Vision correction at 16 years old. Laser vision correction: can it be done for children? Anterior radial keratotomy

There is no need to be afraid. Fear usually occurs when there is uncertainty. In any case, you need to learn more about excimer laser correction: read the literature, including on the Internet. You can undergo a diagnostic examination in our Eye Microsurgery Clinic to determine possible indications, contraindications and features of the operation, as well as ask all the questions to the doctor and obtain the necessary information.

At what age is it better to undergo laser vision correction surgery?

Excimer laser vision correction operations are recommended to be performed at the age of 18-45 years. Usually by the age of 18, the growth and formation of the eye ends, vision stabilizes and correction can be made.
From the age of 40-45, presbyopia begins to develop - a condition when a person’s distance and near vision differs. That is, even with excellent results from the operation, it will not be possible to completely get rid of glasses: from the age of 40-45 you will need reading glasses. Therefore, starting from the age of 42, we warn the patient about the need to use glasses at close range after correcting myopia.

Is it possible to have surgery on a 16-year-old teenager (vision -8, no other abnormalities)?

We do not recommend surgery at this age. The optimal age for vision correction is over 18 years old. In addition, myopia should not progress. To make sure of this, you need to undergo diagnostic examinations at intervals of six months to a year (you can do it in our Clinic). If there are no deviations, then at the age of 18 we will be able to perform the operation.

What kind of vision will there be after surgery?

A forecast regarding the percentage of vision recovery is made during diagnosis. Typically, the maximum predicted vision without glasses after surgery is equal to vision with glasses or contact lenses before surgery.

What to do if myopia progresses?

If there is confirmed evidence that myopia is progressing by more than one diopter per year, then scleroplasty surgery should be performed to stop the progression. Excimer laser vision correction should be performed when vision is stable. Myopia usually progresses during childhood and adolescence, when the eye grows and develops as an organ.

Do properly fitted contact lenses affect the progression of myopia? Is wearing contact lenses for a long time harmful?

Contact lenses do not affect the progression of myopia.
Long-term wearing of contact lenses can lead to disturbances in the cornea of the eyes - ingrowth of blood vessels, etc. Periodic examinations by an ophthalmologist are necessary.

The patient was going to undergo surgery to correct myopia, but after an examination he was diagnosed with cataracts. For this reason, laser vision correction was not recommended.

Indeed, if you have cataracts, instead of two operations (to correct myopia and to remove cataracts), you should do one - cataract removal with implantation of an artificial lens - an intraocular lens (IOL). It is better to perform this operation on an outpatient basis using phacoemulsification. At the same time, it is also possible to eliminate myopia by selecting and calculating an IOL, and by implanting a toric IOL, astigmatism can also be eliminated.

Are previous operations of scleroplasty and peripheral laser coagulation (strengthening) of the retina a contraindication for vision correction surgery?

The operations of scleroplasty and laser prevention of retinal detachment are not contraindications, but preparatory operations for laser correction, respectively, with the progression of myopia and dystrophic changes in the periphery of the retina.

Does laser vision correction surgery affect pregnancy and childbirth?

Laser vision correction surgery itself does not affect childbirth in any way. You can become pregnant within a month after the operation. The operation can be performed before pregnancy (maximum in the first month of pregnancy) or after childbirth and the end of breastfeeding.
Possible limitations may be related to the condition of the retina.

Why is it necessary to examine the retina in case of myopia?

With myopia, light rays intersect not at the retina, but in front of it. This happens in the vast majority of cases due to the fact that the eye with myopia has an elongated shape. At the same time, all the media and membranes of the eye, including the retina (nervous tissue responsible for the perception of images and their transmission to the brain), are elongated and thinned. These changes are more pronounced the higher the myopia value. With significant thinning of the retina, peripheral dystrophies and even local ruptures can occur. Peripheral retinal dystrophy itself may not manifest itself in any way, however, with overload, severe stress, shocks and other impacts, the risk of developing retinal detachment significantly increases, which can lead to sudden loss of vision and the need to perform urgent complex surgery in a hospital without guarantee of vision restoration.

During laser vision correction, excessive pressure is briefly created on the eye, so before performing the operation, the doctor must be sure that the retina is in order.

Therefore, an examination by a retina and fundus specialist is included in the initial examination program at our Center. If certain forms of dystrophic changes or ruptures are detected, it is recommended to perform peripheral laser coagulation of these areas.

Laser vision correction surgery does not affect the retina. That is, after the operation, despite good vision without glasses and lenses, the condition of the retina does not change and all restrictions associated with the retina remain.

Are there complications after surgery?

With modern vision correction methods that we use, the probability of developing complications is less than 1%, but most of them are eliminated by instilling drops, etc. The probability of developing serious complications is less than 0.1%. The condition of the patient’s body plays a major role - the absence of serious general and eye diseases, specific contraindications and other features. They are usually identified during a diagnostic examination and conversation with a doctor.

In accordance with the theory of W. Bates, most visual impairments are associated not with changes in the shape of the cornea or lens, but with tension in the muscles of the eyeball. If his conclusions are correct, then why do vision correction operations affect the cornea and not the muscles of the eyeball?

The Bates method is a method of vision restoration not recognized by science, which includes a number of special exercises. Bates exercises for myopia, as well as exercises for training accommodation and relieving visual fatigue, as a rule, are partially effective only up to the age of 16, when the eye grows and develops (and myopia develops). Correction of the shape of the cornea using a laser gives a stable, predictable result, characterized by a fast recovery period, almost complete absence of restrictions in the postoperative period and other advantages.

Does laser vision correction really worsen vision in the dark and cause various optical effects?

Such problems actually occurred during the operation of excimer laser systems of the first generation, when the maximum laser operating area was small - about 5 mm in diameter. At the same time, some patients after laser vision correction noted an unclear image of bright luminous objects (lanterns, car headlights) in low light conditions. In the evening, the pupil of a person’s eye, expanding, exceeded the zone of the correction performed, and optical aberrations were observed at the border, leading to an unclear image of luminous objects.
The Eye Microsurgery Clinic uses the latest generation excimer laser from the Japanese company NIDEK, which allows correction in areas up to 10 mm in diameter, which in the vast majority of cases does not lead to these problems.
The SUPER-LASIK technology we use allows us to improve the quality of postoperative vision and optimize night vision.

Is surgery possible for keratoconus?

Keratoconus is a degenerative, non-inflammatory eye disease in which the cornea thins and takes on a conical shape. Keratoconus is, in principle, a contraindication for excimer laser vision correction.
In the initial stages of keratoconus, to improve functional vision and stop its progression, we perform implantation of corneal semiring segments. This operation is performed using knifeless technology using a high-precision femtosecond laser. To stop the progression of keratoconus in the initial stages, we perform a procedure for cross-linking corneal collagen with riboflavin. If you have developed keratoconus, we recommend contacting specialists for a corneal transplant, for example, at the Eye Microsurgery MNTK, Moscow, in the Department of Corneal Pathology.

Laser vision correction is a story about how to forget about foggy glasses in winter, about blisters with contact lenses, about how both a child and an adult can live a bright and comfortable life, skiing, swimming, diving in the sea and in general do not limit your development.

Victoria Balasanyan, Candidate of Medical Sciences, leading refractive surgeon at the Lasercorr clinic, told Letidor about who is eligible for laser vision correction and the myths that exist around it.

The history of the use of excimer lasers for refractive surgery begins in 1983. It became possible thanks to the active development of technology and engineering, which made it possible to create lasers that operate on the surface of the cornea without damaging the deep-lying media of the eye.

The operation is called photorefractive keratectomy (PRK). But to achieve a better effect for optical defects greater than 6 diopters, the first LASIK operation was performed in 1989, which minimized the disadvantages of PRK and made it possible to more quickly rehabilitate the patient after surgery.

What does a laser do?

The cornea is a kind of “natural lens” of the human eye. The laser helps give the cornea a different shape. As a result of the operation, the cornea refracts light rays differently, and those images that were previously visible blurry take on clear outlines.

Laser vision correction helps treat eye diseases such as myopia, astigmatism and farsightedness.

Is it possible to have laser correction before giving birth?

Despite all the advantages and long experience of laser correction, there are a huge number of myths around it. Perhaps one of the most common is that laser correction cannot be done before childbirth.

Childbirth itself does not in any way affect the progression of myopia.

It is very important to know that vision correction is not performed during pregnancy and breastfeeding.

During childbirth, vision problems can indeed arise. This is due to the poor condition of the retina and is very often accompanied by myopia. Before performing laser correction, the doctor needs to find out what condition the patient’s retina is in and, if necessary, strengthen it.

It’s another matter when myopia has not stopped growing in principle. And then after laser correction it will appear again, but this again is not due to the fact of childbirth, but to the growth of the eyeball.

Is it possible to do laser correction for children?

For the same reason, there is a second myth that laser vision correction is performed from the age of 18, that is, children cannot have it. But all over the world it has long been carried out in children under certain conditions. In Russia, back in 1990, for the first time, laser vision correction in a child was performed by Academician of the AMTN, Doctor of Medical Sciences. Igor Erikovich Aznauryan.

To carry out laser correction for children, it is important to understand how the child’s eye is structured and how it develops. The age of 18 years for correction is quite arbitrary. There are people whose myopia continues to progress even at 20 years of age. Therefore, if they undergo correction at the age of 18, then after 2-3 years this person will again develop myopia.

Based on my own and foreign experience, I can say with confidence that it is possible to perform laser correction in children.

And they do it not for cosmetic purposes, as in adults, but for the purpose of final rehabilitation for conditions such as strabismus, amblyopia, anisometropia.

Anisometropia- this is a disease in which there is a very large difference between the refractive power of the eyeballs - more than 2 diopters. All over the world, refractive surgery is actively used in children with this diagnosis.

For farsightedness or astigmatism A child’s eyes stop growing by the age of 5-6 years, and by 9-10 years his visual organs are already fully formed.

That is why, already at the age of 10, a child with farsightedness or astigmatism can undergo refractive surgery and have his glasses removed at school age.

Is it painful to have surgery?

Laser correction can be done both under local anesthesia and in medicated sleep.

With local anesthesia, special anesthetic eye drops are used to block pain. All the patient feels is light touch and occasional slight pressure during the operation.

Although, of course, any operation is almost always stressful for a person, and it is difficult for the patient to stop worrying both before and during the operation, because these fears and concerns arise unconsciously. At the same time, a person’s blood pressure may increase, he may experience discomfort, negative emotions, and he may experience a rapid heartbeat.

That is why laser correction can be done with the help of so-called medicinal sleep.

There is an opinion that laser vision correction can only be done after 18 years of age. But at the same time, there are surgeons who perform this operation on children at 10 and 6 years old. What kind of doctors are these? Pest surgeons? Or innovative surgeons? The NNmama.ru portal talked about this with Victoria Balasanyan, candidate of medical sciences, ophthalmologist, leading ophthalmic surgeon at the Lasercorr clinic.

According to the Association of Ophthalmologists and Strabismologists, every third student graduates from school wearing glasses. Some people put on glasses even before school. I think everyone understands perfectly well that glasses limit the child and interfere with a full-fledged childhood. Wearing glasses you have to run, watch cartoons, play with friends.

What about sports? Swimming, playing football, doing martial arts? Then, when children grow up, they begin to use lenses. They also cause a lot of inconvenience and often cause dry eye syndrome. But the main thing is that vision problems prevent children from realizing their dreams. Become an athlete, ballerina, pilot, policeman...

With poor eyesight, these professions are inaccessible. And now we are faced with a problem. For example, Petya wants to work in the Ministry of Internal Affairs and has been wearing glasses since childhood. He has congenital myopia, to which amblyopia was later added. When he gets close to admission, he learns that the Ministry of Internal Affairs does not accept people with eye diseases, including myopia and amblyopia.

Then Petya decides to have laser vision correction. And somewhere on the Internet he reads that such an operation can only be performed at the age of 18. And when he finishes school he will only be 17. So what? An unattainable goal and a shattered dream? Look for another university and choose another profession? But in fact, in Petya’s case, laser correction had to be done before school age, until amblyopia developed.

The myth that laser correction can only be done by adults deprives many children of their childhood, and deprives teenagers of a wide choice of profession. Where did the myth come from? There is some truth in this myth. It was previously believed that by the age of 18, myopia in children is completely stabilized and no longer increases. Until then there is no point in the operation. If you do it with increasing myopia, the decline in vision will still continue. But modern ophthalmologists are now noticing another trend - myopia can increase up to 20 years, and even up to 25. So age itself does not matter. It is important how myopia grows and what it is like.

Laser vision correction: for what diseases is it indicated?

If a child has acquired myopia, that is, vision began to decline, for example, at school, then you really need to wait until the age when the myopia stabilizes and stops.

If a child’s vision does not decrease within three years and he has no contraindications, then he can undergo laser correction.

You need to understand that laser correction for children is not just a cosmetic operation that helps to remove glasses. We perform such operations on many children for therapeutic purposes. And sometimes laser correction is the only effective treatment.

If a child has congenital myopia and farsightedness, this must be corrected before school. We usually advise parents to wait until they are 6 years old. By this age, the visual system is fully formed, and farsightedness and myopia are stabilized. And at the age of 6, laser vision correction is not only possible, but also necessary. After all, if these congenital pathologies are not corrected, then with age the child will develop amblyopia, or as people call it “lazy, weak” eye. This is when the vision in one eye drops sharply, and then the eye is completely switched off from the visual process.

Sometimes mothers bring to us for appointments children who have developed strabismus due to congenital farsightedness. I want to say that in this case laser correction is sufficient. As soon as we remove farsightedness, strabismus also goes away.

Modern ophthalmologists also perform laser operations on children with astigmatism and anisometropia (when there is a very large difference between the eyes, for example, one is +6, the other is -2). Children's laser correction has long been used for therapeutic purposes all over the world. But many people believe myths and do not know about the real possibilities of modern medicine.

In Russia, the first laser vision correction for a child was performed by Academician of the AMTN, Doctor of Medical Sciences. Igor Erikovich Aznauryan in 1999.

Laser vision correction: how is the operation performed?

For many, the word “surgery” itself brings fear. I want to reassure you: modern ophthalmology allows you to perform laser correction painlessly and in the most relaxed conditions.

We have developed and practice laser correction in medicated sleep. This is a very mild form of short anesthesia. A person falls asleep for 20 minutes, and when he wakes up, he sees the world without glasses. Laser surgery techniques are simple and refined.

Every week I operate on children with complex forms of strabismus. And laser correction (compared to such operations) is like a multiplication table for a mathematics university student.

Laser vision correction: what to pay attention to?

Before surgery, the child should be tested for dry eye syndrome. It usually appears in those who work a lot on the computer, but modern children are all about gadgets. They are always with their phone, tablet, TV. Even children experience dry eye syndrome. Before surgery, a competent doctor must do a Schirmer test - a test that determines how well the eye is hydrated. If a diagnosis of dry eye syndrome is made, it must first be treated and then operated on. If this is not done, then after the operation there will be a feeling of sand in the eyes.
You should be confused by the too cheap prices for laser correction. Most likely, this is not an indicator of the doctor’s generosity, but of the fact that the laser machine is of poor quality.

is a highly effective modern method of improving vision. The laser beam is directed at the cornea of the eye, which changes its shape under its influence. At the same time, the retina regains its ability to focus the image normally, which significantly improves vision. The price of laser vision correction is lower than the cost of a year's supply of daily lenses.

Positive aspects of laser vision correction

Currently, more and more people with vision problems are choosing this method of correction. Indeed, the uniqueness of this procedure is difficult to overestimate:

This type of operation has been carried out for more than a quarter of a century. According to statistics, during this time thousands of people have significantly improved their vision. And this method is constantly being improved.
Despite all the effectiveness of laser vision correction, it is completely safe and does not harm the eyes. The risk of complications after such an operation is practically reduced to zero.
This procedure usually lasts no more than fifteen to twenty minutes. In this case, most of the specified time is spent preparing the patient for surgery, and the laser effect on the cornea itself lasts about a minute.
This operation involves the use of local anesthesia. This eliminates the harmful effects of potent drugs on the body, as with general anesthesia. In this case, pain and any discomfort during the operation are completely absent.
This method of improving vision is carried out on an outpatient basis, that is, the patient does not need to go to the hospital in order to prepare for the operation and recover after it.
Immediately after the operation, the patient notes a significant improvement in vision. Within a week after the procedure, complete recovery occurs.

The recovery period after laser vision correction takes a minimum amount of time, subject to certain temporary conditions and restrictions:

sleep exclusively on your back on the first day after the procedure,
mandatory use of eye drops for the time specified by the doctor,
minimal physical impact on the operated eye,
compliance with special hygiene standards in relation to this organ of vision, including the refusal of decorative cosmetics,
lack of physical activity and sports for some time after surgery,
maximum protection of the eye from direct sunlight,
limiting computer work, watching TV and reading,
refusal to drink alcoholic beverages.

Indications for laser vision correction

It should be remembered that this procedure only corrects eye problems, but does not cure them; it significantly improves vision, but does not restore it. The effect of laser will have a beneficial effect on the condition of eyes subject to:

Stable myopia - that is, in cases where vision does not decline and remains within the range of -10.0 diopters for several years,
Stable farsightedness – when farsightedness is constant and does not exceed +6.0 diopters,
Low and in special cases medium degrees of astigmatism – up to 4 diopters.
Impaired functioning of one eye and resulting fatigue in the other.

Also, laser vision correction is relevant for those people who have poor vision, but due to their profession cannot use glasses and contact lenses. This category of patients includes military personnel, firefighters, swimmers, and chemical production workers.

Contraindications for laser vision correction

There are exceptions to each of the above points. That is why, before deciding on laser correction, it is necessary to undergo an examination and consult with a specialist.

Indeed, despite the obvious advantages, this method of vision correction is a surgical medical intervention, and therefore has a number of contraindications:

Laser vision correction is not indicated for any stage of cataracts and glaucoma,

It cannot be done with progressive myopia, farsightedness and astigmatism,
Any inflammatory disease of the organs of vision may be a contraindication for such a procedure.
Pregnant and lactating women should not agree to such an operation.
Laser exposure will not help with dystrophy, as well as with degeneration of the cornea of the eye,
People suffering from severe diabetes should not have this operation.
Laser correction will most likely be denied to those patients who have undergone surgery due to retinal detachment,
For any type of fundus changes, this method will also not be indicated.
For children under 18 years of age, laser correction does not make sense due to the fact that their visual system is still developing.
Endocrine diseases are also a contraindication to this operation.

As already said, the risk of complications after laser correction is almost zero, but still, as after any surgical intervention, it exists. This includes:

Swelling of the cornea after surgery,
Temporary drooping of the eyelid
Allergic reaction to medications prescribed in the postoperative period,
Insufficient hydration of the mucous membrane of the organs of vision,
Infectious inflammation of the cornea of the eye and its clouding.

All these troubles can be caused to a greater extent by poorly performed correction of the organ of vision. But these complications can be completely avoided.

If you have decided to undergo laser vision correction, then your main task is to find a good clinic and, first of all, a highly qualified specialist. A laser ophthalmic surgeon with extensive experience in performing such procedures will be able to perform this type of correction efficiently without causing harm to your eyes.

Therefore, when looking for a place to perform an operation, give preference, first of all, to those eye clinics that have proven themselves well in this area. The Eye Microsurgery Center at the SKZD Road Clinical Hospital is, first of all, experienced doctors. The clinic successfully performs these operations using modern, high-quality, world-class equipment.

Thus, laser vision correction can truly become a panacea for solving many different ophthalmological problems. However, this issue should be approached with all responsibility - taking into account all contraindications, observing all restrictions, passing all the necessary examinations and, of course, choosing the best specialist for laser vision correction.

I want to get rid of myopia, but I’m very afraid. How to overcome this fear?

There is no need to be afraid. Fear usually occurs when there is uncertainty. Perhaps you need to learn more about excimer laser correction: read the literature, including on the Internet, as millions of people have already had this operation. You can undergo an initial diagnostic examination with us. Its cost with a doctor’s consultation is 600 rubles. You will be able to determine possible indications, contraindications and features of the operation in your case, as well as ask questions that interest you and obtain the necessary information.

Is it possible to pay for clinic services from an organization?

Yes, this option is possible. To do this, you must first issue an invoice at the clinic’s reception desk, and after receiving the funds in our bank account, it will be possible to carry out the necessary examination or treatment

At what age is it better to have surgery?

Excimer laser vision correction operations are recommended to be performed at the age of 18-45 years. Usually by the age of 18, the growth and formation of the eye ends, vision stabilizes and correction can be made. From the age of 40-45, you, like all normal people, will begin to develop presbyopia - a condition when your distance and near vision will differ. That is, even with excellent results from the operation, it will not be possible to completely get rid of glasses - from the age of 40-45 you will need reading glasses. Therefore, starting from the age of 45, we recommend surgery only in cases of myopia of more than –5 diopters or astigmatism affecting vision.

My vision is -8, there are no other abnormalities, and I am 16 years old. Can I have surgery?

We do not recommend that you undergo vision correction surgery at this time. The optimal age for correction is over 18 years. In addition, your myopia should not progress. You can undergo diagnostic examinations with us at intervals of six months to a year to make sure that myopia does not progress. Then at the age of 18 we will be able to perform an operation on you.

What kind of vision will I have after surgery?

What to do if myopia progresses?

If myopia progresses by more than 1 diopter per year, then scleroplasty surgery is necessary to stop the progression. Excimer laser correction can be done if vision is stable. Myopia usually progresses during childhood and adolescence, when the eye grows and develops as an organ.

I wanted to have surgery to correct myopia (-5 diopters), but after an examination I was not recommended to have surgery due to the fact that I was diagnosed with cataracts.

Indeed, if you have cataracts, instead of two operations (to correct myopia and remove cataracts), you should do one - cataract removal with implantation of an artificial lens - an intraocular lens (IOL), preferably on an outpatient basis using phacoemulsification. Myopia can be eliminated by selecting and calculating an IOL.

What are the contraindications to the excimer laser vision correction method?

Contraindications are identified during the diagnostic process. Correction is preferably done between the ages of 18 and 45 years. Myopia should not progress. It is necessary that you do not have severe general or eye diseases or chronic diseases in the acute stage. If you use soft contact lenses, they should be removed 2 days before the diagnosis; hard - 2 weeks.

Are previous operations of scleroplasty and peripheral laser coagulation (strengthening) of the retina a contraindication for vision correction surgery?

What are the limitations after excimer laser vision correction?

Specific recommendations are given depending on the amount of myopia resulting from the operation. In most cases, the restrictions after laser vision correction surgery are as follows: Limit heavy physical activity for 2 weeks (if there are restrictions on physical activity related to the condition of the retina with high myopia, these restrictions remain after the operation!); Limit intense visual stress for 1 week; Do not visit the bathhouse, swimming pool, sauna for 1 month; Avoid drinking alcohol for 1 month.

I spend a lot of time at the computer. What restrictions await me after surgery?

After laser vision correction surgery, you can read, work with papers and a computer 1-3 days after the operation. However, prolonged visual strain on the eyes is not recommended for 7 days. You have to get used to your new vision, so there may be some discomfort at first. In the future, the rules of visual hygiene when working with a computer are the same as for any person (alternating visual stress and relaxation, gymnastics to relieve visual fatigue, working at a safe distance of 40 cm, etc.).

When can you have sex after laser vision correction surgery?

The operation is performed on people at a young active age, so this question interests many. There are no restrictions on having sex after laser vision correction surgery. For the first 2-4 weeks, you should be careful - do not touch your eyes with your hands, avoid heavy physical activity, do not be in an inclined position or upside down.

Does laser vision correction surgery affect pregnancy and childbirth?

Laser vision correction surgery itself does not affect childbirth in any way. You can become pregnant and give birth within a month after the operation. The operation can be performed before pregnancy (maximum in the first month of pregnancy) or after childbirth and the end of breastfeeding. Possible limitations may be related to the condition of the retina of your eyes. With myopia, especially moderate and high degrees, there may be changes in the periphery of the retina - dystrophy, tears, etc. In the presence of certain forms of dystrophy, it is recommended to completely exclude all possible overloads, impacts, heavy lifting, etc., women are recommended to give birth by cesarean section. If there are no problems with the retina, you can give birth as much as you like. You can conduct a retinal examination, for example, in our clinic. Please also keep in mind that laser vision correction surgery does not affect the retina. That is, after the operation, despite good vision without glasses and lenses, the condition of the retina does not change and all restrictions associated with the retina remain.

Are there complications, and if so, what are they? Causes?

With modern vision correction methods that we use, the probability of developing complications is less than 1%, but most of them are eliminated by instilling drops, etc. The probability of developing serious complications is less than 0.1%. The condition of your body plays a big role - the absence of serious general and eye diseases, specific contraindications and other features. They are usually identified during a diagnostic examination and conversation with a doctor.

At one time I came across a book by W. Bates. He argued that most visual impairments are not associated with changes in the shape of the cornea or lens, but with tension in the muscles of the eyeball. If his conclusions are correct, then why do vision correction operations affect the cornea and not the muscles of the eyeball?

Bates exercises for myopia, as well as exercises for training accommodation and relieving visual fatigue, as a rule, are only partially effective until the age of 16, when the eye grows and develops (and myopia develops). We use excimer laser correction of the shape of the cornea, since this method gives a stable, predictable result, is characterized by a fast recovery period, no restrictions in the postoperative period, and other advantages.

The information about deterioration of vision in the dark, various optical effects, etc. after correction is confusing. I have a dilated pupil (up to 8 mm in the dark), what is the likelihood of distortion if the treated area is only 6 mm?

Indeed, some patients after laser vision correction note a blurred image of bright luminous objects (lanterns, car headlights) in the evening. This effect especially occurred in the operation of excimer laser systems of the first generation, when the maximum laser operating area was small, on the order of 5 mm in diameter. In the evening, the pupil of a person’s eye, expanding, exceeded the zone of the correction performed, and optical aberrations were observed at the border, leading to an unclear image of luminous objects. We use the latest generation excimer laser MICROSCAN, which allows correction in areas with a diameter of up to 8 mm, which in the vast majority of cases does not lead to these problems. In your case, the answer can be given taking into account the data of a diagnostic examination - measuring the size of the pupil and the curvature of the cornea, which affects the maximum size of the laser operating area. Usually, in the postoperative period, 2-3 months after the operation, even in the case of such a large pupil as yours, no visual problems are noted.

I have keratoconus in both eyes and cannot tolerate contact lenses. Is vision correction surgery (any) possible?

Keratoconus is a contraindication for excimer laser vision correction. Our clinic does not specialize in the treatment of keratoconus. This is a very narrow and complex area in ophthalmology. I recommend contacting specialists in this disease, for example, at the Eye Microsurgery MNTK, Moscow, in the Department of Corneal Pathology.