Treatment of eye diseases and vision defects requires great precision and this is the direction in which modern ophthalmology is developing. A technician comes with the help of doctors, incl. more and more versatile lasers and computers cooperating with them. How do they help us maintain good eyesight?

A dozen or so years ago, many people with retinal diseases or glaucoma had no chance to preserve their eyesight. Now, new treatment techniques in ophthalmology have changed this situation - if they cannot reverse the effects of the disease, at least they stop its progression.

And in the case of vision defects - they even made it possible to improve vision without the need to wear glasses or contact lenses. This revolution could have happened, inter alia, in thanks to the very dynamic development of laser therapy and optical devices, thanks to which it is possible to perform fast, bloodless and extremely precise treatments.

Implantation of an artificial lens

In the case of cataracts, medicine cannot stop the lens from clouding - only surgical treatment, during which an artificial lens is implanted, is effective.

A commonly used method is phacoemulsification. A probe is inserted through a small incision in the cornea (2-3 mm) and the cloudy lens is broken with ultrasound, and then gently sucked out of the eye. Through the same incision, an artificial foldable intraocular lens is inserted, which then immediately takes the correct shape. Thanks to the step cut, the wound closes tightly by itself under the pressure inside the eyeball.

Another method of cataract removal isfluid emulsification-the cloudy lens is broken and rinsed with a stream of fluid under a certain pressure and an artificial lens is inserted in its place. However, this method can only be used when the lens is quite soft, there is no so-called hard kernel.

Laser operations - glaucoma

Glaucoma leads to irreversible vision loss, unless… It cannot be completely cured, but changes caused by rising intraocular pressure and degeneration of the optic nerve can be inhibited or slowed down at a much slower pace.

The most important thing is to lower the intraocular pressure. Firsteye drops are usually used to reduce the production of aqueous humor or increase its outflow. However, if the disease is rapid or the drops do not work, the laser can help.

  • In open-angle glaucoma, laser trabeculoplasty is performed - by performing focal photocoagulation, the fluid outflow holes are widened, which lowers the pressure in the eye. The effect is not permanent, but fortunately such treatments can be repeated.
  • Laser iridotomy is used to treat closed-angle glaucoma. It involves making holes in the iris of the eye with a laser so that, even with dilated pupils, when the outflow path is closed, the aqueous fluid can drain away through these additional holes.

Laser operations - eye defects

Nearsightedness, farsightedness, astigmatism and their combinations - each of these eye defects can be permanently corrected using a laser.

The procedure involves changing the curvature of the cornea so that the light rays focus on the retina and create a clear image. There are several methods of performing such procedures, and they differ mainly in the way of getting into the cornea and, consequently, in the speed of its healing. And like this:

  • LASIKconsists in the formation and tilt of the corneal flap and the action of a laser beam on the corneal stroma. After correcting the curvature of the cornea, the flap is placed in place to form a natural dressing.
  • In theEPILASIKmethod, a corneal epithelial flap is created (even 3 times thinner than in the LASIK procedure), thanks to which laser penetration is limited to the outer layer of the corneal stroma, after which the flap returns in its place.
  • PRKis a method of removing the corneal epithelium and modeling its surface layers with a laser beam. After the procedure, before the epithelium rebuilds, a bandage contact lens is put in place.
  • In theLASEKmethod, the superficial layer of the cornea is also modeled, and then it is covered with a previously shifted layer of epithelial cells.

Retinal surgery

Changes in the retina of the eye most often occur due to diabetes. This disease - diabetic retinopathy - leads to retinal proliferation, vitreous hemorrhage, macular edema, and in advanced stages to retinal detachment.

In the case of minor changes, e.g.focal photocoagulationis performed, the purpose of which is to directly destroy the damaged fragments of the vascular system of the fundus.

It is used for more advanced changes diffuse photocoagulation . The laser can also "weld" a torn retina or "stick" a delaminated retina.

In some cases where vitreous excision is needed to save eyesight, the only salvage is vitrectomy. The doctor makes 3 tiny incisions in the sclera through which he inserts surgical instruments into the eye. After the vitreous excision, another substance is injected into this place: sterile air or a mixture of expansion gas, which is gradually replaced with intraocular fluid.

In severe cases, when it is necessary to press the retina to the ground for a long time, silicone oil is administered. The oil is not changed into a fluid and after some time it must be surgically removed or only replaced.

Quick treatments

Most ophthalmic procedures can be performed on an outpatient basis after anesthesia with eye drops. The procedure takes a few minutes. After putting a special cover on the eye to protect it overnight, the patient can go home.

Keratoconus surgery

A corneal cone is a congenital bulge formed at some point in the cornea that is shaped like a sphere. The cone-shaped cornea does not focus the light rays properly, which impairs vision. Usually, hard, gas-permeable contact lenses are used first - wearing them corrects the curvature of the cornea.

When that proves to be insufficient, surgical treatment remains. One of the methods isimplantinginto the eye of specialintracorneal rings, intacs- they are inserted through small incisions in the corneal limbus. The rings press against the curvature of the cornea, flattening the apex of the cone and restoring it to a more natural shape.

Another method iscross-linking- a photosensitizing drug is instilled into the affected eye and irradiated with a laser that stimulates the production of collagen in one of the corneal layers, which improves its mechanical strength. The treatment stops the cone enlargement for a longer time.

When treatment with either method is ineffective, the rescue iscorneal transplant , which involves removing the changed part of the cornea and sewing a matched block of tissue from the recipient.

After the surgery

After each ophthalmic treatment, you must strictly follow the doctor's instructions, because improper treatment may not only extend or complicate the recovery period, but even destroy the effect. It is important, for example, not only to maintain proper hygiene, but also to avoid sauna, working at a computer or traveling by plane for some time. For some treatments it is important to adopt certain body positions as often as possible, e.g.lying on the stomach or sitting with a bowed, supported head.

Category:

Geriatrics