LASIK Retreatment: Making the Right Choice
Q. How is vision checked at an ophthalmologist's office?
Vision and refractive error were checked through a visual acuity chart test and an autorefractor. If necessary, slit lamp or retinal examinations were additionally performed.
Q. What symptoms should prompt a visit to the ophthalmologist?
Blurred vision, pain, redness, glare, flashes, or seeing dark spots warranted a visit to the ophthalmologist.
When considering vision correction, SMILE surgery has become a popular option for helping vision recovery by reducing corneal incision. The key is a process of separating and extracting a thin piece called a lenticule from the inside without making a large incision on the corneal surface. The laser operated inside the cornea to the required depth, and finally, the lenticule was removed through a small passage. Because the incision area was relatively small, it was easier to plan a return to daily life.
Let's start by outlining who might consider SMILE surgery. It could be an option for those who find wearing glasses or contact lenses inconvenient and whose vision easily blurs due to myopia or astigmatism. Basic conditions such as sufficient corneal thickness and stable shape, no excessive signs of dry eye, and suitable night pupil size and corneal topography needed to be checked.
For those with a history of other surgeries, the possibility range was re-examined based on existing records. Many also asked about the possibility of LASIK retreatment during this process, but since SMILE surgery has different advantages and disadvantages compared to LASIK, it was safer to choose according to the purpose. The preparation stage for SMILE surgery began with examinations.
Corneal topography, corneal thickness map, tear film condition, pupillary response, and retinal condition were checked in order, and stability was verified by re-examination to see if the measured values were consistently repeated. Daily routines and work environments were also considered because recovery plans varied depending on whether one frequently drives at night or spends long periods in dry environments. After the examination, the eligibility and expected correction range were explained, and precautions were confirmed through schedule coordination and information guides.
On the day of the surgery, the eye was stabilized with a fixation device after local anesthetic eye drops were administered, and the lenticule boundary was created inside the cornea with a laser, and an exit passage was prepared. Then, the refractive power was adjusted by separating and extracting the lenticule with micro-instruments. Pain sensation varied from person to person, so it could not be definitively stated, and a brief stinging sensation or foreign body sensation may be felt temporarily.
Some may think of LASIK retreatment at this point, but SMILE surgery differed in that it does not create a large flap on the upper layer of the cornea. Recovery focused on managing initial dryness and using protective eye drops. Lifestyle habits such as avoiding rubbing the eyes, taking care to prevent direct contact of water streams during showers, and using protective eye shields during sleep could be helpful.
In the early stages, near work time should be divided and screen brightness should be lowered to reduce glare. If necessary, artificial tears should be used regularly to keep the surface condition comfortable. Using sunglasses for outdoor activities could reduce glare and the feeling of dryness. The characteristic of SMILE surgery came from the structure that does not widely lift the corneal surface.
As a result, it was designed to prevent excessive lengthening of sensory changes or dryness around the incision. However, because the sensation may vary depending on individual corneal thickness, pupil size, contact lens wearing history, and tear layer condition, it was important to determine the surgical intensity based on the examination results and adhere to the post-operative check-up schedule. In the same context, if considering LASIK retreatment, the current corneal reserve and remaining refractive error should be precisely assessed.
It was good to understand possible side effects and discomfort without hiding them. Initial glare, blurring, and decreased contrast sensitivity may appear temporarily, and in rare cases, dryness may last for a long time. In this case, scheduled follow-up observations and prescription adjustments could be helpful. Exercise or swimming was allowed after a certain period, and it was safer to avoid prolonged exposure to dusty places or strong winds.
SMILE surgery was not suitable for everyone. If there were signs of keratoconus risk, abnormally thin corneas, severe dry eye, or suspected retinal disease, other correction methods should be considered first. It was recommended to adjust the timing during pregnancy or breastfeeding because test values may fluctuate.
Also, if you have a history of LASIK retreatment, the corneal condition should be carefully re-analyzed to determine the suitability of SMILE surgery. Pre-examination preparations were also important. If you wore hard contact lenses, you should stop wearing them for a certain period to allow the cornea to return to its original shape to obtain accurate values.
If you have frequent allergic conjunctivitis, it was safer to schedule the procedure after the inflammation has subsided. If you have systemic conditions that affect your overall health, such as diabetes or thyroid disease, you should communicate with your 담당 진료과 (attending department) to adjust your medication plan. If the tear film was unstable, re-measurement after stabilizing the surface with eye drops could reduce numerical fluctuations. The surgical plan could be solidified only when the examination data were stably collected.
There were also things to keep in mind before and after surgery. If you were concerned about nighttime glare, you should discuss pupil size and optical zone design sufficiently in advance. If your work pattern was shift work, it was better to plan how to control eye usage in the early stages of recovery. If you have been wearing contact lenses for a long time, it may take longer for the corneal surface to recover, so it was comforting to allow sufficient time between schedules.
Rather than rushing to choose based solely on cost and schedule, it was safer to follow the flow of examination, explanation, consent, surgery, initial management, and follow-up check-ups step by step. It was good to ask enough questions before surgery and make a decision after understanding the expected progress and possible variations. And when comparing with other methods, including LASIK retreatment, the choice could be clearer if you used target vision, work environment, and lifestyle patterns as criteria.
Source :https://blog.naver.com/koikoro/224052144231
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