Eye surgery: treatments and prognosis

Although varying degrees of vision loss are very common and caused by a variety of factors, surgery can now be used to correct many of these problems. But at the same time, you need to be careful any time you deal with your eyes and vision, so be sure to consult an eye doctor before making a decision.

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LASIK

LASIK, short for laser-assisted keratomileusis in situ, is the most common type of refractive eye surgery to treat a range of vision problems, including:

However, the procedure cannot reverse age-related near vision (presbyopia). But, if a person with presbyopia wishes to undergo LASIK, they can go for a modified version of surgery called “monovision,” in which one eye is corrected for distance and the other to see things nearby.??

Standard LASIK

Standard LASIK is an outpatient surgical procedure that uses an ultraviolet laser to remove a thin layer of the cornea, reshaping it in the process, allowing light rays to focus more clearly on the retina.

The procedure is performed using anesthetic eye drops while the patient is awake and takes about 10 to 15 minutes for each eye.Although not all patients have 20/20 vision after LASIK, 95% of people report being satisfied with the result.??

Personalized LASIK

Personalized LASIK, also known as “wavefront guided LASIK,” uses a more advanced type of laser to obtain a three-dimensional image of the patient’s eye. The goal is then to use this image to ensure that the corrections made to the patient’s cornea are as precise as possible.??

Lasers are used in more than refractive surgery

Laser surgery and refractive surgery are often used interchangeably, but they are not the same thing.

  • Refractive surgery is the general term for surgical procedures aimed at correcting myopia, hyperopia and astigmatism.
  • LASIK is a type of refractive surgery that uses lasers, but lasers are also used for many other types of surgeries. Likewise, there are methods of refractive surgery that do not involve a laser.

PRK

Refractive photokeratectomy (PRK) is another type of laser surgery used to correct mild myopia, farsightedness, and astigmatism.

Like LASIK, the procedure involves using ultraviolet light to reshape the cornea. The difference is that in PRK the laser reshapes the surface of the cornea while LASIK reshapes the cornea under a flap.

About 90% of people who have had PRK reported having 20/40 or better vision without glasses or contact lenses.??

Cataract surgery

When the lens of a person’s eye becomes cloudy, it is most likely caused by cataracts. Surgery is often necessary to treat cataracts.

Cataract surgery involves removing the cloudy lens of the eye (located in the front of the eye) and replacing it with an artificial, transparent lens.??

About 90% of people say they have seen improvement in their vision after cataract surgery, although this does not mean that a person’s vision will be fully restored. Many people still need to wear glasses or contact lenses after the procedure.??

Use of anesthesia in eye surgery

Because there are several types of eye surgery, with varying degrees of invasiveness, different types of anesthesia are used.

Any eye surgery performed on children typically uses general anesthesia (when the whole body is put into a medically induced “sleep”).

For adults, it really depends on what is involved in the procedure. For example, while some cataract surgeries can be performed under local or topical anesthesia, others require the patient to receive general anesthesia.??

Glaucoma surgery

If someone has had glaucoma and drugs or laser treatments aren’t helping, their doctor may recommend surgery. While glaucoma surgery does not cure glaucoma or reverse any vision loss, it can at least prevent a person’s glaucoma from getting worse and help reduce the pressure in their eyes. If a patient requires glaucoma surgery in both eyes, the doctor will perform each procedure separately.

There are three main types of glaucoma surgery:

Trabeculectomy

This surgery, typically used to treat open-angle glaucoma, involves the surgeon making a small opening in the top of the eye (below the eyelid, so it’s pretty well hidden). The incision allows additional fluid to flow into the patient’s eye, thereby reducing the pressure in the eye.

Although performed in a hospital, the outpatient procedure typically takes less than an hour.

Glaucoma implant surgery

Used to treat:

  • Congenital glaucoma
  • Neovascular glaucoma
  • Glaucoma caused by injury

This outpatient procedure takes one to two hours and involves the surgeon implanting a small tube in the white part of the eye to allow extra fluid to drain out of the eye, lowering eye pressure.

Minimally invasive glaucoma surgery (MIGS)

There are several different types of MIGS, although they all use microscopic-sized equipment and tiny incisions. While this could mean that a patient heals faster after surgery, it can also mean that the surgery is not as effective as that using traditional methods.??

Overall, glaucoma surgery is generally 70-90% effective in older patients.??

Macular degeneration surgery

There are two types of macular degeneration: dry and wet. About 80% of people with macular degeneration have the dry variety, which unfortunately has no effective treatment at present. But the 20% of those with wet macular degeneration, which is the most severe type, treatment options include injectable medication or laser surgery.

During laser surgery, the doctor shines a beam of laser light on the abnormal blood vessels in the patient’s eye, thereby reducing the number of vessels and slowing their leakage.

Although the specific success rate for this procedure is not available, a 2015 study demonstrated that in some cases laser surgery limits the progression of macular degeneration.

Corneal surgery

While some corneal issues can be resolved with LASIK or other procedures, in some cases a person’s anterior and inner corneal layers are damaged, which means they need a transplant. cornea. This is called penetrating keratoplasty (PK), or full thickness corneal transplant.

This involves removing a diseased or damaged cornea from a patient, and then the seam of a transparent donor cornea is sewn in place.??

Considering such factors as the potential rejection of the donor cornea, the success rate of PK varies widely, so it is best for a patient to discuss their specific situation with their doctor.??

Diabetic retinopathy surgery

People with diabetes can be diagnosed with an eye disease called diabetic retinopathy. This condition, which can lead to vision loss, occurs when high blood sugar levels damage the blood vessels in the retina. While there are some non-surgical options for diabetic retinopathy (like medication), two types of surgery are used to treat the condition:

  • Laser surgery: Used to help narrow or seal leaky blood vessels, which can reduce swelling in the retina. In some cases, several treatments are necessary.
  • Vitrectomy: A surgery that removes glassy gel and blood from leaky vessels at the back of the eye, allowing light rays to focus properly on the retina again. It can also include the removal of scar tissue from the retina.

While the results of surgical procedures vary depending on the extent of the patient’s eye damage, between 75 and 98% of patients report significant improvements in their visual activity after recovering from the procedures.??

Vitreoretinal surgery

In addition to treating diabetic retinopathy, vitreoretinal surgery can also be used for the following conditions:

  • Floats and flashes
  • Macular degeneration
  • Macular holes
  • Retinal detachments or tears
  • Retinitis pigmentosa
  • Retinal venous occlusion
  • Retinopathy of prematurity
  • Retinoblastoma

There are a few different procedures that are considered vitreoretinal surgery, although they usually involve a surgeon making three small incisions in the patient’s eye and using them to make necessary adjustments in the eye.??

Again, since there are different procedures considered to be vitreoretinal surgeries, success rates are procedure dependent, although they typically range from around 90-98%.??

Eye muscle surgery

Eye muscle surgery is used to correct eye muscle problems that cause strabismus (also called crossed eyes). Although it is most often performed on children, eye muscle surgery can also be performed on adults.

The procedure involves the surgeon making a small incision in the clear tissue covering the white of the eye called the conjunctiva.

From there, the surgeon will identify the eye muscles that require surgery and then strengthen or weaken the muscle, depending on the specific needs of the patient. The earlier the eye muscle surgery is performed, the more effective it is.??

About 10-20% of adult patients return for follow-up surgery to resolve remaining eye alignment issues.??

A word from Verywell

It is quite normal to be nervous before any type of surgery, especially surgery involving your eyes. If the risks of a procedure outweighed its benefits, the doctor wouldn’t even have brought it up as an option in the first place.

On the day of your surgery, make yourself as comfortable as possible. This may include wearing loose or loose clothing (you will probably be putting on a gown, but you might as well travel comfortably to and from the hospital) or bringing a trusted friend with you (you will also need these to get you back to the hospital). the House).


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