Dr. Semrin Timlioğlu | Laser Eye Surgery

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Laser eye surgery is an effective method used in the treatment of myopia, hyperopia, and astigmatism for those who wish to permanently correct their vision defects. This procedure is safely performed using modern technologies for patients who desire clear vision without relying on glasses or contact lenses.

Today, the most frequently used eye laser surgery methods are LASIK, PRK, and SMILE laser techniques. Each method has its own advantages and disadvantages. So, which laser eye surgery method is right for you?

Types of Laser Eye Surgery

Laser eye surgeries are performed using different techniques. Factors such as the patient’s prescription (refractive error), corneal thickness, and overall eye health determine which method will be applied.

SMILE Laser (Small Incision Lenticule Extraction)

SMILE Laser Surgery (Small Incision Lenticule Extraction) is a modern laser eye surgery method used in the treatment of refractive errors such as myopia and astigmatism. This technique is performed by creating a minimal incision in the cornea and removing a small piece of tissue called a lenticule. This reshapes the cornea and enhances visual quality.

Advantages of SMILE Laser

Minimally Invasive Procedure: SMILE laser is performed through a small incision of approximately 2-4 mm in the cornea. This means less tissue damage compared to traditional LASIK.
Lower Risk of Dry Eye: Due to the small incision, the corneal nerve fibers are less affected, which reduces the risk of dry eyes after surgery.
Fast Recovery Process: Patients can generally return to their daily activities within a few days. Visual quality improves rapidly and stabilizes quickly.

Disadvantages of SMILE Laser

Limited Application Area: SMILE laser is currently not approved for hyperopia treatment. It can only be applied in cases of myopia and certain astigmatism.
Restrictions for High Astigmatism: Since SMILE laser does not have the eye tracking system found in excimer laser systems, it can be disadvantageous, particularly in high astigmatism corrections.

SMILE Laser Prices

The cost of SMILE laser surgery varies depending on geographic location, hospital, technology used, and the surgeon’s experience. As of 2024 in Turkey, SMILE laser treatment prices range between 20,000 TL and 35,000 TL.

SMILE laser surgery is an effective option for treating myopia and astigmatism due to its minimally invasive nature and fast recovery process. However, as with any surgical procedure, it is important to undergo a detailed eye examination and consult with an expert eye surgeon to determine if you are a suitable candidate.

Table 1: Types of Laser Eye Surgery
Laser Treatment Type	Flap Creation	Recovery Speed	Risk of Dry Eye	Who Might Be Suitable?
LASIK	Yes	Fast	Moderate	Wide patient base, those desiring quick results.
PRK	No	Slower	Low	Those with thin corneas, professions exposed to trauma.
SMILE	No	Much Faster	Very Low	High myopes, those with an active lifestyle.

PRK Laser (Photorefractive Keratectomy)

PRK (Photorefractive Keratectomy) is a laser eye surgery method developed before LASIK and is still preferred for specific patient groups today. In this procedure, the uppermost layer of the cornea (epithelium) is completely removed, and the laser is applied to the underlying tissue to reshape the cornea.

Advantages of PRK Laser

Suitability for Patients with Thin Corneas: PRK is an ideal option for patients with thin corneas or those who are not suitable for LASIK due to structural characteristics.
No Flap Creation: Since no corneal flap is lifted in this method, there is no risk of flap-related complications, and the structural integrity of the cornea is preserved.
Suitable for Active Lifestyles: As no flap is created, PRK can be a safer option for active individuals such as athletes or military personnel who face a high risk of eye trauma.

Disadvantages of PRK Laser

Longer Recovery Period: The recovery time after PRK is longer compared to LASIK. Full visual clarity may take several weeks to achieve, and patients may experience discomfort during this period.
Postoperative Discomfort: Patients may experience complaints such as severe pain, burning, and light sensitivity lasting 2-3 days after the surgery.
Temporary Blurred Vision: Temporary blurred vision and sensitivity to light may be experienced during the healing process.

PRK Laser Prices

PRK laser surgery is generally more cost-effective compared to LASIK. However, prices may vary depending on geographic location, hospital, and the surgeon’s experience.

PRK is an effective laser eye surgery option, especially for individuals with thin corneas or an active lifestyle. However, it should be considered that the recovery process may be longer and more uncomfortable. It is important to determine the most suitable treatment method through a detailed eye examination and consultation with a specialist doctor before the surgery.

LASIK Laser (Laser-Assisted in Situ Keratomileusis)

LASIK (Laser-Assisted in Situ Keratomileusis) is one of the most commonly used laser eye surgery methods for correcting vision defects. In this procedure, the shape of the cornea is altered to ensure that light is focused correctly onto the retina, thereby achieving clear vision.

Advantages of LASIK Laser

Fast and Safe Procedure: LASIK surgery typically takes about 20 minutes, and patients remain awake during the procedure. The laser is designed to stop automatically in the event of sudden eye movements, which enhances safety.
Quick Recovery and Results: Most patients notice a significant improvement in vision quality within a few hours after surgery and can usually return to their normal activities the next day.
High Success Rate: LASIK is a procedure with a high success rate. Most patients achieve 20/20 or better visual acuity after surgery.

Disadvantages of LASIK Laser

May Not Be Suitable for Everyone: LASIK is not a suitable option for every patient. Especially in individuals over 40, presbyopia (difficulty with near vision) may develop, and this condition cannot be corrected with LASIK. Furthermore, it may not be suitable for patients with thin corneas or high degrees of myopia.
Temporary Side Effects: Some patients may temporarily experience side effects such as dry eyes, night glare, or halos after surgery. These symptoms usually resolve within a few months.
Rare Complications: In rare cases, complications such as under- or overcorrection may occur, which might require additional treatments.

LASIK Laser Prices

The cost of LASIK surgery varies depending on geographic location, surgeon’s experience, and the technology used. In the United States, the average cost for one eye ranges between $1,500 and $3,000 USD.

LASIK is an effective vision correction option for suitable candidates, offering a fast recovery time and high success rate. However, because it may not be suitable for everyone, a detailed pre-operative eye examination and consultation with a specialist surgeon are essential.

Risks of Laser Eye Surgery

Although laser eye surgery is considered an effective and safe method for correcting vision defects, it can involve certain risks and side effects, as with any surgical procedure. These risks are minimized when performed by an experienced surgeon. Here are the possible risks and side effects of laser eye surgery:

Dry Eye: Reduced tear production may occur after surgery, leading to dry eyes. This condition is usually temporary and can be controlled with artificial tear drops. However, in some patients, this feeling of dryness can last between six months and a year.
Night Vision Problems: Some patients may see halos or glare around lights, especially in low-light conditions, after surgery. This can cause difficulties when driving at night. These symptoms usually diminish over time, but may be permanent in some patients.
Recurrence of Refractive Error: After surgery, especially in patients with high-grade vision defects, a portion of the refractive error may return. In this case, an additional enhancement surgery may be required.
Infection and Inflammation: As with any surgical procedure, there is a risk of infection after laser eye surgery. While this risk is extremely low, infection or corneal inflammation can occur if postoperative care instructions are not followed.
Flap Complications: In some types of laser surgery, such as LASIK, a flap is created in the cornea. In rare cases, this flap may become dislodged or fail to heal properly, which may require additional interventions.
Corneal Haze: Especially in surface ablation techniques like PRK and No Touch T-PRK, there is a risk of corneal clouding (haze). This can affect visual quality and prolong the recovery period.
Corneal Thinning or Irregularities: Although rare, thinning or shape irregularities (ectasia) of the cornea may develop after surgery. This can lead to a deterioration in visual quality and may require additional treatments.

If you are considering laser eye surgery, it is important to take these risks and side effects into account, undergo a detailed pre-examination, and consult with an expert eye surgeon. A professional ophthalmologist’s evaluation is essential to determine if the surgery is suitable for you and to minimize potential risks.

Who is Not Suitable for Laser Eye Surgery?

Laser eye surgeries are an effective method for correcting vision defects such as myopia, hyperopia, and astigmatism. However, not every patient is a suitable candidate for this surgery. Laser eye surgery is not recommended in the following cases:

Those with Unstable Prescription: Individuals whose glasses or contact lens prescription has changed in the last year.
Pregnant or Breastfeeding Women: Hormonal changes during pregnancy and breastfeeding may cause fluctuations in the eye prescription.
Those with Corneal Diseases: Individuals with structural abnormalities of the cornea such as keratoconus or corneal dystrophies.
Those Experiencing Severe Dry Eye Syndrome: Symptoms may worsen after surgery in individuals with severe dry eyes.
Those with Diabetes or Autoimmune Diseases: Diseases like uncontrolled diabetes, rheumatoid arthritis, or lupus can negatively affect wound healing.
Individuals Under 21 Years of Age: Laser surgery is not recommended for individuals under 21 as the refractive state of the eye has not yet stabilized.
Those with Active Eye Infection or Inflammation: Surgery should be postponed in cases of existing eye infection or inflammation.
Those with Other Eye Diseases such as Cataract or Glaucoma: If these types of diseases are present, laser surgery may not be a suitable option.

If you are considering laser eye surgery, it is important to determine whether you are a suitable candidate by undergoing a comprehensive eye examination and consulting with an expert ophthalmologist .

Side Effects of Laser Eye Surgery

Laser eye surgeries are safe and effective methods widely preferred for the correction of vision defects. However, as with any surgical procedure, these surgeries can have certain side effects.

Common Side Effects of Laser Eye Surgery

Blurred Vision: Patients may experience blurred or hazy vision for the first few days after surgery. This condition usually resolves quickly, and visual clarity improves.
Night Vision Problems: Some patients may see halos or glare around lights, especially in low-light conditions. This can cause difficulties when driving at night. These symptoms usually decrease and disappear over time.
Dry Eye and Stinging Sensation: Reduced tear production may occur after surgery, leading to dry eyes and a stinging sensation. This condition is usually temporary and can be controlled with artificial tear drops. However, in some patients, this feeling of dryness can last between six months and a year.

Rare Side Effects of Laser Eye Surgery

Infection and Inflammation: As with any surgical procedure, there is a risk of infection after laser eye surgery. While this risk is extremely low, infection or corneal inflammation can occur if postoperative care instructions are not followed.
Corneal Shape Irregularities: In rare cases, thinning or shape irregularities (ectasia) of the cornea may develop after surgery. This can lead to a deterioration in visual quality and may require additional treatments.

Pre-Operative Care for Laser Eye Surgery (Before Surgery)

Before laser eye surgery, it is important for patients to make certain preparations for a successful operation and a quick recovery process. Here are the main points to consider:

Discontinue Contact Lens Use: Contact lenses can temporarily change the shape of the cornea, which can affect the precision of the surgery. For this reason, soft lenses should not be worn for at least 3-5 days before the surgery. Hard or gas permeable lenses should be discontinued at least 2-3 weeks before the operation.
Eye Examinations and Medication Use: Antibiotic and Anti-inflammatory Drop Use reduces the risk of infection and prevents inflammation if you use the antibiotic and anti-inflammatory eye drops prescribed by your doctor for the period specified before the surgery. Artificial Tear Drops help keep the eyes moist when used four times a day for two weeks before the surgery.
Personal Hygiene and Cosmetic Products: Makeup and Skin Products should be avoided on and around the eyes on the day of and for a few days prior to surgery. Also, do not use perfume, hairspray, or scented skin products, as these can affect the precision of the laser device. Face and Eye Hygiene: thoroughly clean your face and eye area on the day of the surgery. Gently cleaning your eyelids and eyelashes reduces the risk of infection.
Surgery Day Preparations: Wear Comfortable Clothing: choose loose and comfortable clothes for comfort during and after the surgery. You can eat a light meal before the surgery; there is no need to fast. However, avoiding caffeinated beverages may help you rest after the operation. Arrange for a Chaperone: due to blurred vision and sedatives given after the surgery, it is important to arrange for someone to drive you home.

These preparations contribute to the safe and effective performance of your laser eye surgery. Always remember to follow your doctor’s instructions and consult your healthcare team if you have any questions.

Post-Operative Care for Laser Eye Surgery (After Surgery)

The recovery period after laser eye surgery is critically important for achieving a successful outcome and preventing complications. Paying attention to the following points during this process will help protect your eye health:

Eye Protection and Hygiene: Avoid Rubbing Your Eyes: avoid rubbing your eyes for the first month after surgery. Rubbing can displace the corneal flap or lead to infection. Wear Protective Eyewear: wear the protective glasses recommended by your doctor for one week, especially while sleeping, to protect your eyes from accidental contact.
Medication and Drop Use: Eye Drop Application: regularly use the antibiotic and steroid drops prescribed by your ophthalmologist for the specified duration. This reduces the risk of infection and controls inflammation. Artificial Tear Drops: use preservative-free artificial tear drops regularly to prevent dry eyes.
Activities and Environmental Factors: Avoid Water Activities: stay away from activities such as swimming, saunas, and jacuzzis for at least one week after the surgery. This minimizes the risk of infection. Makeup and Cosmetic Products: avoid applying makeup on and around the eyes for one week. Also, prevent products like hairspray and perfume from contacting the eyes. Avoid Dusty and Dirty Environments: avoid dusty and dirty environments for the first week after surgery. This reduces the risk of infection.
Resting and Follow-up: Limit Screen Time: limit the time spent looking at computer, phone, and television screens for the first few days after surgery. Rest your eyes regularly. Attend Control Appointments: attend your follow-up appointments with your doctor at regular intervals, within the first 24-48 hours after surgery and thereafter. This is important to ensure your recovery process is progressing correctly.

Following these recommendations in the postoperative period will speed up your recovery and minimize the risk of complications. It is important to consult your ophthalmologist immediately if you experience any abnormalities or discomfort.

Laser eye surgery is a safe and effective method for patients who want to get rid of their dependence on glasses and contact lenses. It is important to consult an ophthalmologist to determine the most suitable laser treatment among the different options like SMILE, PRK, and LASIK, based on your eye structure. By correctly managing the process before and after laser eye surgery, you can achieve clear vision and improve your quality of life.

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