Refractive Surgery

Refractive surgery or laser surgery refers to surgical methods used to correct refractive errors. The aim of refractive surgery is to increase the patient’s vision quality and to eliminate the necessity of lens or glass use.

Am I a Good Candidate for Laser Surgery? 

Every person is not a good candidate for refractive surgery due to the different ocular structure. Even if the eye structure is suitable, the refractive error may not be completely eliminated. A detailed ocular examination and corneal topography examination should be performed to decide the refractive surgery and to evaluate the potential risk factors.  Generally, patients with very high myopia, astigmatism or hyperopia values, thin corneal thickness, severe dry eye, and corneal disease are not suitable for laser surgery.

Laser Surgery Examination

• Detailed measurement of refractive error
• Detailed ocular examination of anterior and posterior segments of the eye
• Corneal topography
• Dry eye measurements
• Measurement of refractive errors after pupil dilatation with eye drop
• Explaining the benefits of the surgery and possible surgical risks to the patient in detail

PRK (Photorefractive keratectomy) / LASEK / No – Touch Laser

In these types of laser surgery, the excimer laser is applied to the outermost layers of the cornea and the corneal surface is reshaped. No-Touch Laser or LASEK surgeries basically have the same principle as PRK surgery but have differences in application techniques. In no-touch laser surgery, laser procedure is applied directly to the eye without any intervention. In PRK surgery, the cell layer called the epithelium at the top of the cornea is removed before the laser and then the laser is applied. In LASEK surgery, the cell layer called the epithelium at the top of the cornea is removed before the laser and then the laser is applied. The epithelium layer is placed back after the surgery. 

Advantages:

• Short surgery time (15 minutes)
• Minimum contact with the patient’s eye
• Painless surgery
• Treatment of mild and moderate myopia and astigmatism
• Can be performed in thin corneas

Disadvantages:

• 24 hours of pain, burning and watering in the eye after laser
• Not applicable in high myopia, astigmatism and hyperopia 
• Increased vision quality after the 4th day after laser

Risks

Like every surgical procedure, laser surgery also carries some risks.

• Infection: It is quite rare. Antibiotic drops are used to protect against infection after laser.
• Dry eye: It occurs in the vast majority of patients. Artificial tears are used for the first 6 months after laser surgery and sunglasses are recommended outdoors.

LASIK (Laser in-situ keratomileusis)

LASIK (Laser in-situ keratomileusis) surgery is used in the treatment of myopia, astigmatism and hyperopia. LASIK surgery consists of 2 steps:

• An incision is made on the corneal surface with the help of a femtosecond laser and a layer (flap) of approximately 100-120 microns thick is lifted from the corneal surface
• After the flap is lifted, excimer laser is applied to the corneal surface. After the procedure, the lifted flap is meticulously placed back in its previous position.

Advantages:

• Painless surgery
• No pain after laser surgery
• High vision quality on the first day after laser surgery
• Treatment of mild, moderate and high levels of myopia and astigmatism
• Treatment of mild and moderate hyperopia

Disadvantages:

• Long surgery time (30 minutes)
• Eye contact during laser surgery
• Cannot be applied to thin corneas

Risks

Like every surgical procedure, laser surgery also carries some risks.

• Infection: Quite rare. Antibiotic drops are used to protect against infection after laser.
• Severe healing response: Quite rare. In some patients, decreased vision may occur due to the severe healing response in the cornea after laser surgery. This condition is treated with eye drops.
• Dry eye: Occurs in the vast majority of patients. Artificial tear drops are used for the first 6 months after laser and sunglasses are recommended outdoors.
• Flap wrinkles: Rarely develop and usually do not affect the patient’s vision. In cases where it affects vision, the corneal flap position should be corrected.

Laser Surgery Process

Before Surgery

• Unless your doctor tells you otherwise, you do not need to stop your daily medications
• You do not need to stay in the hospital
• Since laser surgery is performed with local anesthesia, fasting is not required before surgery.

Day of Surgery

• Anesthesia is applied to the surface of the eye with eye drops
• The average surgery time varies depending on the laser technique to be applied, but is approximately 15-30 minutes
• The patient does not feel any pain during the surgery

After Surgery

• Eye drops will be used for 1 month after surgery.
• You can do most of your daily activities within 3 days after surgery.
• Swimming in the sea or pool, heavy lifting and heavy sports activities can be done after the 2nd week.
• There are control examinations on the 1st day, 1st week and 1st month after surgery. Additional control examinations can be done if needed.