Thursday, 19 December 2024

Options for surgery to correct refractive errors, part 1

03 May 2024
168

Our vision is caused by light hitting the surface of the cornea. Then there was a refraction that focused exactly on the retina. The visible image is therefore clear. But if the curvature of the cornea or the length of the eyeball is too much or too little It will make the picture unclear. and call this condition “Irregular vision conditions” There are 4 types of abnormal vision conditions: nearsightedness, farsightedness, astigmatism, and farsightedness in the elderly. Treatment of abnormal vision is divided into non-surgical treatments. and surgical treatment 1. Non-surgical treatments for refractive errors include wearing glasses and contact lenses. 1.1 Wearing glasses causes inconvenience in performing activities. Or sometimes it makes you dizzy. Eye discomfort can occur. 1.2 Wearing contact lenses. The image quality will be better. Because it’s stuck in the eye, it’s convenient, but there must be some foreign object rubbing against our eye. And if you do not take good care of the cleanliness of your contact lenses It may cause infection and blindness. 2. Surgery for refractive errors It can only treat nearsightedness, astigmatism, and congenital farsightedness. Presbyopia in the elderly cannot be treated. Current surgical treatment for refractive errors involves using a laser to target the cornea, the clearest part at the front of the eye. which has the function of reflecting light so that we can see a clear picture Therefore, the cornea has an inappropriate curvature. This causes abnormal vision such as short, long, and astigmatism. To correct this abnormality Therefore, a laser is used to modify the cornea to make it beautiful. To be able to perform duties exactly as they should The resulting vision will be as normal as normal people. Using laser in surgery to correct refractive errors. There are 3 methods in total as follows: 2.1 PRK (Photorefractive Keratectomy) is an ancient method. It was used before LASIK, that is, shooting a laser at the surface of the cornea. It is the grinding of the outer surface of the cornea. The advantage of this method is The cornea is not separated. The disadvantage is that the wound is inflamed for a long time and is easily infected. There is a lot of irritation. And it takes a long time for complete recovery. Patients who choose to undergo refractive surgery with PRK must have a long recovery time. And they don’t want even the slightest bit of wound remaining. People who do PRK are now left with only specific occupations, such as soldiers, pilots, and people who play sports that are at risk of hitting the wound. Correcting refractive errors through PRK has decreased in popularity. But it can still be done. Because it is very beneficial to the patient. 2.2 LASIK is a method that has been done for a long time and has good results. LASIK is the use of a first laser to separate the corneal layers. Let it open up about 1 and a half layers, then there will be about 3 and a half layers left, then the laser will be shot in the middle to close the old wound. Close the opened cornea. The cornea has the property of being stuck when closed. Therefore, these wounds do not require stitches. Lasik surgery is therefore easy to perform, heals quickly, and can be used quickly. The word Lasik actually comes from the words “Laser In-Situ Keratomileusis,” which in the past used a blade to separate the layers of the cornea. But currently it is no longer used. Because of low accuracy and very dangerous. So use a laser instead. Therefore, today’s Lasik surgery is called “Femto Lasik”, which comes from the word “femto laser” to separate the corneal layers and then shoot another type of laser to correct vision. 2.3 Relex Smile is the most modern method at the moment. It is developed from LASIK, which is using a laser to scoop out the middle layer of tissue and then separate it. Then the doctor will gradually Take a small tool. Go in and pick up the middle layer and pull it out through the small hole. The wound will be reduced to only 1/6 of the size of the Lasik wound. The principles of Relex Smile are the same as Lasik, but the wound is smaller and the side effects are reduced. Less infections, less dry eyes, therefore at present Relex Smile is almost a method that replaces Lasik. But the general public is still stuck with the word “Lasik”. Nowadays, there are quite a lot of people who have had Relex Smile done. Who is LASIK suitable for? LASIK is suitable for people who are nearsighted. Congenital farsightedness and astigmatism For those who are farsighted or who are elderly, they can have Lasik surgery. But the things that are fixed do not stay with us forever. Therefore, it must be a person with stable vision. It is a person who has had stable vision for at least 6 months or more. – A person who is 20 years of age or older – should not be too old to be bothered by eye disease. – The appropriate age for having LASIK is 20-60 years old. – A person who does not have an underlying disease that requires caution during surgery, such as allergies or uncontrolled diabetes. Any disease that causes wound healing to be slower than normal people Steps for surgical correction of refractive error with laser 1. Get evaluated by an ophthalmologist to see if you can do it. If you can, make an appointment for surgery. and post-surgery care 2. Laser refractive surgery uses anesthetic drops. The patient will always be aware. Therefore, you should lie still. To enable doctors to work comfortably 3. If it’s a PRK surgery, then the laser is used to shoot the skin. Wear contact lenses to make your eyes comfortable. Cover your eyes and go home4. Lasik surgery begins with the first laser being fired to separate the layers of the cornea to open it up. And use the second laser to fix the cornea to make it more beautiful, close the wound back, cover the eye and go home. Then the attached wound will gradually become firmly fixed within 24 hours. 5. As for the Relex Smile procedure, there is only one step: Use a laser to separate the layers. Then make it into small pieces of the cornea. Placed in the cornea Then the doctor will pull out a small piece. that leaves the cornea Wash the wound and cover it. If the patient cooperates, it will take no more than 8 minutes. Next week there will be interesting stories about taking care of yourself after the procedure, side effects, advantages and disadvantages of Lasik surgery. Please wait and follow@@@@@@@@Source Assoc.Prof. Dr. Warintorn Chakkapaiwong, Department of Ophthalmology Faculty of Medicine Ramathibodi Hospital Mahidol University read the column “Health Friday” more here.