Refractive surgery uses excimer lasers to reshape the cornea’s surface to correct or significantly reduce refractive vision defects (myopia, hyperopia, or astigmatism). It is an eye surgery with permanent effects that can be performed on a large sample of patients (about 6-7 patients out of 10 are eligible). 

Refractive defects significantly impact a person’s life: those affected by myopia, hyperopia, or astigmatism need corrective lenses, whether prescription glasses or contact lenses, and refractive surgery can be a valuable ally in getting back to looking at the world. 

Some centers offer innovative technologies for refractive surgery that allow specialists to fully customize refractive surgery based on the eye’s morphology and the patient’s clinical conditions.

In addition, the study “Advanced Surface Ablation With a New Software for the Reduction of Ablation Irregularities,” published in the Journal of Refractive Surgery, reports that patients following the surgery had better vision without glasses than they had with glasses before refractive surgery.

What is refractive surgery? And which patients can benefit from it?

Excimer Laser: How Does It Work?

The excimer laser is a state-of-the-art instrument that allows the cornea to be reshaped by removing microscopic tissue parts with the utmost precision. The software enables advanced tracking to compensate for all the involuntary movements the eye may make during treatment, although the patient stays still. In this way, the action on the cornea is constantly compensated, and the procedure can be carried out swiftly.

 A common fear relates specifically to the consequences of unintentional head or eye movements. Still, one can rest assured: the excimer laser’s eye tracker is extremely sensitive and can follow eye movements by monitoring them a thousand times per second.

 In addition, an optical coherence tomography (OCT) system can record extremely high-resolution images of the cornea and measure its thickness from the beginning to the end of treatment. Excimer laser refractive surgery allows for a noninvasive procedure that can take place in a clinic, with topical anesthesia administered via eye drops and without sedatives. The procedure lasts only a few minutes, and at the specialist’s discretion, both eyes can be treated simultaneously.

What Are the Advantages of Refractive Surgery?

As shown in the study mentioned above, patients following the surgery had better vision without glasses than they had with glasses before refractive surgery.

Correcting the refractive defect after excimer laser surgery is a permanent and stable solution. However, there can still be changes in vision over the following years. These changes do not depend directly on the surgery but usually occur over time. In addition, certain factors that may result in the greater or lesser success of the operation can already be found during the preliminary examination and will be explained to the patient before the surgery is scheduled.

Factors that may result in a disappointing outcome include:

  • An abnormal tissue response.
  • The unsuitability of the patient.
  • Errors in treatment.
  • Problems in the functioning of the instrumentation.

However, an additional session might resolve the issue.

When to Choose Refractive Surgery?

Approximately 60-70% of patients with refractive defects can undergo excimer laser surgery, while the remaining patients may be found unfit after the ophthalmologist’s examinations. The specialist uses state-of-the-art instrumentation at the diagnostic stage to assess all aspects of the patient’s eye health and precisely define the surgery.

Refractive Surgery: Age and Type of Vision Defect

To undergo refractive surgery, one must be at least 18 years old, and the stability of the refractive defect must have been diagnosed for a minimum of one year since the last eye examination; thus, the defect – whether myopia, hypermetropia, or astigmatism – must not have worsened in that time. As a rule, these disorders stabilize after the age of 20, in the case of hyperopia, and a few years later, in the case of myopia.

To Whom Is Surgery Not Recommended?

Refractive surgery is not recommended for pregnant patients, as drugs administered during the surgery and convalescence period may not be suitable. Also, the physiological biomechanical weakening of the cornea may compromise the treatment outcome.

What Behaviors to Follow After Refractive Surgery?

As previously mentioned, surgery can be performed on both eyes simultaneously at the specialist’s discretion. However, depending on differences assessed at the consultation, the timing of surgery between one eye and the other may differ. In this case, the specialist may prescribe changes to the eyeglass. 

It should be emphasized that one should never take a personal initiative and always follow the medical instructions about the possible use of specific eye drops or other medications.

Can One Play Sports After Surgery?

Excimer laser surgery is noninvasive, and the patient’s recovery is speedy, so those who engage in physical activity can resume it quickly. The eyesight, however, needs an adequate amount of time to readjust, so sports performance initially may not be optimal.

Can One Go to the Pool or the Beach After Refractive Surgery?

In the first period after surgery, environments that are particularly irritating to the eye, such as steam baths and saunas, should be avoided, and proper precautions should be taken when going to the pool or sea. Wearing goggles or masks is essential, as is the use of sunglasses if exposed to sunny days.

Can One Wear Makeup After Eye Surgery?

It is best to avoid wearing makeup until five days after refractive surgery. We recommend consulting the specialist during the follow-up visit for more detailed instructions.