yulius hermanto
Refractive Eye Surgery
Introduction
Blurred vision is common complaint that seen in eye clinics. There are a lot of cause of blurred vision, one of them is refraction abnormality.
Refractive disease of the eye is the most common cause of blurred vision in mankind. In United States about 120 millions have refraction abnormality.
The good news is that refraction abnormality can be corrected with the usage eyeglasses or contact lens. Refractive surgery is used to correct common eye disorders such as nearsightedness, farsightedness, and astigmatism. Refractive surgery is designed to alter the shape of the cornea in order to improve the patient's vision. Since the development of refractive eye surgery, the technique has been widely used and modified with the invention of technology.
History of Refractive Eye Surgery
The first refractive eye surgeries probably were done in ancient Greece. These ancient eye surgeries involved removal of cataract (clouding of the lens in the eye). In the 1850s, the first refractive lensectomy (removal of the lens of the eye for purposes of correcting high myopia) were performed. In the late 19th century, the first corneal surgery for correction of astigmatism was performed. Astigmatism was reduced with a horizontal incision in the corneal stroma.
Modern day ophthalmic surgeons have been performing refractive surgery for the treatment of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (irregular shaped cornea) for many years, but the past decades have produced rapid change and growth by means of refined techniques and the emergence of laser vision surgery.
In 1978 a refractive procedure called radial keratotomy (RK) was introduced in the United States. RK involves making a number of cuts in the cornea to change its shape and correct refractive errors. Following the introduction of RK, doctors routinely corrected nearsightedness, farsightedness, and astigmatism, using various applications of incisions on the cornea.
In the 1980s a new type of laser, called the excimer laser, was developed. Though originally used to etch computer chips, ophthalmologists began using the excimer laser successfully in refractive surgery techniques to remove very precise amounts of tissue from the eye's surface. Excimer lasers revolutionized refractive surgery by providing a degree of safety and precision that was previously unattainable with other techniques. Nearly all lasers used today are excimer lasers.
The first generation lasers were called "broad beam lasers." The results were satisfactory and still today a small number are used. Later, scanning lasers were developed where a small spot or strip of laser beam rapidly scans the cornea.
Photorefractive Keratectomy
Like other types of refractive surgery, the goal of Photorefractive Keratectomy (PRK) is to reshape the cornea so that light traveling through it is properly focused onto the retina located in the back of the eye.
A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. Using one of several techniques, the central epithelium is removed. An excimer laser, which delivers a pulsing beam of ultraviolet light, is then used to reshape the stroma. The procedure takes about 10 minutes for both eyes. In a relatively short time after the procedure, usually three to four days, the epithelium will heal over the exposed area.
The outcome of PRK is quite good, since it is highly accurate in correcting many cases of refractive error. It has been estimated that approximately 80% of patients have 20/20 vision without glasses or contact lenses one year after the surgery; 95 - 98% have 20/40 vision or better without glasses or contacts.
People with myopia, or nearsightedness, with or without astigmatism, and those with moderate amounts of hyperopia, or farsightedness, with or without astigmatism, are potential candidates for PRK.
Many patients experience some discomfort in the first 24 to 48 hours after PRK surgery, and almost all experience sensitivity to light. Other side effects may include: Dry eyes, Infection, Glare, Seeing halos around images. These are most noticeable when you're viewing lights at night, such as while you're driving.
While longer term side effects that may occur such as: loss of best vision achieved with glasses, seeing a minor glare which can be permanent, mild halos around images, dry eyes.
LASIK
The acronym LASIK stands for Laser-Assisted In Situ Keratomileusis, and is a procedure that permanently changes the shape of the cornea using an excimer laser. The goal of LASIK is to reshape the cornea, or the clear front part of the eye, so that light traveling through it is properly focused onto the retina.
People with myopia, or nearsightedness, with or without astigmatism, and those with moderate amounts of hyperopia, or farsightedness, with or without astigmatism, are potential candidates for LASIK.
Some patients experience discomfort in the first 24-48 hours after LASIK surgery. Other side effects may include: dry eyes, glare, seeing halos around images. These are most noticeable when you're viewing lights at night, such as while you're driving.
The FDA has found that LASIK is generally safe and effective, although there are some risks to the procedure. These risks may include: Corrections can only be made by additional LASIK surgeries. LASIK is technically complex. Problems may occur when the doctor cuts the flap, for example the flap can become unhinged or the microkeratome can potentially cut too deep. These problems can adversely, and permanently, affect the patient's vision.
The eye may hemorrhage due to the pressure from the suction ring.
The flap can dislodge following trauma, even years after the procedure.
LASIK is more likely to cause a loss of "best" vision with or without glasses at one year after surgery. Your best vision is the highest degree of vision that you have achieved wearing your contact lenses or eyeglasses.
Differences Between PRK and LASIK
The primary difference between PRK and LASIK refractive surgery is that in LASIK, the vision correction occurs under an epithelial flap, while in PRK, the vision correction is performed on the surface of the cornea after the epithelium has been removed. The epithelial cells then heal during the following three to four days, in order to cover the cornea.
Many providers believe that LASIK offers numerous advantages over refractive vision correction performed on the cornea's surface (PRK). There is often a more rapid improvement in vision and decreased discomfort with LASIK, since the surface epithelial cells have been preserved and do not need to heal or regrow. However, there are additional risks associated with the LASIK procedure.
In some patients, PRK is a safer alternative that may promise better outcomes. Patients who might benefit from PRK include those in whom the cornea might be too thin for LASIK, or in some patients with corneal irregularities or scars. Occupational demands may also make PRK a better option because flaps created during LASIK can easily be lifted, even years after surgery.
Blurred vision is common complaint that seen in eye clinics. There are a lot of cause of blurred vision, one of them is refraction abnormality.
Refractive disease of the eye is the most common cause of blurred vision in mankind. In United States about 120 millions have refraction abnormality.
The good news is that refraction abnormality can be corrected with the usage eyeglasses or contact lens. Refractive surgery is used to correct common eye disorders such as nearsightedness, farsightedness, and astigmatism. Refractive surgery is designed to alter the shape of the cornea in order to improve the patient's vision. Since the development of refractive eye surgery, the technique has been widely used and modified with the invention of technology.
Laser Eye Surgery
History of Refractive Eye Surgery
The first refractive eye surgeries probably were done in ancient Greece. These ancient eye surgeries involved removal of cataract (clouding of the lens in the eye). In the 1850s, the first refractive lensectomy (removal of the lens of the eye for purposes of correcting high myopia) were performed. In the late 19th century, the first corneal surgery for correction of astigmatism was performed. Astigmatism was reduced with a horizontal incision in the corneal stroma.
Modern day ophthalmic surgeons have been performing refractive surgery for the treatment of myopia (nearsightedness), hyperopia (farsightedness), and astigmatism (irregular shaped cornea) for many years, but the past decades have produced rapid change and growth by means of refined techniques and the emergence of laser vision surgery.
In 1978 a refractive procedure called radial keratotomy (RK) was introduced in the United States. RK involves making a number of cuts in the cornea to change its shape and correct refractive errors. Following the introduction of RK, doctors routinely corrected nearsightedness, farsightedness, and astigmatism, using various applications of incisions on the cornea.
In the 1980s a new type of laser, called the excimer laser, was developed. Though originally used to etch computer chips, ophthalmologists began using the excimer laser successfully in refractive surgery techniques to remove very precise amounts of tissue from the eye's surface. Excimer lasers revolutionized refractive surgery by providing a degree of safety and precision that was previously unattainable with other techniques. Nearly all lasers used today are excimer lasers.
The first generation lasers were called "broad beam lasers." The results were satisfactory and still today a small number are used. Later, scanning lasers were developed where a small spot or strip of laser beam rapidly scans the cornea.
Photorefractive Keratectomy
Like other types of refractive surgery, the goal of Photorefractive Keratectomy (PRK) is to reshape the cornea so that light traveling through it is properly focused onto the retina located in the back of the eye.
A numbing drop will be placed in your eye, the area around your eye will be cleaned, and an instrument called a lid speculum will be used to hold your eyelids open. Using one of several techniques, the central epithelium is removed. An excimer laser, which delivers a pulsing beam of ultraviolet light, is then used to reshape the stroma. The procedure takes about 10 minutes for both eyes. In a relatively short time after the procedure, usually three to four days, the epithelium will heal over the exposed area.
The outcome of PRK is quite good, since it is highly accurate in correcting many cases of refractive error. It has been estimated that approximately 80% of patients have 20/20 vision without glasses or contact lenses one year after the surgery; 95 - 98% have 20/40 vision or better without glasses or contacts.
People with myopia, or nearsightedness, with or without astigmatism, and those with moderate amounts of hyperopia, or farsightedness, with or without astigmatism, are potential candidates for PRK.
Many patients experience some discomfort in the first 24 to 48 hours after PRK surgery, and almost all experience sensitivity to light. Other side effects may include: Dry eyes, Infection, Glare, Seeing halos around images. These are most noticeable when you're viewing lights at night, such as while you're driving.
While longer term side effects that may occur such as: loss of best vision achieved with glasses, seeing a minor glare which can be permanent, mild halos around images, dry eyes.
LASIK
The acronym LASIK stands for Laser-Assisted In Situ Keratomileusis, and is a procedure that permanently changes the shape of the cornea using an excimer laser. The goal of LASIK is to reshape the cornea, or the clear front part of the eye, so that light traveling through it is properly focused onto the retina.
People with myopia, or nearsightedness, with or without astigmatism, and those with moderate amounts of hyperopia, or farsightedness, with or without astigmatism, are potential candidates for LASIK.
Some patients experience discomfort in the first 24-48 hours after LASIK surgery. Other side effects may include: dry eyes, glare, seeing halos around images. These are most noticeable when you're viewing lights at night, such as while you're driving.
LASIK Procedures
The FDA has found that LASIK is generally safe and effective, although there are some risks to the procedure. These risks may include: Corrections can only be made by additional LASIK surgeries. LASIK is technically complex. Problems may occur when the doctor cuts the flap, for example the flap can become unhinged or the microkeratome can potentially cut too deep. These problems can adversely, and permanently, affect the patient's vision.
The eye may hemorrhage due to the pressure from the suction ring.
The flap can dislodge following trauma, even years after the procedure.
LASIK is more likely to cause a loss of "best" vision with or without glasses at one year after surgery. Your best vision is the highest degree of vision that you have achieved wearing your contact lenses or eyeglasses.
Differences Between PRK and LASIK
The primary difference between PRK and LASIK refractive surgery is that in LASIK, the vision correction occurs under an epithelial flap, while in PRK, the vision correction is performed on the surface of the cornea after the epithelium has been removed. The epithelial cells then heal during the following three to four days, in order to cover the cornea.
Many providers believe that LASIK offers numerous advantages over refractive vision correction performed on the cornea's surface (PRK). There is often a more rapid improvement in vision and decreased discomfort with LASIK, since the surface epithelial cells have been preserved and do not need to heal or regrow. However, there are additional risks associated with the LASIK procedure.
In some patients, PRK is a safer alternative that may promise better outcomes. Patients who might benefit from PRK include those in whom the cornea might be too thin for LASIK, or in some patients with corneal irregularities or scars. Occupational demands may also make PRK a better option because flaps created during LASIK can easily be lifted, even years after surgery.
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Wow, you gonna done LASIK next month, you gonna done several examination first, i think, such as eye USG to measure your eye refractive condition.
Anyway i hope your Lasik gonna success, and welcome to live without glasses.
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I have asked several clinics and all of the requires presurgery assessment, after that the fastest is 1 day wait before the lasik surgery, but one very experienced doctor requires 1 week wait after the presurgery assessment for the surgery, and does surgery on each eye with another 1 week gap, but conventionally, most doctors do both eyes on the same day
Thx!