The goal of laser correction is to improve vision for various disorders. The operation helps to see clearly without glasses and contact lenses, which improves a person’s quality of life. Laser correction does not treat age-related vision problems, including glaucoma and cataracts. Surgical treatment of these diseases after laser vision improvement remains possible. What restrictions exist after laser vision correction and how to get around them, read this article.
Returning home after laser correction
After laser eye surgery, it is advisable to stay in the clinic for several hours. During this time, visual perception becomes sharp and clear, although some instability of vision is possible. It must be remembered that the strength of vision may change more than once in the first time after surgery, but such fluctuations are usually insignificant.
After laser correction, you should not leave the clinic unaccompanied, since your vision is unstable at first. It is advisable to come to the operation with a relative or friend. Also, before the procedure, you should inform your doctor about planning long independent trips in the first month after surgery.
Laser correction does not impose a ban on flights, but immediately after the operation it is better not to use air transport. This is due to the increased sensitivity of the eyes to light and blurred vision, which persist for some time after laser correction.
When to visit an ophthalmologist
Immediately after the operation, the doctor must confirm the results, and only after his approval can you go home. It is advisable to visit a doctor on days 7, 30 and 60 after correction. The clinic will help you remove bandage lenses.
The final analysis of visual function is carried out after 3 months. It is noteworthy that examinations on days 7 and 30 can be carried out by an ophthalmologist at your place of residence. However, the results must be transferred to the clinic where the operation was performed.
Recovery and return to work
After surgery, vision is restored within a day on average. It is recommended to postpone work for the day, including the day of the procedure. After a complex intervention, recovery occurs in 3-5 days, and it is better to take a vacation for 7-10 days.
The issue of ability to work is very individual. Many patients return to work within a few days; others take longer to recover. You need to listen to the body and navigate by sensations.
The time to return to work also depends on the patient's type of activity. It is advisable to ask your doctor for recommendations for a specific case. It must be remembered that the recovery process proceeds differently for many patients. Typically, it takes 1-3 months for vision to stabilize. Only after this time can the results be assessed.
Eye care after laser correction
Since laser correction involves intervention in the structures of the eye, discomfort after surgery is normal. The following symptoms are possible: excessive lacrimation, sensitivity to light, inflammation, dilated pupils, foreign body sensation, swelling of the eyelids. Spots or spots may appear before the eyes. These are temporary consequences of the operation, which, in the absence of visual stress, disappear very quickly.
If there is a need to clean your eyes, you need to use gauze soaked in boiled water at room temperature. It is advisable not to touch the mucous membrane. You should not use special eye liquids, as they increase redness, itching and swelling. For severe dryness, discomfort and a feeling of tightness, your doctor may prescribe preservative-free tear substitutes. If there is excessive tearing, you need to use a sterile wipe, gently wiping away the tears under the eyes.
After laser correction, regular use of eye drops is required. Moisturizers and sometimes even antibiotics are prescribed for 10 days. It is recommended to use a moisturizing gel for a month. If healing is normal, the doctor changes the drops, but moisturizers should continue to be used.
After laser correction, it is difficult to choose lenses that will take the desired shape, so the choice should be entrusted to a professional. The result of the correction largely depends on the correct selection of contact lenses. After correction, it is necessary to gradually increase the adequate load on the visual system.
Protective contact lenses prevent epithelial irritation and reduce discomfort. After putting on the lenses, pain may occur, which will disappear after 6-20 hours. After 3-4 days you need to return to the clinic to have them removed.
If bandage lenses are intolerable, they are removed earlier. This need is evidenced by significant discomfort and pain during their use. To enhance the effect, you need to rest and take analgesics. Do not exceed the dosage of medications and do not remove bandage lenses yourself. Discomfort may increase if the lens falls out of the eye. There is no need to try to insert it back, you should consult a doctor.
On the first day after correction, you should not rub your eyes or close your eyes too tightly. You need to try to relax, rest and avoid activities that require visual concentration (reading, watching TV, using a laptop or computer). If there are children in the house, you need to ask relatives for additional help.
Eye protection after correction
For the first few weeks after laser correction, you should wear sunglasses while walking. Glasses help reduce light sensitivity and irritation. In spring and summer, it is necessary to use high-quality glasses with a high degree of ultraviolet radiation reflection. Glasses should be worn even in cloudy weather, because clouds only increase the impact of ultraviolet rays.
In dusty rooms and in the wind, you need to protect your eyes from dirt with glasses. It is advisable to use special glasses that have protection on the sides. You need to use glasses for at least a month after laser correction.
For a week after the intervention, you should avoid smoky rooms and active smoking. In the first days, it is better not to play with children and animals, as this increases the risk of injury to the operated eyes.
Permissible eye strain
It is important to dose visual stress. You should not overwork yourself with reading, rub your eyes, put pressure on them or squint too much. Depending on the extent of laser correction, the patient may have difficulty reading small print. This phenomenon should not be a cause for concern as it will disappear within a few weeks.
Patients over 45 years of age may need glasses for presbyopia. Additional correction for age-related changes in vision is needed only for certain types of activities. These are usually activities that require good near vision.
You can watch TV on the first day, but it’s better to focus on your feelings. For complete comfort, you can close your eyes. When using technology with displays, you should take breaks every 45 minutes. After surgery, prolonged concentration of vision greatly tires the eyes for the first 3 weeks, which can cause various disorders.
Nutrition rules
There are no special restrictions on food products after laser correction. It is important to follow a diet that prevents constipation. It is advisable to give up alcohol for 10-20 days to reduce the burden while taking medications.
Drinking alcohol in the first 3 days is prohibited. Alcohol will blunt the effects of antibiotics, and intoxication increases the risk of eye injury. Alcohol can increase the load on the liver when combined with medications, and can also cause dry eyes.
Sleep position
Even the slightest mechanical impact on healing eyes can lead to complications. At first it is better to sleep on your back, but strict restrictions on body position during sleep apply only to the first night after surgery. In the following days, you can sleep in any position, just do not bury your face in the pillow.
Hygiene procedures
It is important to prevent water from getting into your eyes for the first week. In the shower, you should turn your back to the pressure and stand one step further than usual. In this position, you need to lean back, and then less water gets on your face, and the shampoo will flow past your eyes. If shampoo or other hygiene product gets on the mucous membrane, do not rub your eyes. For rinsing, you need to use refreshing drops to relieve the burning sensation and prevent burns.
Do not allow tap water to get into your eyes, as this can cause inflammation and affect the results of the operation. Water from swimming pools and natural bodies of water is also dangerous.
Makeup after laser vision correction
The use of decorative cosmetics should be limited 2 days before surgery and for 30 days after the procedure. For two weeks, you should not apply makeup to the area around the eyes and eyelashes, or it is better to avoid makeup altogether. Creams, moisturizers and corrective products should not be applied close to the eyes.
Since waterproof mascara is more difficult to remove from eyelashes, you can use this product only a month after correction. During the week, you should not use eye shadow, eye cream, mascara, eyeliner, or makeup remover. Also, do not spray aerosols, hairsprays or makeup fixing products.
Any cosmetic products must be used carefully to prevent them from getting into your eyes. Otherwise, it is necessary to wash the irritant with refreshing drops without rubbing the eyelids.
Limitations on physical activity
Laser vision correction is a reason to avoid intense physical activity during the period of complete restoration of the visual system. As a rule, this process takes a month, but it is better to consult a doctor about this issue. During the rehabilitation period, you cannot go to the gym, dance, yoga, fitness, Pilates or jogging. To be completely safe, it is best to give up football, tennis, boxing, wrestling, scuba diving, diving and team sports for a year.
Restrictions on various types of activities:
- Running – 2 weeks.
- Aerobics – 1 week.
- Yoga and Pilates – 1 week.
- Strength exercises – 2 weeks.
- Swimming – 1 month.
- Football – 1 month.
- Non-contact martial arts – 1 month.
- Sauna, steam room – 1 month.
- Snowboarding and skiing – 1 month.
- Squash, cricket, tennis – 1 month.
- Rugby, contact martial arts – 1.5-3 months.
- Scuba diving – 3 months.
When playing sports, you need to protect your eyes from sweat. To do this, you should wear a bandage. After laser correction, it is not recommended to throw back your head, bend over sharply, or lift heavy objects.
It is better to plan a pregnancy six months after laser correction. Hormonal imbalance and subsequent childbirth can affect the results of vision correction.
Driving after laser vision restoration
After laser correction, you should not drive until your doctor gives permission. In order not to create a danger on the road, a person must clearly see at a distance of 20 m. Driving should be avoided until vision stabilizes. You need to wait for the blurred vision to disappear, even if it appears sporadically. After restoration of visual function, you should stop driving for long periods of time and driving in the dark.
Features of active recreation
After surgery, direct sunlight should be avoided. For 3-6 months it is prohibited to visit the solarium and relax by the sea. To avoid retinal burns, it is important to wear high-quality glasses with UV protection (not all sunglasses have this). It is advisable to choose glasses with durable lenses and glasses of a brown tint.
In the first week after the intervention, it is better not to plan long trips in order to be able to visit the doctor on time. When visiting countries with hot climates, you need to wear high-quality sunglasses with special UV protection. Glasses must block UV A and UVB rays.
Sunbathing is prohibited for a month after laser correction. The beach is dangerous due to water and sand getting into the eyes, as well as increased exposure to ultraviolet radiation. Winter sports require the use of goggles of the “mask” type with full protection from ultraviolet radiation, which severely injures the eyes in the mountains.
Complications of laser correction
Local anesthesia helps make laser correction painless, but discomfort occurs after its effect wears off. The sensation of a foreign body in the eye persists for 24-38 hours. Depending on the surgical technique, discomfort may be milder or stronger, so this should be discussed with your doctor before the procedure. Medicines and special contact lenses can help ensure comfort after surgery. If even after a day the feeling of severe pain persists, you need to contact the clinic where the operation was performed. Emergency physicians are unlikely to be able to provide adequate treatment for complications of laser correction.
During the recovery process, there may be slight clouding of the cornea, which will disappear a month after the operation. This reaction is normal and often mild, so most patients do not notice it. In rare cases, clouding persists for six months or even a year.
The risk of corneal clouding may increase with drug overdose. If necessary, you should consult your doctor. Severe forms of opacification require additional therapy (eg, steroid drops).
After surgery there may be residual disorders, which are usually mild. When driving or operating dangerous equipment in poor lighting conditions, some patients are advised to continue to use additional correction, but most often, after laser correction, the need for glasses and contacts disappears completely.
If you neglect the recommendations of specialists, you can provoke tearing of the corneal flap and superficial keratitis. Therefore, you should not overstrain the visual system ahead of time, even if there is no discomfort. It is better to wait a few days and rest before returning to active life.
Review of eye drops to improve vision, to strengthen the retina, after laser correction.
Important: Vision is one of the five most important senses. Therefore, vision must be protected and ophthalmic diseases should not be left to chance.
Modern ophthalmology successfully copes with many eye diseases. And, as you know, there are more than a dozen of them. Let's list the most common ones.
Diseases that impair visual acuity:
- Myopia
- Farsightedness
- Astigmatism
Diseases that can lead to vision loss:
- Cataract
- Glaucoma
- Retinal dystrophy
Important: The retina is the inner sensitive layer of the eye that perceives light. The light is then converted into nerve impulses and sent to the brain. Essentially, the retina is the main “tool” that provides vision.
Retinal disease Only an ophthalmologist can diagnose retinal dysfunction. In the initial stages, retinal pathologies do not manifest themselves in any way. Those who are at risk need to undergo diagnostics and make sure that everything is fine with the retina. Risk groups include:
- People suffering from myopia
- Patients with diabetes
- Aged people
Important: It is extremely dangerous to prescribe drops on your own to treat, restore or strengthen the retina. Entrust this matter to the ophthalmologist observing you.
At retinal dystrophy An ophthalmologist may prescribe the following drops:
- Emoxipin
- Taufon
- Aktipol
At retinal angiopathy:
- Aisotin
- Solcoseryl
- Quinax
- Emoxipin
Video: Retinal diseases
Eye drops Taufon: how to use for visual impairment?
Taufon- transparent eye drops. The main active ingredient is taurine.
Taufon eye drops Drops are used for retinal dystrophy, corneal injuries, cataracts, and as an additional treatment for open-angle glaucoma.
The drug has not been tested for safety when administered to children, so it is prescribed only to adults. Pregnancy is a contraindication for the use of Taufon drops.
Vitamin eye drops to improve vision with decreased
Useful vitamins for eye health:
- Vitamins A and C
- Riboflavin
- Thiamine
- Pyridoxine
- Folic acid
- Niacin
Vitamin drops need to be instilled in courses, not on an ongoing basis. Vitamin drops help relieve eye fatigue, prevent dystrophy and cataracts, and improve visual acuity.
Vitamin eye drops include:
- Visiomax
- Okovit
- Myrtilene forte
- Quinax
- Oculist
- Riboflavin
What vitamin drops are there for the eyes? Vasoconstrictor eye drops for redness due to eyestrain
The most popular vasoconstrictor drugs for the eyes:
- Visine
- Naphthyzin
- VizOptic
- Polinadim
Remember that red eyes are not only caused by eye strain. Often the cause of redness is ophthalmological diseases or seasonal allergies to flowering.
To avoid worsening your eye health, consult your doctor for an accurate diagnosis. Before examining the ophthalmologist, you can alleviate the condition with the help of vasoconstrictor drops.
Popular eye drops Vizin Anti-fatigue eye drops to improve vision
The eyes of a modern person are subject to stress every day. This is facilitated by working at the computer and active use of gadgets. Contact lenses also contribute to eye fatigue. In ophthalmology, there is such a concept as “dry eye syndrome,” when discomfort, dryness, and burning appear in the eyes in the evening. In this case, it is worth purchasing moisturizing eye drops. For example:
- Stillavit
- Cationorm
- View-Chest of drawers
- Optiv
- Natural tear
Eye drops for fatigue create a membrane that moisturizes the eyeball. Attention should be paid to the choice of drops when wearing contact lenses. Some medications can be instilled without removing the lenses. Others - only after removal.
Important: Many people mistakenly consider Visin to be drops for eye fatigue. Classic Visine is a vasoconstrictor drug that cannot be used continuously. Moisturizing drops to relieve fatigue and dryness are Visine pure tears.
Stillavit is one of the drugs for eye fatigue Video: Eye inflammation
Eye drops to improve vision with cataracts
With cataracts, clouding occurs in the lens, which itself is transparent. A person with cataracts sees as if through a veil. This disease develops in most cases in older people, but sometimes it occurs due to injuries and can be congenital.
Important: The only way to treat cataracts is surgery. Cataracts cannot be cured with eye drops. Eye drops will only help slow down the process of cataract development.
To prevent complications after cataract surgery, the following drops are prescribed:
- Diclofenac
- Nevanak
- Broxinac
The following medications are used to slow the development of cataracts:
- Catalin
- Quinax
- Oftan Katahrom
- Catarax
Cataracts in an elderly person The best eye drops to improve and restore visual acuity: list
- Reticulin
- Stillavit
- Zorro
- Sante 40
Eye drops after laser correction: list
Important: Drops after laser correction can only be prescribed by a supervising doctor. You can replace the drug with an analogue only after consulting a doctor. The duration of use of the drops is also determined by the doctor.
After laser correction, two types of drops are prescribed:
- Anti-inflammatory
- Moisturizing
Anti-inflammatory drops, list:
- Tobradex
- Dexamethasone
- Maxitrol
- Maxidex
- Oftan Dexamethasone
Moisturizing drops, list:
- Systane
- Oksial
- Hilo-Chest
- Oftagel
Anti-inflammatory drops Tobradex Eye drops to improve vision Oftan Katahrom: how to use for visual impairment?
- Oftan Katahrom drops are indicated for cataracts. The drug stimulates metabolism in the tissues of the lens and has an antioxidant effect.
- The drug should be instilled 2-3 drops 3-4 times a day for no longer than 15 days. An open bottle can be stored for 1 month.
- Contraindications: age under 18 years, breastfeeding and pregnancy.
Important: Before using Oftan Katachrom drops, you must remove your contact lenses. After instillation, do not wear lenses for at least 15 minutes.
Oftan Katahrom for the treatment of cataracts Irifrin eye drops: how to use for visual impairment?
Irifin- eye drops that help dilate the pupil.
Drops are used in vision diagnostics, before surgery, and in the treatment of iridocyclitis.
It is worth knowing that sometimes side effects occur, such as burning eyes, tearing, increased blood pressure.
Important: Irifin drops are contraindicated for elderly people.
This is what Irifin eye drops look like Eye drops for vision prevention
Vitamin drops and drops to relieve fatigue are suitable for vision prevention.
The eyes of a modern person are exposed to a lot of stress every day, so moisturizing will not harm, but on the contrary, it will help maintain good vision.
A set of eye exercises, multivitamins to maintain vision, along with eye drops will help maintain normal vision.
Age-related vitamin eye drops for the elderly
Important: With age, 99% of people experience visual impairment. Elderly people often suffer from retinal dystrophy, senile cataracts, and glaucoma. Prevention will help prevent or delay ophthalmic diseases.
Eye drops for the elderly:
- Taufon
- Catarax
- Quinax
- Riboflavin
Older people need to keep their eyes healthy What drops should I put in my eyes to improve my vision instantly?
If you have problems with your vision, you should understand that the drops will not improve your vision 100%, they will only help you a little.
These drops include:
- Taufon
- Sante 40
- Zorro
- Reticulin
Important: Each case is individual, so you should definitely consult an ophthalmologist.
Relaxing eye drops
To relax the eye muscles, drops are used in several cases:
- When diagnosing
- For the treatment of inflammatory processes
- Before surgery
Such drugs include:
- Atropine
- Midriacil
- Cyclomed
- Midroom
Pupil dilation after Atropine Eye drops to improve vision for children and adolescents: list
Important: A child does not need to take drops to prevent vision without a doctor’s prescription.
Most eye drops have a general contraindication - children's age. To prevent vision, it is better to use a multivitamin complex.
If a child has an eye infection, the doctor may prescribe the following medications:
- Sulfacyl sodium
- Levomycetin
- Phloxal
- Albucid
The dosage and period of use are prescribed purely individually.
At the end, I would like to add a few words about the hygiene of using eye drops. It is unacceptable to use other people’s drops, just as you should not give your own drops to other people. Wash your hands thoroughly before instillation. It is advisable to instill heated drops, since cold ones are much less absorbed. To warm up, simply lower the bottle into a glass of warm water for a few seconds.
Video: How to instill eye drops?
To combat all possible undesirable consequences and speed up the healing process, doctors usually prescribe several types of drops:
- Antibacterial (often with an antihistamine or glucocorticosteroid component) - they are instilled starting from the day of the operation and thereafter for a week. Then they go to the doctor to assess healing and possibly change the medication.
- Moisturizing - they are used for a month or longer.
It is important to follow the following rule: when prescribing different drops at the same time, it is necessary to leave an interval between instillations of at least 20 minutes.
You should see a doctor if:
- Purulent discharge from the eyes appeared. After surgery, mucous discharge. The appearance of pus means that the prescribed antibacterial drops do not act on the existing pathogenic microflora.
- Allergy manifestations occurred in the form of burning, hyperemia of the cornea and eyelids, itching, and copious mucous discharge.
Moisturizing drops are similar in composition to tear fluid; they replenish its deficiency and protect the cornea from drying out. Some of them may contain substances that heal microtraumas of the cornea.
Drugs that are prescribed for a month or longer:
In addition, Oftalmoferon may be prescribed. It fights viral infection and inflammation, and hypromellose in its composition eliminates dry eyes.
Antibacterial drops are usually used in the postoperative period Tobradex and Dexamethasone.
All medications and treatment regimens are determined by the doctor.
How to instill correctly
Step-by-step instruction:
- Hygiene first: Wash your hands thoroughly with soap.
- Take a comfortable position: it is better to lie down or sit on a chair with a high back. Tilt your head back and look up. Now pull back the lower eyelid with your fingers and drop 1 or 2 drops into the resulting bag.
- Relax: close your eyes and lie down for another 3-4 minutes.
- After the procedure: do not blink, do not rub your eyes, and do not touch them with your hands at all.
Remember the general rules for handling eye drops:
- Screw the cap on tightly after each use to prevent contamination of the solution.
- Do not touch the tip of the dropper to your eyes.
- Keep the medicine in the correct place.
- Do not use an open bottle for more than a month, unless otherwise indicated in the instructions.
- Don’t skimp on your health: throw away any drops left after treatment.
- One person – one package of eye drops. The bottle must not be used by anyone else, even if they are members of the same family.
Useful video
Vision is restored up to 90%
- After excimer laser correction you will have to spend about an hour or two in the clinic. This is necessary so that after the laser correction procedure, the doctor does a control examination of your eyes to make sure that the upper layers of the cornea fit correctly.
- After excimer laser correction, you can return home on the same day. Vision correction is carried out in a “one-day” mode, without hospitalization. But you need to pass mandatory control checks vision after 1,3,7,14 days, and after - after 1.3 months. All these post-operative examinations are performed at the Excimer Eye Clinic for free!
- If necessary, your doctor will give you special drops, protecting against infection, which you will need to instill for several days.
- Instill drops (2 drops 4 times a day) until the doctor cancels them. It is necessary to instill drops into the lower fornix of the conjunctiva - when looking up, moving the lower eyelid down. It is effective to instill drops while lying down, fixing both eyelids.
- Please note that drops, ointments, and eye gels can only be used as prescribed by a doctor!
- IMPORTANT! After the correction, lacrimation is possible, do not rub your eyes under any circumstances, blot the tear on your cheek with a clean handkerchief or sterile napkin. Avoid touching your eyes in any way during the first 24 hours after correction.
- In the first hours after surgery and during the day (2-3 times), if necessary, you can take sedatives and painkillers (analgin, baralgin, ketorol, etc.).
- On the first day after laser vision correction, try to sleep on your back.
- Avoid getting soap or shampoo in your eyes for the next 2-3 days.
- During the rehabilitation period (about a week) CONTRAINDICATED:
- getting dirty water into your eyes, visiting a swimming pool, bathhouse, sauna, swimming in ponds;
- physical activity associated with increased injury and heavy lifting (dancing, skiing, skating, contact and extreme sports and other traumatic activities);
- women are not recommended to use decorative cosmetics, hairspray, and aerosols;
- Sunbathing is not recommended; doctors also advise wearing sunglasses in sunny weather;
- During the recovery period you should refrain from drinking alcohol.
- Be sure to undergo follow-up vision tests prescribed by your doctor (the post-operative follow-up schedule will be drawn up by your attending physician). All these post-operative examinations are performed free of charge at the Excimer Eye Clinic.
- If your visit is impossible, please notify the clinic reception staff.
After laser correction of high degrees of myopia, farsightedness, and astigmatism, a person needs some time to finally adapt to the new vision. The brain must adapt to visual information that is unusual for it. In order to “help” him, at the Excimer clinic, patients are given the opportunity to adapt using a special device “Reamed”, developed by specialists from the Brain Research Institute.
The operation of the device is based on the method of video-computer auto-training. This approach optimizes the functioning of neurons in the visual cortex, and vision is significantly improved.
Remember! The result of laser correction does not change over time- this is a proven fact. Vision correction underwent multi-stage clinical trials before it was used by ophthalmologists in medical centers and clinics around the world. Since the late 80s, more than 15 million corrections have been made and so far there have been no cases of vision deterioration after excimer laser correction using the LASIK technique.
For good vision (clear from different distances), the light must be focused precisely on the retina. Otherwise, various types of pathologies arise: blurred images (astigmatism), myopia (myopia), farsightedness (hypermetropia). Visual function can be restored by changing the refraction of light in the cornea - the frontal part of the eyeball, where the main refractive processes occur. Traditionally, this effect is achieved with the help of glasses, contact lenses and microsurgical operations - intraocular and on the cornea.
About 30 years ago, high-precision excimer (cold) lasers began to be used for vision correction. The laser beam is directed into the main, thickest part of the cornea (stroma), scans it, simultaneously eliminating defects that prevent light from reaching the retina. The required refractive environment is formed by point evaporation of anomalous areas.
The current methods of laser vision correction differ in the method of eliminating the outer layers of the cornea - epithelial and Bowman's membranes, the depth of laser penetration into the stroma and the rehabilitation period.
In photorefractive keratectomy (PRK), the epithelial and Bowman's membranes are completely removed and the laser is applied to the upper part of the stroma. In the LASIK (Laser-Assisted in Situ Keratomileusis) technique - laser intrastromal keratomileusis and LASEK (LASer Epitheliale Keratomileusis) - laser epithelial keratomileusis, the outer shell of the cornea is not destroyed, but is partially cut off (a so-called flap is formed) and bent to the side. In the first case, the epithelium, Bowman's membrane and the upper part of the stroma are raised, the laser, accordingly, corrects the deep layers of the stroma, in the second case, only the epithelium is cut off, which is due to the cornea being too thin or its significant convexity. After grinding, the flap is returned to its place and, thanks to the highly cohesive stromal collagen, quickly attaches to the cornea and fuses with it. The latest technique - Super LASIK ensures smoothing of not only large, but also small damage to the cornea.
Why does postoperative dry eye occur and how to avoid it?
Despite the fact that excimer laser surgery minimally destroys eye tissue, in the postoperative period, approximately half of the patients experience complications, the leading place among which is dry eye syndrome (DES) or keratoconjunctivitis sicca. And the more gentle methods of LASIK and LASEK do not completely save the patient from this side effect, although after LASEK the risk of developing the disease is less, because only the epithelial membrane is damaged.
With dry eyes, a person feels as if there is a foreign body or sand in his eye, and the eyelid sticks to the eyeball. This discomfort is usually accompanied by pain, pain, burning, itching, redness of the conjunctiva, which does not bring relief with lacrimation. During the day, visual acuity fluctuates; blurry vision, however, is restored after blinking. Frost, wind, excessively dry air (including air-conditioned air), smoke, especially poisonous tobacco, are poorly tolerated.
Keratoconjunctivitis sicca occurs due to insufficient hydration of the eye or increased evaporation from its surface. And during surgical vision correction, including laser, the tear film, which protects the eye from drying out, irritation and infections, is damaged. The flap never fully heals. After surgery, soft lenses are often placed on the damaged areas. In addition, when cutting off the outer part of the cornea, the nerve endings of the glands responsible for producing tears are destroyed. Damaged nerve tissue is not restored either in density or structure. The situation is further aggravated by photorefractive keratectomy, which leads to the formation of microerosion on the surface of the cornea that does not heal within 24–72 hours.
According to medical research, after laser refractive surgery, dry eye symptoms develop most intensively in the first 2-4 weeks. Up to 30% of patients record their appearance within three months, about 20% even after six months, and in a pronounced form. Some people who have undergone this type of surgery have been bothered by this type of discomfort for several years. With a 3–6% probability, long-term irreversible complications are possible.
Factors for the occurrence of dry eye syndrome after laser correction
In the early postoperative period, the risk of developing dry eye syndrome increases:
- dry eyes at the time of surgery or in history;
- high myopia;
- thyroid disease;
- Parkinson's disease;
- Sjögren's syndrome;
- lack of vitamin A;
- taking medications (primarily antiallergic, antihypertensive, antidepressants);
- spending long periods of time at the computer and in air-conditioned rooms; menopause in women;
- wearing contact lenses because they absorb tear fluid.
Postoperative dry eyes can be avoided if you first assess the degree of predisposition to it, or identify hidden symptoms. Therefore, before going under the “laser knife”, you need to undergo a special examination and obtain a medical opinion on the condition of the conjunctiva, cornea, eyelid margins, the quality of tear production (the rate of formation and evaporation of tears, the degree of its homogeneity), and the stability of the tear film. The presence of the disease and its severity can be determined using special drops. More complex and labor-intensive methods for diagnosing and assessing the severity of dry eye syndrome have been developed.
If signs of the disease or risk factors for its development are identified, 1–3 weeks of preoperative tear replacement therapy should be completed. Prevention of dry eye disease in the postoperative period is essential. Women should avoid wearing cosmetics. If the preventive measures taken did not give a positive result, and the pathology began to develop, in order to avoid complications in the form of corneal dystrophy, you should register with an ophthalmologist and visit him at least once every six months.
How to treat?
The main focus of treatment for dry eye syndrome is to stimulate tear production and improve the stability of the tear film. At the same time, disturbing symptoms and the supposed primary causes of the disease are eliminated - chronic blepharitis and conjunctivitis, general diseases (diabetes mellitus, Sjögren's syndrome, etc.). A set of health measures is selected based on the cause of the disease, the patient’s condition, and the reaction of his body to certain medications.
The most common and effective treatment for keratoconjunctivitis sicca are artificial tears and gel-like tear replacement medications. They vary in active substance, consistency, and duration of effect. For those who are outside the home, disposable dropper tubes have been developed. In addition to being comfortable to wear, they provide maximum hygiene and minimize the risk of infection.
Preference should be given to those medications that moisturize the eyes as gently as possible, effectively combat insufficient tear production, and quickly relieve irritation, redness and eye fatigue. It is equally important that the medicine is completely natural and has a long-lasting effect, which is largely ensured by the viscosity of the solution (the higher the viscosity, the longer the healing potential remains). Preservatives in the composition can lead to allergic reactions, and drugs that constrict blood vessels can limit the production of tear fluid.
Artificial analogues of natural tears are preparations based on hyaluronic acid contained in the tissues of the eye. Sodium hyaluronate molecules, by binding water molecules, promote the formation of a tear film on the frontal surface of the cornea. Such drops quickly relieve discomfort, maintain visual acuity even immediately after instillation, promote rapid recovery after surgery, and have a long-lasting effect. Among them:
- Artelak Splash;
- Khilozar-chest of drawers;
- Hilo chest of drawers.
Povidone-based drops (Vid-komod) provide a similar therapeutic effect. Systane and Visine combine several active components.
Drops based on hypromellose (Artificial tears, Hypromellose-P) are viscous, which ensures a prolonged effect. Tear substitutes based on the high molecular weight polymer carbomer (Oftagel, Vidisik) also have the property of increased viscosity. But these drops are not without a drawback - after use, they cause a burning sensation for a short time and reduce the sharpness of vision.
Postoperative tear replacement therapy should last from 3 to 6 months, and if necessary, longer. If the eyes are highly resistant to artificial moisturizing, the problem can be solved by closing the tear ducts with plugs. A tear held in the eye will wash it well. Plugs made of absorbable collagen are temporary, but plugs made of silicone last much longer.
Other measures that can help relieve dry eyes include:
- maintaining the body’s fluid balance at the proper level (you should drink 8–10 glasses of liquid daily);
- increasing the consumption of plant and animal fats, primarily flaxseed oil or fish oil (promotes the secretion of the fatty layer of the tear film, which protects the eye from moisture evaporation);
- frequent blinking (favors uniform distribution of tears over the surface of the eye).
Excimer correction is the least invasive correction of vision defects associated with distortion of the focusing of the light signal due to physical defects of the cornea. By successfully stopping dry eyes after surgery, you can achieve maximum improvement in the patient’s vision and quality of life in the shortest possible time.
