LASIK is a type of refractive surgery performed using a laser, which allows the patient to stop wearing glasses.

LASIK is a type of refractive surgery performed using a laser that allows the patient to stop wearing glasses, since the correction of refractive errors is performed safely and effectively.

Nowadays, there is a set of surgical techniques that allow the correction of the different types of ametropias (myopia, hypermetropia e astigmatism), making glasses independent.

LASIK, using the Excimer laser, is nowadays the technique of choice to eliminate existing refractive errors since it is a less invasive, quick and painless surgery. However, apart from the laser (LASIK or PRK) refractive surgery can also be performed by implanting intraocular phakic or pseudophakic lenses.

You should have an ophthalmology consultation and respective complementary examinations so that the ophthalmologist can advise you on the most suitable procedure for your case.

To be a candidate for refractive surgery, you need:

  • Be over 18 years of age;
  • Refractive stability, i.e. it is necessary that the grading has remained stable in the last year;
  • Absence of ocular pathologies, apart from refractive error, which condition the results of the surgery;
  • Absence of systemic pathologies;
  • Perform complementary diagnostic tests in order to determine the most suitable surgical technique for each case.
LASIK and Phakic Lenses 2
  • Laser Excimer

    As previously mentioned, the Excimer Laser allows for the surgical correction of refractive errors (myopia, astigmatism and hyperopia) in a quick, painless and safe way. There are several types of laser, but the most commonly used today are LASIK and PRK.

    Currently, we can associate the Femtosecond Laser to the Excimer Laser. Over the last few years, the technology used in ophthalmologic surgery has benefited from great evolution, always with a view to reducing surgical risk, accelerating postoperative recovery and also facilitating the surgery itself.

    LASIK, acronym for Laser Assisted In-situ Keratomileusis, is a type of corneal surgery in which a small, very thin corneal flap, called a flap, is created and lifted. After the flap is lifted, a pulsed beam ultraviolet laser (Excimer laser) is placed directly on the cornea, changing its curvature and correcting the refractive error. At the end, the flap is repositioned on the treated area. This type of surgery does not require stitches as the flap adheres and heals naturally.

    The use of the femtosecond laser to perform the "Flap" allows for greater precision and speed when compared to the use of the microkeratome (mechanical instrument that cuts the corneal flap), which translates into a significant decrease in surgical complications, eliminating irregular cuts and traumas induced by manual manipulation of the microkeratome.

    An alternative to LASIK surgery is PRK, which stands for Photorefractive Keratectomy, which despite having some similarities, may be recommended by the ophthalmologist in some specific situations, such as in people with less thick corneas or in people with a higher refractive error. In these situations, although recovery takes longer compared to LASIK, it has the advantage of saving corneal thickness. 

    The surgery begins with the process of corneal de-epithelialisation, i.e. a light abrasion is performed on the outermost layer of the cornea, the epithelium. Next, the Excimer laser is applied on the cornea in order to shape it. 

    In both processes, the surgery is performed only with local anaesthesia administered through eye drops, preventing the person from feeling pain or discomfort during the procedure, thus allowing a more positive collaboration on the part of the patient, which influences the post-surgical results. 

    The surgery is programmed according to the exams previously carried out, which allow us to personalise the treatment to be applied to each person.

  • Phakic IOL Implantation

    A phakic lens is an intraocular lens (IOL) that is added to our visual system without having to remove the lens - one of the structures responsible for the focusing process of our eye. Thus, the phakic IOL implant presents itself as another surgical option to eliminate the various ametropias. Depending on the type of phakic IOL used, it can be placed in front of (anterior chamber) or behind (posterior chamber) the iris, but always in front of the lens. 

    Surgery with phakic lens implantation consists of inserting the lens through a small opening in the base of the cornea, which does not usually require suturing. The lens is placed in a folded position and, thanks to its flexibility, unfolds inside the eye. 

    The most commonly used lenses today are ICL, which are placed between the iris (coloured part of the eye) and the lens, adapting naturally to the eye and providing clear vision. The focusing process is similar to that of spectacles or contact lenses. 

    Any person who wants to stop using glasses or contact lenses is a candidate for refractive surgery with IOL implantation, even those who, due to the characteristics of their eye or because they have a higher degree, cannot undergo LASIK or PRK. 

    This type of surgery is an evolution in the field of refractive surgery, as this technique has the advantage of being reversible, with predictable and stable results and its implementation is not dependent on corneal thickness, as is the case with laser refractive surgery, as it does not alter the corneal tissue.

As pathologies associated with any of these types of surgery, we find the refractive errorsmore precisely, the myopia, a hypermetropia and astigmatism.

Refractive surgery is performed in an outpatient clinic, with the aid of topical anaesthesia. 

With both LASIK and PRK, it is common for both eyes to be operated on the same day, whereas with phakic IOL implantation, it is advisable to perform each eye on a different day, since it is an intraocular surgery.

These surgical procedures are painless and of short duration, usually taking around 20 to 30 minutes, plus the patient preparation time, which is longer with IOL implantation.

LASIK is considered to be a very safe surgery, where the results obtained are largely positive. For this reason, the risks associated with the various surgical techniques and procedures are very low, although they do sometimes exist. Most of the time, in order to resolve the situation and bring the vision back to an ideal level, it may be necessary to administer corticoids through eye drops. 

One of the main risks to be taken into consideration and present in any refractive surgery is the possibility of the existence of a residual dioptric value, that is, the person's refractive error may not be totally corrected. In most cases, this residual value is not significant and may not even have any influence on daily vision. In rarer situations, where the visual acuity obtained is not satisfactory, it may be necessary to perform a new surgery to correct the residual graduation, if the patient still has the necessary conditions for such. 

Among the less common risks, corneal lesions associated with surgery can sometimes result, such as scarring, which can impair vision and make daily activities difficult. In the more specific case of IOL implantation, the risks are the same as those associated with intraocular surgery. 

To avoid any risk of infection after surgery, it is very important to apply all the therapy recommended and prescribed by the ophthalmologist.

After refractive surgery, it is recommended that you completely follow all the information and recommendations made by the surgeon. Anti inflammatory and antibiotic medication may be prescribed to reduce both discomfort and the risk of infection. Recovery is fast, however it is expected that in the first hours the patient may experience cloudy vision and dry eye.

It is not recommended to perform extreme physical or visual efforts in the first days after the surgery. During the recovery, it is possible that in environments with more luminosity there is an increased discomfort, and the use of sunglasses with UV protection is recommended. 

The recovery process, from the moment the surgery is performed until the vision is stabilised and completely clear, differs according to the surgical technique used. With LASIK and PRK, visual recovery can take a few weeks or even a few months (between 1 to 3), and there is some variation in the quality of vision. With PRK, recovery depends on the complete regeneration of the corneal epithelium, so it may take longer and be more painful than with LASIK.

 With IOL implantation, recovery is expected to be rapid, and by the next day you may have reached full visual acuity. 

Throughout this period, it is necessary to monitor the healing process, respecting the dates of the post-surgical appointments.

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