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EXPERT OPHTHALMOLOGY WITNESS
What Are The Different Types Of Eye Surgery?
What are the different types of eye surgery? As humans age, one of their natural tendencies is a decrease in eye performance. Individuals in their mid-40s begin experiencing presbyopia, or the gradual loss of the eye’s ability to focus on nearby objects. It is a normal part of aging issues that affect the daily activities of many adults. In addition, adults over 40 with the following health and work issues may be more vulnerable to developing eye and vision disorders:
- Diabetes or high blood pressure
- History of macular degeneration or glaucoma in the family.
- A job that requires a great deal of vision or one that puts your eyes at risk.
- High cholesterol, thyroid, depression, anxiety, or arthritis that require medication.
While glasses and contact lenses may be adequate for many years, there will probably come a time when they are not. Others could merely seek a longer-term solution, like eye surgery, to simplify their lives.
Eye surgery refers to the eye treatment that addresses certain vision problems, which include cataracts, glaucoma, detached retinas, retinal tears, diabetic retinopathy, and nearsightedness
or farsightedness. Like the other existing surgeries, eye surgery provides healing benefits to the patients, especially when there is a well-planned post-surgery routine. Meanwhile, it's crucial to understand that many different eye surgical operations exist because every eye’s need is unique. In this article, you will get to know the various types of surgery to improve your eyesight.
Different Types Of Eye Surgery
Generally speaking, the types of eye surgery can be categorized into two: eye surgery for disease and eye surgery by area. Below is a description of common eye surgery procedures.
Cataract Surgery
A cataract is one of the eye diseases that cause foggy, fuzzy vision that may appear as a white curtain. It might be inherited or acquired or most frequently brought on by aging. To treat this eye disease, there is a need for cataract surgery. It aims to remove the clouded lens and replace it with a new, transparent artificial lens.
The surgeon uses a scalpel or a laser to make small incisions near the corneal edge during surgery. Once the lens has been broken up via phacoemulsification, it is removed to make room for the new intraocular lens. Cataract surgery is the best option for removal as it is painless, secure, effective, and seldom causes complications.
Corrective Eye Surgery
This type of eye surgery aims to treat refractive errors in the eye, which results in nearsightedness, farsightedness, and astigmatism. The idea behind corrective eye surgery is to “correct” the refractive error by reshaping the cornea and changing its refractive power, enabling the light to strike the retina directly rather than in front or behind it. Corrective eye surgery is a permanent treatment, unlike eyeglasses and contact lenses.
Meanwhile, the FDA has approved the refractive surgery procedure conductive keratoplasty (CK) for treating hyperopia (or farsightedness). The cornea is reshaped using low-level radiofrequency energy instead of a laser during this operation. The radiofrequency energy is applied to the outer cornea in a circular pattern using a tiny probe that is larger than a human hair strand. The cornea shrinks in a few localized regions as a result. In order to boost the cornea’s curvature and overall power, this circular shrinkage pattern causes a band-like tightening of the cornea.
Through the process of automated lamellar keratoplasty (ALK), the abnormal curvature in the cornea can be treated. The abnormal curative prevents the cornea from precisely focusing light on the retina (the photosensitive layer at the rear of the eye). ALK is recommended for vision disorders such as near- and farsightedness.
Laser Thermal Keratoplasty (LTK) procedure uses a laser beam powered by holmium-YAG radiation to reshape the cornea to treat farsightedness. LTK is a non-contact laser procedure, which means a cornea is not cut, and only the laser beam and a device hold the eye open to make contact with the eye before, during, or after the operation. The collagen fibers are shrunk by steepening the cornea and altering the eye's focal point. During the surgery, no eye tissue is removed.
Glaucoma Surgery
Glaucoma causes an increased intraocular pressure that damages the optic nerve resulting in blindness. The production of aqueous humor may be increased, or its outflow may be reduced, resulting in a rise in intraocular pressure.
Retinal Surgery
The retina is the most important part of the human eye. It is responsible for transmitting images to the brain, which is directly attached to the optic nerve. Any condition that affects the retina directly impacts our eyesight and may worsen it, reduce its field, and even cause blindness.
For any retinal disease, securing the retina back to its supporting tissue while restoring its position and function to stop further fluid buildup, detachment, or degeneration is essential. Retinal tears, retinal detachments, and diabetic retinopathy cause retinal dysfunction.
Squint Surgery
This kind of surgery is designed for a disorder that affects the appearance and function of the eyes and causes both eyes not to line up while they are gazing at the same thing. This is called squint, strabismus, amblyopia, or lazy eyes. Over time, the damaged eye loses its ability to see, and the brain ceases processing the images it formerly processed. Thus, squint surgery involves either strengthening weak muscles or weakening opposing ones.
Types of Keratoplasty Surgeries
One of the parts of the human eye is the cornea. The cornea is a clear layer on the eye’s frontal part that aids in focusing light on seeing well. When damaged, the patient needs to undergo a surgical procedure to have it replaced with a layer of healthy tissue. This operation is called keratoplasty or a corneal transplant that aims to restore your vision, ease your pain, and even improve the appearance of your cornea.
Depending on which area of the cornea is damaged or how much of it has to be replaced depends on the type of corneal transplant that needs to be executed. Hence, the patient may consider one of the following options.
- penetrating keratoplasty (PK)- full-thickness transplant
- deep anterior lamellar keratoplasty (DALK)- replacing or reshaping the layers of the cornea (outer and middle or front layers)
- Endothelial keratoplasty (EK)- rebuilding the cornea's deeper (back) layers.
WHICH TYPE OF EYE SURGERY IS BEST THAT WILL HELP YOU SEE BETTER
Eye surgery is considered the first-choice treatment when a patient experiences any eye condition which results in substantial vision loss. A specific eye surgery needs to execute for a specific eye problem. Thus, depending on eye treatment needs, these three are the most frequent and best eye surgery operations to carry out.
Corneal Transplant
The damaged cornea is replaced with a healthy one provided by a donor during a cornea transplant. Your surgeon will advise the ideal cornea transplant options for the patient. Although the surgery is often performed without a hospital stay, the recovery takes longer than it does for most eye procedures. Thus, postoperative care must be done to avoid further complications.
The damaged cornea is replaced with a healthy one provided by a donor during a cornea transplant. Your surgeon will advise the ideal cornea transplant options for the patient. Although the surgery is often performed without a hospital stay, the recovery takes longer than it does for most eye procedures. Thus, postoperative care must be done to avoid further complications.
Refractive Surgery
The most common purpose of refractive surgery is to treat eye problems to enhance vision. Patients who suffer from presbyopia, astigmatism, myopia, hyperopia, or astigmatism will need to undergo refractive surgery. The most popular refractive surgery is Laser-Assisted Stromal In-situ Keratomileusis, or LASIK, in which the ophthalmologist will reshape the cornea to improv its focus.
The most common purpose of refractive surgery is to treat eye problems to enhance vision. Patients who suffer from presbyopia, astigmatism, myopia, hyperopia, or astigmatism will need to undergo refractive surgery. The most popular refractive surgery is Laser-Assisted Stromal In-situ Keratomileusis, or LASIK, in which the ophthalmologist will reshape the cornea to improv its focus.
Cataract Removal
During the operation, the doctor will remove the clouded natural lens and replace it with an intraocular lens (IOL), a clear artificial lens. IOL will be special to one patient because it was selected using precise measurements of the eyes. Cataract surgeries are done as outpatient procedures, and the recuperation period is not too long. There are some cases when the patient’s eye gets damaged during a procedure, as there are risks with any surgery. When malpractice has occurred, a lawyer is often hired and that lawyer seeks an expert review of the case from an expert ophthalmologist witness.
During the operation, the doctor will remove the clouded natural lens and replace it with an intraocular lens (IOL), a clear artificial lens. IOL will be special to one patient because it was selected using precise measurements of the eyes. Cataract surgeries are done as outpatient procedures, and the recuperation period is not too long. There are some cases when the patient’s eye gets damaged during a procedure, as there are risks with any surgery. When malpractice has occurred, a lawyer is often hired and that lawyer seeks an expert review of the case from an expert ophthalmologist witness.
What are the considerations for anesthesia during eye surgery?
Some types of eye surgery offer general anesthesia, which leaves you unconscious or asleep throughout the eye surgery procedure. Meanwhile, it is more likely that you will receive a supplementary regional anesthetic block in addition to controlled sedation to help you relax and block any pain. These are important so that patients will stay calm during the surgery without worrying about the pain they may feel. With that, here are some of the considerations a patient should note concerning anesthesia.
Level of sedation
The level of sedation is crucial since the surgeon doesn't want your head to move during eye surgery. That may occur if you are so heavily medicated that you become fully asleep. Too much sedation can make your eyelids appear droopier than they actually are, which could cause the surgeon to overcorrect them during blepharoplasty.
The level of sedation is crucial since the surgeon doesn't want your head to move during eye surgery. That may occur if you are so heavily medicated that you become fully asleep. Too much sedation can make your eyelids appear droopier than they actually are, which could cause the surgeon to overcorrect them during blepharoplasty.
Monitored sedation
Due to the position of the surgeon and anesthesiologist, there is a high preference for monitored sedation. In most surgical procedures, the surgeon stands near the patient’s middle body, whereas the patient’s head stations the anesthesiologist. However, in eye surgery, the surgeon and the anesthesiologist have reversed positions, which results in difficulty for the anesthesiologist to intervene if the patient has breathing issues.
Due to the position of the surgeon and anesthesiologist, there is a high preference for monitored sedation. In most surgical procedures, the surgeon stands near the patient’s middle body, whereas the patient’s head stations the anesthesiologist. However, in eye surgery, the surgeon and the anesthesiologist have reversed positions, which results in difficulty for the anesthesiologist to intervene if the patient has breathing issues.
Are there special anesthesia considerations for children?
Local and general anesthesia are the two main types of anesthesia. The former aims to numb the area around the place to be operated on by applying or injecting anesthetic medications. For instance, dentists administer local anesthesia when performing dental surgery by injecting lidocaine into the affected area. The patient is still awake, able to move, and aware of the procedure. Meanwhile, the latter reduces a patient’s possible movement because it puts the entire body to sleep. It means that the patient is unaware of the procedure and experiences no pain.
For children, it is always considered to use general anesthesia, especially during eye surgery. It ensures that the operation is safe and effective for young ages. General anesthesia may be required for a complete examination of children who are very uncooperative and whose ophthalmologist is unable to obtain important information. Minor eyelid surgery can be done under local anesthesia in older children, but this requires the patient to be calm and cooperative.
Are there medical conditions that can complicate eye surgery?
Prior to your eye surgery, it is recommendable to schedule a preoperative visit. It is essential to ensure that you do not have any medical conditions that will drastically affect the operation during eye surgery. Some of these conditions affect a patient’s ability to remain still and in a flat position. Such scenarios may interfere with the surgeon and the surgery itself. Preoperative visit encourages patient you may have the following:
- Reflux
- Back pain
- Emphysema
- Temporary cough
For eye-related medical conditions, one of the possible eye disorders that may mitigate against eye surgery, especially LASIK, is called keratoconus. This kind of eye disorder causes the eye’s cornea to thin out and become cone-shaped. Keratoconus results in disturbance to one’s vision, such as blurry vision, sensitivity to light, seeing multiple images, and distortion of objects.
How do you choose an eye surgeon?
Choosing an eye surgeon who is efficient and effective is a challenging task. The reason stems from the effectiveness and safety that a surgeon may offer. Thus, it is crucial to choose the best eye surgeon, or your safety will be compromised otherwise. Fortunately, there are some factors that a patient may consider in choosing an eye professional that will cater to every vision-related need.
Specialization
For more detailed eye examination and diagnosis of any eye-related conditions, a patient may need to see an ophthalmologist. They are eye doctors who have post-graduate qualifications in Ophthalmology. They are entitled and qualified to examine, diagnose, and execute eye surgery and visual treatment procedures. Ophthalmologists are just one of the two types of eye professionals.
For more detailed eye examination and diagnosis of any eye-related conditions, a patient may need to see an ophthalmologist. They are eye doctors who have post-graduate qualifications in Ophthalmology. They are entitled and qualified to examine, diagnose, and execute eye surgery and visual treatment procedures. Ophthalmologists are just one of the two types of eye professionals.
The other one is optometrists. They are eye professionals that are not doctors, but they can offer general eye check-ups with refraction and prescription of eyeglasses and contact lenses. Thus, in choosing your eye surgeon, obviously, you need to see an ophthalmologist.
Look for their credentials.
After determining the eye professional with the correct specialization, patients need to undergo a thorough credential assessment of their chosen eye specialists. The credentials should include professional and quality background of their training, skills, experiences, and degree certification. In addition, a patient should ensure that the ophthalmologist has no history of malpractice claims or has not been subjected to any disciplinary actions.
After determining the eye professional with the correct specialization, patients need to undergo a thorough credential assessment of their chosen eye specialists. The credentials should include professional and quality background of their training, skills, experiences, and degree certification. In addition, a patient should ensure that the ophthalmologist has no history of malpractice claims or has not been subjected to any disciplinary actions.
Consider their experiences in eye surgery.
Always count the success rate of any eye surgeon in their previous operations. The more experiences they have, the better. In eye surgery, experiences do not mean the length of years, but they refer to the number of patients they treated successfully. Consider these steps in addition to the details provided.
- Ask a friend who has undergone successful surgery.
- Look for a doctor who has had at least 200 surgeries and closely follows his patients.
- Avoid offers that sound too good to be true.
Common Eye Surgeries for Every Age Group
When considering eye treatment options, it is also necessary to assess how age relates to the right eye surgery a patient needs. It means that there are respective eye surgeries appropriate to every age group, as eye needs differ uniquely.
1. For Ages 20-35
People of this age range work with naturally clean and flexible eye lenses, so giving them a quick and easy eye treatment procedure will allow them to ditch contacts and glasses for years to come.
LASIK – Laser-Assisted In Situ Keratomileusis uses a laser to reshape the cornea to correct nearsightedness, farsightedness, and astigmatism. When LASIK corrects corneal defects, light is properly focused on creating a precise image on the retina, allowing the patient to see more clearly.
SMILE – Small Incision Lenticule Extraction gently reshapes the cornea by removing a thin contact lens-like layer just below the surface of the eye. It aims to correct refractive errors. This high-precision process takes only a few minutes in total, is relatively convenient and practical, and the visual results are highly predictable.
2. Ages 35-55
Notable changes may begin to occur in this age range. Patients may start using reading glasses. They also start experiencing more issues like dry eyes and eye allergies. For many people in this age group, LASIK or SMILE are still viable options. However, it is highly recommended to implement refractive lens replacement.
Refractive Lens Replacement – Presbyopia is the normal loss of ability to focus near objects as age progresses. In this case, having Refractive Lens Replacement (RLE) may be a better option than LASIK or SMILE. This procedure replaces the eye's natural lens with an artificial intraocular lens. As a result, a patient will have a clear, stable vision without the risk of regression. Although it is a more complicated procedure than LASIK, it provides similar results, has many unique advantages, and is useful for demographics with a greater need for vision correction.
3. For Ages 55 and above
After reaching the age as mentioned earlier, the quality of eye performance naturally decreases. Ages 55 and above may already be using bifocal lenses. They may also notice the development of dysfunctional lens syndrome and/or cataracts. Thus, at this stage, cataract surgery or premium lens surgery is recommended.
Cataract Surgery – This procedure is like the refractive lens replacement, but in this case, the catalyst for the surgery is a cloudy lens known as a cataract. The procedure takes just 8-15 minutes, and the average patient sees a dramatic improvement in vision within the first 24 hours of the procedure. Although this surgery is life-changing for most people, you may need glasses for reading and other close-up photography.
Premium Lens Surgery – A premium alternative for those undergoing cataract surgery, Lens implants can reduce or eliminate the need for eyeglasses. This is the only option that allows you to see both near and far with both eyes without glasses. However, premium lenses are considered optional upgrades and are not covered by health insurance.
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