Prescription glasses are much different from readers

Operation of farsightedness and myopia


Important NOTE:
The description of the interventions was compiled with the greatest care. However, it can only be an overview and does not claim to be complete. The websites of the service providers and the personal consultation with the doctor or the surgical explanation in the respective operating facility provide further information.
The persons responsible for the content of this website do not guarantee the completeness and correctness of the information, as constant changes, further developments and concretizations are made as a result of scientific research or adaptation of the guidelines by the medical specialist societies.

Here you will find:

Around every fourth European between the ages of 20 and 30 is nearsighted, around one in five farsighted. As an alternative to glasses and contact lenses, laser surgery is now available in many centers to correct the refractive error, which can usually be carried out on an outpatient basis.

What happens during this procedure?

Myopia: Various methods are used to compensate for myopia, depending on the strength.
The Photorefractive Keratectomy (PRK) has been performed for about 10 years for myopia down to about minus 6 diopters. First, an eyelid retractor is inserted, which prevents the eye from being accidentally closed. Then the top covering layer of the cornea is carefully removed and then, depending on the degree of ametropia, up to 20% of the horny layer is removed. In the ideal case, this changes the refractive index of the cornea in such a way that the ametropia is compensated.
With the LASIK method (laser-assisted in-situ keratomileusis) Myopia can be compensated for up to minus 8 dioptres. The difference to the method mentioned above is that the inside of the cornea is abraded. To get there, a thin slice of the cornea is partially cut off with an automatically controlled plane and opened like a lid. Then the inside of the cornea is ground with the laser. Finally, the corneal disc is folded back again. After a short period of time, it sucks itself in, so there is no need to sew. A very similar process is that Laser epithelial keratomileusis (LASEK procedure). The difference is that no corneal slice is cut off, but the cornea is first moistened with 20% alcohol (ethanol) for half a minute. This causes the top layer to peel off as a thin membrane and the surgeon can get inside. Finally, the thin protective layer is spread over the wound surface again.
In the case of very severe myopia (between minus 10 and minus 20 dioptres), the ametropia can be caused by the Insertion of an artificial lens (intraocular artificial lens - IOL) be balanced. This is used in addition to the existing lens in front of or behind the iris. To do this, the eye is opened over about 3 mm at the edge of the cornea, the artificial lens is inserted and attached to the iris or between the back surface of the cornea and the iris with two flexible hooks. The small opening in the cornea does not usually need to be sutured, but closes by itself. In some cases, the procedure is combined with the LASIK method.

Farsightedness: When correcting farsightedness, procedures similar to those used for nearsightedness are used.
In the case of farsightedness of up to plus 3.5 diopters, the ametropia can be corrected using LASIK or LASEK procedures.
In rare cases, greater farsightedness (plus 5 to plus 8 diopters) can be compensated for by inserting an additional plastic lens (intraocular artificial lens - IOL) in front of or behind the iris.

In the case of very pronounced myopia over minus 20 diopters, the lens can be removed and replaced with an artificial posterior chamber lens, similar to cataract surgery (Clear Lens Extraction -CLE). CLE is an ideal procedure for people with high farsightedness.

When does the doctor advise you to have this procedure?

The ophthalmologist will be able to tell you exactly whether your form of ametropia can be corrected by a surgical procedure and what the chances of success are.
The prerequisite is always that the nearsightedness or farsightedness is stable, i.e. that your diopter values ​​have not changed much in recent years.

However, your doctor cannot guarantee that you will actually get by without glasses or contact lenses after the procedure.

Which stunning method is usually used?

The photorefractory keratectomy (PRK), LASIK and LASEK methods can usually be performed under local anesthesia using eye drops. If a plastic lens has to be used, conduction anesthesia is usually performed. This anesthetic also suppresses the protective reflex of the eye and the eye is completely painless and motionless.

How long does the procedure take on average?

The procedure usually takes 20 to 30 minutes per eye.

Who may not be suitable for this procedure?

Only an experienced ophthalmologist can assess whether your specific ametropia can be corrected by surgical intervention on the cornea. The same applies to the choice of the respective procedure.
As a rule, people in whom the number of diopters still changes very significantly are not suitable, e.g. young people who are growing.

Presbyopia, which is caused by the deformability of the lens that declines with age, cannot usually be corrected surgically.

How is the risk to be assessed?

In principle, every eye is different and reacts differently to the treatment. Therefore, no laser can guarantee absolute precision (despite all promises). Plastic or metal can be treated precisely, but the cornea cannot! A residual error of plus 1.0 diopters is always possible after laser treatment. This limited precision is not a risk but a normal course of the laser treatment. Therefore 5 - 10% follow-up treatments are possible.

With today's technology, the risk of permanent damage to the eye as a result of surgical correction of the ametropia is very low.
As with any surgical procedure, however, complications cannot be completely ruled out. The doctor will explain to you in detail about possible complications such as insufficient or uneven correction, scarring and infections before the procedure.

With the PRK and LASIK methods, only part of the cornea is treated, the ametropia remains in the outer area. If the pupil becomes very wide in the dark, the light also falls on the untreated part of the cornea. In rare cases, this can lead to increased glare or double contours.

The laser surgical measures cannot be reversed. You should therefore think carefully before the procedure whether you can accept any undesirable consequences for yourself.

What do you have to consider before the procedure?

Before the procedure, it is recommended to get a second opinion from an expert on the advisability of the procedure.

What happens after the procedure and what should you watch out for?

Even with an outpatient eye operation, you will remain under observation for some time after the operation - until you feel fit for the way home. You are not allowed to drive a car yourself after the procedure and you should also not use public transport on your own. Have family or friends pick you up or take a taxi home.

An eye bandage - sometimes in the form of a contact lens - is usually put on immediately after the procedure and should remain on the eye for about 12 to 24 hours.
The eye must not be rubbed in the first few days after the operation.

With a LASIK treatment, you can see immediately and the final result can be assessed immediately.

With other procedures (e.g. PRK) you shouldn't be shocked if you can see worse immediately after the procedure than before. Gradually, the eyesight gets better and better. In the first six weeks, the refractive power of the eye can still be subject to fluctuations. In this case, working at close range can be difficult at first and the eye may be more sensitive to glare. You should avoid driving in the dark for the first time.

You should also avoid working in dusty air for about 2 weeks after a PRK operation, after interventions with the LASIK method this is for 1 - 2 days.

If the numbing effect of the eye drops wears off, you may experience slight pain, but this usually only lasts a few hours. With the PRK method, however, severe pain can occur over a period of 2 days.

The anti-inflammatory eye drops prescribed by the ophthalmologist should be used exactly as prescribed in order to promote the healing process.

When does the next doctor's appointment usually take place?

On the day of the procedure, your doctor will tell you when you should come back for the next check-up. In your own interest, you should absolutely keep this appointment.

If you get a fever or very severe pain at home, you should contact your doctor immediately. Even if you are unsure and still have questions about the normal course of healing, in practice no one will be angry with you if you call for advice.