Laser vision correction – St. Adalbert’s Hospital

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Benefits:

Laser corrective surgery can free many patients from their glasses and contact lenses.
Patients can get rid of heavy and uncomfortable eyeglass lenses (especially in case of large refractive difference).
For myopic patients it is possible to eliminate the effect of viewing objects perceptibly smaller than they really are and the patients’ eyes appearing smaller from behind the glasses (correcting a large refractive difference will eliminate this unfavourable effect for outside observers).
Patients can stop using troublesome contact lenses (wearing contact lenses requires observing special hygiene rules, lenses cannot be worn longer than several hours in a day and wearing contact lenses may lead to a number of complications).
Laser corrective surgery enables patients to have a natural field of vision which is not distorted by wearing eyeglass lenses.
Laser corrective surgery enables patients to undertake such jobs as fire fighter or machine operator and take up certain sport activities otherwise inaccessible to people with a refractive error.

Indications and contraindications:

Indications:

Refraction errors: myopia, hyperopia, astigmatism, and also some cases of presbyopia (loss of the accommodation reflex or the ability to focus on near and distant objects, common in patients after 30-40 years of age).
Range of refractive errors – Patients whose refractive error is between -10.0 D and +6.0 D.
Patients willing to undergo laser vision correction must be at least 18 years of age to ensure that their eyes have matured.
Candidates for surgery should be in good general health. Chronic diseases such as diabetes or hypertension are not a contraindication for surgery but they need to be well-controlled.

Unstable refractive error is diagnosed in patients whose refractive error changed by at least 0.5 D in the last 6-12 months.
Poor general condition. The following general diseases are a contraindication for surgery: connective tissue diseases and autoimmune diseases such as rheumatoid arthritis, systemic lupus and psoriasis.
Eye diseases such as glaucoma (elevated intraocular pressure), cataracts (clouding or opacity of the lens of the eye) and conjunctivitis, keratitis or other inflammatory conditions of the eye, and other conditions such as dry eye syndrome and severe keratoconus are all contraindications for surgery.
If you are pregnant you need to reschedule your surgery. The recommended interval between childbirth and laser vision correction is at least 6 months.
Do not undergo laser vision correction if you are taking oral steroids because they interfere with the healing process and immune response.

Frequently asked questions

Should I stop doing sports after laser vision correction?: Not at all. Many athletes (including professional athletes) decide to undergo laser vision correction to free them from wearing glasses. In some countries this procedure is even recommended to law enforcement officers and soldiers.
What will happen if I blink or move my eye during laser eye surgery?: To ensure a stable eye position you will be asked to look at a target light. A small device will hold your eyelids open during the procedure so blinking will not interfere with any step of the surgery.
Does laser eye surgery guarantee I will never need to wear glasses again?: As you age (usually when you are around forty) the lenses in your eyes lose some of their elasticity and gradually also the accommodation range which is the ability to switch focus between distant and near objects. In patients who had their refractive error corrected during laser eye surgery the same process continues to take place so they may still need to wear glasses after reaching a certain age.
You also need to bear in mind that there is a very slight possibility for your refractive error to be over- or under-corrected during surgery and this may mean that you will still need to have your vision corrected but with low power lenses.
Am I eligible for surgery if I already need a separate pair of reading glasses?: In this case it is possible to consider Monovision. During the Monovision corrective procedure one eye is “set” for better near focus, and the other eye is set for better distance focus.
Will my vision stay sharp forever?: In 99% of cases the procedure is successful and there is no regression after laser eye surgery. However, you need to bear in mind that after about the age of 40 your near vision will be deteriorating and you may even need reading glasses. You should also remember about regular ophthalmological examinations because other eye problems are likely to occur (unrelated to laser eye surgery) such as cataract formation or age-related macular degeneration.
Can I use contact lenses to correct my vision after surgery if necessary?: If necessary, you can start wearing contact lenses about 3-4 months after surgery.

Types of laser vision correction

LASEK (Laser Epithelial Keratomileusis)
It is a surface ablation technique where the corneal epithelium is loosened with a diluted alcohol solution and moved aside to create a surface which is then treated with the laser. Following LASEK patients may experience pain for about 2-3 days so this procedure is only recommended when it is impossible to use the Microkeratome (the cornea is too thin, the patient has deep-set eyes). Up to 6-7 days after surgery patients are required to wear protective contact lenses. Visual acuity returns to normal after about 2-4 weeks.
EBK (Epi Bowman’s Keratomileusis)
This is an improved surface ablation technique where the surface epithelium is removed using the Epi Clear™ device with a disposable head.
SBK (Sub-Bowman’s Keratomileusis, also known as thin flap LASIK)
This is an improved LASIK technique where a very thin corneal flap (the intended flap thickness is about 100 µm, or microns) is created using the Moria Microkeratome which makes it possible to reduce the amount of tissue ablation and correct higher order aberrations. Patients enjoy clear vision from the first day after surgery but slight visual acuity fluctuations may persist for about a month.

Following all laser vision correction procedures patients should avoid strenuous physical exercise, swimming in a swimming pool, sunbathing and dry and smoky environments. Side effects which may occur and persist up to a few months postoperatively include low contrast sensitivity at night, glare sensitivity while night driving and dry eyes.

Eligibility for surgery:

At a pre-operative appointment your ophthalmologist will carry out a full eye examination and:

establish your visual acuity without correction and your best corrected visual acuity for both eyes;
most probably apply special eye drops to paralyse the pupils and accommodation to be able to determine your refractive error (the eye drops may cause blurred vision for a couple of hours so do not operate any motor vehicle while under the influence of the medication);
exclude other eye diseases and general diseases which may disqualify you from undergoing the laser procedure;
after summing up your test results, taking detailed measurements of your cornea (its shape, curvature and thickness) and determining the size of your pupils, your ophthalmologist will recommend a suitable type of laser vision correction. This will be the best opportunity to clarify any uncertainties or doubts regarding the procedure that you may have.

A complete ophthalmological examination includes examination of the anterior and posterior segments and intraocular pressure measurement. Additional tests will be performed as needed.
Warning!
Do not wear contact lenses 7 days before your pre-operative appointment because they can affect the shape and condition of the cornea. If you are eligible for laser vision correction, do not wear contact lenses until the day of surgery and refrain from using certain cosmetics and doing makeup a few days before surgery.

About the procedure:

The procedure only takes up to 20 minutes. Laser treatment takes about 30-60 seconds.
Patients feel no pain thanks to local anaesthetic eye drops and they also do not see any surgical tools because they are asked to look at a target light to ensure a stable eye position during surgery.
The surgeon will clean and disinfect the skin around the eye to minimise the risk of infection. The other eye will be covered with a sterile gauze pad in order not to distract the patient.
The procedure may be performed on both eyes during the same surgery.

After surgery:

Regardless of the laser vision correction procedure, after surgery patients are required to:

take antibiotics and anti-inflammatory medication (eye drops) and cover their eyes at night for protection for a week after surgery;
wear sunglasses when out in the sun for at least 3 months after surgery.

The first follow-up visit is scheduled for about an hour after surgery so the entire appointment including surgery may take about 1.5-2 hours. A few days after surgery patients should strictly follow their doctor’s recommendations regarding medication and follow-up visits.

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+48 61 62 33 111

Wielkopolskie Centrum Medyczne
Sp z o.o. S.K.A

st. Bolesława Krzywoustego 114
61-144 Poznań, POLAND

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