One eye doubles after lasik. View full version

Since with my disadvantage it was quite difficult for me to love the world with glasses, and the lenses made my eyes inflamed and I needed to take a long break (this happens sooner or later for everyone who wears them), I decided why wait, this is the kick and a sign, it’s time to do what you’ve been planning for a long time. And I began to study the issue.

I chose between Helmholtz, the Research Institute of Eye Diseases, the Fedorov clinic and the Gazprom clinic. The best website is at the Gazprom clinic, everything is written there clearly, but the prices there are quite high. I heard a lot of negative reviews about Fedorova’s clinic. It was simply impossible to get through to Helmholtz. It turns out that this is a fairly popular request on Google - how to reach Helmholtz. And on the website of the Research Institute of Eye Diseases there was a promotion that all preoperative examinations are deducted from the cost of the operation. In addition, they immediately responded to my request, set a date for the examination, I Googled doctors, equipment - everything suited me. And even prices. That's why I went there.

If you have a slight disadvantage, then you will most likely be offered Lasik surgery. If it’s big, like mine, then Femtolasic. The differences are in price and in the fact that in the first case, the flap on the eye is formed with a microkeratome, and in the second, with a laser. That is, the flap will be several microns, healing is faster and the important thickness of the cornea, which is needed for vision correction, is not consumed.

The thickness of my cornea was measured during the first examination. They also did an ultrasound of the eyes, measured intraocular pressure, all sorts of radii, minuses, axes, etc. It takes three hours. Then I donated blood there for HIV, hepatitis, etc. The cost of blood tests, as well as examinations, will be deducted from the cost of the operation when I have it. And so the examinations cost 2500 rubles + blood 1500. The whole operation cost me 115 thousand.

After all the examinations, the doctor, a very pleasant and sweet woman, met with me and answered all my million questions about the operation. She said that with my disadvantage and the thickness of the cornea, it would not be possible to achieve 100% vision, that the cornea is a weakly regenerating organ, so in the end, after all the recovery, I would most likely be left with -0.75 in one eye and -1 or -1.5 in friend. Also, after the operation, in the evening I will have circles around streetlights, headlights and other light sources.

Then the surgeon talked to me. All operations there are performed by one person, a strict, taciturn professor who seems to hate the whole world. He looked at all my tests and made a verdict that he would take me for the operation, but warned me about the circles and the residual minus.
On the day of the operation it was very scary. I talked to other patients who had already undergone surgery before me, they all assured that it did not hurt, but tears flowed from their eyes.

I was taken to the preoperative room and anesthesia was dropped into my eyes. The eyes and half of the face became wooden after some time. All this time you sit in a comfortable chair, they treat your face with some stinging disgusting solution, change into a robe, and put on a cap. Then they bury me again and take me to the operating room.

An operating room is a room full of instruments. You lie down on the table. The surgeon sits behind your head. You can’t move your hands and head when he’s already looking through the microscope into the eye, so just in case, it’s better to put your hands under your butt so as not to twitch instinctively.
Anesthesia is injected again. Such a luminous circle with glowing bulbs around the perimeter approaches the eye - something similar was shown in the X-files, when a saucer with aliens flew to earth. First, the face is covered with a surgical diaper with a hole for one eye, so that you look at this approaching ball with only one eye through a hole in the cloth. Scary fucked up.

This shit lands right in your face. All this time, the surgeon is yelling at you to look straight ahead at the center of this fucker. I decided that I was acting in a movie, I was in the series The X-Files and now I would be abducted by aliens. It was easier to survive than the thought that it would hurt your eyes.

When this thing lands on your eye in a hole in a rag, it doesn’t hurt. But it's unpleasant. You feel strong pressure on your eye. This round thing is suctioned to the eye and the laser cuts out a horseshoe-shaped flap around the perimeter. You feel nothing and see nothing except darkness and flashes of light around - as if you have already been kidnapped and you are in outer space. Absolutely crazy sensations, you look there into the center of emptiness and are shocked by the unreality of what is happening. All this takes probably half a minute.

Then everything is repeated on the second eye. It is important - no matter what happens, look in the center, do not move your eye. You won’t blink, because they insert such a dilator there, like dentists insert a rubber thing into your mouth, so that you can relax and sit with your mouth open.

After these cosmic visions, you get up with the help of a nurse and move to another table. Another laser is waiting for you there. The surgeon inserts the expander again, places a cloth on the face, bends back the flap that the previous laser just cut out, and says that now will be the main stage of the operation. The second laser turns on. You see a red and green spot in front of you. It is important to look at the center of the red spot. Even when it disappears, you still look somewhere there.

Again, it’s not painful, but very scary. The laser chirps like a grasshopper and smells like something is fried. It burns your eye. The main thing here is not to shit yourself from fear. It seems to me that there are two wet spots left on both tables from my sweaty palms. This entire act of burning lasts about 20 seconds. Then it is repeated on the second eye. But the second time it’s always not so scary, you already know what will happen and that it ends sooner or later.

After the laser has treated the eye - doctors call this treatment, but in fact they burn out the surface of the cornea so that light is refracted differently - the removed flap is returned to its place and smoothed. You can already see how they run a smoothing spatula over your eye. Then they pour water on you, drops, and remove the dilator.

You get up and walk back to the pre-op room. You see much better now, but it’s very blurry. You sit and rejoice for an hour that it’s all over.

At first everything is fine, but then the anesthesia begins to wear off and tears begin to flow from the eyes. It stings, as if citric acid had been poured in, everything is disturbed, as if sand had been poured in, and then, as the anesthesia wears off, it still hurts, as if someone had punched it in the eye. You can’t touch your eyes, so you sit and wipe yourself with tissues.

Then, an hour later, the surgeon looks at you again on the machine, the nurse gives you a set of different drops and instructions on how to drip them, and releases you from the preoperative room. It is very important that someone is waiting for you there, because the light hurts your eyes - and there is already citric acid, sand and pain - call a taxi, walk you to the car by the hand and take you home.

At home, everyone usually passes out from the stress they have experienced. I passed out too. You can only sleep on your back so that nothing gets into your eye from the pillow and so that the flap does not move. After sleep it becomes easier, you can see quite well, but still without details. It gets even better in the evening.

The next day you go back to the hospital so they can see how the flap behaves. They look at it on the device and go home. I advise everyone who has a significant disadvantage to take sick leave for 2 weeks, and also load up on audiobooks, because for the first three days you can’t read or watch anything. And when there is no Internet, laptop and books, then there is absolutely nothing to do.

The first week I suffered and regretted that I had this operation. Because I didn’t see very well, clearly, but as if through plastic film. When you enter a room and the lighting changes, I see worse, it takes time to adapt. I see normally on the street, but even there everything is a little double. The doctor says that this is due to the dryness of the eye, which is visible on the machine, but it is important to continue to drip and everything will pass. By the end of the first week, I no longer believed her, because nothing was going through or changing.

A week later, instead of drops, I was prescribed a moisturizing gel. It is not prescribed immediately, because the gel can move the flap, but after a week, when the flap has grown in, it is already possible. With the gel and other gel drops everything went better. I can still see through the polyethylene, but it's thinner. And it doubles less often. Still, when the lighting changes, it takes time to adapt; in the evenings there are the promised circles around lanterns and light sources. The doctor says that the dryness was expected; it is stronger for me than for others because I had a larger surface treated. But she doesn't know anyone who hasn't had it.

So I drip, suffer and wait.

Astigmatism manifests itself as a consequence of a violation of the cornea of the eye, which occurs due to injury, hereditary predisposition, occupational factors, etc.

Side effects include diseases of the visual organs; visual impairment, lack of effect from surgery, retinal rejection and other consequences are also possible. Sometimes complications appear immediately after surgery and, often, depending on the severity, a repeat operation is performed.

However, there are cases where symptoms of complications appear after some time. This may occur due to a malfunction of the installed lens. Immediately after the operation, strict restrictions are imposed for a period from several days to 90 days, but, for example, visual and physical stress must be avoided for life.

What is astigmatism?

Astigmatism - consequences after laser correction Source: Astigmatism - consequences after laser correction

All information on the site is provided for informational purposes. Before using any recommendations, be sure to consult your doctor. Self-medication can be dangerous to your health. Astigmatism is one of the three most common vision defects.

This vision defect is more complex than myopia and farsightedness. The disease is caused by a disruption of the outer layer of the eyeball: the cornea and/or lens. The image seen by an astigmatic person is unclear and blurred in different axes of vision.

This eye defect can be corrected with glasses or contact lenses. The laser allows you to get rid of astigmatism once and for all. The disease results in poor visibility of all objects, regardless of whether they are nearby or far away. Typically occurs when the cornea is shaped like an elongated ellipsoid rather than a sphere.

The uneven shape causes light rays entering the eye to be focused in many places, not just on the retina. With astigmatism, the eye that looks at a point sees not a point image, but two linear ones, called focal ones.

Most often this happens because the cornea does not have a constant radius of curvature, i.e. it is not spherical. When the eyes are constructed correctly, light rays are focused at one point: the retina.

With astigmatism, due to irregularities in the curvature of the cornea, the beam of rays passing into the eye is focused at 2 points, causing image blurring effects. The irregular shape of the cornea (resembling a fragment of a rugby ball) is responsible for 98% of cases of eye defect (so-called corneal astigmatism).

In rare cases, this vision defect may also be a consequence of an irregularly shaped lens (called lenticular astigmatism). As a rule, it appears as a result of a congenital defect of the lens. Sometimes congenital astigmatism develops as a result of cataracts.

The disease is very common, affecting 1/3 of the population, usually from birth. In many cases, people with nearsightedness or farsightedness have slight astigmatism. A small degree of this refractive error is considered normal and does not require correction.

In mixed astigmatism, the symptoms of nearsightedness and farsightedness occur simultaneously. This combination causes the inability to see clearly.

Contraindications for correction

The use of laser techniques for vision correction is not a medical procedure. These are corrective manipulations that make it possible to eliminate the consequences of eye diseases, restoring vigilance, but not to treat the disease itself.

A person with a large difference in diopters in different eyes can also undergo correction in order to avoid constant overwork of one of them. Before the procedure, the patient must undergo certain preparation. This may include:

full examination to identify contraindications;
checking visual acuity immediately before manipulation;
application of anesthetic drops immediately afterwards.

During the day before the procedure, you should not use decorative cosmetics or drink alcohol. During the operation, a laser is used to target certain areas of the cornea, changing its shape. Many correction methods have currently been developed, for example, PRK, Lasik, Lasek, Epi-Lasik, Super-Lasik, Femtolasik.

Lasik machine

The first of them is a laser effect on the surface of the cornea in order to strengthen it and restore vision. The return of vigilance occurs gradually over the course of a month. Lasik techniques involve affecting the deep corneal layers, and vision returns to normal faster.

Not everyone is allowed to correct imperfections in their eyes. This cannot be done:

minors (sometimes young people under 25 years of age);
those over forty to forty-five years old;
pregnant and nursing mothers;
in the presence of keratoconus;
people with certain immune system or metabolic dysfunctions;
for serious eye diseases.

Correction is not carried out during periods of exacerbation of any chronic ailments. If contraindications are neglected, the risk of side effects can greatly increase. During the operation, a failure may occur, most often caused by technical reasons or insufficient professionalism of the doctor.

Risk factors for such problems include: Incorrect values entered into the computer. Incorrectly selected tools. Lack or interruption of vacuum supply. The cut is too thin or split.

This or that complication can lead to clouding of the cornea, astigmatism, monocular double vision, and decreased vigilance. According to statistics, unpleasant consequences occur in 27 percent of cases.

Possibility of complications

During the first time after surgery in the dark, contrast sensitivity is significantly reduced; patients have difficulty distinguishing the boundaries of colors and the boundaries of objects. Therefore, driving at night and at dusk is strictly undesirable.

Patients also noticed the appearance of stars and circles before their eyes. Cases of excessive dry eyes are common. Inflammatory processes such as edema, conjunctivitis, epithelial ingrowth, inflammation, hemorrhage may also appear as postoperative complications.

The likelihood of their occurrence does not depend on the qualifications of the surgeon or on the apparatus with which the operation was performed. The reason for them is the individual characteristics of the patient’s body.

Such complications may require long-term and quite expensive treatment, which, however, is not guaranteed to give a 100% result (full recovery). There is also the possibility of “undercorrection”.

This is the so-called residual myopia, which is corrected by repeated laser correction two months after the first operation. This is another additional burden on an already weakened eye. There is a possibility of long-term consequences of laser vision correction.

Such consequences have not yet been practically studied, because It is difficult to calculate whether the complications that appeared 3 years after the operation were the result of the operation itself or whether these were characteristics of the body or even the patient’s lifestyle.

In the absence of serious medical indications, all ophthalmologists do not recommend resorting to laser vision correction or any other eye intervention. Although the percentage of successful operations is very high, it is still not 100% and, as you understand, there is a possibility of complications.

The eyes are your own, after all, and it’s better not to expose them to the laser. Glasses or lenses practically do not create problems and they can always be removed, unlike the results of an intervention, even by an experienced surgeon.

Diagnosis of the disease

To see if you have astigmatism, you will need to see an ophthalmologist. When such a vision problem was identified, the first tool for detecting it was the keratoscope - the invention of the Portuguese ophthalmologist A. Placido.

It is a disk with white and black consecutive circles. The study involves observing the shape of their reflection on the cornea. The degree and axis of astigmatism in the eyes is measured by an ophthalmometer (keratometer).

It uses an image of the Placido disk reflected on the surface of the cornea, which is recorded using a camera and then transferred to a computer and analyzed. The result of the study is a colorful map and section of the surface of the cornea, a map of the digital value of its curvature.

The last study is necessary before the procedure for laser correction of eye defects. In everyday practice, an autorefractometer equipped with a topograph is used. All these studies are painless and are carried out during an eye examination by an ophthalmologist using instruments.

What happens after surgery?

After laser vision correction, the patient does not experience any significant pain, but for 2-3 hours after the operation he may be very bothered by:

Tearing
Stinging in the eyes
Feeling "sand"
Photophobia

Bright light may aggravate these complaints, so you should bring sunglasses with you to the clinic. It is advisable to wash the frame well with soap in advance. After laser vision correction, the patient may experience pain in the eyes, a feeling of blockage, and watery eyes. After 3 hours these phenomena disappear.

During the first hour after surgery, your vision without glasses will improve, but there will still be fog and blurriness. In just a few hours, these complaints will subside, and just a feeling of discomfort will remain.

You should definitely have a follow-up examination at a slit lamp to ensure that the corneal flaps are properly seated. In extremely rare cases, if the patient accidentally roughly rubs the eyes, a slight displacement of them may occur, which requires the supervision of a doctor.

1-2 hours after the correction, you should undergo a control examination using a microscope and be allowed to go home until the next day of examination. After the doctor’s examination, you will be able to go home. We do not recommend that you drive yourself after the correction, as post-operative discomfort symptoms will not allow you to drive safely.

Take a taxi or ask your loved ones to take you. Public transport is not contraindicated, but one must be wary of eye infections and colds. It is better to leave the clinic by taxi or ask your loved ones to take you home. Driving is prohibited immediately after surgery.

In some clinics that take a particularly responsible approach to the prevention of complications, patients are given special occluders for the eyes - transparent protective screens with ventilation holes that eliminate the possibility of mechanical pressure on the eye, so as not to damage the cornea during sleep or accidental touch.

Many patients are afraid of the undesirable consequences of laser vision correction. Yes, they exist, but their percentage is so small that with proper selection of patients and exclusion of contraindications, it does not exceed 0.02-0.05%. Deterioration of vision after laser vision correction can be due to several reasons:

Firstly, this is the progression of myopia.

If the patient is young and his eye continues to grow in length, then the corrected myopia may partially return.
This issue is always discussed with the patient during the preoperative examination. If myopia returns, then it is possible to discuss with your doctor a repeat operation.

With careful preoperative diagnosis, undesirable consequences of laser vision correction occur in 0.02-0.05% of cases.

Secondly, the reason for dissatisfaction with the result may be incomplete correction.

Those. the patient has a residual 0.5 - 0.75 diopters of myopia, farsightedness or astigmatism. In this case, as a rule, additional correction is proposed to achieve the desired result, but not earlier than after 2-3 months. Experience shows that such cases of additional correction are infrequent: 1 eye per 100-200 operations, or even less often.

Thirdly, the cause of some changes in vision in the long-term period after vision correction may be mild cloud-like opacities.

These phenomena are extremely rare. A carefully collected anamnesis allows you to identify patients at risk and almost completely eliminate these problems.

Fluctuations in hormonal levels during pregnancy can adversely affect the healing of corneal tissue.
It is precisely because of the occurrence of corneal opacities that ophthalmologists recommend not planning childbirth or pregnancy after laser vision correction for at least six months.

This is due to the unfavorable effect of hormonal fluctuations on the healing processes of corneal tissue. Complications after laser vision correction can occur if the operation itself deviates from the planned plan. Most of these problems improve over time or with active treatment.

Postoperative restrictions

After laser vision correction, the operated organ becomes fragile and vulnerable. Any, even the smallest damage can lead to serious consequences, including blindness. It is very important for those undergoing the procedure to follow all the doctor’s recommendations. Prohibitions may include:

touching the operated eye within 24 hours, rubbing it for at least three months after surgery;
washing and washing your hair for 72 hours after laser vision correction;
drinking alcohol while taking antibiotics;
heavy physical work, professional sports for 90 days after eye surgery;
swimming, sunbathing and applying decorative cosmetics for a similar time;
driving at dusk and at night for approximately two months after the procedure due to a temporary decrease in contrast sensitivity.

During the postoperative period, clinic clients sometimes complain about the appearance of stars or circles in the eyes, as well as dry vision. Also after laser vision correction you may experience:

swelling,
retinal rejection,
conjunctivitis,
epithelial ingrowth,
hemorrhages,
sensation of a foreign object in the eyes.

Such side effects do not occur due to low qualifications of the doctor or malfunctioning devices. Such complications are caused by the body’s individual reaction to surgery. In some cases, they go away after a rehabilitation period, but sometimes additional treatment is required.

Another type of complication is called undercorrection, when instead of one result another is obtained. For example, vision decreases in the form of residual myopia. Or instead of myopia, a person develops farsightedness. This will require repeated correction after a period of one to three months.

Long-term consequences of surgery

Complications can appear long after laser vision correction. Such long-term troubles pose the greatest danger to health. Correction removes the consequences of eye diseases that lead to decreased vision.

But she is unable to eliminate the causes of these ailments. In this case, as the disease progresses, vision may deteriorate after laser correction after several years. True, it will be difficult to say whether this is due to hidden problems during the operation or the patient’s lifestyle. Each of the following problems may appear months after the procedure:

disappearance of the positive effect of laser intervention;
thinning of the tissues affected by the device;
clouding of the corneal layer;
development of eye diseases that did not exist before.

To prevent the operated patient’s vision from subsequently deteriorating, he must lead a healthy lifestyle, say goodbye to bad habits, avoid excessive physical or visual stress, and follow other doctor’s instructions.

If a person feels that his vision is deteriorating after correction, he should immediately consult an ophthalmologist. Of course, problems after eye surgery can be eliminated. But there is no absolute guarantee that after the new correction everything will get better. Although doctors can still predict the chances.

If there are no vital indications for eye surgery, it is better not to perform it. Then you won’t have to deal with complications after laser vision correction. But if correction is necessary, you should choose a trusted clinic and a doctor who has performed many successful operations.

Laser correction of astigmatism - consequences

Source: bolezniglaznet.ru

Laser vision correction has recently enjoyed well-deserved popularity. One of the most popular techniques is currently considered LASIK (Laser-Assisted in Situ Keratomileusis) - a type of vision correction using an excimer laser.

Device capabilities

This operation allows a person to regain vision and corrects almost all deviations from the norm. Restoring vision through laser vision correction has many positive aspects, but we should also not forget about the dangers of this operation, which can affect the human body in various ways.

You need to be interested in and know this before resorting to such a method. Of course, these are postoperative difficulties in restoring the body that can be overcome. But researchers also talk about cases of deterioration in the quality of vision after surgery.

With such complications, vision is no longer amenable to such correction. The statistics of Russian colleagues also largely coincide with foreign studies. Scientists studied 12,500 operations performed using the Lasik technique, noting that subsequently various complications and side effects were observed in 18.61 percent of cases.

This is already a serious reason to think about it. Moreover, these operations were performed by the best doctors using only the best and modern equipment. Scientists also note that in 12.8 percent of cases the operation had to be repeated. Here are the complications you may encounter after laser correction.

These are various difficulties of postoperative recovery of the body. First of all, this includes the usual inflammatory reactions: inflammation, swelling, conjunctivitis, epithelial ingrowth, “sand in the eye” syndrome, hemorrhages, retinal detachment, binocular vision disorders and much more.

These consequences do not depend on the skill of the operation performed, but are purely individual and related to the characteristics of the body of each client. The treatment period is also quite long, and requires special attention and the use of high-quality medications.

In some cases, repeated operations are even required. But in such situations, it is imperative to consult with your doctor. Also, postoperative complications are also understood as simply the client’s dissatisfaction with the result and quality of the operation.

Surgical complications. Unlike postoperative complications, everything here depends on the quality of the equipment and the professional level of your doctor. According to the data, the percentage of such complications is 27, and the proportion of surgical complications that subsequently affect the quality and result of laser vision correction is approximately 0.15 percent.

And it entails both a decrease in maximum visual acuity, monocular double vision, induced astigmatism and irregular astigmatism, and corneal opacification. Although the percentage of these complications is small, nevertheless, no one is immune from such consequences.

No doctor will give a 100% guarantee about the outcome of the operation. Therefore, before resorting to surgical intervention, think carefully and weigh the pros and cons.

Complications associated with ablation. This type occurs quite often and is associated with unsatisfactory results after laser correction. Most often this manifests itself in residual myopia. In such situations, doctors resort to repeat surgery after 1-2 months.

If the doctors did more than was initially expected, then they will also have to perform another operation, but after 2 or 3 months. But, as in previous cases, this does not mean that a repeat operation will fix everything. But, nevertheless, not everything is as scary as it might seem at first glance.

Long-term consequences of laser vision correction. Such consequences are the most dangerous for the human body. This is due to the fact that laser vision correction surgery does not cure myopia, farsightedness, or astigmatism, but only corrects the shape of the eye so that the image becomes clear without affecting the disease itself.

Therefore, over time, the result of this correction weakens and returns the person to his previous vision. There are more deplorable cases. It has been recorded that sometimes the patient, over time, acquires a list of additional diseases of the body.

Also, various physical stress and damage to the eye can lead to rupture of the membrane. The consequences of which are by no means happy. Also, do not forget about groups of people who are strictly prohibited from resorting to laser vision correction.

Of course, these are young people under 18 years old. Some are talking about a limit of up to 25 years. Also, after the age of 40, farsightedness develops. These visual defects are already associated with the aging of the body, and not with the disease as such. It is also worth mentioning the complications after laser correction that occur in the evening.

Farsightedness as a complication

People with such consequences have circles in their eyes when looking at the lights and headlights of cars. This puts car drivers at particular risk. Particular complications arise when correcting myopia. Professor John Marshall from St. Thomas's Hospital in London says that in some cases even a corneal transplant was required.

In any case, no matter what, the patient must be informed about all possible complications before resorting to laser vision correction. However, the risk of such a new method has not yet been fully studied, but the Lasik method is already very popular and more and more people are resorting to this particular treatment for the disease.

What are the most serious complications?

Complications with LASIK are up to 6%, with femtoLASIK and FLEX - up to 2%, with SMILE - 0.5-1% (depending on the generation of lasers, 0.5% is the sixth).

One of the worst complications of any correction other than PRK is keratoectasia (when the cornea bulges, as in keratoconus). As a result of surgery, this can happen due to a significant violation of the biomechanics of the eye - as a rule, either due to incomplete diagnosis, or due to a surprise that the doctor's diagnostic tools could not detect.

That is why it is important to do the diagnosis very carefully and using different methods. It must be admitted that clinics often skimp on the most expensive “reinsurance” equipment. On the other hand, if a patient already comes in with keratoectasia, then he will most likely have a direct indication for good old PRK.

In general, any thin cornea, and even one that is not completely smooth, can be smoothed well by PRK. In the early stages of keratotonus, PRK levels the surface and immediately on top we also do cross-linking (treatment with a product high in B12, then the release of oxygen due to laser heating and fixation of collagen in ultraviolet light - everything to make it rigid, but more on that later separately ).

This niche will ensure the life of PRK for at least another 10 years. Keratoconus is a complex complication in the medium term. Cross-linking is done immediately, that is, cartectasis is treated as usual. Intracorneal half-rings can be inserted.

Historically, some of the keratoectasia after SMILE are cases where the surgeon discovered a diseased cornea and decided not to do the invasive procedure LASIK or its derivative, but for some reason decided that ReLEx could “ride” due to its low invasiveness. A diseased cornea does not need to be corrected without strengthening. You can do cross-linking, rings, transplantation.

Our next most popular flap is the flap after LASIK, femtoLASIK or FLEX. More often, of course, they get LASIK - they have a total risk of various side effects of 6%, and at the same time they are still being done a lot in the country. Any patchwork correction methods are a contraindication for contact sports.

You can give birth, but getting punched in the face is undesirable. There were cases when the flap was torn off because a child simply inaccurately poked his finger in his mother’s face, because a woman caught her eye on a tomato stick - in general, all sorts of things.

The crux of the problem is that with these methods, a “lid” is cut, which is “folded back” to create a lens inside the cornea, and then this “lid” is closed back. It is connected to the eye by a thin bridge-“loop” and a thin layer of epithelium that has grown on top.

The flap does not grow in, and is held in place without opening, only with the help of the superficial epithelium on top. The LASIK flap itself can be removed even after 8-10 years (there have been cases) - and it will come out exactly in the same place as on the day of the operation.

In the case of femtoLASIK and FLEX, the flap holds more firmly, there is often scarring along the edges (a thin white stripe) - after 2-3 years you can already try to tear it off with your teeth, and it will not give in. In the case of SMILE, there is no flap at all, but there is a “tunnel” (2.5 mm incision) through which the lenticule is removed from the cornea - it is also covered with epithelium, but before it heals, you cannot wash, so as not to cause an infection.

Contrary to popular myth, Bowman's membrane, which is located on top of the cornea (which is destroyed during PRK and severely damaged during femtoLASIK methods) does not provide protection against impact-type mechanical damage. It provides “slow” type stability, in particular, it compensates for pressure from inside the eye.

Now it’s worth talking about the halo effect - this is a halo around light sources at night. Any laser correction can give it. It depends on the size of the correction zone in relation to the pupil. The usual correction zone is 7 millimeters. Some people's pupils open up to 8 millimeters in complete darkness.

Previously, correction zones of 4-5 millimeters were generally made. The second reason for a halo (more relevant to modern surgeries) is how flat your cornea is in the center. The center should be elevated (a healthy cornea has more diopters in the center than at the edges - for example, 38 D in the center, 42 D at the edges).

A good professional calculates the profile for laser cutting so that the cornea is flattened over a large area. Excimer lasers have different aspheric profiles for this purpose. ReLEx SMILE itself is aspherical in its very intervention architecture. Yes, the natural state of the cornea worsens with any correction, but with SMILE - a little less.

Then we have photophobia and tissue overgrowth. The problem is with the medications. In PRK in Russia, the “usual” metamycin for this operation is not used (it is not approved at the state level). Analogs are a little riskier. Now ophthalmologists are trying to lobby for the approval of this drug for operations.

The next case is incomplete extraction of the lenticule during SMILE surgery. There were extremely rare cases when there was a part left that could not be picked up with tweezers. In this case, cortisone is injected, which stains the small fragment and then you can go inside and remove it.

In London, one of the very expensive surgeons makes a second cut for such a case opposite the first - he does not use it, but keeps it in case of problems during the operation. Usually, if the laser did not cut something in the lenticule, this is the problem of the surgeon, who for some reason went in and tried to separate the place where there was no cut.

That's right - let it heal and do PRK with topography. Or, as an option, switch to FLEX instead of SMILE. Then tearing the edge of the incision is a very unlikely thing in experienced hands, when the surgeon uses an instrument to tear the entrance to the “tunnel” leading to the lenticule.

For this to happen in practice, you need to push him in the shoulder during the operation. However, there is usually no problem: the incision was 3 mm, it will become 3.5 mm - no big deal, really. In the vast majority of cases, the incision is torn radially, but there was one example at the very beginning of the history of corrections, when a tear of 1.5 mm occurred towards the center.

From a zone of 7.8 mm to a zone of 6.8 mm, the patient received a halo effect in deep darkness. The solution is simple - you need to hold the eye with tweezers with your other hand, since then this has been included in the mandatory SMILE protocol. One of the serious (but, fortunately, reversible) cases is keratitis.

This is an inflammation of the cornea, most often as a result of an infection. Its three stages - in the second, usually cortisone and treatment at the discretion of the doctor, and in the third, rinsing the pocket is mandatory (there is a risk of irreversible scarring). Therefore, after the operation, you are observed the next day and several more times.

Everything else, as a rule, goes away within a week or two after surgery, and is associated with the body’s reaction to mechanical damage to tissues, or the characteristics of medications. Yes, you may cry for a couple of hours, yes, it may sting, yes, in some people the painkiller then causes a wild desire to touch the eyes (which you should not do). And yes, for the first couple of days it is better for you not to appear at the beauty contest and take portraits for the dating site. Then everything will be fine.

Daily Life Forecast

The disease interferes with everyday life and activities that require good vision, both from afar and up close. The difficulties depend on the extent of the vision defect and how it can be effectively corrected.

Absence or ineffective correction can lead to diseases such as chronic inflammation of the conjunctiva, eyelid margins or constant headaches, increased fatigue when working on a computer.

Children sometimes develop a reluctance to learn, and adults experience blurred vision and increased fatigue when driving a car, which is why they cannot see the lights of other cars. Therefore, contact lenses and corrective glasses for this eye defect must be precisely selected.

Vision can be corrected with glasses with cylindrical glasses or soft toric lenses, but if the surface of the cornea is destroyed to a significant extent (for example, due to scars, diseases) or the astigmatism is large, then with an optical disc.

If the vision defect is corneal, eye astigmatism can be treated with laser correction. If the origin of the defect is related to the lens, for example, it arose as a result of cataracts, then the problem disappears after surgery to remove the underlying disease.

Using Alternative Methods

In the case of cataracts, surgery involves replacing the clouded natural lens with an artificial one. With slight astigmatism (up to 1 diopter), glasses are generally worn only for studying, driving a car, or working on a computer.

And almost every person experiences so-called physiological astigmatism: about 0.5 diopters, because the correct cornea is destroyed more vertically than horizontally.

Tips for patients

You need to find out who is a real professional in this field. To do this, you should chat with people on forums on the Internet. You should also consult with an ophthalmologist or ophthalmologist. Please note that surgery to restore vision will not be cheap.

Once you have an appointment with a specialist, do not be afraid to ask him all the questions that interest you. Examination before surgery makes it possible to identify those people for whom this operation is unlikely to significantly help. The specialist must conduct a thorough examination of the eyeball.

The doctor measures the size of the pupil in the dark, determines the thickness of the cornea, as well as its topography, and carefully examines the fundus of the eye (there may be a retinal detachment or rupture). Be sure to inform your ophthalmologist about all, even minor, diseases.

For competent doctors, the rate of surgical complications does not reach even one percent. All major clinics monitor and provide assistance after surgery, right up to correction after surgery (if necessary).

After laser (excimer) vision correction, patients often encounter various complications. One of them is diplopia, that is, double vision. Why does it occur and is this phenomenon considered normal for the postoperative period? Read the answers to these questions in our article.

Vision correction using LASIK surgery is considered today one of the widely advertised and very effective procedures. It is often recommended for myopia, farsightedness and astigmatism. Thousands of similar operations are carried out every day all over the world.
Quite a lot is known about the benefits of LASIK or other types of laser vision correction. Technologies for their implementation are constantly being improved, however, this does not completely eliminate the risk of possible complications.

What complications occur most often after surgery?

According to ophthalmologists, the most common side effects after surgery include:

decreased vision in the dark, as well as in unfavorable weather conditions;
sensation of a foreign body in the eye, which may persist for several days;

increased tearfulness, especially on the first day after surgery;
the occurrence of “dry eye” syndrome due to drying of the upper layer of the cornea after LASIK;
eye sensitivity to bright light.

Double vision after surgery. Is this normal?

During the first three days after laser vision correction, the patient may see a blurred or double image. In most cases, this effect disappears within the next few days after the operation, but it can also “accompany” the patient for quite a long time. Doctors note that such a reaction is absolutely normal, but only if you see double for a short time. This can be especially pronounced when there is insufficient lighting, for example, when working at a desk lamp, as well as under unfavorable weather conditions.

Typically, patients complain to their doctors about the appearance of halos around the object they see or double image. Moreover, such defects do not depend in any way on the time of day, that is, they can appear both during the day and in the evening.

What to do if you see double vision for more than three months?

It also happens that the double image does not go away after three, five days or a week. It can persist for several months, which causes significant discomfort to the patient. In most cases, in the first days, patients who have undergone laser correction do not attach much importance to this, considering it a normal consequence after LASIK. Doctors themselves share a similar opinion. However, after a certain time, this ceases to be the norm characteristic of the rehabilitation period, and begins to cause anxiety in patients. The experience is even more intensified in cases where all other postoperative effects have passed quickly enough, and double vision remains unchanged. Concern in this case is completely justified. In such situations, ophthalmologists recommend performing keratotopography and drawing conclusions based on its results.

It often happens that the reason lies in the characteristics of the patient’s cornea itself. It is believed that the outcome of surgery can be assessed no earlier than three months after LASIK. If double vision does not go away even after this period, then most likely the doctor will recommend repeated intervention or, as it is also called, additional vision correction.

Diagnosis of double vision and its causes

As ophthalmologists explain, double vision after surgery can be explained by the manifestation of a prismatic effect. If, for example, double vision is observed in only one eye, then astigmatism is most likely to blame. It provokes blurriness of the image along one of the axes, while on the other everything remains unchanged. If the examination shows that the problem lies in the imperfection of the surface of the cornea (this is usually seen during examination with a keratotopograph), then we are talking about coma - one of the most complex spherical disorders, consisting of asymmetrical coloring relative to the central part of the pupil.

If the results of the keratotopogram are negative and do not show any abnormalities, then the cause of double vision is a violation between the stroma - the transparent layer that forms the basis of the cornea, and the flap - a flap of the cornea.

Laser vision correction(LKZ) allows you to completely restore vision when myopia, farsightedness and astigmatism.

The speed of the procedure, the absence of pain, the stability of the results (in the absence of progressive myopia) make this operation possible popular.

Time frame for vision recovery after PRK

Discomfort goes away after PRK procedure on the third or fourth day.

The patient receives 70% planned result, in a month - 90%, and only during the next 5-6 months (sometimes 6-12) After the operation, vision is completely restored.

After LASIK

Already in 2-3 hours After LASIK surgery, the patient begins to see well. Vision is gradually restored in 24-48 hours. The final result is achieved within 1-3 months.

When one eye sees worse than the other after laser correction

This phenomenon occurs quite often, especially if there was difference in diopters of the two eyes. Moreover, visual acuity can vary significantly several times during the day. This phenomenon can last up to six months after operation.

Preservation postoperative edema that go away over time.
Spasm of the eye muscles in this case, the doctor may recommend doing simple eye exercises.

Preservation residual myopia due to insufficient correction (hypocorrection).

In this case, it is possible to perform a repeat operation no earlier than in 1-2 months. It is after this time that it becomes clear whether the cause of vision deterioration is spasm of accommodation(temporary phenomenon due to excessive visual load) or occurred regression myopia.

Hypercorrection- overcorrection. Additional surgery is required.
Displacement or loss of corneal flap(either the surgeon placed it unevenly, or the patient dislodged it while rubbing the eye). Possible only after LASIK surgery. Eliminated by suturing or repeat surgery.
Keratitis(inflammation of the cornea) due to injury and bacterial infection.

Important! After correction of high myopia (over 6 diopters) likely over time regression of myopia (deterioration of vision by 1-2 diopters).

Why is my vision blurry?

Cloudy, blurry images are often observed in patients within 72 hours after surgery.

Corneal opacity due to slow recovery of damaged cells(common after PRK surgery).

As a treatment, the doctor prescribes eye drops that protect the damaged cornea, eliminate swelling and have an anti-inflammatory effect.

A cloudy image may be due to dry eye syndrome, when a tear does not sufficiently wash the eyelid. When using special drops, it goes away in one to two weeks.
Inflammation of the cornea (keratitis) due to bacterial infection.

What to do if the patient has difficulty seeing

Postoperative symptoms requiring immediate medical attention:

severe, prolonged pain, especially in 24 hours after operation;
Availability inflammatory process(preservation of severe swelling, redness, “sand” in the eyes) for a long time after surgery;
bright flashes of light;
sudden loss of vision.

Attention! As a rule, during months After vision correction, an ophthalmologist provides free consultations to his patients.

Useful video

Check out the video, which explains how vision is restored after surgery and what recommendations you need to follow.

Unpleasant consequences of laser vision correction are possible, despite the speed, painlessness and accuracy of the procedure. They can occur both due to incorrect manipulations during the operation process itself, and due to non-compliance with medical recommendations in the postoperative period. Correction of such complications is real, but no ophthalmologist can ever give a 100% guarantee.

The use of such correction is recommended for severe myopia or farsightedness, sometimes complicated by astigmatism. A similar restorative technique is recommended for people who, due to professional factors or the individual structure of their visual organs, are not able to wear glasses or contacts. A person with a large difference in diopters in different eyes can also undergo correction in order to avoid constant overwork of one of them.

Before the procedure, the patient must undergo certain preparation.

This may include:

full examination to identify contraindications;
checking visual acuity immediately before manipulation;
application of anesthetic drops immediately afterwards.

During the day before the procedure, you should not use decorative cosmetics or drink alcohol.

During the operation, a laser is used to target certain areas of the cornea, changing its shape. Many correction methods have currently been developed, for example, PRK, Lasik, Lasek, Epi-Lasik, Super-Lasik, Femtolasik. The first of them is a laser effect on the surface of the cornea in order to strengthen it and restore vision. The return of vigilance occurs gradually over the course of a month. Lasik techniques involve affecting the deep corneal layers, and vision returns to normal faster.

Not everyone is allowed to correct imperfections in their eyes.

This cannot be done:

minors (sometimes young people under 25 years of age);
those over forty to forty-five years old;
pregnant and nursing mothers;
in the presence of keratoconus;
people with certain immune system or metabolic dysfunctions;
for serious eye diseases.

Correction is not carried out during periods of exacerbation of any chronic ailments. If contraindications are neglected, the risk of side effects can greatly increase.

During the operation, a failure may occur, most often caused by technical reasons or insufficient professionalism of the doctor.

Risk factors for such problems include:

Incorrect indicators entered into the computer.
Incorrectly selected tools.
Lack or interruption of vacuum supply.
The cut is too thin or split.

Postoperative side effects

Prohibitions may include:

touching the operated eye within 24 hours, rubbing it for at least three months after surgery;
washing and washing your hair for 72 hours after laser vision correction;
drinking alcohol while taking antibiotics;
heavy physical work, professional sports for 90 days after eye surgery;
swimming, sunbathing and applying decorative cosmetics for a similar time;
driving at dusk and at night for approximately two months after the procedure due to a temporary decrease in contrast sensitivity.

During the postoperative period, clinic clients sometimes complain about the appearance of stars or circles in the eyes, as well as dry vision.

Also after laser vision correction you may experience:

swelling,
retinal rejection,
conjunctivitis,
epithelial ingrowth,
hemorrhages,
sensation of a foreign object in the eyes.

Long-term consequences of surgery

Complications can appear long after laser vision correction. Such long-term troubles pose the greatest danger to health.

Correction removes the consequences of eye diseases that lead to decreased vision. But she is unable to eliminate the causes of these ailments. In this case, as the disease progresses, vision may deteriorate after laser correction after several years. True, it will be difficult to say whether this is due to hidden problems during the operation or the patient’s lifestyle.

Each of the following problems may appear months after the procedure:

disappearance of the positive effect of laser intervention;
thinning of the tissues affected by the device;
clouding of the corneal layer;
development of eye diseases that did not exist before.

If a person feels that his vision is deteriorating after correction, he should immediately consult an ophthalmologist.

Of course, problems after eye surgery can be eliminated. But there is no absolute guarantee that after the new correction everything will get better. Although doctors can still predict the chances.

They divide all complications after laser vision correction into three large subgroups:

One eye doubles after lasik. View full version

What is astigmatism?

Contraindications for correction

Possibility of complications

Diagnosis of the disease

What happens after surgery?

Postoperative restrictions

Long-term consequences of surgery

Laser correction of astigmatism - consequences

What are the most serious complications?

Daily Life Forecast

In this article

What complications occur most often after surgery?

Double vision after surgery. Is this normal?

What to do if you see double vision for more than three months?

Diagnosis of double vision and its causes

Time frame for vision recovery after PRK

After LASIK

When one eye sees worse than the other after laser correction

Why is my vision blurry?

What to do if the patient has difficulty seeing

Useful video

Postoperative side effects

Long-term consequences of surgery