Many people desire refractive surgery to decrease their reliance on glasses and contacts – especially if they have high prescriptions that make glasses look odd and contacts hard to put in and take out. They may, however, be confused as to what options are available to them and how the process of refractive surgery works. Below is explained how one goes about getting refractive surgery and what the recovery process is like.
Your Appointment Before LASIK
Refractive surgery might start with you asking your primary eye doctor about it, or you may go straight to a surgical center for inquiry. Either way, both of these visits will try and determine some basic parameters about your eyes and vision. If you are below the age of 18 years old, for example, you are not a candidate for laser surgery.
Your prescription also has to be stable for a couple years before you will be deemed a candidate. At the surgical center, specialized testing will be done to evaluate every aspect of your corneas. They must be thick and strong enough to be able to withstand having tissue lasered off to change your prescription, and the amount of tissue required increases drastically as your prescription increases.
If your corneas are too thin or your prescription too high, you also will not be a candidate for certain procedures. Some other underlying eye conditions such as retinal diseases or underlying systemic diseases like abnormal scar formation may also stop you from getting these elective surgeries.
The Day of Refractive Surgery
The actual surgical process is extremely quick at only around a few minutes, no matter what refractive procedure you end up receiving. Four common procedures include laser in-situ keratomileusis (LASIK), photorefractive keratectomy (PRK), small incision lenticule extraction (SMILE), and implantable collamer lens (ICL) insertion. These are described briefly below.
LASIK is when a laser is used to cut a flap from the front part of the cornea, like a door that swings on a hinge. This flap is then lifted and another laser is used on the deep corneal tissue below it that does not regenerate. This is the part that actually changes your eye’s prescription. Once this is completed, the flap is allowed to sit back on the cornea so that this tissue can reattach.
PRK is often used if the cornea is too thin to support LASIK. Instead of a flap being made, the top layer of the cornea is taken off with alcohol and the underlying tissue is then ablated with a laser. A bandage contact lens is placed on the eye after the procedure to decrease pain and protect the wound while it heals for a few days.
SMILE is another alternative to LASIK that is similar but without the flap. A single laser is used to separate a mass of tissue from within the cornea that will correct the prescription. A small incision is then made and this mass is taken out to complete the procedure.
Finally, ICL insertion is a great option for very high prescriptions that are outside the bounds of the other procedures. In this case, incisions are made and a small artificial lens is placed in the eye between the colored part (the iris) and the natural lens. This can correct as much refractive error as needed.
Post-op Eye Surgery Visits
After your surgery, depending on the procedure, you may be asked to return to the surgical center for post-op check ups at the one day, one week, 2-3 weeks, one month, 3-6 months, and one year marks. Signs of infection, poor healing, regression, or other complications will be screened for at these appointments and managed as necessary. It is vital to go to these appointments and follow instructions closely to avoid complications.
