Refractive surgery aims to reduce or eliminate dependence on glasses or contact lenses permanently. It is a safe and effective option for correcting refractive errors such as myopia, hyperopia, and astigmatism.
We currently have various advanced surgical techniques that allow us to correct these errors and restore clear vision without the need for optical aids.
We mainly distinguish between two major types of refractive surgery:
- Laser surgery on the cornea, usually indicated for mild to moderate degrees of myopia, hyperopia, and astigmatism.
- Surgery with the implantation of a phakic intraocular lens, indicated in cases with higher prescriptions or when laser surgery is not suitable due to specific ocular characteristics.
Refractive Surgery Techniques
Corneal Refractive Surgery
LASIK
LASIK is the most commonly used laser refractive surgery technique. It involves reshaping the cornea to alter the eye’s refraction. A corneal flap is first created, either mechanically or with a femtosecond laser, and then an excimer laser is used to sculpt the cornea according to the diopters to be corrected.
At the Institut de la Màcula, we use a high-precision excimer laser that allows us to perform customized treatments to improve visual quality and preserve as much corneal thickness as possible.
LASIK refractive surgery is performed under topical anesthesia, is painless, lasts only a few minutes, and enables almost immediate visual recovery. Within a few hours, the patient can resume most daily activities without glasses.
PRK
Photorefractive keratectomy (PRK) is an excimer laser technique in which the cornea is reshaped on its outer surface, after the epithelium is removed.
Its main advantages are simplicity, safety (no corneal incision is required), and precision. However, epithelial regeneration can cause mild postoperative discomfort during the first few days.
PRK is especially indicated for:
- Low myopia
- Thin or irregular corneas
- Presence of superficial opacities to be removed
Refractive Surgery with Phakic Lens Implantation
ICL Lens Implant
Phakic ICL lenses are an excellent alternative for patients with high myopia or hyperopia or for those who cannot undergo corneal laser surgery. These lenses are placed between the iris and the crystalline lens, without removing any natural eye structures.
The main advantage of the ICL lens is that it is a reversible and highly safe procedure, offering excellent visual quality. If there is enough intraocular space, high refractive errors can be corrected with great precision.
Currently, due to their high predictability and safety, these lenses are also recommended for patients with moderate refractive errors.
Preoperative Considerations
The choice of the most suitable refractive surgery technique for each patient depends on several factors. It is essential that:
- The refractive error is stable for at least one year
- The patient is over 18 years old
- There is a clear motivation to stop using glasses or contact lenses
The surgeon evaluates:
- The number of diopters
- The shape, curvature, regularity, and thickness of the cornea
- The characteristics of the anterior segment of the eye
- The depth of the anterior chamber
- The overall condition of the ocular structures
After a complete ophthalmological examination and the performance of specific complementary tests, the safest and most effective technique is determined for each case.