Is Vision Correction Surgery Safe? Understanding Causes of Vision Regression After LASIK Surgery and Solutions.

Thanks to modern medical advancements, various vision correction surgeries such as LASIK, LASEK, and SMILE have emerged, liberating many from glasses and lenses. However, some individuals experience deterioration in vision several years after surgery. Let's delve into the reasons behind this and explore professional insights on prevention and management.

 

Vision correction surgery offers benefits to many individuals, yet vision regression can occur due to various factors such as changes in corneal epithelial thickness, regression phenomenon, and progressive myopia.

 

Causes of Vision Regression After Vision Correction Surgery

Changes in Corneal Epithelial Thickness

The core principle of vision correction surgery is altering the shape of the cornea to ensure light reaches the retina correctly. LASIK, LASEK, and SMILE all involve cutting into the cornea to correct vision. During this process, the corneal stroma (deep layer) does not regenerate once cut, but the corneal epithelium (surface layer) can thicken over time. Thickening of the epithelium can alter corneal refraction, leading to a regression in vision.

Regression Phenomenon

Regression, the phenomenon where vision worsens after vision correction surgery, mainly occurs due to.

• Excessive corneal ablation: The more corneal tissue removed during surgery, the higher the likelihood of regression. This is akin to losing weight and then easily gaining it back.
• Natural recovery of the cornea: The cornea naturally tends to revert to its original state over time in response to external stimuli. Changes from surgery may gradually revert.
• Progressive myopia: This occurs when the eyeball elongates, progressing myopia, and is mostly observed in cases of high myopia. It can happen independently of corneal ablation.

Impact of Lens Implantation Surgery on Regression

Implantable Collamer Lenses (ICL) correct vision by inserting a lens into the eye without cutting the cornea. Therefore, changes in corneal thickness do not cause regression. However, progressive myopia can still cause deterioration in vision after ICL surgery, albeit with a lower probability of around 2-3%.

 

Preventive Measures for Vision Regression After Vision Correction Surgery

Reduce Digital Device Usage

In today's society, increased use of smartphones and computers has led to rising rates of myopia and astigmatism. Reducing digital device use can help prevent vision deterioration. While completely avoiding digital devices may not be practical, consider the following strategies.

• Take regular breaks: Apply the 20-20-20 rule, looking at something 20 feet away for 20 seconds every 20 minutes.
• Use larger screens: Opt for a PC with a larger screen instead of a smartphone to reduce eye strain.
• Eye exercises: Incorporate regular exercise like stretching, running, or yoga to give your eyes a break.

Improve Lifestyle Habits

Maintaining healthy lifestyle habits is crucial for preventing vision deterioration.

• Balanced diet: Consume foods rich in antioxidants like vitamins A, C, E, and omega-3 fatty acids to maintain eye health.
• Adequate sleep: Sufficient sleep relieves eye fatigue and improves overall health.
• Avoid smoking and excessive drinking: Both can adversely affect eye health, so minimizing these habits is beneficial.

 

Methods for Re-Correction After Vision Regression

Re-Surgery

If the initial surgery was LASIK or LASEK and the corneal thickness and shape allow, a re-surgery with LASEK may be attempted. If further corneal ablation is not possible, consider lens implantation surgery.

• LASEK re-surgery: If corneal thickness and shape allow, re-correction can be done with LASEK.
• Lens implantation: If further corneal ablation is not feasible, consider improving vision through lens implantation surgery.

Ortho-K Lenses

Orthokeratology lenses (Ortho-K) are worn at night and reshape the cornea temporarily, correcting vision during the day without surgery. This method is suitable when further corneal ablation is not an option.

• Sufficient epithelial cell count.
• Adequate intraocular space.
• Age suitability: May not be suitable for older individuals.

 

Conclusion

Vision correction surgery offers benefits to many individuals, yet vision regression can occur due to various factors such as changes in corneal epithelial thickness, regression phenomenon, and progressive myopia. To prevent this, reduce digital device usage, maintain healthy lifestyle habits, and undergo regular check-ups. If vision worsens post-surgery, consider re-surgery or alternative methods like Ortho-K lenses. Remember, ongoing management and care are essential for maintaining healthy eyes and enjoying clear vision for years to come.