. The eyes should not be rubbed or scratched, and drops are applied based on instructions given before leaving the hospital.