Laser vision correction is one of the types of vision corrections that give the patients an opportunity to return to life worth living. Laser correction is the most sophisticated and the most effective way to improve patient vision; after laser correction, its quality is usually significantly higher than wearing eye-glasses or contact lenses, which not only have to be taken care of constantly, but one also has to put up with various related restrictions.

Unlike other eye surgeries, laser vision correction has virtually no medical indications. In essence, it is a cosmetic procedure that helps to improve the quality of vision and life. The ophthalmologist only determines whether such surgery is appropriate for the patient and which of the laser correction techniques will be most effective in particular case. In turn, the final decision on whether to perform laser vision correction should be left to the patient.

How is the laser vision correction done?
Before performing laser vision correction, the patient has to undergo a complex examination of vision system. If after examinations performed, it is concluded that laser correction is not appropriate for the patient, an intraocular lens implantation or non-invasive correction techniques such as glasses or contact lenses are recommended as an alternative to vision correction.

The principle of operation of any laser vision correction is based on the correction of refractive error of vision by careful and gentle reshaping of cornea. The surgery is performed on both eyes and takes about 15 minutes, including preparations. The laser exposure itself lasts only few seconds, depending on scale of the laser correction required.

Laser vision correction is completely painless. Usually, the patient experiences only light touches; sometimes slight pressure on the eyes, and bright light during the procedure. Repeated laser correction is required in very rare cases when the expected result is not satisfactory. These are usually cases where the refractive changes in the eye continue to progress, more often in patients with a higher degree of short-sightedness or far-sightedness. Similarly, the result of laser correction may be affected by the individual features of the healing of cornea.

Laser vision correction techniques
There are several basic techniques and their modifications for laser vision correction, the individual suitability of which is determined by the eye doctor in cooperation with the patient. The most common laser vision correction techniques are:

LASIK
LASIK is the oldest classical laser vision correction technique that is also the most economically advantageous. It is suitable for most patients. During LASIK laser correction, a very thin (≈ 0.1 mm) corneal tissue flap or “cap” is created in the front of cornea with the help of a special mechanical blade or so called microkeratome. During the procedure, this "cap" is lifted or folded (but not completely removed) and further treatment of the exposed corneal surface is performed with laser pulses or ablation (excimer laser ablation of the cornea). After corneal treatment, the flap is folded back; this does not require stitches to heal - to facilitate faster healing of the eye, eye drops for a certain period after surgery shall be used and special protective contact lenses shall be worn for one day.

After laser correction, the patient may experience slight discomfort - a slightly burning, irritating sensation in the eyes, which disappears after a very short time.

PRK (also TRANS EPI-LASIK or EPI-LASIK)
This method is usually recommended for patients for whom the LASIK laser correction is not suitable. The reason is that the cornea is too thin to make a "cap" and perform full vision correction. The surgery is performed in two stages, during which all operations are performed with an excimer laser. In the first stage, the laser removes the corneal epithelium without altering the corneal curvature, while in the second stage, the cornea is "polished".

After laser vision correction applying PRK technique, the recovery period is longer and there is some discomfort about one week while the corneal epithelial cells grow onto cornea. Special protective contact lenses should be worn for faster epithelial regeneration. Complete vision stabilization takes a few months.

FEMTO-LASIK
Laser correction by FEMTO-LASIK follows a similar principle to LASIK, only with the exception that the flap is created with a special femtosecond laser (no blade or so called microkeratome). It is a short procedure during which the stromal tissues of the cornea are processed and separated by short laser pulses. This method requires a greater financial contribution, but is more up-to-date because the femtosecond laser is able to perform the flap removal much more precisely and predictably.

SMILE
SMILE laser correction is the gentlest technique. Like FEMTO-LASIK, SMILE vision correction is performed using a femtosecond laser. The major difference of the SMILE technique is that the flap is not removed during the procedure. Instead, a femtosecond laser creates a smile-like incision or opening of up to four millimetres wide within the cornea (hence name of the method – SMILE), through which a very precise and thin corneal stromal tissue or lenticule (film) is extracted.

After this procedure, vision stabilizes much faster than after LASIK or PRK, and the healing process is also smoother. There is also a lower risk of dry eye or corneal instability. The SMILE method is well suited for the correction of myopia and astigmatism.

How safe is laser surgery?
Thanks to nearly 30 years of experience and development of technologies, laser vision correction has a very high success rate. However, as with any other surgery, in laser vision correction a risk of complications also may present. During laser correction itself, the complications occur very rarely, and they are mainly due to the patient's failure to follow the prescribed regimen. Although they are preventable, patients should always keep in mind that in order to achieve the most effective result of correction, they should strictly follow doctor's instructions.

During the first month after laser correction, minor side effects such as discomfort in the eyes, sensitivity to light and blurred vision may occur. Patients with extremely high levels of nearsightedness or astigmatism may require neuroadaptation - a period of several months as the brain becomes accustomed to new vision.

What should be observed before and after laser vision correction?
Strict individual recommendations are given to each patient, both verbally and in writing, before and after surgery, but there are some essential conditions at each stage of laser vision correction that should be observed by everyone.

Preoperative examination:
One should not wear contact lenses two weeks before arriving to a preoperative consultation with an ophthalmologist or optometrist. During the visit, the patient undergoes both standard and in-depth examination required for the preparation of an individual laser vision correction program. At this stage, the patient is told in detail about the surgery process and the recommendations to be followed during the postoperative period.

On the day of the procedure:
Perfumes, face and eye make-ups are prohibited on the day of surgery. Laser correction is performed at once on both eyes applying local anaesthesia (numbing eye drops). The whole procedure takes about 15 minutes for both eyes, but the laser effect itself takes up to 40 seconds (depending on the type of correction applied). It is very important to follow the doctor's instructions during the procedure and do not make abrupt movements. After the laser correction procedure, it is necessary to stay in the clinic under the supervision of a doctor for approximately two hours.

After laser correction:
On the day after the surgery, the patient must arrive for re-examination. After laser correction, special eye drops should be applied for a certain period of time.
During the first days after vision correction, it is desirable to avoid intense visual stress, while during the first two weeks, when being outdoors, it is advisable to wear sunglasses. Also, do not use eye makeup, and avoid getting dust and water in your eyes. Do not rub your eyes under any circumstances.

The main advantages of laser vision correction
Laser vision correction has a number of advantages; one of the most essential - non-contact effect on the eyes, so that the patient does not feel any pain during the procedure, while the effect of laser correction itself is easily predictable and the long-term results are stable. Additional benefits of laser vision correction:

• Maximum safety and accuracy of the procedure. Modern laser correction techniques are completely safe and gently for patients. Before the vision correction procedure, the patient is given numbing eye drops, but the discomfort resulting from the surgery usually disappears within a few days.
• The most effective vision correction method with successful and stable long-term results. Thanks to laser correction, the quality of vision usually gets significantly higher than with glasses or contact lenses. In addition, laser vision correction does not require a physically or emotionally difficult and long recovery period. After the procedure, vision remains stable for years (provided that other eye diseases are not diagnosed).
• Simple and fast procedure. Laser correction in no way affects the patient's normal rhythm of life. You do not need to take a leave or sick-leave certificate, as the maximum duration of the surgery is 15-20 minutes and the laser exposure is only a few seconds. On the same day, the patient can already go home and return to normal life expecting the gradual stabilization of vision.
• A more comfortable and good life after surgery as the patient is completely relieved of the use of glasses or contact lenses and the related inconvenience and restrictions.

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