The first step is to undergo a correct evaluation of our refractive defect and ocular condition. Once this has been determined, it must be assessed which technique will best suit the specific circumstances of each individual and their refractive problem. For this reason, it is vital to make a prior diagnosis with exhaustive tests that offer an individualized assessment of each case.
Refractive surgery procedures are used to solve different problems of myopia, hyperopia and/or astigmatism. The three main techniques are:
- PKR or Lasek
- Lasik
- ICL lens implantation
What is the difference between PRK, Lasik and ICL techniques?
The most commonly used technique is the Lasik technique. In this technique, the surgeon separates a lamella of corneal tissue with superficial stroma and epithelium. This flap, known as the corneal flap, is folded back, exposing the superficial part of the corneal stroma, ready for laser treatment. The Excimer laser is then applied and the corneal flap is repositioned, which adheres naturally and is completely stable within 24 hours, without the need for stitches. It is a painless technique with a fast functional recovery.
On the other hand, in the surface technique called PKR, the surgeon removes the outer layer of the cornea (the epithelium), making a kind of ulcer, in order to access it and apply the excimer laser directly on the cornea. This technique is more painful and with a slower recovery, because the corneal epithelium has to grow, delaying the functional recovery to a few days. During the postoperative period, a soft contact lens must be worn to avoid discomfort. With the Smart Surface program, the removal of the epithelium is performed directly by the laser and is very precise.
Finally, the ICL technique is based on the implantation of the soft intraocular lens behind the iris, respecting the structures of the eye and the crystalline lens. The procedure is used for high cases of astigmatism and myopia, being a painless, fast and safe technique, which allows preserving the cornea intact. It is a reversible technique, which offers extra peace of mind to patients. In short, the ICL technique is ideal for patients with high or medium myopia, where the preoperative evaluation does not recommend corneal surgery.
Before surgery
The most advisable thing to do in each case is to foresee, therefore, it is recommended that daily actions such as taking a shower be done the day before so as not to need to do it the day of the surgery, since it is important to avoid soap getting into the eye and head movements.
If the patient uses soft contact lenses, he/she should not use them for at least 7 days to avoid corneal molding (modification of the corneal curvature). The ICL technique does not require so many days, since it is performed behind the cornea and the cornea is not intervened.
The technique is performed from one eye to the other on different days, so the patient can use his usual contact lens in the operated eye. In any case, the patient is recommended to rest and leave work for a minimum of two days.
The day of the operation
The surgery is performed with topical anesthesia (a few drops), so the patient can have breakfast at home without any inconvenience. Only in the case of the ICL implant, the patient will need to come on an empty stomach.
The patient should wash his eyes with saline solution and his eyelashes (without makeup). On the day of the surgery, the doctor will give the patient a relaxing pill, so it is recommended that the patient be accompanied, since he/she will be somewhat drowsy.
The surgery, which is completely painless, usually lasts about three minutes per eye. The patient will come out seeing, with his eyes uncovered, and will have to remain in the clinic for an hour without blinking hard or rubbing his eyes. Once the hour has elapsed, the doctor will examine the evolution, taking the vision. The patient will be able to see how, in just one hour, he/she will be able to see almost 100%.
Finally, the doctor will explain how to apply the drops and care for that day.
After the operation
The day after the operation, the doctor will do a check-up to make sure everything is going as planned. Once the operation is over, any chemical product or external element (makeup, for example) should be avoided for seven days.
The patient should moisturize the eye with eye drops and take an antibiotic. From the following day the patient will be able to lead an almost normal life, such as driving, going to the gym, using the computer, etc. He/she will only have to follow up with the doctor, with periodic check-ups until the day of the definitive discharge.
In short, it is a quick and simple recovery, totally painless and with highly satisfactory results.