Complications after lasik eye surgery. Complications of lasik surgery. When is laser correction needed?

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 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.

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.

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.

Postoperative side effects

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.

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

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.

24-10-2011, 06:36

Description

Complications after laser correction?

And they told me...

LASIK- laser, superficial, outpatient, but surgery. And therefore, like all operations, there are complications.

LASIK- one of the safest surgical operations in the world.

The vast majority of LASIK complications can be reversed. Of course, the patient must be warned about this before the correction. Because everything the doctor says after the correction is considered as an excuse for his own unprofessionalism.

But there are more serious complications of LASIK that reduce visual acuity. The probability of their occurrence is many times less than one percent, but they exist. That's what we'll talk about now.

This low rate of complications is phenomenal for surgery. Therefore, it is not customary to talk about these complications to patients, which, of course, places a large burden of responsibility on the shoulders of the surgeon. There are the following opinions on this question.

There is an opinion among doctors that the patient should not know all the nuances of treatment, since he can evaluate them incorrectly and subjectively.

And he will refuse treatment, dooming himself with a much higher probability to a more sorrowful fate. Not to mention the need to instill optimism in the patient to create a positive emotional background for treatment. Legally, this is a very precarious position, since according to the law on consumer protection, the patient has the right to know all the nuances.

On the other hand, the health insurance system, which came to us from the West, forces the doctor to familiarize the patient with the possible complications of a surgical operation against signature. There, the doctor not so much fights for the patient’s health and life using all available methods, but rather carries out the algorithm prescribed to him in this case by insurance companies. He is only trying to protect himself and the insurance company from the patient’s legal claims. This is the price for high salaries of health workers. Just like the lack of masterpieces is the price to pay for the large budgets of Hollywood films. So we came to this system. So far only in excimer laser and cosmetic surgery.

Refractive surgeons did not hide the complications of laser correction, but did not advertise them either, trying to justify the promises of advertising with their professionalism. However, now even medical management is coming to the need for broader coverage of these issues. Because the response to the silence was the unbridled growth of rumors about the dangers of LASIK. Just look at the forums on the Internet about laser correction. A mixture of ignorance and prejudice. True, several professional websites have now appeared that explain and answer questions from future patients.

Public opinion is inert, and if the growth of mistrust in laser surgery is not broken now, then it will be difficult to justify it later. I hope this book will help to objectively assess the capabilities of excimer laser surgery and determine its place in the provision of medical services.

Complications of PRK

There are different classifications of complications. By time of appearance, by reason of occurrence, by localization. Apparently, in this book the most appropriate classification is based on the degree of influence on the result of laser correction.

Complications that worsen (extend, make uncomfortable) the healing period, but do not affect the final result of correction:

Delayed reepithelialization;

Filamentous epitheliokeratopathy;

Corneal edema;

Allergy to medications used;

Dry eye (mild form).

Complications that require intensive drug treatment to eliminate them, and sometimes repeated intervention to eliminate the consequences:

Exacerbation of herpetic keratitis;

Dry eye syndrome (severe degree);

Corneal opacification (in other words, haze, subepithelial fibroplasia, or fleur) (mild);

Bacterial keratitis.

Incomplete removal of the epithelium;

Decentration of the ablation zone;

Undercorrection;

Hypercorrection of myopia;

Regression of the refractive effect;

Corneal opacification (in other words, haze, subepithelial fibroplasia or fleur) (severe degree).

Complications of LASIK

Complications that worsen (extend, make uncomfortable) the healing period, but do not affect the final result of the correction:

Damage to the corneal epithelium by an eyelid speculum or during marking;

Temporary ptosis (some drooping of the eyelid);

Toxic effect on the epithelium of the dye or coloring of the subflap space after marking;

Debris (remnants of tissue evaporated by the laser under the flap, invisible to the patient and dissolving over time);

Ingrowth of the epithelium under the flap (not causing decreased vision or discomfort);

Damage to the epithelial layer during flap formation; marginal or partial keratomalacia (resorption) of the flap; dry eye syndrome (mild form).

Complications that require intensive drug treatment to eliminate and sometimes repeated intervention to eliminate the consequences:

Keratitis.

Complications that require repeated intervention to eliminate:

Incorrect placement of the flap;

Decentration of the optical zone of laser ablation;

Undercorrection;

Hypercorrection;

Folding the edge of the flap;

Flap displacement;

Ingrowth of the epithelium under the flap (causing decreased vision and discomfort);

Debris (if located in the center of the optical zone and affects visual acuity).

Complications for which other treatment methods are used:

Poor-quality cut of the flap (decentred, incomplete, thin, torn, small, with striae, full cut of the flap);

Traumatic damage to the flap (tear or tear of the flap);

Dry eye syndrome (chronic form).

A few words about those complications that can be eliminated through repeated intervention.

Debris and epithelial ingrowth under the flap

During the process of laser ablation, that is, the evaporation of the corneal substance, tiny particles are formed, most of which become airborne. This is where the “burning” smell comes from. But a small amount of these particles settle back on the cornea. Of course, the cornea is washed, but some laser ablation products, along with the detached meibomian glands (glands on the edges of the eyelids), talc from the surgeon's gloves, etc., may remain under the corneal flap. This “garbage” is called debris. Most often, it does not affect vision in any way or bother the patient and gradually resolves. If the debris is large enough, is located close to the center of the optical zone of the cornea, and the patient notices it as a speck in the field of view, then the subflap space is washed and the flap is repositioned. Nothing special. The same is done when the epithelium (the surface cellular layer of the cornea) grows under the flap.

Ingrowth occurs due to insufficient adherence of the corneal flap, its uneven edges, or due to the entry of cells under the flap during surgery. Cells trapped during surgery dissolve on their own. The epithelium, which grows under the edge of the cornea, has a connection with the main layer and receives constant recharge. Therefore, it can grow quite far. This causes local elevation of the flap, a feeling of a foreign body in the patient, and a change in refraction towards increasing astigmatism. There is no need to further correct this astigmatism. When this ingrowth is removed, most of the astigmatism will also go away. But relapse is quite possible. The fact is that under an operating microscope the epithelium is mostly invisible. Therefore, it is quite difficult to remove all of it. There are various techniques to exclude relapse, in particular, the use of dyes (which permanently stain the entire subflap space), washing the subflap space (interface) with a weak solution of dexamethasone, and thoroughly cleansing the site of ingrowth. At the site of epithelial ingrowth, it is necessary to de-epithelialize a small area of the cornea. The edge of the flap should not be torn, but smooth and, therefore, fit more tightly to the corneal bed.

Incorrect placement, edge tucking, or flap misalignment

If the surgeon is insufficiently experienced, the flap may be placed incorrectly (unevenly, unevenly). Or the patient may accidentally touch the eyelid and tuck or displace the edge of the corneal flap. In such cases, re-installation is also carried out.

Poor quality flap cut

If the flap is of poor quality, the possibility of laser ablation is assessed. If a sufficient area of the corneal bed is exposed, then you can proceed as usual. If there is not enough space, then the flap is carefully placed in place (you can put a contact lens on top for a couple of days for fixation) and after 3-6 months a new cut and a new correction are made. All this applies to decentralized, incomplete, thin, torn (botton hole and other options), small flaps and full cut flaps.

Flap with striae- This is a flap that has folds. Folds can appear both due to non-standard operation of the microkeratome or the peculiarities of the condition of the cornea, and due to mechanical effects on the eye in the first days. If the flap has been moved from its place, then, of course, it must be repositioned, but the remnants of the folds (striae) will remain. Striae can lead to a decrease in the quality of vision due to aberrations (more on this in the next chapter). The second stage of laser correction will help improve the situation.

If you want to avoid all sorts of problems after laser surgery, diseases, node corrections and poor-quality flap cuts, then you can restore your vision in a proven and reliable way. Allowing you to get rid of vision problems once and for all without the help of glasses, lenses or contact surgery.

Michael Richardson's method has helped many people say goodbye to glasses and contacts and see better without glasses than with glasses.

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Decentration of the optical zone of laser ablation.

Undercorrection. Hypercorrection

Everyone has heard about nanotechnology. Scientists create miracles by manipulating substances at the molecular level. Super apparatuses are required to work on such a miniature scale. Nanotechnology opens the way to the future for humanity.

But when carrying out laser correction, it is necessary to evaporate the cornea with an accuracy of 1000 nanometers. And for this purpose, equipment is used that is close in complexity to spacecraft. That is why the accuracy of the excimer laser is checked several times a day - calibration is carried out.

Yet such precision is not enough. Each person is too individual. There are several hypotheses that explain the occasional small discrepancies between the planned and obtained results of laser correction.

For example, hydration in human tissue varies over a fairly wide range. You yourself know about this. Some people's faces may swell after sleep. By evening, your legs may swell, especially for those who stand in one place all day. Worse than that. One person has a loose constitution, the tissues are saturated with water, while the other has a dry, thin constitution, and he almost never experiences edema. And everyone’s cornea is different. And water absorbs ultraviolet radiation, including the ultraviolet excimer laser. Therefore, with the same calculated dosage of laser radiation, a person with a loose, watery cornea may experience undercorrection, since water will “eat up” a lot. And in a person with a low density of water in the cornea, a hypercorrection may occur, evaporating more micrometers of thickness than planned.

Or there are, for example, scientific works that prove at the histological level the difference in the reaction of the cornea to LASIK. When forming a corneal flap and evaporating the corneal tissue, part of the connective tissue microfibers - collagen fibrils (of which the cornea mostly consists) is removed. Some of the remaining fibrils, having lost one of their attachment sites, shrink and thicken. This process is centrifugal in nature and can lead to a slight, 1-2 micron, thickening of the periphery of the cornea, which has almost no effect on its curvature. Almost. It is impossible to predict the degree of this influence and the severity of this process individually in each case.

These are just a couple of hypotheses that attempt to explain the likelihood of undercorrection or overcorrection occurring. There are many more such hypotheses.

However, in practice, such complications are extremely rare and, if they occur, they will not ruin the rest of your life. Your vision will improve after correction in any case. And the second stage of laser correction will help you achieve a 100% result.

As for decentration, much depends on the subtleties of the diagnostic manipulations performed and the individual characteristics of the location of the optical axis of the eye. The appearance in excimer lasers of tracking systems for the position of the eyeball and new aberrometers with the function of determining not only the center of the pupil and the center of the cornea, but also the localization of the optical axis has almost led to eliminating the possibility of decentering almost completely.

Decentering is best corrected with an excimer laser, which can eliminate higher order aberrations.

Dry eye (chronic)

It would seem like a small thing. But this little thing sometimes causes a lot of trouble. It’s no wonder that so many ophthalmologists have been looking for a solution to this problem in the last five years.

Causes of dry eye syndrome comes out a lot. Ecology, air from air conditioners, stress, increased dryness of indoor air, working at a computer and, of course, increased visual stress.

With prolonged visual concentration, whether driving a car or watching TV, a person actually blinks less often. This is how nature intended it. And this condition of “drying out” the eye and reducing tear production becomes chronic. And then there is air. And then there is laser correction, which somewhat disrupts the nervous regulation of tear production. Temporarily. But if you had dry eye syndrome before the correction, it will not go away even after. And for some time it will intensify.

You will have to instill artificial tear preparations; fortunately, addiction to them does not develop (but still try to take more breaks when using them).

Keratitis

Keratitis- inflammation of the cornea, accompanied by pain, decreased vision, severe photophobia and lacrimation. Keratitis can be traumatic, bacterial, viral, neurotrophic and of unknown etiology (cause). Like many other diseases, no one is immune from keratitis. It can occur in those: who wear contact lenses; who has the flu; who was blown away; who got garbage in their eyes; who has a toothache; who has sinusitis; who got wet in the rain or froze in the cold.

In academic terms, the etiological factors for the development of keratitis are divided into general and local. Common causes that can cause keratitis include colds (acute respiratory infections, acute respiratory viral infections), diseases of the paranasal sinuses, caries, tuberculosis, syphilis, etc. Local causes of keratitis are conjunctivitis, small foreign bodies of the cornea, improper use of contact lenses, trauma and etc.

After laser eye correction- a weak point and any infection that is in the body can trigger the development of keratitis. The main thing is to diagnose keratitis in time and treat it well. Therefore, before correction it is necessary to undergo a general blood test, RW, Hbs Ag, HIV. It is advisable to consult a dentist, otolaryngologist and others. In the presence of sluggish chronic diseases (from chronic pyelonephritis to stomatitis), the patient should warn the surgeon about them and, if necessary, carry out preventive treatment.

Keratitis that occurs immediately after laser correction is treated with drops and tablets and has no consequences for vision. Usually. But there are also exceptions.

Herpetic and fungal keratitis are difficult to treat. If you have had herpetic keratitis before and are planning to undergo laser correction, then warn your doctor and begin preventive treatment on the eve of the operation. The herpes virus, once settled in our body, almost never leaves it. After all, a cold on the lips can only be an infection transmitted from someone for the first time. And the second time, and all other times, it’s often just an exacerbation of the disease due to decreased immunity. The same thing happens to the eye - the ultraviolet light of the laser can activate the herpes virus that was dormant in the past focus of inflammation in the cornea. In such cases, laser correction should be carried out under the cover of appropriate medications (at a minimum).

As for the treatment of fungal infections, in addition to standard treatment, modern drugs of general antifungal therapy (for example, flucostat) should not be neglected. Invaluable assistance in early diagnosis can be provided by the patient himself, who promptly admitted the presence of chronic fungal diseases that can be localized in any part of the body (otomycosis, mycosis of the feet, etc.).

Complications of LASIK that can significantly and irreversibly reduce vision

Now in more detail about those complications of LASIK that can irreversibly reduce vision. The likelihood of each of them occurring is measured in tenths and hundredths of a percent, and the likelihood of irreversible vision loss is even less. But this possibility exists.

Traumatic flap injury

Serious traumatic injuries after LASIK are extremely rare. During the first month after LASIK, patients try to adhere to restrictions and avoid even light touching the eye area. As a rule, they succeed.

In the world ophthalmological scientific literature there are descriptions of the loss of a corneal flap due to injury. Of course, emergency hospitalization is indicated for a patient who has lost a corneal flap. Such an extensive corneal wound takes a long time to heal and is painful. After the end of a long healing process, such a patient has large “plus” diopters - induced, or rather, iatrogenic hypermetropia. And a serious decrease in the quality of vision. Further treatment consists of implanting the patient instead (or together, that is, phakic IOLs) with an intraocular lens (artificial lens, IOL). The intraocular lens is selected in such a way as to cover the resulting deficiency in diopters and eliminate iatrogenic farsightedness. A similar operation is performed during cataract surgery. This, of course, is an abdominal operation. But this is a way out of the situation in case of loss of a corneal flap.

Diffuse lamellar keratitis (DLK)

Keratitis has already been discussed above, but DLK should be separated into a separate group.

Diffuse lamellar keratitis (DLK) It is insidious in that no one reliably knows the cause of its occurrence and cannot predict and prevent it. On the 2-4th day after LASIK, minor discomfort appears, accompanied by some decrease in vision and fog in one eye. Then the gradual progression of these symptoms begins.

Many patients come for laser correction from populated areas, sometimes far away. There is no need to rush to go back. Even if your doctor allows you to. Stay near the clinic where you had LASIK for about a week. And for any unpleasant symptoms, consult a doctor.

If DLK is not treated on time with intensive courses of hormone therapy, then you can lose several lines of visual acuity. It is quite difficult to remove the developed cloudiness under the corneal flap in the optical center of the cornea without consequences.

For DLK, it is necessary to instill dexamethasone (preferably oftan-dexamethasone) or 1% prednisolone acetate into the eye 4-6 times a day (sometimes every hour). The same dexamethasone should be administered under the conjunctiva. Sometimes even general hormonal therapy is indicated. In a specialized clinic, a single rinse with dexamethasone under the corneal flap is possible.

For the prevention of DLK, there is only one piece of advice so far - it is advisable for allergy sufferers to take prophylactic antihistamines (Kestin, Zyrtec, Erius, Claritin, Loratadine, etc.) on the eve of laser correction and after it for 10-14 days.

There are suggestions that the cause of DLK may be debris, microkeratome lubricant, or talc from the surgeon’s gloves that got under the flap during LASIK, but no direct connection with these factors has been found. However, it is better for the surgeon to play it safe and not take risks.

Article from the book:

When performing laser correction of myopia or farsightedness, the doctor uses normograms, with the help of which the required intensity of laser exposure is established. These normograms are based on the average human response to excimer laser radiation. Due to the fact that each eye is individual, the amount of laser exposure required may differ from the average values. Most often, this difference is insignificant and does not affect the final result, but in some cases, after vision correction, hyper- or hypo-correction occurs.

Incomplete correction of visual impairment (hypocorrection)

With hypocorrection, there is an insufficient effect when performing LASIK. During laser correction, the cornea is resurfaced, but the reaction to laser radiation in most cases is individual. In this regard, after LASIK, sometimes insufficient vision correction occurs, that is, refractive error is not fully corrected, and vision does not reach 100%. Minor hypocorrection usually does not affect the daily life of patients, and in people over forty years of age it may even be desirable due to the development of presbyopia. If the degree of hypocorrection is significant, then you can perform repeated laser correction or use spectacle and contact correction methods.

Excessive correction of visual impairment (overcorrection)

Overcorrection is less common than undercorrection with LASIK. Typically, this condition goes away on its own within a month after the operation. With overcorrection of farsightedness, temporary myopia occurs, that is, the patient sees distances somewhat blurry, while he perceives close objects quite clearly. If myopia has been treated, then with overcorrection temporary farsightedness may occur, that is, the patient will experience difficulty viewing close objects. Due to the fact that all these phenomena are temporary in most cases, glasses or lenses with a small number of diopters are used to correct them. However, there are cases of pronounced overcorrection when repeat LASIK is required.

Specialist on complications of LASIK

Restoration of vision after laser correction of ophthalmic refractive errors (farsightedness, myopia, etc.) depends on several factors. Firstly, the patient’s well-being and the condition of the eye depend on how much the doctor took into account all the characteristics of the human body and whether there were any contraindications for the operation. Secondly, rehabilitation is easier and faster if the surgical intervention itself was performed by an experienced, qualified specialist and in a well-equipped medical center. Thirdly, the person himself is responsible for the successful restoration of the ability to see, and he must follow all the doctor’s recommendations in the postoperative period. To dispel doubts and fears about the operation and further rehabilitation, you need to understand all the factors separately.

How contraindications can affect eye recovery

During eye rehabilitation after LASIK correction, some negative effects may occur. They may be associated with diseases for which this procedure is contraindicated. That is, the doctor must take the following measures before making a decision on surgery:

Check the patient for ophthalmological diseases: cataracts, glaucoma, retinal dystrophy and detachment (if the patient has undergone surgery to correct it), fundus pathology, progressive myopia. In addition, inflammatory and infectious processes in the eyeball also prevent the use of this technique.
The doctor takes into account autoimmune diseases, AIDS, diabetes mellitus in the form of decompensation, and herpes infection in the body.
For patients, it is mandatory to check whether the woman is pregnant, since such a procedure is not performed when carrying a child.

Eye pathologies complicate the healing of tissues affected by this manipulation and general systemic disorders in the body. If there is an infection in the human body, it can spread to healthy tissue during manipulation, which will also complicate rehabilitation. And during pregnancy and breastfeeding, many medications that are simply necessary for the healing of the cornea are contraindicated.

If a person’s examination does not reveal such contraindications before using LASIK, then the processes of restoration of the eye and visual ability should proceed normally.

How does the progress of surgery affect rehabilitation?

There are now many centers for visual restoration that actively advertise their services. But it should be taken into account that complications are also possible as a result of surgeon errors. Therefore, you can entrust your eyes only to experienced specialists in large centers who have long proven themselves and have good reviews from the patients themselves. When manipulations are performed correctly by qualified surgeons, the recovery period passes in most cases without complications.

To ensure that the manipulation itself is successful and that no problems arise immediately after the procedure, you need to remember the following preparation nuances:

all preliminary tests prescribed by the doctor must be performed;
You cannot wear contact lenses for about two weeks before the procedure;
to eliminate negative consequences from the administration of drugs, it is necessary to give up alcoholic beverages at least two days in advance;
before going to the ophthalmology center, you need to take sunglasses with you (they will come in handy after the procedure), wear clothes with a loose collar (to prevent damage to the operated eyes);
It is advisable to wash your hair in advance - you cannot do this for three days after the manipulations. Women should not use eye cosmetics at least 24 hours before the procedure.

You should learn about the preparation rules directly from your doctor: each ophthalmology center may have its own characteristics.

Rules to follow during rehabilitation

The rehabilitation period depends on how conscientiously the patient adheres to the rules. If a person is prepared for the restrictions that will be necessary to improve refraction, the risk of complications (including vision deterioration after laser correction) will be minimal. So, what are the contraindications after laser vision correction?

People who have been involved in sports, especially contact sports, should be prepared to completely abandon such hobbies. After using LASIK, increased stress on the body is eliminated, especially in the first weeks. Whether the doctor will allow you to train and take part in competitions in the future will depend on the success of the intervention and the condition of the eyeball. Lighter sports are usually not prohibited, and a couple of weeks after the manipulations a person will be able to return to training (though at first only with half the load).

If a person experiences increased stress at work, he may have to change jobs (or at least take a long vacation - this is decided by the attending physician).

Even physical activity that a person experiences at home (for example, lifting weights) can affect the healing process. In the first time after the intervention, even short-term overexertion can be dangerous; in the future, adverse consequences can arise if the permissible load is regularly exceeded.

In addition, after laser vision correction you cannot:

wash and shower on the first day after the procedure. After this, you can wash your face only with boiled water;
rub your eyes, expose them to the risk of mechanical damage or dust. While the visual analyzer is being restored, it is not recommended to travel outside the city, where there is a high probability of dust particles getting into the eyes with gusts of wind;
expose your eyes to bright sunlight: it is better to wear sunglasses, and it is not recommended to sunbathe for a month;

be exposed to high temperatures, visit a bathhouse or sauna for 4 weeks;
women, while the cornea is recovering, use eye cosmetics and aerosols that can get on the cornea (hairspray);
on the first day, work at the computer and sit in front of the TV screen.
drive vehicles (the doctor must indicate for how long) due to the likelihood of glare in the eyes;
be exposed to hypothermia and direct exposure to cold wind on the eyes: inflammatory processes and infectious diseases will increase the healing time of the cornea;
swim in open water until the end of rehabilitation therapy: there is a high probability of pathogenic microorganisms getting on the damaged membrane of the eyeball.

A complete list of everything that cannot be done after laser vision correction should be obtained from your doctor. Often, ophthalmology centers issue special instructions that help the patient navigate the rules of conduct after the procedure.

To help the cornea recover faster, you need to use special drops. In the first days you will need a whole list of medications, including hormonal and antibacterial ones; Over time, the amount of medication needed decreases. However, there is a possibility that drops to moisturize the cornea will have to be used periodically in the future.

Is it possible to have a child after using LASIK?

Women who are planning to correct ophthalmological pathology (for example, astigmatism) are interested in: is it possible to give birth after surgery? Pregnancy itself is a contraindication for surgery, as is breastfeeding. If a woman is pregnant and about to give birth, she needs to wait until she finishes breastfeeding.

Pregnancy after laser vision correction is not contraindicated. However, in the first 3 months (and sometimes a little more - you should ask your doctor about this) it is necessary to use protection. The fact is that when healing wounds on the cornea, it is necessary to use antibacterial and hormonal agents, and they can negatively affect the development of the fetus. It is possible to give birth after laser vision correction after the specified period.

And childbirth is a completely compatible concept. But it is worth remembering that in order to avoid negative consequences, you need to not only postpone pregnancy after correcting the cornea, but also in some cases opt for a cesarean section.

Natural childbirth after laser vision correction can be dangerous, because during contractions the woman in labor experiences very strong tension, which can cause vision loss.

How quickly does the ability to see return?

Typically, indications for such intervention are myopia, farsightedness, and astigmatism. Moreover, the doctor can recommend correction only with LASIK if the decrease in visual ability is 25–40%. That is, before the intervention the person sees very poorly. If you do not take into account some postoperative symptoms (which will be discussed below), a significant improvement in the quality of refraction occurs within 24 hours. How long this result will last is unknown, but usually refractive problems are solved for many years. Repeated exacerbation and deterioration in the quality of refraction develops, as a rule, due to age-related changes in the eyeball.

Possible consequences

The consequences after laser vision correction can be different. Normal symptoms include extraneous glare and stars in front of the eyes, as well as a feeling of dryness in the eyeball. To eliminate this discomfort, special moisturizing drops are used. After laser vision correction, fog in the eye also appears in many patients, but this sensation soon passes. You also need to be prepared for the fact that the ability to see in the twilight (provided by the peripheral part of the retina) may deteriorate for a very long period.

Sometimes the eye tissue becomes inflamed and conjunctivitis occurs. Hemorrhage and epithelial ingrowth due to improper healing are also possible.

But with the right selection of an ophthalmological center and surgeon, as well as following the rules during rehabilitation, the likelihood of serious complications is minimized.

Deterioration in visual ability after the procedure

Almost all patients are very concerned about the question: is it possible to go blind after laser vision correction? Practice shows that complete blindness does not occur after such an intervention. A slight drop in the quality of refraction sometimes occurs when the corneal flap is cut incorrectly, which is removed with a special blade so that the necessary layer of the eyeball becomes accessible for manipulation.

Refraction may deteriorate due to an error in calculating the depth of penetration into the cornea, while myopia may be replaced by farsightedness, and astigmatism may remain, but with different indicators.

Such negative consequences occur very rarely. Repeat surgery may be necessary to correct them.

Sometimes visual ability decreases due to non-compliance with the rules of behavior during the healing period. So, if you start rubbing it as hard as you can, unable to endure the discomfort in the eye in the first day, the corneal flap will shift, which will entail a disruption of the light-conducting system of the eyeball.

If your vision has decreased after laser correction, you should definitely inform your doctor about it. He will determine whether this may be a complication caused by the operation itself, or whether the patient himself does not adhere to the recommendations during rehabilitation. The ophthalmologist will decide whether any additional medications or procedures are needed, or whether a repeat operation is needed.

The limitations after laser vision correction are quite impressive, but the ability to see the world around us, which returns after the intervention, compensates for all the difficulties. If you behave correctly when preparing for surgery (pass all the necessary tests and choose a good ophthalmology center), and also follow all the rules during rehabilitation, the chance of overcoming farsightedness, nearsightedness or astigmatism in this way is very high.