Laser eye surgery: Debunking myths, half-truths and falsehoods
Sight is one of the most important human sense organs, which is why we are very sensitive about it. In the case of vision problems, many people look for information on social networks or “google” it. However, the internet is “ruled” by a huge number of self-proclaimed experts who give guaranteed advice or set themselves up as judges of our doctors. It also happens, however, that even doctors themselves do not have the same opinion on one and the same health problem of a patient. In this article, several myths, half-truths and falsehoods are debunked by MUDr. Ivo Ďurkovič, MPH, who is one of the recognised experts in the field of eye surgery, with many years of experience in laser surgery and refractive surgery.
A preoperative examination and eye surgery on the same day is not right - false
A preoperative examination and laser eye surgery on one and the same day is a common procedure in many eye clinics not only in the Slovak Republic but also abroad. If someone claims that this procedure is not right, they are being a little misleading.
What matters is whether the preoperative examination also includes an examination under so-called cycloplegia. That means whether the patient has been given drops that cause dilation of the pupil together with temporary paralysis of the ciliary muscle. The preoperative examination may, but in principle need not, include the use of these drops. This type of examination is of practical importance especially in small children or in patients who are unable to cooperate with the doctor (e.g. if they have a mental or severe physical disability, are in psychological distress or another situation arises that prevents the doctor from communicating validly with the patient). An examination under cycloplegia is also performed, for example, in patients in whom it is not possible to determine the dioptre value by examination on an autorefractometer and by a standard examination of central visual acuity using trial lenses or a phoropter.
On the other hand, cycloplegia is not normally used when examining dioptres if, in the standard examination, the patient precisely identifies the dioptres with which they see best. However, if the results are not clear-cut and the patient cannot tell the doctor which dioptre suits them best (see the reasons mentioned above), the doctor usually proceeds to examine the dioptres under cycloplegia. In this case, however, it will be an examination of objective, not subjective, refraction, which may, however, lead to inaccurate results.
However, this type of examination also has its risks. These include a sharp rise in intraocular pressure, headache, eye pain or a feeling of disorientation.
Conclusion:
Today, eye surgeons have devices at their disposal that can measure the amplitude of accommodation and also evaluate it graphically, all without burdening the patient with an examination under cycloplegia. On the other hand, a comprehensive eye examination also includes so-called dilation of the pupil with drops, so that the doctor can check the internal structures of the eye if the patient's condition requires it (for example in diabetes, high dioptres, systemic vascular diseases or if eye diseases occur in the family).
If the preoperative examination and laser eye surgery are done on the same day, that is fine, as long as the patient does not need an examination under cycloplegia. If this examination does need to be done, the operation is performed on a different day.
You need to beware of clinics that offer eye surgery at promotional prices - false
If you have ever come across the information that you need to beware of clinics that offer discounted prices for eye surgery, this is unfounded “scaremongering”. The fact is that large, comprehensive eye clinics also have a much larger number of doctors, so they can operate on many more patients per month than smaller clinics. For this reason, they can sometimes afford to offer patients operations at better prices. Thanks to their comprehensiveness, they can also offer their patients many different types of surgical procedures. The surgical procedures they offer at a better price are carried out with the same high quality as the other methods to which the discount does not apply, because the staff and the lasers are always the same. For example, the iClinic eye clinic responds to what is happening in society and has therefore decided to give patients the opportunity to undergo surgery at a better price. At a temporarily reduced price, for example, it is now offering surgical methods that are currently among the very best: Relex Smile 3D (uses the ZEISS VISUMAX 500 femtosecond laser, year of manufacture 2021), Femto Lasik 6D (this method uses the ZEISS VISUMAX 500 femtosecond laser, year of manufacture 2021 + the Swiss laser Alcon EX 500, 1050HZ, year of manufacture 2022) and Femto Z-Prelex (in this method, the patient's own lens is replaced with a new, artificial one, and this procedure uses the FEMTO LDV Z8 femtosecond laser, which is one of the newest lasers from the Swiss manufacturer Ziemer).
Conclusion: A temporarily reduced price for eye surgery has absolutely no effect on the quality of the procedure.
Eye surgery during the summer or winter months is not recommended - false
Nowadays, some top-equipped clinics in Slovakia too have the most modern technological equipment at their disposal, thanks to which they can perform the most advanced surgical methods. These make it possible to carry out eye surgery at any time of the year, including the summer or winter months. There are no restrictions related to the season that could prevent the procedure from being performed, perhaps only minor recommendations. Modern methods are unique in that just a few days after the operation you do not have to postpone your holiday, but can exercise, swim, ski or do anything else without worry. Of course, every human body is different, so the recovery period may be shorter for some people and longer for others. In connection with the weather, it is good to follow certain rules that your doctor will tell you. For example, avoiding direct sunlight or wearing good-quality sunglasses on windy or sunny days.
Conclusion: There are no restrictions related to the season that could prevent the procedure from being performed.
MYTH NO. 1
A preoperative examination and eye surgery on the same day is not right - falseA preoperative examination and laser eye surgery on one and the same day is a common procedure in many eye clinics not only in the Slovak Republic but also abroad. If someone claims that this procedure is not right, they are being a little misleading.
What matters is whether the preoperative examination also includes an examination under so-called cycloplegia. That means whether the patient has been given drops that cause dilation of the pupil together with temporary paralysis of the ciliary muscle. The preoperative examination may, but in principle need not, include the use of these drops. This type of examination is of practical importance especially in small children or in patients who are unable to cooperate with the doctor (e.g. if they have a mental or severe physical disability, are in psychological distress or another situation arises that prevents the doctor from communicating validly with the patient). An examination under cycloplegia is also performed, for example, in patients in whom it is not possible to determine the dioptre value by examination on an autorefractometer and by a standard examination of central visual acuity using trial lenses or a phoropter.
On the other hand, cycloplegia is not normally used when examining dioptres if, in the standard examination, the patient precisely identifies the dioptres with which they see best. However, if the results are not clear-cut and the patient cannot tell the doctor which dioptre suits them best (see the reasons mentioned above), the doctor usually proceeds to examine the dioptres under cycloplegia. In this case, however, it will be an examination of objective, not subjective, refraction, which may, however, lead to inaccurate results.
However, this type of examination also has its risks. These include a sharp rise in intraocular pressure, headache, eye pain or a feeling of disorientation.
Conclusion:
Today, eye surgeons have devices at their disposal that can measure the amplitude of accommodation and also evaluate it graphically, all without burdening the patient with an examination under cycloplegia. On the other hand, a comprehensive eye examination also includes so-called dilation of the pupil with drops, so that the doctor can check the internal structures of the eye if the patient's condition requires it (for example in diabetes, high dioptres, systemic vascular diseases or if eye diseases occur in the family).
If the preoperative examination and laser eye surgery are done on the same day, that is fine, as long as the patient does not need an examination under cycloplegia. If this examination does need to be done, the operation is performed on a different day.
MYTH NO. 2
You need to beware of clinics that offer eye surgery at promotional prices - falseIf you have ever come across the information that you need to beware of clinics that offer discounted prices for eye surgery, this is unfounded “scaremongering”. The fact is that large, comprehensive eye clinics also have a much larger number of doctors, so they can operate on many more patients per month than smaller clinics. For this reason, they can sometimes afford to offer patients operations at better prices. Thanks to their comprehensiveness, they can also offer their patients many different types of surgical procedures. The surgical procedures they offer at a better price are carried out with the same high quality as the other methods to which the discount does not apply, because the staff and the lasers are always the same. For example, the iClinic eye clinic responds to what is happening in society and has therefore decided to give patients the opportunity to undergo surgery at a better price. At a temporarily reduced price, for example, it is now offering surgical methods that are currently among the very best: Relex Smile 3D (uses the ZEISS VISUMAX 500 femtosecond laser, year of manufacture 2021), Femto Lasik 6D (this method uses the ZEISS VISUMAX 500 femtosecond laser, year of manufacture 2021 + the Swiss laser Alcon EX 500, 1050HZ, year of manufacture 2022) and Femto Z-Prelex (in this method, the patient's own lens is replaced with a new, artificial one, and this procedure uses the FEMTO LDV Z8 femtosecond laser, which is one of the newest lasers from the Swiss manufacturer Ziemer).
Conclusion: A temporarily reduced price for eye surgery has absolutely no effect on the quality of the procedure.
MYTH NO. 3
Eye surgery during the summer or winter months is not recommended - falseNowadays, some top-equipped clinics in Slovakia too have the most modern technological equipment at their disposal, thanks to which they can perform the most advanced surgical methods. These make it possible to carry out eye surgery at any time of the year, including the summer or winter months. There are no restrictions related to the season that could prevent the procedure from being performed, perhaps only minor recommendations. Modern methods are unique in that just a few days after the operation you do not have to postpone your holiday, but can exercise, swim, ski or do anything else without worry. Of course, every human body is different, so the recovery period may be shorter for some people and longer for others. In connection with the weather, it is good to follow certain rules that your doctor will tell you. For example, avoiding direct sunlight or wearing good-quality sunglasses on windy or sunny days.
Conclusion: There are no restrictions related to the season that could prevent the procedure from being performed.
