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Getting laser eye surgery? Here’s what you need to consider

Mareike Steger
16/8/2023
Translation: Katherine Martin

Many people who need glasses would happily get rid of them. Thank goodness for contact lenses. But what if years of contact-lens use has dried out your eyes? Instead of going back to glasses, there’s the option of laser eye surgery. Your choice of surgeon, however, will depend on one important thing.

These days, there’s a much easier way to compensate for visual deficits such as short- or long-sightedness: wearing glasses or contact lenses. And there are even more options out there for near-sighted children.

According to Dr. Hafezi, however, modern transPRK offers some advantages. In comparison to other methods, he says, it’s gentler and safer. Rather than cutting a lamella into the outer corneal layer as is done during LASIK surgery, or following the SMILE method of cutting a lenticule out of the cornea, transPRK works on the cornea without touching it. In my interview with eye expert Dr. Hafezi, I took a deep dive into the world of laser surgery:

If you get your eyes lasered, you’re basically having cosmetic surgery done, aren’t you?

Are there statistics on which visual disorder is most commonly treated with laser surgery?

«Worldwide, and in Switzerland too, there are far more people with short-sightedness than long-sightedness. As for how many people in this country undergo laser eye surgery, the figures are just estimates. From experience in my practice, however, I can tell you that it’s usually younger people up to their early 30s who come to me. Then there’s a second peak between ages 40 and 50.»

Can over-60s get laser eye surgery? Or is there an age limit?

«There’s no age limit. I’ve also done laser surgery on patients who were in their 80s. However, these people weren’t having cosmetic procedures. They were patients with corneal diseases, and I was giving them medical treatment. When it comes to this type of reconstructive laser surgery, the ELZA Institute is one of maybe 15-20 institutes in Europe that performs complex surgeries like this on a regular basis.»

I’m short-sighted myself, and a few years back, I read that as long as you’re getting along fine with glasses and/or contact lenses, there’s no reason to get laser surgery. Is that still the case?

«The question of whether or not to operate is always answered on a case-by-case basis. You can definitely stick with contact lenses or glasses if that system has been working for you for years. What many contact lens users aren’t aware of, however, is that laser refractive surgery is about as safe as wearing contacts. A study has demonstrated as much.»

In your experience, what are the most common reasons that drive people to get laser eye surgery?

«I can think of two main reasons: sport and the discomfort of wearing contact lenses. Patients old enough to need reading glasses don’t want to wear varifocals or classic reading glasses. And then there are people affected by contact lens intolerance. After many years of wearing contacts, their eyes are often so dry that they can only keep them in for a few hours a day.»

Why do eyes that have tolerated contact lenses for years suddenly become too dry for them?

Eye laser technology has changed drastically since the first excimer laser was used in 1986. In the video linked above, you argue in favour of the transPRK method – that’s the modern, refined version of laser surgery from the 1980s – as long as the patient fulfils the criteria. If the advantages of transPRK outweigh those of other treatments, why is a method like Femto LASIK still available?

«The video simplifies things a bit – that’s the nature of video. On the whole, all three methods are very safe. But relatively speaking, transPRK is that little bit safer because it doesn’t involve cutting the cornea. For certain indications, Femto LASIK is clearly the preferred method. Let’s say, for patients with a severe refractive error with or without astigmatism, as was the case with me. But for many people, all three methods are safe.»

What’s the most feared side effect of modern transPRK?

«The healing process is slower with transPRK than with LASIK, but it can be managed extremely well. It’s important for patients to work together with their doctor in the first few months, for example, by always coming in for follow-up visits.»

Do you think the technologies involved in laser refractive surgery will evolve in such a way that you’ll consider, say, SMILE, the most suitable treatment?

Can short-sighted people with age-related vision issues get laser surgery to completely eliminate the need for glasses?

How do you take away people’s fear of lasers? I imagine people get incredibly anxious.

Why do ophthalmologists often wear glasses themselves?

Header image: Shutterstock

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Mareike Steger
Autorin von customize mediahouse
oliver.fischer@digitecgalaxus.ch

I could've become a teacher, but I prefer learning to teaching. Now I learn something new with every article I write. Especially in the field of health and psychology.


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