Refractive Surgery Operations
Refractive surgery is any type of surgery that is supposed to make your vision better. Lasik is the most common type of refractive surgery performed in the US with 2 million operations a year. Lasik stands for laser-assisted in situ keratomileusis.
The FDA has approved lasik for people who are older than 21 although there are circumstances in which the surgery can be legally performed on younger patients.
It took 10 years of development by Summit Technology to get the PRK excimer laser system used for PRK lasek approved by the FDA, this article provides more information about the huge milestone article in detail here.
Any age above 21 can receive the surgery and you are not prevented from the surgery even if you are 150 years old which you are most likely not.
If you have a history of eye infection, rheumatoid arthritis or systemic lupus erythematosus you should not have any type of eye surgery because theses illnesses may negatively affect your eye’s ability to heal. If your cornea is too thin, flat or steep you should also not receive the surgery because this can affect the outcome of the surgery negatively meaning your results will not be as good.
Before getting lasik, people who regularly wear soft contacts should not wear their lenses for at least two weeks, and hard and toric lenses need to be not worn for much longer which depends on how long the person has been wearing these lens types before they decide to go into surgery.
Eye surgery often works by changing the shape of the cornea using a laser which allows the eye to now focus properly. A laser is needed to measure the eye first and must be precise to the amount of 1/100,000 of an inch in order for the treatment to be effective.
The options to reshape the cornea are three types of surgery: photorefractive keratectomy (PRK) and laser epithelial keratomileusis (LASEK), or LASIK, which is surgically created corneal flap.
The newest technology uses wavefront technology to take away high-order aberrations which are imperfections in the eye which distort vision and are not able to be corrected by wearing glasses or contacts.
As with any surgery there is a risk. There is as high of a 1-2% chance of a small issue that will slow down recovery, require post-op vision issues or even need more surgery. There is a .2-.4% chance of having major complications that can actually cause permanent vision problems.
There are people who are at a higher risk than others for these major issues, and they should have a thorough consultation with their eye doctor beforehand to understand all the risks involved.
94% of lasik refractive surgery patients will never need another surgery and will have permanently healed vision, however the remaining will need additional enhancement procedures, especially those who initially had large amounts of vision correction.
Cosmetic Eye Surgery Operations
In addition to vision corrective surgery, some people consider cosmetic eyelid surgery for aesthetic reasons. When people age, their skin becomes loose, losing its elasticity and becoming droopier, especially in the eyelid area.Once firm eye tissue becomes soft and fat around the eyes creates bags and bluges which places undue emphasis on undereye wrinkles and circles.
There are two types of wrinkles on the face, one is dynamic wrinkles which are only wrinkled when we move our skin or facial muscles. An example of a dynamic wrinkles is when we smile our eye corners wrinkle as the skin contracts and thickens in this area.
Static wrinkles area always present, even when the face is still. Static wrinkles are caused by gaining as the skin breaks down and its collagen is damaged by the sun.
The more dynamic movement the skin has, the more static wrinkles will develop over time as well.
There are different types of cosmetic eyelid surgery that people consider:
Upper eyelid blepharoplasty is the technical term for an eyelid lift. The surgeon uses a steel blade, laser or heated instrument to perform the operation. The patient is first sedated and given numbing in the area of surgery.
The goal of this type of surgery is to lift the tissues in the upper eyelid for cosmetic improvement. To do this, the surgeon cuts the upper eye lid crease and then dropping skin, muscle and herniated fat in the upper eyelid is removed, then the wound is closed and stitched shut. Then it is treated with an antibiotic for a little over a week and the stitches are taken out about a week after the surgery.
Brow lift is meant to lift the brow with the goal being a decrease in the sagging of the brow skin. This is achieved in two ways, a cut can be made on the top of each eyebrow and then extra skin and muscle be removed.
Then the eyebrows are lifted when the cuts are closed. The other option is an endoscopic brow lift where cuts are actually made in the hairline where the scars will be less apparent.
Lower Eyelid Blepharoplasty is a surgery that takes away fat bags that can develop under the eye. This can be performed in multiple ways. One option is to cut the skin under the eyelashes and remove the excess fat but requires stitches and can cause scarring.
Another method is to literally go inside the lower eyelid to take out the fat, which is called transconjunctival blepharoplasty, and it does not need stitches and therefore does not have any noticeable scarring. The downside to either of theses procedures is that taking away the lower eyelid fat bags can cause the skin to be too loose. If this happens people may opt for an additional surgery to tighten the skin.
One way is called transcutaneous blepharoplasty which is when the loose skin is actually cut out but it is necessary to not remove too much skin or the lower eyelid will be awkwardly tight and out of place.
The other option is called laser skin resurfacing and is where a laser vaporizes the top layer of skin causing the loose skin to contract. This laser can also be used to decrease wrinkles on one’s whole face.
After the laser resurfacing procedure it is important to frequently apply moisturizer and not wear makeup for about 2 weeks after the surgery. The laser touched skin may also be pink and appear slightly sunburned for up to 6 months after and may require makeup so as not to be noticeable.
Botulinum Toxin also known as botox is a solution that can be injected into the skin to freeze the muscles from movement. It helps treat dynamic wrinkles and causes fewer static wrinkles to appear.
It can be injected into the forehead and areas surrounding the eyes to prevent static and dynamic wrinkles. It lasts for around 3-4 months and injections can be redone at this point. One drawback is the face losing expression and movement and can cause the person to look unemotional or robotic. (Fekrat, Weizer 2006)