Refractive surgery is the specialized medical procedure designed to correct refractive errors of the eye, such as myopia, hyperopia and astigmatism. The need for refractive surgery has increased significantly in recent years, as more than 30 million people around the world have undergone such a procedure. The technologies and techniques used in refractive surgery have evolved rapidly, offering safer and more effective options. The first forms of refractive surgery were recorded as early as the 19th century, but the real revolution began in the 1980s with the introduction of LASIK (Laser-Assisted in SituKeratomileusis). This technique left traditional methods behind, offering faster recovery and better results. Subsequently, research led to the creation of other techniques, such as SMILE (SmallIncisionLenticuleExtraction), which acted as an alternative with even fewer side effects and greater safety.
LASIK: A classic technique
The LASIK procedure involves the use of a laser to reshape the cornea of the eye. At the beginning of the procedure, the surgeon creates a thin waxy texture (flap) from the cornea and then uses another laser, the excimer laser, to remove small amounts of tissue from the corneal surface. This allows the curvature of the cornea to change, helping light to focus properly on the retina.
Benefits of LASIK
- Most patients notice an improvement in vision within a few hours.
- Although in some cases corrections may be required in the future, most results are permanent.
- Because of the local anesthetic used, patients usually do not feel any pain during the procedure.
Risks and restrictions
Despite the many benefits, LASIK is not suitable for everyone. Some unsuitable candidates include people with dry eyes, corneal disease or other eye conditions. There may also be side effects, such as night vision, clouding or problems with quality of vision.
SMILE: A new revolution in refractive surgery
SMILE is a more recent technique that uses a femtosecond laser to remove a disc of tissue from the cornea without creating the waxy texture that LASIK requires. Instead of separating the cornea into two parts, SMILE removes from the inner layers, which reduces potential side effects and complications.
- SMILE requires only a small incision (about 2-4 mm), which reduces the risk of complications.
- There is less damage to the corneal nerves, which can lead to fewer dry eye problems.
- Data suggest that patients undergoing SMILE tend to report higher quality of vision compared to LASIK.
Risks and restrictions
SMILE may have its advantages, but it is not without its risks. As with any surgical procedure, side effects can occur, although most are mild and temporary. Some patients report that the procedure may be less revolutionary for those who need very high prescriptions.
Comparison of LASIK and SMILE results
An important aspect of the debate surrounding refractive surgery is the comparison of LASIK and SMILE results. Several studies have shown that both methods are quite effective, but SMILE seems to have slightly better quality of vision after surgery.
Results after the surgery
LASIK: The majority of patients report improvement in vision in less than one day, with many people achieving 20/20 vision.
SMILE: Patients may take a little longer to achieve the desired results, but long-term studies show that many of them have excellent vision with certainty.
Technological innovations
Advances in technology have led to significant improvements in the safety and effectiveness of refractive surgery. The use of high-precision lasers reduces interventions and allows surgeons to focus on smaller areas of the cornea. Three-dimensional imaging, sophisticated mapping techniques and physician training have contributed to the success of these procedures. In addition, evolution is leading to the development of new specialisation methods that can tailor the approach to the individual needs of each patient. These personalised approaches may include the use of specific laser programmes tailored to specific corneal conditions. Refractive surgery has advanced significantly in recent years, thanks to the development of new technologies and techniques such as LASIK and SMILE. The ability of doctors to offer safer and more effective procedures has improved the quality of life for many people. However, choosing the right procedure depends on the individual needs and circumstances of each patient. Continued research and development in technology promises even greater improvements in the future, which raises hopes for even better outcomes and safety in refractive surgery.
