There are many different types of eye surgeries. This article focuses on procedures that correct your vision, along with common eye surgeries that treat certain eye diseases.
Refractive surgery refers to procedures that correct your eyesight if it is the result of refractive errors, which include:
LASIK is a type of laser refractive surgery. One feature that sets LASIK apart from other laser refractive surgeries is that LASIK involves the creation of a corneal flap on the surface of your eye, which reduces recovery time and discomfort after surgery. The flap is created by a laser or microkeratome (a special surgical blade).
PRK is another form of laser refractive surgery that delivers comparable visual results to LASIK. However, PRK does not require the formation of a corneal flap. Instead, the surgeon removes the upper layer of tissue in your cornea (epithelium) using an alcohol solution and surgical tools, before applying the laser. As a result, there are some key differences between PRK and LASIK:
These procedures are modified PRK and LASIK techniques. LASEK involves using an alcohol solution to loosen the corneal epithelium and form a thin flap, significantly thinner than that of LASIK.
Instead of alcohol, epi-LASIK uses a mechanical epithelial separator to create a thin flap. Avoiding the use of alcohol preserves more of the epithelial tissue.
Benefits of these procedures include:
Small incision lenticule extraction is a relatively new procedure that corrects myopia. During the process, a laser creates a small disc of tissue within the inner layer of your cornea. Then, the surgeon removes this tissue, called a lenticule, via a small incision on your cornea.
Some surgeons favor SMILE over LASIK because there is no corneal flap involved, resulting in a more stable cornea and less dry eye. Although SMILE may be less invasive, other surgeons feel that more experience with this technology is needed before they can recommend SMILE over LASIK.
In the United States, SMILE cannot treat hyperopia and astigmatism.
Before laser eye surgery was widely available, radial keratotomy was a procedure to correct low to moderate amounts of myopia. RK gained popularity in the 1980s but is now considered obsolete.
During this procedure, the surgeon makes several incisions on your cornea in a radial pattern, similar to bicycle spokes or slices of a pizza. These incisions flatten your cornea to correct myopia. Most people who receive RK cannot have LASIK but may be eligible for PRK if they experience vision changes.
Similar to radial keratotomy, these procedures include making incisions on the cornea to flatten the tissue. Astigmatic keratotomy and limbal relaxing incisions can correct lower amounts of astigmatism and are often performed after cataract surgery or corneal transplants.
The surgeon makes incisions where the cornea is steepest. LRIs are more common than AK. One reason is that LRI incisions are closer to the edge of your cornea, resulting in better vision and less glare.
In modern cataract surgery, these procedures may be replaced with laser refractive surgery or toric intraocular lens implants.
This procedure involves the same steps as cataract surgery. The difference is that these patients do not have cataracts, but rather, their natural lenses are still clear.
During surgery, your natural lens is replaced with a permanent intraocular lens implant (IOL) that corrects your vision. There are many types of lens implants available, depending on your prescription and visual needs.
RLE may be suitable for:
Another benefit of this surgery is that you do not have to worry about developing a cataract when you are older.
Presbyopic lens exchange is a type of refractive lens exchange surgery. While RLE can be performed on younger people, PRELEX focuses on correcting the near vision in people over age 45. Typically, this is the age when people experience presbyopia, which is the loss of ability to focus at near.
The surgeon corrects both the distance and near vision so that you do not need reading glasses or other corrective lenses after surgery. There are a variety of intraocular lens implant (IOL) options:
Unlike a refractive lens exchange, phakic IOLs leave your natural lens in place. This surgery is an excellent option for people with high myopia who may not be candidates for laser refractive surgery.
A benefit of this procedure is that the phakic IOL may be removed later if needed. For example, if you receive a phakic IOL but develop cataracts, the surgeon can remove the phakic IOL before performing cataract surgery.
There are two main types of phakic IOLs:
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Keratoplasty refers to surgeries performed on the cornea. The following procedures correct various refractive errors.
This is a noninvasive procedure to correct mild hyperopia and presbyopia without the use of lasers. Some people undergo conductive keratoplasty to reduce or eliminate the need for reading glasses.
CK uses a probe tip to deliver radiofrequency currents to your cornea, which shrinks the peripheral areas of the cornea. As a result, the cornea steepens in shape, which reduces hyperopia and improves near vision symptoms of presbyopia. CK can be performed after LASIK or cataract surgery if additional vision correction is necessary.
Similar to conductive keratoplasty, laser thermal keratoplasty uses a holmium laser to shrink the corneal tissue, correcting low to moderate hyperopia. Unlike LASIK, this is a noncontact procedure, meaning there is no cutting into the cornea or other direct contact.
Automated lamellar keratoplasty corrects severe myopia or low hyperopia without the use of a laser. Similar to a LASIK procedure, the surgeon uses a microkeratome to create a flap on your cornea. Instead of using a laser to reshape the cornea underneath the flap, the surgeon removes a small disc of corneal tissue before replacing the flap.
Since safer and more reliable refractive surgeries are currently available, not many surgeons perform ALK.
Diabetes causes bleeding, fluid leakage, and abnormal blood vessel growth in your retina, which is the sensory tissue lining the back of your eye. Mild diabetic retinopathy does not always require treatment.
However, more severe cases may require treatment, such as:
Traditional cataract surgery involves a procedure called phacoemulsification. First, the surgeon makes an incision in your cornea. Then, an ultrasound device is inserted through the incision into your eye. Ultrasound waves break up the cataract into small parts before a suction device vacuums the pieces out of the eye.
Laser cataract surgery incorporates a laser to replace some steps of phacoemulsification:
There are several types of treatment for glaucoma, including laser procedures. Laser glaucoma surgery is designed to lower the eye pressure by increasing the amount of fluid draining out of the eye.
The two primary forms of laser treatment are:
Trabeculectomy is another form of glaucoma surgery that lowers eye pressure. During this procedure, the surgeon creates a small flap in your sclera, which is the white part of your eye. This opening serves as a fluid channel.
The sclera is covered by a tissue called the conjunctiva. The surgeon uses this tissue to form a bleb, which acts as a reservoir for fluid draining out of the eye. The upper eyelid hides the bleb so it is not visible to others.
There are two main types of age-related macular degeneration (AMD), dry and wet AMD. The dry form is an earlier stage of the disease, and there are no specific treatments other than nutritional supplements.
Wet AMD is more advanced and causes significant vision loss as abnormal blood vessels start to leak into the macula. Treatment for wet AMD includes:
Intacs corneal implants primarily treat keratoconus, a condition where your cornea progressively steepens and thins out. Because of the irregular shape of their cornea, many people with keratoconus do not see well with glasses and contact lenses.
Intacs improves vision by flattening the cornea to reduce myopia and astigmatism, possibly eliminating the need for glasses or contacts. The implants are two crescent-shaped pieces of plastic that are placed inside of your cornea. If necessary, the surgeon can remove the implants or replace them with thicker implants if more vision correction is needed.
Eyelid surgery, also known as blepharoplasty, is a surgical procedure that modifies the eyelid skin and the skin around the eyes to improve the eye’s functioning and give you a more youthful appearance.
During strabismus surgery, ophthalmologists manipulate muscles around the eye by either loosening, tightening, or repositioning to improve the alignment of the eyes and vision.
Like any surgery, the more extensive it is, the longer the healing period. This means that it may take adults up to seven days to begin feeling comfortable. The eyelids may also be swollen and make it challenging to open the eye shortly after surgery.
An ocular prosthesis is an artificial eye that ocularists implant in patients who have lost eyes or have eye abnormalities.
Once the artificial eye is ready, it will fit behind the upper and lower lid over the shrunken eyeball or orbital implant that’s placed after the surgeon removes the actual human eye.
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