Understanding Eye Surgery: Types, Benefits, and Risks

Nearly 20 million people in the US suffer from visual impairments; they affect all ages but are more common in older adults. Some visual impairments, such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism, can be solved by traditional solutions like glasses and contact lenses. However, conditions like cataracts, glaucoma, and age-related macular degeneration (AMD) need more than traditional methods.

Given this context, the emergence of eye surgery is a real game-changer in the medical field, especially in treating complex eye conditions. Eye surgeries are medical procedures that help to correct vision, treat diseases, or repair eye injuries.

This article will discuss the different aspects of eye surgery, exploring its types, benefits, and risks. This article will guide readers in preparing for their eye surgery and during the recovery process.

Common Types of Eye Surgery

Eye surgeries have significantly improved, helping millions of people worldwide every year. Surgeons apply advanced techniques and technology to help correct vision impairments. Each type of eye surgery addresses specific eye conditions and improves the patient's quality of life.

The common types of eye surgeries include:

LASIK

LASIK (Laser-Assisted In Situ Keratomileusis) is a refractive surgery designed to correct vision impairments such as astigmatism, myopia (nearsightedness), and hyperopia (farsightedness). Patients may achieve 20/20 vision after this surgery, especially for those who do not have high prescription needs. More than 150 million people in the US have refractive errors, making LASIK eye surgery one of the most common surgeries, with over 800,000 procedures done yearly in the US.

In LASIK surgery, a surgeon cuts and lifts a small flap in the eye's cornea. Then, they use a laser to reshape the cornea depending on the vision problem. Lastly, the flap is placed back to heal naturally.

Benefits of LASIK

LASIK eye surgery has a satisfaction and success rate of 95%, which is the highest among optional surgeries. Its many benefits include:

• Improved and enhanced vision often results in 20/20 vision.
• Surgery takes less than 30 minutes and offers quick recovery.
• Results are noticed immediately, usually within a day.
• Results are long-lasting.
• There are no stitches or bandages.
• Reduced dependence on glasses.

Candidates for LASIK

LASIK is typically suitable for individuals with a moderate level of refractive error and has no other significant vision issues. Before undergoing LASIK eye surgery, individuals must undergo significant eye health examinations to assess their suitability. LASIK is generally recommended for those over 18, as vision can change in teenage years or later.

Candidates for LASIK should not have:

• Progressive eye diseases like keratoconus
• Inflammatory eye conditions
• Eye injuries
• Large pupils, particularly in low light
• Glaucoma and cataracts

Cataract Surgery

Cataract surgery is one of the oldest and most common procedures performed worldwide. 24.4 million older adults aged 40 and above in the US are affected by cataracts, and over 2 million cataract surgeries are done yearly. Eye specialists perform this to treat cataracts, where the eye's lens becomes cloudy, leading to decreased vision. Cataract surgery involves the removal of the eye's cloudy lens, which will be replaced with an artificial lens known as an intraocular lens (IOL).

Among the various types of IOLs, Multifocal Implants are the most advanced. It offers multiple focal points that enhance distance, intermediate, and near vision.

Benefits of Cataract Surgery

Cataract surgery is quick and typically completed within 5-10 minutes, with a success rate of 99%. Aside from that, the other benefits of cataract surgery include:

• Improved vision since the cloudy lens is removed.
• Quick surgery lasting about 10-20 minutes.
• Results are long-lasting.
• Reduced dependence on glasses.

Candidates for Cataract Surgery

The average age of people diagnosed with cataracts is 40, while those getting cataract surgery are generally 65. There is no age that's generally better to get cataract surgery. The ideal candidates for cataract surgery include:

• Individuals diagnosed with cataracts who experience vision impairment that hampers with daily activities.
• Individuals who are not diabetic and do not have health issues that can prevent proper healing.
• Individuals who do not have advanced macular degeneration, detached retina, or glaucoma.

Eye specialists will review different eye examinations to ensure the candidate's safety before, during, and after the eye surgery.

Glaucoma Surgery

Glaucoma is a vision problem known by increased eye pressure. This pressure damages the optic nerve, eventually leading to vision loss. Glaucoma affects 3 million people in the US, and it causes vision loss and blindness. There are usually no early symptoms of glaucoma, hence why many do not know that they have the disease.

The procedure for glaucoma surgery depends on the type of surgery done.

There are different types of glaucoma surgery, this includes:

• Trabeculectomy: This is the most common type of glaucoma surgery. It involves creating a small opening in the white of the eye (sclera) under the eyelid to help drain fluid from the eye, thus reducing eye pressure.

One study found that trabeculectomy has a 73% success rate with no complications after follow-up.

• Minimally Invasive Glaucoma Surgery (MIGS): These are newer procedures designed to reduce eye pressure with less invasive techniques and a quicker recovery time than traditional surgeries.
• Glaucoma Implant Surgery: This involves placing a tiny tube or shunt in the eye to help drain excess fluid, thereby reducing eye pressure. The tiny tube typically remains permanently in the eyes and is designed to drain excess fluid continuously.

Benefits of Glaucoma Surgery

According to reports, glaucoma surgery has a 70-90% success rate. Glaucoma surgery does not restore already lost vision, but it helps prevent it from worsening. The many benefits of glaucoma include:

• Helps prevent vision from getting worse.
• Reduces eye pressure.
• Fairly quick and painless.

Candidates for Glaucoma Surgery

The candidates for glaucoma surgery differ depending on what kind of surgery the patient is getting. The candidates for the different types of glaucoma surgery include:

Trabeculectomy

• Patients who have moderate to advanced glaucoma where medications or laser treatments have not been effective.
• Recommended for patients who may need to keep more surgical options available in the future, as it doesn't limit the possibility of undergoing other types of surgeries later on.

Minimally Invasive Glaucoma Surgery

• Patients who have mild to moderate glaucoma.
• Individuals whose intraocular pressure (IOP) is not adequately controlled with topical eye drops or laser trabeculoplasty.
• Those who cannot tolerate glaucoma drops or have difficulties adhering to their medication.

Glaucoma Implant Surgery

• Patients with specific types of glaucoma are known to have lower success rates with trabeculectomy.
• Those who have previously undergone intraocular surgeries or have had an unsuccessful trabeculectomy.

Retinal Detachment Surgery

Retinal detachment surgery is necessary when the retina, the light-sensitive layer at the back of the inner eye, detaches from its normal position. This surgery is considered an emergency and should be done immediately. The surgery reattaches the retina to the back of the eye and restores vision.

Just like in glaucoma surgery, there are different surgical techniques to address specific needs.

The different types of retinal detachment surgery include:

• Pneumatic Retinopexy: This is a minimally invasive procedure used to repair certain types of retinal detachment. Here, a gas bubble is injected into the eye. The gas bubble then gently presses against the detached retina, pushing it back into its proper position against the eye's wall. A laser will then be used to repair any holes or tears.
• Scleral Buckle: This procedure involves attaching a flexible band (buckle) around the eye’s sclera (the white part of the eye). These bands will gently push the sides of the eyes inward to help the retina reattach. The buckle will stay in the eyes permanently.
• Vitrectomy: In this surgery, the doctor removes the vitreous gel that's pulling the retina out of place. Then, they put the retina back where it should be and fill the eye with a gas bubble or silicone oil to keep it in place.

Benefits of Retinal Detachment Surgery

The benefits of retinal detachment surgery include:

• Prevents vision loss.
• Prevents the retina from detaching again.

Candidates for Retinal Detachment Surgery

The candidates for retinal detachment surgery include:

• Patients whose retina is detached.
• Patients whose retinal detachment is progressing and poses a risk of permanent vision loss.

Corneal Transplant

A corneal transplant, known as keratoplasty, involves replacing a damaged or diseased cornea (outermost eye layer) with healthy corneal tissue from a donor. This surgery is often needed for corneal scarring, keratoconus (a condition where the cornea becomes cone-shaped), or corneal ulcers.

Corneal transplants are becoming more common, with 49,000 transplants done in 2021. The procedure also has a 90% success rate.

In a corneal transplant, a surgeon removes the damaged section of the cornea from the patient's eye. They then replace it with a clear cornea from a donor. The new cornea is secured in place with tiny stitches, which may be removed later.

Benefits of Corneal Transplant

The benefits of corneal transplant include:

• Improve the vision of those whose cornea has been damaged.
• Relieve pain and discomfort from painful eye conditions.
• It's an effective treatment for corneal diseases such as keratoconus, Fuchs' dystrophy, or corneal ulcers that don't respond to other treatments.
• The risk of the body rejecting the transplanted cornea is relatively low.

Candidates for Corneal Transplant

The ideal candidates for corneal transplant include those suffering from:

• Corneal scarring from infections or eyelash scratches.
• Keratoconus.
• Corneal Ulcers.
• Bullous Keratopathy.
• Corneal burns.

Eye specialists will thoroughly examine the needs of the individual to ensure that they are ideal for corneal transplant or if they are better candidates for other eye procedures.

All of the procedures above have helped millions worldwide by allowing them to see the world better through their eyes. These surgeries are highly successful thanks to the advancement of technology and research. However, before undergoing these procedures, preparations are done, which will be discussed in the next section.

Preparing for Eye Surgery

Proper preparation for eye surgery is essential to ensure the procedure and recovery are going well. Following pre-surgery guidelines can minimize risks and improve the outcome of the surgery.

Here’s how to prepare for eye surgery:

Refrain from Wearing Contact Lenses

The shape of the cornea must be in its natural state before surgery. Contact lenses, especially long-term wear, can temporarily alter the shape of the cornea. Individuals must stop wearing contact lenses a few days to weeks before surgery to avoid this. The eye specialist or surgeon will suggest how long the patient should avoid wearing contact lenses.

The recommended period of not wearing contact lenses depends on the type of lenses. The common recommended period includes:

• Disposable, soft, or toric lenses: Remove at least two days before surgery.
• Soft extended-wear lenses: Remove one week prior.
• Hard, gas-permeable lenses: Remove at least three weeks before surgery.

Remember, this applies both to the initial consultation and the day of the surgery. The eye surface changes can also affect the scans and examinations during the initial consultations. When eye surgery patients cannot wear contact lenses, they are recommended to switch to wearing glasses to help maintain the natural shape of the eye while still having vision aids.

Avoid Makeup and Fragrances

Patients should be completely clean and free of makeup, hairspray, or perfume on the day of the surgery. These products can harbor bacteria and irritate the eyes, potentially complicating the surgery or affecting the healing process. If the patient has worn makeup days before the surgery, ensure thorough cleaning of the eye area to remove all traces of cosmetics.

After surgery, avoiding eye makeup for at least two weeks is advisable to reduce the risk of infection and ensure proper healing.

Plan Time Off Work

Recovery time varies depending on the type of eye surgery the patient undergoes. It is essential to take time off work to have adequate rest and quicken the recovery process.

Recovery time varies depending on the type of eye surgery undergone. The commonly needed time off work includes:

• LASIK patients: 3 days off
• Cataract patients: 3 days off
• Glaucoma patients: 1-2 weeks off
• Retinal detachment patients: 2-4 weeks
• Corneal transplant patients: 2-3 weeks

Recovery and Post-Operative Care

Proper care during the post-operative phase is critical as it impacts the healing process and the outcome. Here are some tips for a smooth recovery after eye surgery:

• Individuals should regularly visit and have follow-up appointments with their doctor. This allows the surgeon to monitor the eyes' healing and promptly address concerns.
• Gradually return to normal activities. Avoid harsh activities that could strain the eyes during the initial recovery phase.
• Follow the doctor’s instructions by using any prescribed antibiotic and hydrating eye drops. The drops are essential to prevent eye infections and maintain eye moisture.
• Wear eye protection, especially outdoors, for at least two weeks post-surgery. This protects the eyes from dust, wind, and potential irritants.
• Individuals may experience sensitivity to light after surgery. Staying in rooms with dim light can help the eyes recover more comfortably.
• Avoid rubbing the eyes to avoid irritation.
• Refrain from swimming in pools, hot tubs, or the ocean for three weeks due to the risk of bacterial exposure.
• Delay wearing makeup for a while post-surgery.
• Limit time spent in front of computer screens for a few days to a week post-surgery. Avoid screens altogether during this period.
• Stay away from environments with smoke or other harmful contaminants that could irritate the eyes.

These guidelines and tips can enhance healing and protect the eyes from complications. Individuals should always consult with their eye surgeon for personalized advice and follow their instructions diligently to recover properly.

Risks and Complications

Eye surgery, like any medical procedure, carries certain risks and potential complications. While advancements in technology and surgical techniques have significantly reduced these risks, patients must be aware of them before surgery.

Here are some of the common risks and possible complications associated with eye surgery:

Infection

Post-operative infections are rare but can occur. An example of an intraocular infection after eye surgery is endophthalmitis, which occurs between 0.13% and 0.7%. Infections can happen if bacteria or other foreign bodies enter the eye during or after surgery. They can be avoided by avoiding makeup, swimming, and using prescribed eye drops after surgery.

Inflammation

Some inflammation is normal after eye surgery, but excessive inflammation can lead to discomfort and affect healing. After cataract surgery, only 0.1% to 2% of patients experience persistent or recurring inflammation. Anti-inflammatory medications and eye drops are often prescribed to manage this. However, further intervention is needed for inflammation that lasts longer than expected.

Dry Eyes

Many patients experience dry eyes after surgery, which can cause discomfort and blurry vision. It is very common, with studies showing that it happens to about 95% of people who undergo LASIK and 87% of people with cataract surgery. Dry eyes are typically temporary, lasting 6-12 months, and can be managed with lubricating eye drops or other treatments as the doctor recommends.

Glare, Halos, and Double Vision

Patients might experience visual disturbances like glare, halos around lights, or double vision post-surgery, especially at night. According to a study, LASIK patients specifically experience an increase in the halo phenomenon at night, even with successful surgeries. These symptoms usually improve over weeks or months but may require further treatment in some cases.

Bleeding

Bleeding can occur due to blood vessels getting injured during surgery. This is more common in surgeries that involve more profound layers of the eye, such as retinal or glaucoma surgeries.

According to a study, postoperative vitreous hemorrhage (bleeding within the vitreous cavity of the eye) following vitrectomy is a frequent complication, with about 65% of patients experiencing a single occurrence and 35% facing two or more recurrences.

During the post-operative phase, patients may be advised to avoid activities that could increase blood pressure and cause bleeding, such as heavy lifting or strenuous exercise.

Discussing these risks properly with the eye surgeon and how they apply to the patient's situation is essential. Understanding these risks helps in making informed decisions to help prepare for a smooth recovery process.

Final Thoughts

Eye surgeries are a significant advancement in medicine. They continuously improve the lives of millions of people suffering from different visual impairments. From LASIK to cataract surgery, glaucoma treatment, retinal detachment procedures, and corneal transplants, these surgeries have changed how eye conditions are treated. Each has its benefits that significantly change the lives of the patients.

Preparation and post-operative care are both essential to eye surgery patients. Adhering to the guidelines given can enhance the surgery outcomes. Aside from that, it is also essential to acknowledge the risks and potential complications that can come during and after surgery. Knowing these risks and applying preventative measures can help manage them effectively.

The decision to undergo eye surgery should be made with careful consideration and a thorough understanding of the whole process. Eye specialists will also help individuals identify if they are ideal candidates to ensure they are undergoing the proper procedure for their needs. Eye surgery can be a safe and life-changing experience with the right approach and care.

How long do the benefits of eye surgery last?

The longevity of results varies depending on the type of eye surgery. For instance, LASIK often provides long-lasting vision correction, but some patients might need touch-up procedures years later. Cataract surgery benefits usually last a lifetime, while glaucoma surgery outcomes can vary depending on the individual’s condition and the type of surgery.

Is eye surgery painful?

Most eye surgeries are not painful due to the use of local anesthetics. Patients may feel pressure or mild discomfort during the procedure. Post-surgery, discomfort can typically be managed with over-the-counter pain relief and eye drops.

How soon can I return to normal activities after eye surgery?

Recovery time varies by the type of eye surgery. Many patients return to normal activities for LASIK within a couple of days. For more invasive procedures like retinal surgeries or corneal transplants, the recovery could take several weeks. The doctor will provide specific guidelines based on the surgery.

Can both eyes be operated on at the same time?

For some surgeries like LASIK, treating both eyes in one session is common. For more complex surgeries, such as retinal or glaucoma surgery, the doctor may prefer to operate on one eye at a time to monitor healing and adjust treatment if necessary.