A causal treatment of myopia is unfortunately not. The ill-mannered, therefore, has no choice but to put on glasses or to unsubscribe with contact lenses. In addition, there are also surgical procedures with a special laser (excimer laser), which are now scientifically recognized and established. These treatments are not for everyone and are not without risk. They require an experienced eye surgeon and should only be performed in clinics that have routine with this treatment. Furthermore, it should be considered that the surgical treatment of myopia is not a cash benefit and must be borne by the patient.
Photorefractive Keratectomy (PRK)
In "photorefractive keratectomy", tissue of the cornea is ablated with the laser beam. In myopia, the central cornea is deliberately flattened, with the result that incident light is refracted weaker after treatment. This procedure is only used for moderate myopia (up to -6 dioptres). In 90 percent of the patients, this can reduce the ametropia (to a value between +1 and -1 dioptres). The best results are achieved with low myopia. The outpatient surgery takes only a few minutes. The eye is previously anesthetized with drops. The doctor uses an instrument to remove the top layer of the cornea - the epithelium. Then the laser carries the predicted amount of cornea on a diameter of 6 to 7 millimeters. The procedure is not very stressful for the patient, because it is painless and - thanks to the laser - also non-contact.
After the surgery on the eye
Immediately after the procedure, visual acuity is reduced. In addition, when the effect of the eye drops subsides, pain occurs, which subsides after 2-3 days. The refractive power of the eye may still fluctuate in the first months after treatment. Slightly longer may be an increased sensitivity to light and dazzle and slight corneal opacity (about half a year). In addition, the treatment may result in over- or under-corrections requiring a second procedure or further wearing of visual aids. The PRK has been used since 1986 and was classified in 1995 by the German Ophthalmological Society as well as by the Professional Association of Ophthalmologists as a scientifically recognized method for the correction of myopia to about -6 dioptres and astigmatism (pathological change in corneal curvature) to about 3 dioptres,
For severe myopia: "Laser in situ Keratomileusis" (Lasik)
For more severe myopia, another laser method is possible, the so-called "laser in situ keratomileusis" (Lasik). In this method, first a thin lamella of the cornea is almost cut off and folded back. Now, the laser removes tissue inside the cornea. Then the lamella is folded back and after a few minutes the cornea has sucked in the adjacent lamella again. Finally, eye drops are administered and a bandage or bandage lens applied. This method has been proven to be especially effective for myopia in the range of minus 4 to minus 10 diopters. Here, the success rate is between 70 and 90 percent, depending on the initial level of ametropia. In most clinics, surgery is performed on two consecutive days or both eyes are operated on in one session.
Also with far-sightedness
The hyperopia can be corrected by means of Lasik to +3 dioptres, with some restrictions even up to +5 dioptres. The laser removes corneal tissue in the periphery of the cornea. The central and thus optically effective cornea is thus aufgesteilt so that a "plus lens" is created. LASIK has been used since 1990 and was classified by the German Ophthalmological Society and the Ophthalmologists' Association in 1999 as a scientifically recognized method for the correction of myopia by about -10 dioptres and astigmatism up to about 3 dioptres.
Risks and side effects
The advantage of LASIK over PRK is that the surface of the cornea is not destroyed. Therefore, the scarring is much lower than after the PRK and there is no pain after surgery. The risk of seeing worse after a LASIK surgery than before is very low. In LASIK the complication rate is below 1%. As with any medical procedure, however, a residual risk can never be completely ruled out:
- In the twilight or darkness, glare and the perception of halos and double contours can occur. This can limit the ability to drive during night driving. However, these changes usually only occur in myopia over -5 dioptres and farsightedness.
- In rare cases, rubbing the eye may result in a shift in the corneal flap that requires reoperation.
- Rarely, in the first few weeks, a superficial layer of corneal ingrowing under the corneal lid. Also in this case, another operation may be necessary.
- In very rare cases excessive weakening of the cornea can lead to protrusion (keratectasia).
- Very rarely there is a decrease in vision or an infection with scarring.