What You Need to Know About Excimer Laser Eye Surgery

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What is Excimer laser eye surgery?

Excimer laser eye surgery is a type of refractive eye surgery used to correct vision problems, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. In this surgery, the cornea, the transparent tissue at the front of the eye, is reshaped. This procedure ensures that light entering the eye is focused on the retina, the light-sensitive tissue at the back of the eye.

Considering that there are millions of cells in the retina alone, it can be better understood how sensitive the eye is. “Excimer” technology plays an important role here. Excimer laser eye surgery refers to a special type of ultraviolet laser that can remove microscopic amounts of tissue with precision without damaging the surrounding areas.

This technique is widely used in procedures such as PRK (photorefractive keratectomy) and LASIK (laser-assisted in situ keratomileusis). Thanks to its high precision and minimal thermal damage, Excimer laser technology has become the most important element of modern laser eye surgery, offering long-term solutions to vision problems with minimal invasiveness.

How is Excimer laser eye surgery performed?

Excimer laser eye surgery, which is performed to correct vision defects such as myopia, hyperopia, or astigmatism by reshaping the cornea, consists of several carefully planned and managed stages. Although the duration may vary depending on the severity of the vision defect, the procedure generally takes between a few seconds and a few minutes.

First, your doctor will examine your eyes and determine the details of the procedure to be performed. Afterwards, anesthetic drops are placed in your eyes so that you do not feel any significant pain or discomfort during the procedure.

Depending on which technique (PRK or LASIK) will be used during the operation, your doctor will either remove the surface layer of the cornea or create a flap to reach the underlying tissue. Once the cornea is reached, your corneal tissue is shaped with microscopic precision according to your surgery plan.

Once the cornea has been shaped using laser pulses controlled by a computer system, the flap is replaced if the LASIK technique was used. If the PRK technique is used, a protective contact lens is placed over the eye (in PRK).

The procedure is completed with great precision and in a short time. There is usually no pain after the procedure, but a burning or stinging sensation may occur for a short time. It is important not to rub your eyes after the procedure, as they will be sensitive.

Is Excimer laser eye surgery painful?

Anesthetic drops administered to the eye before laser eye surgery effectively numb the eye, preventing any pain during the procedure. For this reason, the surgery is not generally considered painful. The anesthesia used is effective in the eye. In other words, general anesthesia is not administered during the procedure. Therefore, patients remain conscious during the operation. However, they feel the procedures as pressure rather than pain.

In operations using the PRK technique, patients may experience some discomfort, such as burning, stinging, sensitivity, and watering in their eyes for a few days after surgery. In procedures performed with the LASIK technique, patients experience very little discomfort after surgery and may even notice an improvement in their vision on the day following the surgery.

Any discomfort that may occur after surgery can usually be relieved with over-the-counter pain relievers or eye drops prescribed by your doctor.

Who is eligible for Excimer laser eye surgery?

Excimer laser eye surgery is suitable for many people. It can help those who want to reduce or eliminate their dependence on glasses or contact lenses. People who have healthy eyes (i.e., do not have health problems such as glaucoma, severe dry eyes, cataracts, corneal scars, or retinal problems) and who do not have any significant health problems that affect healing can have this surgery. Factors such as age and eye development are also taken into consideration when determining suitability.

Laser eye surgery in children

Laser eye surgery is generally not recommended for children or adolescents. At this age, vision and eye structures are still developing, and surgical intervention may result in unstable outcomes or complications. Instead, it is recommended that individuals in this age group use glasses or contact lenses until their vision stabilizes and consider such surgical options after their developmental processes are complete.

Laser eye surgery for adults

Most candidates for excimer laser surgery are adults aged 18 and older with stable vision for at least one year. This age group is considered ideal because the eyes have typically stopped growing, and vision changes are less frequent. Adults in good overall health with realistic expectations are generally considered suitable candidates for this procedure.

Laser eye surgery in older adults

Older adults may be candidates for this surgery, especially if they have not yet been significantly affected by cataracts or other age-related eye diseases. However, it is important to first assess whether the benefits of surgery outweigh the risks in these individuals. This requires a comprehensive eye examination. In some cases, alternative treatments such as lens replacement may be more appropriate depending on the person’s eye health.

Is Excimer laser eye surgery safe for pregnant or breastfeeding women?

As with other developmental stages, excimer laser eye surgery is not recommended during pregnancy and breastfeeding. During these periods, hormonal fluctuations cause changes in a woman’s body. This can affect vision and the shape of the cornea, making it difficult to obtain accurate measurements for the surgery.

Additionally, although the surgery itself focuses on the eye and is performed without general anesthesia, the use of medications (such as eye drops or antibiotics) that may be contraindicated during pregnancy or breastfeeding is a consideration. For these reasons, pregnant and breastfeeding individuals are not recommended for this procedure.

For all these reasons, surgeons recommend waiting until hormones and vision have stabilized before undergoing the procedure. This typically means waiting several months after the breastfeeding period has ended.

What are the risks of Excimer laser eye surgery?

Excimer laser eye surgery is generally considered a safe procedure, but as with any medical procedure, there are some potential risks and complications associated with laser eye surgery.

Possible risks include:

• Dry eyes: Temporary or, in rare cases, chronic dry eyes may occur after surgery.
• Halos or glare: Some people, especially at night, may notice vision problems such as halos around lights.
• Insufficient or excessive correction: In rare cases, the desired level of correction may not be achieved, and corrective surgery may be necessary.
• Infection or inflammation: Although rare, infection or inflammation may occur, but these are usually treatable with medication.
• Corneal flap complications (in LASIK): Problems with healing or flap placement may occasionally occur, but these are generally manageable.

During the preoperative consultation, it is important to discuss these risks in detail with your surgeon to determine whether the potential benefits outweigh the potential disadvantages in your case and to make an informed decision about the surgery.

Are the results of Excimer laser eye surgery permanent?

Excimer laser eye surgery involves making changes to the cornea to correct vision problems. In terms of the permanence of these changes to the tissue, the procedure provides a permanent solution to the vision problems in question. After the procedure, the need for glasses or contact lenses is either completely eliminated or significantly reduced.

However, eyes continue to change over time, and similar issues may reappear. Conditions such as presbyopia (age-related difficulty focusing on near objects) or cataracts, which cannot be prevented by surgery, may develop with advancing age. In rare cases, some individuals may notice a slight regression in their corrected vision, but these changes are typically reversible with further treatment.