When considering vision correction, laser eye surgery is one of the most widely spread options for eye patients looking to minimise their dependence on glasses or contact lenses. But how is laser eye surgery performed, and what makes it so beloved by millions worldwide?
This article will tackle how laser eye surgery works, the different types available, why patients love this treatment, and how to determine if you’re a good candidate for this life-changing procedure. Let’s dive into the fascinating process of laser vision correction and learn how it can help improve your vision and quality of life.
What Is Laser Eye Surgery?
Laser eye surgery, or laser-assisted surgery, is a procedure that uses laser technology to reshape the corneal tissue of the eye, improving vision and correcting refractive errors like short-sightedness (myopia), long-sightedness (hyperopia), and astigmatism. The process involves using specialised lasers, including the excimer laser and femtosecond laser, which play essential roles in vision correction.
Laser eye surgery aims to improve the way light rays are focused onto the retina by reshaping the cornea. By adjusting the corneal shape, the light entering the eye can focus more accurately, reducing the need for corrective lenses such as glasses or contact lenses.
Types Of Laser Vision Correction
Various laser surgery techniques are available, each designed to correct specific vision problems and meet different patient needs. Let’s explore the most common types of laser eye surgery and how they are performed.
LASIK Eye Surgery
LASIK, short for laser-assisted in situ keratomileusis, is perhaps the most well-known type of laser eye surgery. A thin corneal flap is created using a femtosecond laser during the LASIK procedure. The excimer laser then reshapes the underlying cornea, correcting the refractive error. The corneal flap is replaced, and healing begins immediately.
LASIK surgery is highly popular due to its quick recovery and minimal discomfort. Many patients report improved vision within 24 hours, allowing them to quickly return to normal activities.
PRK (Photorefractive Keratectomy)
PRK, or photorefractive keratectomy, is another form of laser refractive surgery that works similarly to LASIK but with one key difference. Instead of making a corneal flap, the surgeon removes the outer layer of the corneal epithelium and uses the excimer laser to reshape the cornea. The epithelium regenerates over time during the healing process.
PRK is often recommended for eye patients with thin corneas, as it doesn’t require the creation of a flap. While the recovery time may be slightly longer than LASIK surgery, PRK is a highly beneficial treatment for vision correction.
SMILE (Small Incision Lenticule Extraction)
SMILE is a recent laser eye surgery technique that has gained traction for its minimally invasive approach. Rather than creating a flap, the surgeon uses a femtosecond laser to make a small cut in the cornea and removes a tiny piece of tissue called a lenticule. This reshapes the cornea and corrects vision problems like short-sightedness.
SMILE surgery has the advantage of requiring a smaller cut, which can lead to faster healing and less disruption to the corneal structure.
PRESBYOND Laser Blended Vision
PRESBYOND, also known as laser blended vision, is an advanced type of laser eye surgery to manage presbyopia, the age-related loss of near vision that typically affects people over 40. PRESBYOND offers a customised solution using laser technology to create a “blend zone” in the cornea, allowing patients to see clearly at near and far distances.
Unlike traditional LASIK, PRESBYOND adjusts each eye differently. One eye is corrected for distance vision, while the other is enhanced for near vision. The laser reshapes the cornea so that the brain can blend the images from both eyes, providing a continuous range of vision from close up to far away.
How Is Laser Eye Surgery Performed?
Laser eye surgery is a highly precise and technologically advanced procedure designed to correct vision problems such as short-sightedness, long-sightedness, and astigmatism. While different laser eye surgery techniques may vary slightly in their methods, the overall process follows similar stages.
Here’s a detailed look at how laser eye surgery is performed:
Pre-Surgery Preparation
Before the procedure begins, your eye surgeon will take the steps necessary to ensure comfort throughout the process. You’ll be seated in a reclining chair under a specialised laser system for vision correction.
- Numbing Eye Drops:
The first step involves administering numbing eye drops. These drops ensure minimal discomfort during the procedure, though you may still be aware of movement or slight pressure. Local anaesthesia ensures that your eyes remain numb during the surgery. - Eye Positioning: A gentle device keeps your eyelids open, preventing blinking during the surgery. While keeping your eyes open may seem daunting, the numbing drops and the surgeon’s careful guidance make this a comfortable experience.
- Stabilising The Eye: In procedures like LASIK, a suction ring is often used to stabilise the eye and prevent involuntary movements during the surgery. This ensures the laser treatment perfectly aligns with your unique eye structure.
Once your eyes are numbed and stabilised, the surgeon proceeds with the laser eye surgery.
Corneal Flap Creation (LASIK Surgery)
For LASIK procedures, the first key step involves creating a corneal flap.
- Femtosecond Laser: The surgeon uses a femtosecond laser to create an ultra-thin, precise flap in the corneal tissue. Thanks to the numbing eye drops, this process takes only a few seconds and is comfortable. The femtosecond laser emits rapid pulses of light to make tiny incisions in the cornea, creating a thin flap carefully lifted back to reveal the underlying corneal tissue.
- Flap Retraction: The surgeon gently retracts the flap, folding it back to access the inner corneal layers, which are then treated to correct your refractive error. This step is crucial in allowing the surgeon to alter the shape of the cornea with the excimer laser.
In other laser eye surgery procedures, such as PRK, there is no need to create a flap. Instead, the surgeon removes the cornea’s thin outer layer, called the corneal epithelium, to access the underlying tissue for reshaping.
Corneal Reshaping Using The Excimer Laser
This is the critical phase of the procedure where the actual vision correction occurs.
- Excimer Laser Reshaping: The excimer laser is programmed based on your personalised vision correction plan. It emits cool ultraviolet light beams that precisely remove microscopic amounts of corneal tissue. This reshaping process is tailored to correct refractive errors such as short-sightedness (myopia), long-sightedness (hyperopia), or astigmatism. The laser reshapes the cornea to ensure light entering the eye is accurately focused onto the retina, leading to clearer vision.
- Precision And Accuracy: The excimer laser is extremely accurate, ensuring that the changes made to your cornea are perfectly suited to correcting your refractive error.
- Guided By Advanced Technology: Throughout the laser reshaping phase, advanced eye-tracking technology monitors your eye’s position hundreds of times per second. This ensures that the laser beam is precisely aligned, even if tiny, involuntary movements occur during the surgery.
Repositioning The Corneal Flap
Once the corneal tissue has been reshaped, the surgeon carefully repositions the corneal flap back over the eye.
- Natural Healing: The corneal flap acts like a natural bandage, adhering back to the surface of the eye without the need for stitches. The flap immediately begins the healing process, helping to protect the treated area as it recovers. Since the cornea heals quickly, most patients experience rapid visual recovery.
In procedures like PRK or PRESBYOND, where no flap is created, the removed corneal epithelium will regenerate over time, leading to full recovery in days or weeks.
Final Touches And Post-Surgery
After the main steps of the laser eye surgery are completed, the surgeon will ensure that your eyes are properly cared for to promote healing and minimise any discomfort.
- Lubricating And Medicated Eye Drops: The eye surgeon will apply lubricating and medicated eye drops to aid in healing and prevent infection. These drops also help soothe any temporary dryness or irritation after the procedure.
- Protective Eye Shields: Some patients may be given protective eye shields or goggles to wear immediately after surgery to prevent rubbing or accidental pressure on the eyes as they heal. These are typically worn briefly, particularly while sleeping, to ensure the eye remains undisturbed.
Quick And Comfortable Process
The entire laser eye surgery procedure typically takes a few minutes per eye, with the actual laser reshaping often lasting only a minute or less. Despite how intricate and delicate the procedure sounds, it is remarkably quick and minimally invasive. Patients may report little discomfort during surgery.
Recovery And Vision Improvement
Patients may notice changes in their vision within the first few hours to a day following laser eye surgery. For some, the change is immediate, while for others, vision may continue to sharpen over the next several days or weeks as the cornea fully heals. Your eye specialist will schedule a follow-up appointment to monitor your recovery and ensure your eyes heal properly.
Patients typically return to normal activities, such as driving or work, within a day or two, though it’s important to follow your surgeon’s post-surgery care instructions carefully. The healing process varies from person to person, but in most cases, laser eye surgery offers a high-quality solution for improved vision.
Why Patients Love Laser Eye Surgeries
Laser eye surgery is celebrated for many reasons, with millions worldwide opting for this transformative procedure. Here’s why patients love laser eye surgeries:
Quick And Minimally Invasive
One of the major benefits of laser eye treatment is its speed. Procedures may be completed in around 30 minutes, and the process is minimally invasive, making it a low-stress option for patients.
Rapid Results
Many patients experience improved vision within 24 to 48 hours after the procedure. Laser eye surgery offers almost immediate results, allowing you to enjoy clearer vision shortly after treatment.
Freedom From Glasses Or Contact Lenses
Laser eye surgery eliminates the need for most patients to wear glasses or contact lenses. This newfound freedom is often one of the biggest draws, allowing patients to enjoy life without constantly reaching for corrective lenses.
Restored Joy
Laser eye surgery has earned love and respect through the outcomes it can yield. Patients report wonderful improvements in their quality of life.
How To Know If You’re A Good Candidate For Laser Eye Surgery
Not everyone is a great candidate for laser eye surgery, but many people are eligible for this life-changing procedure. Here are some of the factors that determine if you’re a good candidate:
Stable Vision
To be considered for laser eye surgery, your vision should be stable for at least one year before the procedure. Fluctuating prescriptions can indicate underlying vision changes, making it difficult to achieve long-lasting results.
Good General Health
Patients should be in good overall health, free from conditions that may affect healing, such as autoimmune diseases or chronic eye infections. Additionally, pregnant or breastfeeding women may need to wait until their hormonal changes stabilise before undergoing surgery.
Sufficient Corneal Thickness
Laser eye surgery involves reshaping the corneal tissue, so patients must have sufficient corneal thickness for the procedure. If your corneas are too thin, alternatives like PRK may be recommended instead of LASIK.
Age Considerations
While laser eye surgery can benefit a wide range of ages, most patients are between 18 and 40, when vision is typically most stable. Patients over 40 may need reading glasses post-surgery due to age-related vision changes (presbyopia).
No Significant Eye Diseases
Patients should not have any active eye diseases or conditions, such as cataracts, glaucoma, or severe dry eye. These conditions may affect the outcome of the surgery and require proper reporting before laser eye surgery.
Frequently Asked Questions
Can both eyes be treated on the same day?
Yes, most laser eye surgeries treat both eyes during the same session. This helps reduce overall recovery time and eliminates the need for multiple appointments. However, your eye surgeon will discuss your case and recommend the best approach.
What happens if I blink or move during the procedure?
Advanced laser eye surgery technology includes eye-tracking systems that monitor and adjust to slight eye movements during the procedure. A speculum is also used to keep the eyelids open so blinking will not interfere with the surgery.
What are the risks of laser eye surgeries?
Laser eye surgeries are generally considered okay, but like any surgical procedure, they carry some risks. Potential complications may include dry eyes, glare or halos around lights, under- or over-correction, and temporary disturbances such as fluctuating or blurred vision.
More serious risks, such as infection or vision loss, can occur in rare cases.
However, patients typically experience no major complications, and your eye surgeon will carefully assess your eyes and discuss these risks with you before proceeding to ensure the procedure is right for you.
The Journey To Clearer Vision: What’s Next?
Laser eye surgery is a revolutionary vision correction option that has helped millions of people achieve clearer, sharper vision. Whether you’re considering LASIK, PRK, SMILE, or another form of laser eye treatment, understanding the answer to the frequently asked question, “How is laser eye surgery performed?” can help you make an informed decision.
If you’re interested in discovering whether you’re a good candidate for laser eye surgery, it is time to assess your unique needs and guide you towards the best possible solution for your vision.
If you’re in Melbourne and considering laser eye surgery, take the first step towards clearer vision and improved quality of life with a personalised consultation. Call Dr Anton Van Heerden today at 03 9000 0389 to start your journey towards a better vision.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
Sources:
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Dunkin M A 2023. A Guide to Refractive and Laser Eye Surgery. WebMD. Available at: https://www.webmd.com/eye-health/overview-refractive-laser-eye-surgery [Accessed September 17, 2024]
Healthdirect Australia 2022. Laser Eye Surgery. Healthdirect. Available at: https://www.healthdirect.gov.au/laser-eye-surgery [Accessed September 17, 2024]
Jackson A 2022. Can I Have Laser Vision Correction? Glaucoma Research Foundation. Available at: https://glaucoma.org/articles/can-i-have-laser-vision-correction [Accessed September 17, 2024]
Tai A, Athena Eye Care, & Mission Viejo 2024. LASIK Eye Surgery. MedlinePlus Medical Encyclopedia. Available at: https://medlineplus.gov/ency/article/007018.htm [Accessed September 17, 2024]
Wirth J 2023. LASIK Success Rates: How Safe Is Eye Surgery in 2024? Forbes Health. Available at: https://www.forbes.com/health/eye-health/lasik-success-rates/ [Accessed September 17, 2024]
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