 HYPEROPIA CORRECTION SURGERY
Only recently have safe procedures for the correction of hyperopia (farsightedness) been designed. Some years ago the only possible corrective measures were eyeglasses or contact lenses. At the present moment surgical techniques for the correction of different degrees of hyperopia are very safe and predictable. They have freed many farsighted people from eyeglasses and contact lenses, allowing them to perform their everyday activities and sports without worrying about their vision. The ideal procedure for every case depends primarily on the degree of hyperopia. Most cases are correctable with Laser Assisted In situ Keratomileusis (LASIK). For hyperopia greater than 6 diopters a Phakic Lens or Implantable Contact Lens (ICL) is preferred. LASIK (Laser Assisted In situ Keratomileusis) This is the safest and most effective technique for correction of hyperopia under 6 diopters. It is the most commonly used procedure since 80% of hyperopes have less than 6 diopter hyperopia. LASIK modifies the cornea's refractive power allowing rays of light to adequately focus on the retina. The cornea is the main optical component of the eye. It has three main layers: epithelium, stroma and endothelium. LASIK modifies the stroma's curvature in order to reshape the cornea. An Argon-Fluoride Excimer laser is used to correct refractive errors with this technique. This laser can sculpt the cornea and change its shape. The advantage of LASIK over other laser procedures is that it sculpts the deep layers of the cornea. Press the green button several times to watch the procedure. Who will benefit from LASIK? Most people suffering from hyperopia will benefit from this procedure. Best results are obtained in persons who are not comfortable with eyeglasses or contact lenses and are motivated to change not to depend on these visual aids. Is LASIK safe? In the hands of a good surgeon LASIK is extremely safe if the following criteria are met:
Just as any other surgical procedure, LASIK has risks. One out of a hundred persons operated on with this technique has some sort of complication. In almost every case there is a solution to the problem. Severe complications are extremely rare. How should I prepare for LASIK? No special preparation is needed for LASIK. Your ophthalmologist should make sure there are no associated pathologies which can interfere with the prognosis. An extensive examination of your eyes including pupil dilation (which will determine the exact degree of hyperopia) should be performed. A topography and pachimetry are mandatory since theses exams show the surgeon the exact shape, curvature and thickness of the cornea. With this data he can plan the procedure and discard pathologies not detected in the initial evaluation. What should I do during surgery? During surgery you will be lying on an operating bed specially designed for the excimer laser. The operating microscope is an integral component of the system and will be in front of you at all times. This microscope will continuously generate a bright light. Your face will be covered with sterile drapes and oxygen will be provided under them. You should never touch these drapes. A small device will hold your eyelids open. As the initial cut is performed with the microkeratome you will feel some pressure in your eye. This is due to the suction ring needed to hold the device in place. As the microkeratome creates the flap it must pass directly in front of your eye. For this reason you will not see the light during this step of the procedure. At this point your ophthalmologist will ask you to look at a blinking light inside the laser. At this point you can really help with your treatment: better results are obtained if you hold your head and eye completely still during the laser ablation. Finally the surgeon will put back into place the superficial layers of the cornea and will tell you the procedure is completed. You will occasionally feel cold water over your eye that may even go down your cheek. This is the solution needed to keep your eye properly hydrated. Is LASIK painful? How long does it take? LASIK is performed under topical anesthesia (anesthetic eyedrops). No injections or general anesthesia are required. The patient is awake during the procedure feeling no pain at all. LASIK takes about 5 minutes per eye. Once finished, you will go home without need for hospitalization. What should I do after surgery? It is important not to squeeze your eye the first 5 days after surgery. Normally there will be some foreign body sensation, similar to having an eyelash in your eye. No bandages are required so the patient walks out of the operating room by his own means even though vision will be blurry for 2 or 3 days. Eyedrops will be prescribed for 2 to 3 weeks. Two weeks after surgery you will be able to perform any activity without risk. What results can I expect? The final outcome of LASIK depends primarily on visual acuity with eyeglasses or contact lenses prior to surgery. As a general rule, vision without glasses after LASIK will be pretty much like vision with glasses or contact lenses before LASIK. This vision is usually obtained one week after surgery. Can a second procedure be necessary? LASIK is a very precise procedure, being the laser computer guided. Anyhow, the cornea is a living tissue and heals differently in different persons. Occasionally there is an overcorrection or undercorrection of myopia. If this is the case, a second procedure is indicated in which the cornea is sculpted once again to correct the residual refractive error. This second procedure has no greater risk than the first one. ICL (Implantable Contact Lens) An excellent way to correct hyperopia over 6 diopters is to place a corrective lens inside the eye. These specially designed lenses are better called intraocular phakic lenses. Due to LASIK's low stability and predictabilty in very high hyperopia, these lenses are a good alternative in some cases. The lens is implanted and remains inside the eye with no need for maintenance. It is placed on top of the natural lens of the eye. The lens is foldable, so it will only need a 3mm incision to go into the eye. The long-term safety of these lenses is currently being evaluated. Main risks include transient intraocular pressure elevation and cataract formation. To avoid pressure elevation, laser iridotomies (small orifices in the iris) are required prior to implantation of the lens. Both iridotomies and ICL implant are performed under topical anesthesia (anesthetic eyedrops). Recovery is extremely fast and final visual acuity is achieved one week after surgery. More information about this procedure can be found at the ICL webpage. Clínica Reinoso - Colombia WARNING! The information and/or responses in this eye care education service are not intended to replace consultation with an ophthalmologist. This service contains general eye care information only. Only a doctor can diagnose and treat a medical condition. In NO CASE will Clínica Reinoso or any doctor or sponsor be held liable for any decisions you may make upon reliance of such information. Updated: June 5, 2000 |