Surgery against myopia: procedure, prices and results

According to the World Health Organization (WHO), 2.2 billion people are visually impaired or blind worldwide. Of all these cases, more than 1 billion could have been avoided or have not yet been treated. Of course, these data highlight the fragility of our ocular apparatus and the bill that our lifestyle passes to us visually.

On the other hand, it is estimated that around 25% of the population has myopia, one of the most common refractive errors in modern society. Fortunately, in the last decades, laser techniques have been developed that make it possible to correct, to some extent, simple and pathological myopia. If you are thinking of discarding glasses and contact lenses once and for all, read on, as we have a lot of ground to cover in the following lines.

• We recommend you read: "The 10 most important types of surgery (and their characteristics)"

What is myopia?

Myopia is defined as a type of refractive vice, that is, an eye condition in which light rays entering the eye are not focused on the photoreceptor sheet of the retina

, resulting in the production and interpretation of a blurred image of the environment. In the case of myopia, objects close to the patient are clearly visible, but distant objects are out of focus and blurred. In the United States and Europe, a prevalence of myopia is estimated to be approximately 26%, which translates into 1.6 billion nearsighted people worldwide.

We can distinguish two main types of myopia:

• Simple myopia: the graduation (visual quality of the patient) does not exceed 5-6 diopters and is of limited evolution until 22-24 years of age.
• Pathological myopia: the graduation exceeds 6 diopters and is believed to be caused by poor development of certain eye segments.

What is myopia surgery?

First of all, it is necessary to limit that here we're going to focus on LASIK (Lasser Assisted In Situ Keratomileusis), which is the operation of choice in most cases in which it is sought to correct myopia, hyperopia and astigmatism. It is valid for those patients who present between 1 and 12 diopters, that is, refractive errors with low-medium levels. It is a procedure of an extraocular nature, wide range, effective and safe.

On the other hand, there are other much more specific techniques for those patients with high refractive errors (12-14 diopters). In these cases, intraocular techniques are used, which are the following:

• Phakic lenses: for patients under 40 years of age. It is based on the implantation of intraocular lenses.
• Lensectomy: for patients over 40 years of age. The clear lens is removed from the patient and an intraocular lens is implanted.

When we talk about surgery against myopia, in almost all cases we are referring to LASIK, because it is the method to be followed in most patients (with an average of 20-29 years, according to certain studies sample them). Next, we will tell you what this procedure consists of.

LASIK procedure

First of all, it is necessary to emphasize that it is not enough to enter a medical consultation and request the operation. We are facing a very important procedure and, therefore, multiple tests should be performed on the patient to confirm that he is a suitable candidate for him. Among the preoperative and evaluative tests we find the following:

• A dilation test to quantify the presence (or not) of ocular irregularities.
• The measurement of refractive error. As we have said, patients with serious errors can be referred to other types of procedures.
• Measurements of the diameter of the pupil and thickness of the cornea.
• Making a topographic map of the cornea.
• A functional analysis of the tear duct.

All this is naturally accompanied by an informative talk to the patient with the pros / cons and preparation for the operation. Ultimately, it is the patient who must decide whether or not the process to be performed on their eyes compensates them.

Nor do we want to lose ourselves in the particularities of this process, so we will say that it is based on the following points: a thin layer of corneal tissue is lifted, similar to a lens. Subsequently, the laser of choice is applied on it. After this, the tissue layer is repositioned, without the need for stitches.

Basically part of the eye is “cut” with a specialized type of laser (femtosecond), creating a corneal flap that later partially detaches (as if a window) so that the excimer laser can shape the corneal stroma to correct refractive errors. Finally, this flap is put back in place and attaches itself naturally to the ocular structure. Yes, it is as if a lid were opened in the eye so that the laser could act and then closed again. As simple as that.

As you will see, this procedure is very simple. Therefore, it can be performed on an outpatient basis and does not require general anesthesia. It usually takes about 10-15 minutes to correct each eye and, in addition, the analgesic treatment is local. You will be surprised to learn that the laser application itself takes less than a minute, between 15 and 45 seconds. It's hard to find a faster type of eye surgery than this.

Results

We are entering a slightly more compromised field, since the effectiveness in 100% of the cases does not seem be fully insured, no matter how much private clinics try to convince us of what contrary. According to studies conducted by the FDA (Food and Drug Administration) and the NEI (National Eye Institute), up to 43-46% of the patients in certain sample groups showed sequelae after the intervention, even in the procedures carried out with the most exact and innovative technologies.

Up to 35% of them presented halos in the vision, 30% showed dry eyes that were not present before and another 28% starbursts or flashes. This is not to say that the procedure is medical negligence, but it is clear that there are certain reservations that must be taken into account.

On the other hand, the United States National Library of Medicine indicates that some patients have it may take 3-6 months to regain normal vision after the intervention, during which you may have blurred vision, photophobia and other symptoms. Furthermore, a small group of patients may require a second intervention to obtain the desired results. Depending on the underlying cause of myopia (whether it is simple or pathological), it may also reappear after the operation.

There are many considerations that must be taken into account so, if you are thinking of undergoing LASIK, consult the particularities of your case with your trusted ophthalmologist, better if he is from the public health sector and has no financial interest in you going to the clinic ambulatory.

Prices

You can find LASIK-type surgeries for a base price of approximately 650 euros each. of the eyes (about 1,200 euros, as it does not make sense to have the procedure in only one of the two eyes). Even so, the most common is to find average prices of 1,600-2,000 euros, depending on the professional who will accompany you in the process.

Resume

We understand that wearing glasses or contact lenses can be very annoying, because believe me that, at least in this case, we speak from experience. Unfortunately, myopia surgery is not always the absolute solution, because nobody assures you that your refractive defect will stay where it is and you will not see bad again several years after undergoing the procedure. In addition, in some specific cases side effects may appear that frankly leave you worse than you were before.

This is like everything: each case is different. If a person has 10 diopters and without glasses he cannot see a friend's face from a meter and a half away, it is more than understandable that he undergoes this type of procedure. Although the effect lasts about 10 years (or if it is for life, better), it is 10 years with adequate eyesight for a price that is not too prohibitive. As we have said in previous lines, it is best that you consult with your trusted ophthalmologist about the options on the table before throwing yourself into the arms of a private clinic.

Bibliographic references

• How is the myopia operation at the Baviera Clinic? Clinicabaviera.com. Picked up on December 16 in https://www.clinicabaviera.com/blog/salud-visual/como-es-la-operacion-de-miopia-en-clinica-baviera/
• Myopia surgery: window to other specialties. Picked up on December 16 in http://aeeh.es/wp-content/uploads/2012/05/v2n3a118pdf001.pdf
• LASIK surgery. National Library of Medicine of the United States. Picked up on December 16 in https://medlineplus.gov/spanish/ency/article/007018.htm#:~:text=Es%20una%20cirug%C3%ADa%20de%20los, glasses% 20o% 20lenses% 20of% 20contact.
• Escalona Tamayo, M. D. J., Torres Ortega, R., Welch Ruiz, G., Martínez Rivalta, J., & Zerquera Rodríguez, T. (2014). Correction of myopia through Lasik surgery. Cuban Journal of Military Medicine, 43 (1), 33-41.
• FDA study shows high rates of sequelae after laser eye surgery, ASACIR. Picked up on December 16 in https://afectadoscirugiarefractiva.com/informe-pre-eliminar-sobre-calidad-de-vida-lasik-de-la-fda/
• WHO presents the first global report on vision, World Health Organization (WHO). Picked up on December 16 in https://www.who.int/es/news/item/08-10-2019-who-launches-first-world-report-on-vision
• Moreno, N. R., Srur, A. M., & Nieme, B. C. (2010). Refractive surgery: indications, techniques and results. Las Condes Clinical Medical Journal, 21 (6), 901-910.