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Is it worth doing vision correction? Laser vision correction - when and to whom can it be done? What will you learn

Doctors state: there are fewer and fewer people with good vision, and the number of glasses and contact lens wearers is increasing every day. There are many reasons for this. The quality of vision may depend on heredity, eye diseases, and injuries. Doesn't add health to our eyes
and sitting at the computer for long periods of time. Eye problems are solved in different ways. For some, it is enough to wear glasses, for others, surgery is necessary, and in some cases, special exercises can improve visual acuity. Marina Dzhumova, associate professor of the Department of Eye Diseases of the Belarusian State Medical University, told during a direct line held in Znamenka what to do in certain cases.

- Is it possible to play sports after eye surgery and what kinds of activities are generally allowed without harm to health?
Alina Nikolaevna
(question from the site [email protected])

It all depends on the operation and the condition of the retina. If the reader means laser vision correction, then there are no restrictions on playing sports if there are no changes in the fundus. If there are pronounced changes in the retina associated with myopia, then playing any sports is contraindicated, since stress can provoke retinal detachment. In each case, the issue is resolved by the ophthalmologist individually.

- Is laser correction a surgical intervention? What loads are indicated after such an operation?
Andrey, Minsk

Yes, this is laser refractive surgery. It combines a number of procedures that are performed to change the refraction of the eye by affecting the cornea or lens. LASIK is the most common refractive procedure in recent times. It provides correction of hypermetropia up to 4 diopters, astigmatism without restrictions and myopia up to 12 diopters depending on the thickness of the cornea. If there are no changes in the fundus, you can play sports. Changes in the retina associated with myopia (thinning, tears, peripheral degeneration) limit sports activities. You cannot lift weights, do work with your head tilted, engage in strength sports, jumping, running, etc. Any sudden movements are contraindicated.

- Is it possible to give birth naturally after refractive eye surgery?
Marina, Orsha

It all depends on the condition of the retina. All restrictions are associated with this. If there are no changes in the retina, you can give birth naturally. In case of high myopia, it is necessary to examine the retina in the third trimester of pregnancy, i.e. examine the fundus. If ruptures, pre-ruptures, or peripheral degenerations that predispose to retinal detachment are found in the retina, you should definitely contact the laser center and perform laser coagulation of the retina. If there is a threat of retinal detachment, natural delivery is contraindicated. In each specific case, this issue is decided by an ophthalmologist.

- I want to do laser vision correction. But now I am in the first months of pregnancy. When is it better to do this: now or after childbirth?
Anna, Polotsk

Laser vision correction can be done three months before the planned pregnancy. But during pregnancy and breastfeeding - no. It will be possible to do it after childbirth and cessation of lactation.

- What physical and visual limitations may there be after laser vision correction surgery? And are there any contraindications for such an operation?
Mikhail Davidovich, Minsk

In the first week after laser correction, physical activity is contraindicated and you should not go to the pool. Limitations are associated with possible displacement of the corneal flap and its subsequent deformation and wrinkling. In the future, physical limitations are associated with the condition of the retina. There are no visual restrictions. The operation is characterized by rapid visual rehabilitation and stabilization of refraction, minimal risk of corneal opacities. Contraindications for the operation are pregnancy and lactation, chronic inflammatory eye diseases (blepharitis, conjunctivitis, keratitis, keratouveitis, etc.), glaucoma, cataracts, keratoconus. If you have diabetes, it is better to avoid surgery.
- Is the eye open after such an operation or is a bandage applied?
- The bandage is not applied, the eye is open. Therefore, it is important that the flap does not become displaced. The operation is associated with minimal discomfort.

- Approximately how much is removed from the thickness of the cornea during laser correction surgery and how safe is additional correction?
Lyudmila Alexandrovna, Molodechno

The volume of tissue removed and the effect of the intervention are limited
original corneal thickness. To avoid corneal ectasia (progressive thinning and increased curvature of the cornea with irregular astigmatism, leading to poor vision), the thickness of the residual stroma after flap formation and tissue ablation (removal) should be at least 450 microns.
How safe is additional correction? If this is within the specified corneal thickness, then additional correction is safe.

- For what eye diseases would you not recommend laser correction?
Sergey Anatolyevich, Zhodino

Glaucoma, cataracts, diabetes mellitus, inflammatory eye diseases (blepharitis, conjunctivitis,
uveitis, keratitis (especially herpetic keratitis).

- What consequences can occur after unsuccessful eye surgery?
Tatiana, Orsha

This depends on the method of surgery. Various methods of laser refractive surgery are possible. There are intra- and postoperative complications. For example, after LASIK surgery (laser in situ keratomileusis), complications are associated with damage to the flap (formation of a thin flap, “perforated” holes, uneven flap, etc.). Postoperative complications include shrinkage, distortion or displacement of the flap, epithelial defects, subepithelial opacities that can cause night blindness, and sometimes diffuse lamellar keratitis or bacterial keratitis. Quite often there is dry eye syndrome, when patients complain of a feeling of dryness and burning in the eyes. In such cases, tear substitutes are used, drugs that moisturize the eye: natural tears, Systane, Oxyal, Hilo-Komodo, Vidisic and others. It is necessary to consult with an ophthalmologist, since the choice of drug is decided individually. I must say that in most cases, laser refractive surgery occurs without complications.

- How long does the Lasik surgery last and how quickly after it can you lead your normal life?
Elena, Minsk

Laser ablation lasts up to 2 minutes. The total operation time for both eyes is 30-40 minutes. The operation causes minimal discomfort, rapid visual rehabilitation and rapid stabilization of refraction. The risk of corneal clouding is minimal. For the first few days after surgery, you should limit physical activity to avoid injury to your eyes.

- What methods of vision correction exist? How safe is it to wear contact lenses and do they scratch your eyes?
Andrey, Minsk

For vision correction, glasses, contact lenses and laser refractive surgery are used. The right way, in my opinion, is this: if a person tolerates glasses well, he should wear them. This is the safest correction method. If there are medical indications or a person does not like wearing glasses (for example, there is not sufficient visual acuity, the field of view is worse), he can wear contact lenses. Most of the oxygen for corneal metabolism comes from the atmosphere and the tear film. The contact lens is located within the tear film and creates a barrier to the penetration of oxygen into the cornea. The movement of the lens and the circulation of tears behind the lens is an important mechanism for delivering oxygen to the cornea. With a tight-fitting lens, mechanical and hypoxic tissue damage is possible. The cornea can be damaged by a contact lens or a foreign body caught under the lens. The correct fit of the lens is determined by the doctor. Untimely replacement of contact lenses, poor hygiene and incorrectly selected lenses can cause complications. The oxygen permeability of the contact lens (DK/t value) may be insufficient. Patients cannot wear contact lenses continuously. They can be an addition to glasses. In the presence of complications (superficial punctate keratitis, tight lens syndrome, epithelial microcysts, chronic hypoxia and vascularization, infiltrates, allergic and toxic reactions, corneal ulcer), a reduction in the time of wearing the lens or stopping wearing it altogether is indicated. An increase in oxygen permeability is achieved by replacing lenses with silicone hydrogel soft contact lenses. The risk of complications increases when patients with ophthalmopathology wear lenses. Patients with inflammatory diseases (acute rhinitis, tonsillitis, conjunctivitis, blepharitis) should not use contact lenses. Wearing contact lenses can lead to bacterial keratitis and corneal ulcers. In such cases, contact lenses should be removed until recovery.
- How long can you wear contact lenses?
- Depends on the type of lens. Daily wear lenses of medium hydrophilicity are recommended to be worn for 6-8 hours; in the evening they are removed and treated in special solutions. Lenses can be soft or hard and are made from various materials. Soft contact lenses are divided into daily replacement lenses (the safest - put them on in the morning, throw them away in the evening), frequent scheduled replacement (service life 7-14 days), scheduled replacement (lens replacement once a month), traditional (service life 6-12 months) . Flexible wearing mode provides that sometimes the lens can be left in place for 1-2 nights, continuous wearing mode means that the lens can be worn without removing for a month.
I am not a proponent of continuous lens wear, since bacterial keratitis may develop. During wear, proteins and cellular detritus, lipids, cosmetics, and salts are deposited on the lens and come into contact with the surface of the eye. Treatment products can cause acute or chronic keratopathy. Contact lenses must be changed promptly.
- Are laser surgeries performed at the 3rd Clinical Hospital in Minsk? And what is Lasik surgery?
- In the laser center of the 3rd Clinical Hospital, various types of laser procedures are performed for glaucoma, secondary membranous cataracts, laser photocoagulation of the retina for various pathologies (diabetes, myopia, thrombosis, etc.), photodynamic therapy for retinal diseases and operations on the adnexal apparatus of the eye.
We do not perform laser refractive surgery. These procedures are performed by two commercial centers - “Optimed” and “New Vision”. The LASIK procedure is designed to change the refraction of the eye by affecting the cornea. Using a microkeratome, a very thin flap of epithelium is formed, located on the basement membrane, laser ablation is performed (removal of corneal tissue to a given depth using an excimer laser), the flap is placed in place and held at rest for 30 seconds.
When correcting myopia, tissue is removed in the central zone of the cornea, which leads to its flattening; to correct hypermetropia, ablation is performed on the periphery of the cornea, which makes the cornea steeper in the center.
- Thank you.

- At what age and in what cases can children wear contact lenses? And what if you have an infectious disease (keratitis)?
Oleg, Vitebsk

Children can wear contact lenses from the age of 12 if they have refractive errors. Parents should supervise the treatment of lenses. Lenses can be worn at an earlier age (for example, with aphakia - the absence of a lens). The issue should be resolved individually by a doctor in a contact correction room. The presence of infection (chronic conjunctivitis, blepharitis) is a contraindication for wearing lenses. In this case, wearing glasses is indicated. Wearing contact lenses after suffering from keratitis is not recommended, since it can injure the cornea and cause a relapse of the disease.

- I have farsightedness. I wear glasses. I work at the computer for a long time. The eyes get very tired - to the point of pain and acute stinging. This sometimes does not go away even after sleep and after days off. What to do?
Arkady, Maryina Gorka

With moderate and high farsightedness, patients need distance and reading glasses. In this case, we can recommend limiting work with the computer for a certain period of time. Work at the computer only during the working day, and after work give your eyes a rest. It often happens that a person comes home from work and sits down at the computer again in the evening. It is important to choose the right glasses from your ophthalmologist. Eye exercises are useful. The simplest exercise is to look into the distance for 30 seconds, at a close distance for 30 seconds for three minutes. The exercise can be performed several times a day. In the eye we have the ciliary muscle, which is overstrained during visual work at close range.
By the evening, when working at a computer or reading for a long time, dry eye syndrome may develop. Patients complain of burning, dryness, and a feeling of a foreign body, which intensify during the day. Dry eye syndrome is exacerbated by external factors that accelerate the evaporation of tear fluid (for example, air conditioning, wind or central heating). Drugs for moisturizing the eyes are indicated: natural tears, Systane, Oxyal, Vidisik, Hilo-Komodo and others. If the effect is insufficient, a patient with farsightedness may be advised to wear contact lenses or refractive surgery.

- I am 45 years old. My eyes have been watering for a long time (for 15-20 years now). This is especially true with the onset of spring, when strong winds begin. Or on a sunny winter day. You even have to wear glasses, but this doesn’t always help. I consulted a doctor. He prescribed some kind of gel. Moreover, you need to use it constantly. But is it possible to prescribe the drug for an unlimited period? What could cause this lacrimation and how to deal with it?
Raisa Adamovna, Glubokoe

It is necessary to find out the cause of prolonged lacrimation. This may be a violation of lacrimal drainage (displacement of the lacrimal punctum, obstruction along the drainage system - from the lacrimal punctum to the nasolacrimal canal). Tearing increases when exposed to cold and windy weather and decreases in a warm, dry room. After clarifying the patency of the lacrimal punctum, probing and washing of the nasolacrimal ducts in the clinic at the place of residence is indicated. The choice of treatment depends on the level of obstruction. In case of obstruction of the nasolacrimal duct, surgical treatment is indicated - the creation of an anastomosis between the lacrimal sac and the nasal mucosa (dacryocystorhinostomy).
Tear hypersecretion may be associated with inflammation or damage to the ocular surface. The treatment is therapeutic. Sagging of the lower eyelid can lead to disruption of the tear suction mechanism and tear flow. Treatment depends on the cause of lacrimation and is prescribed individually by the ophthalmologist.
- What can cause fusion of the nasolacrimal duct?
- In adults - chronic rhinitis, idiopathic stenosis, nasoorbital trauma, surgical interventions on the nose and sinuses. For reflex lacrimation (bright sunny day, strong wind), wearing sunglasses is recommended. In case of inflammation or damage to the surface of the eye, drops are prescribed.
- How long can they be buried?
- The duration of instillation is determined by the doctor.

- Why do people have different visual acuity in their eyes? After all, we look at the world with both eyes with the same load, why then does one eye see better and the other worse?
Tatyana, Logoisk

The reason for different visual acuity may be different refraction of the eyes. There are emmetropia (commensurate refraction), myopia (nearsightedness), hypermetropia (farsightedness). For example, one eye may be nearsighted, and the other eye may be farsighted. Other options are also possible. As a result, one eye sees better at distance, the other at close range. Refraction is checked at an appointment with an ophthalmologist. If necessary, glasses are prescribed.
- Can this happen from birth?
- It can be either an acquired or a congenital condition. For example, with school myopia, the refraction can be the same or different in two eyes. The question of prescribing a correction is decided individually.

- Does working at a computer cause vision impairment? And how much time can a child spend on a computer?
Maria, Minsk

Of course it provokes. Prolonged visual work at close range, work at a computer contribute to the development of myopic refraction (myopia). Overstrain of accommodation when working at close range contributes to the formation of myopic refraction. Therefore, it is advisable to limit the time you work at the computer. This is especially true for children. For them, the maximum duration of work at the computer is 0.5 hours per day.

- I have mild astigmatism, I wear reading glasses. I am planning to have laser correction. I would like to ask a specialist whether I need to do this or not?
Alexander Vyacheslavovich, Minsk

For direct and reverse astigmatism up to 2.0 diopters, spectacle correction helps well. A conclusion about the need for laser refractive surgery can only be given after a complete examination by an ophthalmologist.
- Are there effective methods for treating cataracts without surgery? I heard from someone (or maybe on TV) that cataracts are washed out with water? How is that?
- Cataract is clouding of the lens. In the initial stages of acquired cataracts, vitamin drops are prescribed to improve metabolic processes in the lens. Surgical removal of the cloudy lens is the main treatment for cataracts. There are no other effective treatments. Phacoemulsification is the most preferred method of cataract extraction (removal). The technology involves the destruction of the lens nucleus by mechanical vibrations of ultrasound. “Washing out cataracts with water” refers to Alcon's AquaLase technology. This is hydrodynamic destruction of the core due to the injection of a BCC solution heated to 60 degrees Celsius with a frequency of 50 pulses (injections) per second. The chemical composition of the solution closely matches the intraocular fluid. The technology is less effective than mechanical crushing of the kernel using ultrasound vibrations, since the inhabitants of Belarus are characterized by denser kernels.

- My eyes are red. This is especially noticeable after taking a hot shower. What could this be connected with?
Oleg Nikolaevich, Borovlyany village

There is no clear answer. You may have an allergic reaction to water, shampoo, or soap. We are surrounded by a large number of allergens - household, food, medicinal, airborne. The cause of red eyes can be chronic blepharitis and conjunctivitis. Redness of the eyes and deterioration of visual performance in the evening can develop with dry eye syndrome and prolonged work at the computer. A consultation with an ophthalmologist is indicated to determine the need for treatment.

- My cornea and the edges of my eyelids turn red, especially in the cold season. Outwardly, it looks like I just cried. In addition, upon closer examination, some bubbles (pimples) are visible at the base of the eyelashes, but the eyelids do not itch. I visited ophthalmologists many times. They say it's some kind of tick. They prescribe treatment, but at the same time they say that treatment is useless. And my eyelashes have thinned and become uneven. Maybe they'll fall out completely. What to do?
Lyudmila
(question from the site [email protected])

Prepared by Lyudmila SHESTOKOVICH, photo by Dmitry ELISEEV, ZN

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Laser correction is a highly effective correction of many vision defects. It takes no more than 15 minutes, and local anesthesia is sufficient for its implementation. The cornea of the eye bends back. Laser beams are directed to the selected area, which dry out unnecessary parts of the eye tissue. At the end of the procedure, the folded skin is placed in place. The cornea regenerates in a few hours, sometimes you will have to wait a day for complete healing, but this process is painless.

Laser vision correction: pros and cons

Laser correction methods

There are several ways to carry out laser correction. Each patient can determine the optimal one for himself, but in many cases the doctor helps with this.

Way	Description
PRK. LASIK	The outer layer is not used during this procedure. Moisture evaporates during bending, that is, it affects exclusively the middle layers of the cornea. During the operation, it is necessary to use a minimum number of instruments. There is a special device for grasping the edge of the eyelid and raising it to the required height with parallel bending. After the middle part of the cornea is completely released, the doctor uses a laser to correct it, evenly directing the rays from a special device
LASEK	This method solves a rather complex patient problem. If a person with vision pathologies has a too thin cornea, then LASIK surgery is very dangerous. This alternative method guarantees greater security. During the operation, the surgeon acts on the epithelial layer. In this case, a flap of epithelium is necessarily placed on the upper part of the cornea. This method is safer, but the recovery period from it may be longer. This method is currently very common, as it is relatively safe and universal. If such an operation is done correctly, a positive effect occurs in most cases.
Epi-LASIK	This operation is an excellent solution for those for whom LASIK was completely prohibited due to indications. First, a certain layer of epithelium is completely removed from the surface of the cornea, and then they begin to act on it. The surgeon’s tasks include dissection and separation of part of the epithelial flap. After surgery, all patients complain of discomfort, but the recovery period passes quite quickly. Many note excellent results despite the fact that the cornea remains completely intact
SUPER LASIK	This procedure is distinguished by the use of ultra-precise technologies. During the operation, the surgeon grinds the cornea, and all movements are made according to information that comes from a specially designed analyzer. In case of poor vision, there are always distortions in the optical system, and it records and transmits to the doctor data on exactly how it should be corrected. This method is the most accurate, so at the moment it is used in the most difficult cases
FEMTO-LASIK	A special femtosecond laser creates a corneal flap. The use of a mechanical catheter during the operation is not necessary, and there is also no need to use blades, which makes the procedure less traumatic and relatively quick

There is a wide range of positive aspects for which patients invariably prefer the LASIK technique:

Quick and painless achievement of results t without significant physical and psychological costs on the part of the patient.
Increased surgical precision, minimal risk of involving eye tissues that do not need correction. The laser beam is under the full control of a competent doctor, who moves it through a special computer, so the possibility of an error or any unforeseen negative consequences is minimized.
Relatively low invasiveness of the operation. The entire procedure is carried out without the use of dangerous techniques, so even small incisions are not required. The operation is completely bloodless, which automatically indicates that there is no need for sutures.
The effect is only on the cornea, more precisely, on its middle and outer layers, that is, the effect does not penetrate to the layers of eye tissue that are dangerous for injury.
Individual analysis of all factors and communication with the patient. For any refractive deviations from the norm, laser correction can be performed to eliminate any pathologies.
The result always shows great, often maximum efficiency, also ensures its durability. At the moment, there is no more comfortable method than laser correction. All other manipulations are more traumatic and have a low degree of danger, including unforeseen complications.
The rehabilitation period is completely painless, that is, the patient practically does not see the consequences of the surgical intervention, since the impact is minimal. The recovery is completely painless; to fully appreciate the positive effect, you just need to wait a few hours after the operation. At this time the patient will be completely healthy.
The operation can be performed at one time on both eyes.
Affordability. If a person has minor pathologies, then everyone can afford to improve their vision using laser correction. In difficult cases, the price rises significantly, but does not amount to too large numbers.

Video: Laser vision correction. Types of 3D operations

Some ophthalmologists directly or indirectly criticize vision technology. There are contraindications that cannot be ignored, therefore, before the operation, each patient is forced to become familiar with them:

Myopia in a developed form.
Inability to wear contact lenses due to irritation in the eyes.
There is a huge difference in diagnosing refractive errors for each eye. The difference should be no more than 2.5 diopters, otherwise the operation cannot be performed.
Progression of vision problems that are the result of diagnosed forms of disease. It is especially dangerous to undergo laser correction for those people whose astigmatism or similar disorders have clearly progressed over the past year.
There is a diagnosis of keratoconus. The cornea is thinned, while changing its own contours. Surgery cannot be performed, but this condition should not be confused with an initially thin cornea from birth. In this case, surgery is also undesirable, but in order to make sure of this, you should visit a professional doctor, undergo an examination and diagnosis of your eye condition.
Age up to 18 years. A professional doctor will not allow laser correction to be performed on a child that does not have strict indications in a particular case. It should be remembered that sometimes there are situations in which this procedure will make the patient’s life much easier. In this case, a positive decision is made regarding the operation even for a younger patient.

Sometimes it is not advisable to perform laser correction

There are cases in which the use of a laser can leave negative consequences. The laser has an indirect or direct negative effect if the patient has one of the following characteristics:

During pregnancy or lactation, even in the early stages.
Has severe diseases of a chronic nature. This group includes AIDS, so such patients are immediately eliminated, but this is not the only disease that limits the possibility of being present in a specialist’s office. Such features include allergic reactions on the skin or susceptibility to their unexpected occurrence. Signs of psoriasis, neurodermatitis, and eczema are especially dangerous. It is also unacceptable to use a laser for endocrine disorders such as diabetes.
Mental disorders, not only persistent syndromes, but also occasional exacerbations.
Severe eye pathologies, especially cataracts or glaucoma. This is especially dangerous in the first stages of these diseases, since they are not always diagnosed on time, and the laser can lead to a worsening of symptoms and a strong development of pathologies.
Tendency to alcoholism or drug addiction, presence in the blood of one of the following substances in a large dose.
Predisposition to the formation of keloid scars, which may not only not improve vision, but also lead to persistent deterioration and discomfort in the eyes.
The cornea is too thin.

If a person plans to undergo laser correction, it is advisable to carry out this activity between the ages of 18 and 40 years. Until they reach adulthood, they have no right to do it. After 40, there is still a chance to carry out the procedure, but at this age it can be most dangerous.

Video: Contraindications to laser vision correction

Flaws

With the help of surgery, it is impossible to eliminate the cause-and-effect relationships that led to persistent deterioration of vision. If they are then not identified in a timely manner, further vision loss may occur, which will cause problems and reduce the effect of the previously performed laser correction.
Sometimes doctors perform the procedure too quickly. As a result, the patient receives a result that is insufficient, but it is no longer possible to correct or improve it.
If, after the procedure, you use your vision again for a long time and do not give yourself rest after prolonged exercise, the acuity of image perception may fall again, which will nullify all the positive results, and the person will again find himself alone with those problems from which he hoped to recover forever.

What can happen after surgery?

It should be remembered that laser correction in the standard version does not provide for the presence of severe pathologies as complications from the procedure. Some patients still complain of significant aggravating factors that prevented them from enjoying the positive effect of the operation for a long or short time:

Factor	Description
Long-term epithelial healing process	Doctors believe that this process in a healthy person should take place completely within a few hours. In some cases, people report pain and other characteristic signs of damaged epithelium for several days after the procedure, which prevents people from working or pursuing their hobbies
The emergence of various light and color effects	Most people suffering from this contraindication note that flies begin to fly in front of their eyes, and this phenomenon does not go away quickly. Sometimes people complain of glare, which can be compared to temporary blindness from bright light. In everyday life, this can happen when driving a car when exposed to headlights or mirror surfaces from an oncoming vehicle.

These unpleasant consequences are guaranteed to pass, and usually do not leave other negative feelings or consequences. In order to speed up this process, you just need to carefully listen to the advice of the ophthalmologist, and if necessary, come to him for an appointment and voice your own problem.

Sometimes people who have undergone the procedure wish that the procedure took either too long or too quickly, but a layman can find out this only after he can evaluate the result. To correct such negative effects, you will have to use lenses, but a more effective method is a repeat operation, which is usually performed immediately after the disappearance of other negative consequences from the first, if the permission of the attending physician is obtained.

How to choose the right clinic and doctor?

If an ophthalmologist promises from the outset that he is guaranteed to achieve a maximum result of 100% with the help of surgery, he is definitely deceiving. It is impossible to say for sure whether he will be able to perform the operation normally, but a doctor who misleads his patients should not be trusted. It should be remembered that not a single doctor in the world can guarantee a strictly positive effect from laser correction. With any intervention by a surgeon, there is a risk of unpleasant consequences for the patient, so in medicine the concept of an unconditional guarantee cannot be accurately applied.

When a person first comes to the chosen medical institution, he must take the time to ask the workers for his license. If the clinic is reliable enough. This document is located in the hall in a fairly visible place or hung in the center of the hall. You need to pay attention to its expiration date, since an expired license may indicate that the activities of surgeons are not properly monitored. The license contains a clear and complete list of all services that the clinic can provide, that is, the doctors who work in it. It is necessary to carefully check these aspects, since in some cases doctors undertake laser correction or treat children without having the legal right to do so. In this case, if complications or unpleasant consequences occur, it is very difficult to hold the doctor accountable.

It is advisable to additionally check the availability of an Accreditation Certificate. This document confirms that the clinic staff is sufficiently competent. This document is especially valuable as it is issued by the Ministry of Health only after a thorough review of all aspects of the medical services provided in a particular hospital. If the institution has only reputable specialists with extensive experience and an excellent reputation, the level of accreditation will have the highest score.

When doctors are interested in a patient's health, they not only take a general history, but may order an examination to rule out harmful pathologies that would prevent laser vision correction from being performed safely. The work of an ophthalmologist when performing such an operation is as follows: to ensure maximum effect, and in particular, to prevent complications.

When you come to see a doctor, you should visually assess the quality and age of use of his equipment. If the clinic has a high rating, the use of old devices or equipment is excluded. which are not kept in proper condition. It should be noted that the newer and more effective the device, the greater the success of the operation that can be obtained.

If the doctor is highly qualified, he will warn the patient in advance. what kind of negative consequences can happen to him if he decides to carry out the procedure. Sometimes specialists give time to think, especially in cases where the risk of complications is greater than in other cases.

To correct severe vision pathologies, it is often enough to undergo laser correction. This short procedure can relieve a person from the negative manifestations of blurred or improperly focused eyes. This method also has contraindications, however, if the procedures are performed correctly, everyone has the opportunity to avoid complications and undergo a recovery period in the shortest possible time. To get the maximum result from laser correction, you should not only carefully select a clinic and a doctor, but also follow all his recommendations before and after the operation.

I had laser vision correction in October 2014, and this, of course, became the most significant event in the conscious period of my life. I went to the operation for several years - rather, I prepared mentally: I weighed all the pros and cons, collected information, looked for a surgeon.

My vision was not that bad: left eye – 2.5; right – 2.75. In addition, this was also accompanied by slight astigmatism. With my vision, the picture of the world cannot be called a silhouette, but faces, for example, were clearly distinguishable only at a distance of a meter. And the license plates of cars and buses passing by, naturally, were no longer visible.

Few people know that the beauty Julianne Moore had vision correction

Who is suitable for laser correction?

Being a perfectionist by nature, I managed to get irritated with my eyesight. Anyone who suffers from the same “symptoms” will understand me. The body rejected the lenses - such is the physiological feature of my huge eyes. Glasses, especially when driving, are “wonderful”, constantly fogging up and zero visibility on the sides.

Laser correction is not suitable for everyone, and to know for sure, you need to undergo a full examination in the clinic.

It happens that poor vision is not only heredity, but also a predisposition to constant deterioration. In this case, the correction is a temporary phenomenon, and over the years, vision will still decline.

Therefore, laser surgery is a salvation for those who have “stable” poor vision. Another reason to refuse surgery to a patient is a thin cornea, since the correction is carried out by cutting off part of the upper layer. The worse your vision, the, excuse me, the larger piece they will cut off from you. Since no deterioration or pathologies were detected in me, I confidently went for the operation.

Megan Fox, who is nearsighted, prefers to wear glasses

Modern correction methods are Lasik and Lasik-ZET technologies. They differ in the method of cutting. In both technologies, the operation is non-contact, only the laser works. But in the first case, the laser is something like a knife that cuts the cornea smoothly, as if you were cutting off a piece of an apple. In the second case, the laser works pointwise, cutting in a programmed manner - taking into account anatomical features and the presence of astigmatism.

Day of operation: step by step story

On the day of the operation, I was openly shaking - from anxiety, excitement, but more from the anxious anticipation of a miracle, like on the eve of a birthday in childhood. In the preoperative room, my eyes were disinfected, a cap was put on, and anesthetic drops were dropped into my eyes, which lasted for about half an hour. It is for this reason that the entire process is absolutely painless. Doctors explain for a long time and clearly that laser correction is not just an ordinary operation where you passed out, woke up and ola-la - you see. Any patient has to work under the strict guidance of a surgeon; you cannot count crows. Also, you should not get lost and panic, because the entire correction process will be instantly stopped.

Jennifer Aniston - the owner of poor vision without correction

While I was being prepared, the doctor-engineer was adjusting the laser device to the parameters of my eyes. The operating room itself looked more like some kind of laboratory with a huge laser contraption above the table and a bunch of other miracle technology. Out of fear, I no longer remember how many assistants my surgeon had, but there were a lot of people. They shoved a soft dog into my hands for better concentration, explaining that a person needs to direct his fear somewhere. And it seems to me that during the operation I not only strangled her, but also tore her paws.

The operation itself is not long at all, taking about 10 minutes for each eye. But this time, naturally, seemed like an eternity to me. Spacers are placed on your eyes - you blink reflexively, but your eyelids do not close. And they constantly pour a very large amount of water into your eyes.

The surgeon comments on his every action, and you listen and work: “we look up, we see a red dot - we freeze, no, we don’t take our eyes away from fear, but look!”, “Now the laser will start working, we’ll hear a crackling sound,” etc. The laser works for 10 seconds, after which a flap is separated - a part of the cornea, which is removed temporarily by the surgeon himself, and after treating the surface, it is attached back. And what a joy it was to hear - “The operation was successful!”

Feelings after surgery

The first day after the operation, the feeling of a veil before the eyes persists.

Everything is as if in a fog, but even through this fog you suddenly joyfully notice that you see the hands on the clock hanging on the wall, you see the faces of the doctors in the distance, and you want to look, examine and study.

For half an hour after the operation I “rested” in a massage chair - it is forbidden to close your eyes, you need to blink and look a lot. At the same moment, the anesthesia begins to wear off. The sensations after surgery depend on the person’s sensitivity threshold. I always thought that I was low, but that was not the case. Within an hour I wanted to cry loudly. No, it wasn’t a feeling of sand in my eyes or irritation, personally it seemed to me that these very eyes had been gouged out of me, and this pain would never go away.

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Now about what not to do on the day of surgery. You cannot bend over, lie or sleep on your side, touch your face above the chin, and even more so, rub or touch your eyes. All these actions can lead to displacement of the flap, which in the first day is held “on snot,” which means that the whole process will have to be repeated. With any displacement, vision immediately disappears, so it is simply impossible not to notice it.

You are also not allowed to watch TV, use gadgets, or read. Bright light is painful. The only thing that saved me was the player in my ears and endless conversations with my mother on the phone. I also walked around the apartment like a zombie from corner to corner in order to somehow distract myself. Doctors advise you to sleep after the operation, but this advice seemed ridiculous to me, because with such pain it is simply impossible to sleep. During the first day, the eyes constantly “cry”. In fact, this is an ordinary open wound, and until it heals even a little, the sensations remain unchanged. My pain subsided 6 hours after the operation, and I immediately fell asleep.

One day after surgery

But my morning was truly enchanting! I opened my eyes and saw everything! The neighboring house, consisting of bricks, the color of the curtains of the neighbors opposite, dots on the ceiling that previously seemed white. The world in one second became like a bright fairy-tale cartoon that had passed by me earlier. The unpleasant sensations did not go away completely, but they were so tolerable that I didn’t even notice them anymore. And they just looked like “something got in the eye.” A doctor's visit was scheduled for the day after surgery, and examinations showed that we had achieved a result of one in both eyes. I was happy.

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In the first days you can’t drive or wear makeup, in the first month you can’t play sports, go to the sea, visit swimming pools, baths, saunas, beware of winds and sand, in the first 2 weeks you can’t wear sunglasses all the time. Antibiotic drops are also prescribed for the eyes, and additionally, vitamin drops for dry eyes. In all other respects, there are no changes, and life is gradually returning to its usual course.

Two years after surgery

We can talk about stability only a year after the operation; now almost two have passed. To this day, darkness still causes discomfort for me. As the doctors explained, in the dark the pupil expands and coincides with the edges-sutures of the flap, which, perhaps, have not yet resolved and have not become completely transparent. Therefore, it is difficult to drive at night due to the pixelated effect of vision that occurs, especially when oncoming cars are blinded by their headlights.

My eyes have become more prone to redness - most often the whites of my eyes are not perfectly white. Sometimes painful effects occur - however, only in one eye and they still look like something has got into the eye and is bothering you. I noticed that such sensations only occur when I haven’t slept much. Well, and most importantly, after another vision test, it turned out that one eye did not reach “one”, but had an indicator of -0.8.

But despite this, even now I realize that I would go through everything again just to feel this world the way I see it now!

Some people see this world brightly and clearly, but for others everything around is unclear and blurry. Maintaining vision is becoming increasingly difficult. Today, about 4 percent of first-graders have glasses, and by the time they graduate, almost 40 percent of schoolchildren wear glasses.

How to stop this?

The main factor in the massive deterioration of vision is increased visual load. We spend too much time in front of computers, televisions, and all kinds of monitors. Computer syndrome has not yet been identified as an independent disease, but things are moving towards this. The vision situation is aggravated by environmental and nutritional imbalances. As a result, the number of young people whose vision is failing is growing exponentially.

Evgeny Mikhailovich Molokotin, ophthalmic surgeon:“There is such a thing as visual hygiene, which we have all conveniently forgotten about. That is, every hour of visual work we simply must take a break for at least 10–15 minutes. During this period of time, you can do well-known exercises: rotating your eyes clockwise and counterclockwise, looking at the most distant objects, standing by the window, etc. It's quite simple, but this is the essence of visual hygiene. In addition, this creates a culture of working with the main destroyer of our vision - the computer, from which in the near future we are unlikely to be able to protect ourselves in any other way.”

What do we choose: glasses or laser vision correction?

Just a hundred years ago, glasses were worn mostly by older people. Today, the lens and frame industry is thriving with the young and trendy. True, a stylish branded frame will cost you an amount approximately equal to the average salary or the cost of a small computer. Well, if you add the same amount, it’s quite possible to pay for laser vision correction surgery. Many people prefer the latter. Laser vision correction is at the peak of its popularity today. More and more people with poor vision are ready to go on the operating table to say goodbye to boring glasses forever.

Evgeny Mikhailovich Molokotin, ophthalmic surgeon: “Today, laser correction is in great demand. Year by year the number of myopic people is growing. Why go far for an example: there are four of us in the office, three of us are myopic (laughs). Laser correction is carried out, of course, not only for the purpose of correcting myopia. This method allows you to correct any refractive error: myopia, hypermetropia, positive vision, and astigmatism. These can be either separate nosologies or combined with each other.”

The method is deservedly popular. The operation lasts on average 15 minutes, and within an hour and a half after it you can see the world in all its glory!

Evgeny Mikhailovich Molokotin, ophthalmic surgeon: “The operation goes quite quickly, but the time it takes largely depends on how the patient behaves: someone approaches it calmly, and then ten minutes is enough, someone is more nervous and the process drags on. In any case, the procedure itself, in terms of complexity, belongs to the category of cosmetic. Basically everyone is afraid of pain. In fact, there is no pain, because local anesthesia is administered before the operation, while the person is conscious. That is, the situation is approximately the same as at the dentist - it’s scary, but it doesn’t hurt.”

True story

Andrei put on glasses in the fifth grade and wore them for no less than 25 years. Thoughts about laser vision correction have been around for a long time, back in the nineties. But then it was very expensive, and such an operation was performed only in Moscow. As a result, Andrei decided to undergo surgery only a couple of years ago.

My vision deteriorated quite dramatically, and by the end of school I had minus eight dioptres. After this the situation stabilized. Doctors say that the progression of myopia stops when the period of active growth of the body ends. Lately it has simply become difficult to wear glasses: my eyes get tired and the lenses make me red. I decided to have surgery.

Before the operation, Andrey’s detached retina was additionally “welded”, and two weeks later he was ready for the main procedure. The operation went well, the result was brilliant: vision was restored by 100%.

The operation itself took about two minutes per eye. It’s a rather unpleasant procedure: it’s psychologically difficult to survive when your eye is invaded with some kind of instruments. But in general, everything is tolerable: an expander is installed to fix the eye, a piece of the upper layer of the eye is removed, and then a small part from the lower layers is evaporated with a laser. Then you sit with your eyes closed for about an hour, and when they are allowed to open, you see almost everything. Honestly, the feeling is fantastic, because you begin to see the world in a completely new way, in the smallest detail. And this despite the fact that for half of my life I perceived everything through a veil, in a kind of fog, and did not notice some details at all.

Andrey was more than pleased with the result immediately after the operation. But after some time, some unpleasant nuances emerged.

Now a year has passed, my vision has dropped to minus two (initially it was minus eight). This, of course, did not make me happy, but doctors promise that in 5-10 years my vision will return to one hundred percent due to physiological age-related changes. Another unpleasant feature was evening and night vision: halos appeared around light sources, a very unclear “picture” at night. There were no such problems with glasses, and I could see well at night. This still annoys me and prevents me from driving at night. There is one more small nuisance - sometimes your eyes dry out. This didn't happen before. Nowadays, if you work at a computer for a long time, it hurts even just to close your eyelids. If you apply a moisturizer, everything is fine.

Complications after surgery - the rule or the exception?

Of course, any surgical intervention in the delicate balance of the body is fraught with complications. To minimize risks, carefully choose a clinic, look for “your” doctor, find more information about the technique, possible complications, the attitude and actions of the clinic if they arise.

In a word, try to find out as much as possible and only then weigh the pros and cons. Please note that the result of the operation directly depends on the experience, qualifications of the surgeon, as well as on the quality of surgical equipment. And, probably, the only correct decision is not to rely on chance.

Evgeniy Mikhailovich Molokotin, ophthalmic surgeon: “Any surgery involves complications. Do not believe the surgeon who tells you that complications never happen - this is not true, you understand. But fortunately, laser vision correction is a superficial operation, as they say, minimally invasive, so complications are minimal. And certainly, there are no complications that would lead to loss of vision. Moreover, we are not formalists. Even if a person had surgery with us ten years ago, we are always ready to help him if the need arises.

However, it is worth remembering that vision correction surgery does not completely solve the problem, since it does not change the eye itself, but only corrects the shape of the cornea. That is, if you have a minus, then after laser correction you still remain a myopic person. After all, what is myopia? This is an abnormal ratio of the refractive power of the cornea to the length of the eye. If the eye grows larger than necessary in relation to the cornea, you become nearsighted. And if this distance is too small, you have positive vision. That is, your eye has already formed according to these parameters. There is no way we can radically change it through surgery. We just change the shape of the cornea and that's it. But the eye remains myopic. Therefore, all the restrictions that are recommended for myopia: baths, saunas, parachute jumping, weight lifting - do not lose relevance even after surgery. For preventive purposes, I advise everyone to undergo an examination with an ophthalmologist twice a year.”

To do laser vision correction or not to do it? The total probability of complications after laser vision correction is about two percent, but nevertheless, no one wants to fall into this fatal number. In addition, doctors can only recommend such an operation for you, but you will have to make the decision yourself! Therefore, contacting a surgeon should be a carefully considered and reasonable step. If you wear glasses or contact lenses comfortably and they don’t tire you, then you probably shouldn’t make a problem out of it. Why do you really need unnecessary complications? Take care of yourself.

Let's look at the most popular myths about vision correction: who should never have surgery, how to choose the right clinic, and what you need to do to maintain good vision for a long time.

Vision correction surgery is becoming more and more popular every year: it can be done in almost any clinic, prices for the operation are becoming more affordable, and the recovery process takes only a couple of days.

But, despite the popularity and general availability of the procedure, many are still afraid of it, since reviews and information on the Internet vary, and no one wants to risk losing their sight forever. “Reedus” decided to talk with Igor Aznauryan, Doctor of Medical Sciences, refractive surgeon at the LaserCorr clinic, who talked about the most popular myths about vision correction.

What modern vision correction technologies currently exist, and which one is better to choose?

The first laser correction was carried out in 1985, and today there are many techniques that allow laser correction to be performed on people of any age for various indications. It is precisely this multitude of techniques that confuses a person who decides to undergo laser vision correction.

There are two main groups of operations - PRK (photorefractive keratectomy) and LASIK (laser assisted keratomileusis). All other names of laser interventions are minor varieties and modifications of these operations.

The main difference is the corneal processing technology. The choice of laser correction method should be determined by the surgeon, and this choice is determined by the structure and characteristics of the cornea and the degree of myopia, hyperopia and astigmatism of the patient, and not by his desire.

For example, LASIK can be done for thick corneas, PRK and Super Lasik are preferred for thinner corneas. One of the new techniques is the SMILE technology. Some ophthalmologists present it as the most advanced and least traumatic. In fact, the high price of SMILE is completely unjustified, and the price-quality ratio leaves much to be desired.

Thus, SMILE does not correct farsightedness and high degrees of astigmatism, which occur in a fairly large number of people, and for them the only possible solution is LASIK (for thin corneas - PRK). There are also problems with the accuracy of the operation when performing SMILE for high degrees of myopia.

One of the most modern technologies, but possibilities for laser correction, is the use of medicated sleep. Initially, this option was planned for children, but in reality, many adults want to “sleep through” the procedure. And modern technologies provide this opportunity.

Are there any contraindications? Who should not have vision correction?

There are not many of them. This is the presence in a person of cataracts, glaucoma, pathology of the retina or cornea and general diseases (tuberculosis, inflammatory diseases, tumors, infections). With a compensated form of diabetes, laser correction can be done; with an uncompensated form, diabetes is a contraindication to laser correction.

Pregnant and lactating women should postpone correction until the end of the breastfeeding period. Children with progressive myopia should also not undergo laser correction, at least until the myopia stops increasing within three years. But for children with congenital myopia that does not grow, it is quite possible.

Theater - from the hanger, correction - from diagnostics

But what to do if you do not understand medicine, and are afraid that the clinic will “fool” you or choose the wrong solution. Igor Aznauryan compared vision correction surgery to a theater where everything starts with a hanger, so at the very beginning it is worth undergoing a vision diagnosis.

It is very important for the success of the operation to determine as accurately as possible the individual parameters of the patient - the shape of the cornea, its thickness, visual acuity, intraocular pressure and many other parameters. Also pay attention to the equipment on which the correction will be performed, whether the doctor has a certificate, whether laser correction is the clinic’s specialty or whether it is done together with other, non-core procedures, Dr. Aznauryan told Reedus.

At what age is it best to have surgery?

As for age, modern technologies make it possible to have good vision at any age, and when deciding when to carry out correction, we rely solely on the patient’s diagnosis.

When it comes to children, we often perform laser correction for medical reasons. For diseases such as strabismus, amblyopia, anisometropia, clouding of the anterior layers of the cornea, laser correction is therapeutic in nature, and is often the only non-alternative method of radical effective treatment. In addition, by helping a child get rid of glasses in time, we open up wide opportunities for him to have a fulfilling childhood life.

Adults most often resort to laser correction to remove glasses, and the most popular age group is 20−40 years. And the most “popular” diagnoses are myopia and astigmatism. People want to lead an active lifestyle, play sports, dive, run in the morning, jump with a parachute, without regard to the need to wear glasses or contact lenses.

At an older age, a person may experience presbyopia (age-related farsightedness), which occurs in all people with normal vision over 40 years of age.

Many people are interested in whether it is possible to perform surgery on nulliparous girls? I sometimes tell my patients that the eye is not a reproductive organ. Women who have not given birth can undergo laser correction. It does not cause visual impairment after childbirth. Problems during childbirth can arise due to poor retinal health, which often occurs in nearsighted people. Therefore, before laser correction, it is necessary to check the condition of the retina and, if necessary, strengthen it, the ophthalmologist shared.

Cons of the operation

Despite the majority of positive reviews from “former glasses-wearers,” sometimes you come across stories where people complain that the operation was painful, or that poor vision returned quickly. So are there any obvious consequences of vision correction, or are negative reviews the exception?

The patient may experience discomfort in a matter of days, says Igor Aznauryan. It is connected with the fact that the usual way of life is somewhat disrupted - water should not be allowed to get into the eyes, in the first day you need to sleep on your back, limit visual stress for a week, put drops in your eyes, women should not use decorative cosmetics.

Dry eye syndrome may worsen if the patient has not received treatment first. The entire rehabilitation period lasts a month, after which all restrictions are lifted, namely, do not lift weights, do not engage in extreme sports, do not go to the bathhouse, and do not drink alcohol.

If a patient undergoes laser correction from a competent specialist and follows all the doctor’s recommendations during the rehabilitation period, then the patient will be provided with excellent vision for life, Aznauryan concluded.

Typically, vision correction operations are performed once, which provides the patient with excellent vision for several decades, but sometimes such an operation is performed repeatedly.

In rare cases, some time after laser correction, a second stage of additional correction of the refractive result is required for high degrees of myopia, farsightedness and astigmatism. This occurs even with the latest laser vision correction equipment and is due to the physical properties of the cornea. Therefore, we always warn patients in whom such an effect is possible about the possible need for repeated intervention.