Excimer and PRK laser

It acts directly on the cornea, which is the anterior part of the eyeball, like the window through which we see.

What is excimer laser?

The Excimer Laser is the most common method for correcting refractive errors. As mentioned earlier, through this process, the laser alters the shape of the cornea to precisely correct the refractive defect. Within this option, there are two possibilities: the LASIK technique and the PRK technique. Both techniques have been in use for years, and it is the ophthalmologist who will decide the best approach for each individual case.

Types of techniques used with excimer laser

Within the Excimer Laser eye surgery, there are two main techniques:

  • LASIK Technique: In this technique, a cut is first made in the cornea using a femtosecond laser. Then, the superficial layer of the cornea is lifted, and the Excimer Laser is used to reshape the cornea, changing its shape to correct the refractive error. The postoperative recovery is quick, and discomfort is minimal.

  • PRK Technique: In this case, the laser acts directly on the cornea. For PRK laser surgery, the epithelium of the cornea is first removed, and then the laser is applied to alter its curvature, precisely correcting the refractive defect. Afterward, a mitomycin solution is instilled to act for a few seconds, and the eye is then rinsed with a saline solution. After the surgery, soft contact lenses are used as a bandage to protect the eye while the epithelium regenerates. After some time, when this protection is removed, the patient gradually recovers their vision. The postoperative period is somewhat more uncomfortable, more painful, and the vision recovery is slower.

When is excimer laser surgery necessary?

Excimer laser surgery is applied to patients with thinner corneas, ocular surface problems, and mild dry eye. It is also recommended for individuals who are at higher risk of eye trauma for any reason.

  • Excimer laser surgery for astigmatism

In a cornea with astigmatism, the meridians are different; one is more curved, and the other is flatter. This causes patients to experience blurry and distorted vision, both near and far. To permanently eliminate astigmatism, excimer laser surgery can be used. For this, the patient must be over 18 years old and have a stable prescription for at least one year.

  • Excimer laser surgery for hyperopia

Hyperopia (farsightedness) is a refractive error that occurs when parallel rays entering the eye focus behind the retina, creating a blurred image. Treatment may involve excimer laser surgery or intraocular lenses, depending on the refraction and age of the patient.

  • Myopia surgery with excimer laser

Myopia (nearsightedness) occurs when the eye is elongated, and the image focuses just in front of the retina, causing poor distance vision and good near vision. In these cases, excimer laser surgery helps reduce dependence on glasses and/or contact lenses.

Ideal patient for excimer laser surgery

There are ideal cases for working with the Excimer Laser using the PRK technique. These are cases where:

  • The cornea is not thick enough.
  • There is a history of dry eye.
  • The patient has corneal diseases that allow for surgery. 

Recovery After Excimer Laser Surgery

As mentioned earlier, the postoperative period after PRK laser surgery is more uncomfortable than in other procedures, and the recovery of vision takes longer. For example, after the removal of the soft contact lenses (one week) that protect the eye after surgery, vision may still not be optimal. On the other hand, with the LASIK technique, recovery is much faster.

However, patients undergoing PRK laser surgery can soon return to their normal activities. For example, after about a week, most sports can be resumed as usual.

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