Heart to Heart Talk: Refractive surgery By Dr. Philip S.

Chua Cebu Daily News

What is refractive surgery? Refractive or vision correction surgery is an operation on the eyes to correct error of refraction, like nearsightedness, farsightedness and astig atis , to eli inate the use of prescription eyeglasses or contact lenses. What are the various procedures available today? !he advent of "#ci er laser in $%&& ushered in a new revolutionary era in vision correction. 't provided added lifestyle choices ade possible by the freedo fro , or dependence on, prescription eyewears. !hat i portant technological advance resulted in a(or treat ent odalities not possible before then. !he three popular procedures for refractive surgery today are )*S'+ ,)aser *ssisted 'n-Situ +erato ileusis or )aser .ision Correction/, PR+ ,Photorefractive +eratecto y/ and 'ntacs ,Corneal Ring Seg ents/ i plants. What is Excimer laser? "#ci er laser is a co puter-controlled ultraviolet bea of light that reshapes the cornea ,outer window of the eye/, resulting in the light focusing ore directly on the retina at the back of the eye. "#ci er laser gives out a cool or nonther al ,not hot/ light bea , aking it ideal for corneal surgery, eli inating the possibility of ther al burns to the surrounding tissues. "ach laser pulse is so accurate it achieves disruption and re oval of the olecular tissue bonds between the corneal cells up to 0.12 icons ,or 0.00003 of an inch/, which i proves the vision. 4sually, only about 20 icrons of tissue ,about half the thickness of hu an hair/ are re oved to achieve the correct a ount of vision correction. What does each procedure involve? 'n )*S'+, a thin layer of the corneal ,outer covering/ stro a is fashioned using a icrokerato e ,cutting/ instru ent and this tissue is set back in place after the laser procedure is done. )*S'+ reshapes the corneal tissue underneath the surface of the cornea, while PR+ uses laser to re ove the epitheliu , a thin protective 5skin6 on top that covers the cornea, before the actual corrective treat ent is perfor ed. 7or 'ntacs, two tiny incisions and tunnels are ade on the outer edges of the cornea and the 'ntacs ,half- oon or C-shaped/ ring seg ent is i planted in each tunnels and a suture is placed. What are Intacs? 'ntacs are two ini half rings, ade of bioco patible plastic that has been safely used for about five decades in cataract operations and in contact lenses. 'ntacs per anently corrects error of refraction when placed within the outer edges of the eyes as described above. What are the benefits of these procedures? !he corrective surgery decreases or eli inates the dependence on glasses or contact lenses, increases safety while indulging in outdoor or sports activities, provides ore convenience, i proves vision 13 hours a day, and in so e people, it ay i prove self-estee , the look, or satisfy vanity. Is general anesthesia used for this? No, only topical anesthesia is used for these procedures. "ye drops to nu b the eyes are instilled prior to the surgery. !his is enough to prevent the patient fro feeling any pain during the operation.

oes this correct aging vision? "rror of refraction in the elderly, usually starting fro age 30, is called Presbyopia. !he 8 procedures entioned above will not correct Presbyopia. !hose undergoing any of those vision correction surgery will still need reading glasses. !re there potential risks and side"effects? 9ust like any surgery, these vision correction procedures have possible risks and side effects. 7ollowing the surgery around 2 to 12: of patients will have so e ha;iness of vision that is aggravated at night. 't peaks at & to $1 weeks after treat ent and in al ost all of the cases, this proble resolves with eye drops and the natural healing process. So e patients ay notice halos or glare when looking at bright lights or at night. * few of the ay feel increased intraoccular pressure, and any will e#perience so e disco fort that is relieved by ho e pain killers like aceta inophen ,!ylenol/. 'nfection is rare but possible. 't is best to discuss all the details about the reco ended procedure, advantages and disadvantages, ti ing and se<uence of surgery, possible risks and co plications with your =phthal ologist perfor ing the procedure. #an this procedure be done on a pregnant $oman? Because of the nature of the procedure, these laser-assisted procedures ay N=! be done during pregnancy, until three onths after delivery and breastfeeding. *fter the procedure, the patient should wait > onths before beco ing pregnant. Ho$ effective are these procedures? !he statistics fro the Depart ent of =phthal ology and .isual Sciences of the 4niversity of 'owa ?ospital in Clinics ,>th on the top ten list of Best ?ospitals in * erica/, according to *ssistant Clinical Professor " ily C. @reenlee, A.D., show that their results at 4'?C provided %2: of eyes treated i proved 10B30 vision, the legal driving li its in ost states, following the procedure. =ne half to 1B8 of the patients obtained a 10B10 vision ,nor al without prescription eyeglasses/ after the surgery. What is the cost for Refractive %urgery? !he package fee is about C$,&00 per eye for )*S'+ and PR+, and C1,000 per eye for 'ntacs. !his includes the hospital and physician charges and follow-up visits for one year. Who are candidates for this vision correction? !hose age $& or older, with otherwise healthy eyes, with ild to oderate nearsightedness ,-$.00 to D$3.0 dopsters/, farsightedness ,E$.20 to E3.00 diopters/ and astig atis are good candidates for )*S'+ or PR+. 7or 'ntacs, the best patients are those with nearsightedess ,-$.00 to D8.00 dopters/. !hese procedures will provide better vision without eyeglasses or contacts, but none of the will give perfect vision. * realistic e#pectation is very essential with this refractory surgery. SourceF httpFBBservices.in<uirer.netBprintBprint.phpGarticleHidI100&0J$3-$3&8J1

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Refractive or vision correction surgery is an operation on the eyes to correct error of refraction, like nearsightedness, farsightedness and astigmatism. The three popular procedures for refractive surgery today are LASIK, PRK, and Intacs. !cimer laser is a computer"controlled ultraviolet #eam of light that reshapes the cornea $outer %indo% of the eye&, resulting in the light focusing more directly on the retina at the #ack of the eye. LASIK reshapes the corneal tissue underneath the surface of the cornea, %hile PRK uses laser to remove the epithelium, a thin protective 'skin( on top that covers the cornea, #efore the actual corrective treatment is performed. )or Intacs, t%o tiny incisions and tunnels are made on the outer edges of the cornea and the Intacs $half"moon or *"shaped& ring segment is implanted in each tunnels and a suture is placed. Some of the #enefits of this procedure are it decreases or eliminates the dependence on glasses or contact lenses, provides more convenience, improves vision +, hours a day, and in some #ut this procedure has also its limitations. -ne of its limitation is it cannot correct aging visions, complications of diseases, and none of the said procedure %ill give perfect vision. .ust like any surgery, these vision correction procedures have possi#le risks and side effects. Some patients %ill have some ha/iness of vision that is aggravated at night. It peaks at 0 to 1+ %eeks after treatment and in almost all of the cases, this pro#lem resolves %ith eye drops and the natural healing process. Some patients may notice halos or glare %hen looking at #right lights or at night. A fe% of them may feel increased intraoccular pressure, and many %ill e!perience some discomfort that is relieved #y home pain killers like acetaminophen $Tylenol&. Infection is rare #ut possi#le. So it is very important to discuss all possi#le effects and %hich procedure is #etter for your condition to minimi/e ma2or pro#lems. Through the advancement of technology and researches, scientists had come up again %ith ne% procedures in the field of paramedics. It3s nice to kno% that they had discovered a ne% solution for correcting eye vision. This is really a #ig help to people especially to those %ho doesn3t %ant to %ear glasses or contact lenses due to some cases of safety %hile indulging in outdoor or sports activities. Through this procedure people may improve their self"esteem, the look, or satisfy vanity.

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