What disqualifies from laser vision correction?

Choć laserowa korekcja wzroku jest szybkim i mało inwazyjnym sposobem na pozbycie się okularów i soczewek kontaktowych, to jednak nie każdy może skorzystać z takiego rozwiązania. Istnieje szereg przeciwwskazań, które trzeba wykluczyć, zanim podejmiemy ostateczną decyzję o przeprowadzeniu operacji metodami laserowymi jak FemtoLASIK. Przeciwwskazania do laserowej korekcji wzroku mogą dotyczyć niejednej wady wzroku. Aby dowiedzieć się, kto kwalifikuje się na laserową korektę i jakie są główne przeciwskazania, które bezwzględnie dyskwalifikują pacjenta, to warto jest zapoznać się z treścią niniejszego wpisu.

Laser vision correction who qualifies?

O tym, czy pacjent może być poddany laserowej korekcji wzroku, decyduje okulista – na podstawie specjalistycznych szczegółowych badań, które pozwolą precyzyjnie ocenić kondycję oka i stwierdzić, czy FemtoLASIK jest najlepszym rozwiązaniem dla danej osoby. Na początek pacjent powinien zostać umówiony na specjalne badanie kwalifikacyjne, które ma na celu sprawdzić, czy występują u niego jakieś przeciwwskazania bezwzględne. Niektóre z nich mogą prowadzić do nieprawidłowego przebiegu zabiegu, co może bezpośrednio skutkować w pojawieniu się przeróżnych niechcianych powikłań czy też w problemach z okresem rekonwalescencji po zabiegu. Badania, które wykonuje się w ramach kwalifikacji do zabiegu laserowej korekty wzroku, to:

• Wavescan Wavefront aberrometry
• corneal topography,
• intraocular pressure,
• keratometry,
• objective and subjective refraction testing,
• testing visual acuity under different conditions
• refraction after acmodation paralysis
• badanie dna oka,
• pupil measurement in day and night conditions,
• measurements of the current correction,
• spatial vision tests.
• measurement of intraocular pressure
• determining the aberrations of the optical system of the eye, i.e. the length of the eyeball and the width of the iris

Laser vision correction contraindications

Lekarz może zlecić po kwalifikacji dodatkowe badania, jeśli konieczne będzie pogłębienie diagnostyki, np. z powodu podejrzenia jaskry czy dry eye disease. Najczęściej badania można wykonać na miejscu. Bardzo często będą one niezbędne przed wykonaniem zabiegu laser vision correction po to, aby ustalić, czy posiadana wada wzroku nadaje się do bezpiecznej korekty. Dodatkowe badania, które pomogą wyjaśnić, czy istnieją jakieś przeciwwskazania do zabiegu korekcji wzroku to:

• field of vision,
• OCT – optyczna koherentna tomografia siatkówki,
• Ocular ultrasound,
• Schirmer test,
• time of tear film interruption.

Laser vision correction - what disqualifies?

Contraindications to laser vision correction - investigating these is key to the safety and effectiveness of the procedure. Contraindications to laser vision correction can include a number of conditions, such as cataracts, vascular disease of the eye, dystrophic diseases of the retina, or congenital pathologies of the cornea. Their presence can significantly affect the results of the correction and, in some cases, increase the risk of complications. In addition, there are temporary contraindications that require the surgery to be postponed until they are resolved. A pre-treatment qualifying examination allows for a thorough assessment of the condition of the eyeball and the exclusion of these contraindications, which is essential to ensure that laser vision correction is safe and has the desired results. Skipping this step may expose the patient to unnecessary risks and result in unsatisfactory treatment outcomes.

• Age too young. It is accepted that the lower age limit to have a vision correction procedure is 18 years. This is primarily related to another contraindication, namely progressive visual impairment. We recommend that the patient should be at least 21 years of age, as it is around this time that young patients' visual defects begin to stabilise and their anatomical development of the eye comes to an end. However, there are exceptional situations that may require an individual approach.
• Unstable visual defect. The result of laser vision correction is in most cases permanent, so the procedure can only be carried out if the defect has been stable (not progressing or regressing) for at least six months and preferably a year. If the defect is not stable, laser vision correction surgery will unfortunately not affect the patient's normal vision. He or she will then require additional laser correction, which is generally rather undesirable and can be dangerous. Often the stability of the visual defect comes with age, which may result in such a procedure being possible in the future.
• Dry eye syndrome. Laser vision correction surgery can exacerbate this condition. Besides, after the correction, the eyes are prone to dryness for a certain period of time and need to be regularly moistened with drops prescribed by the ophthalmologist to control the degree of corneal hydration. Dry eye syndrome could hinder the healing and regeneration of the cornea and increase the risk of epithelial erosion. It is important to remember that vision correction surgery involves a long recovery process, and dry eye syndrome could be a major setback and could significantly delay the return to good, healthy eye health.
• Glaucoma. High intraocular pressure in people with glaucoma can falsify measurements taken during qualification. More importantly, however, if lesions have developed in the affected person's optic nerve, they will cause impaired vision regardless of the visual impairment. Performing laser surgery in such a case will therefore not yield satisfactory results.
• Corneal cone. Rogówka przybiera stożkowaty kształt i staje się coraz cieńsza. Zbyt cienka rogówka to choroba, która ze względu na swój postępujący charakter, jest dosyć mało przewidywalna by bezpiecznie przeprowadzić laserową korekcję wzroku. Stożek rogówki leczy się innymi metodami laserowej korekcji niż FemtoLASIK.
• Zwyrodnienie plamki żółtej i niektóre choroby degeneracyjne siatkówki. W tych sytuacjach receptory siatkówki nie są wstanie przekazać prawidłowego obrazu do nerwu wzrokowego, zatem skorygowanie wady wzroku nie miałoby wpływu na lepsze widzenie. Zwyrodnienie plamki żółtej niestety bezwzględnie dyskwalifikuje pacjenta z zabiegu laserowej korekcji wzroku.
• Profound visual impairment. Excessive visual impairment is a condition that is caused by poor development or damage to the optic nerve, which does not properly transmit signals from the retina to the brain. Alignment eye's refraction laser treatment will not restore the proper functioning of the optic nerve, just as spectacle lenses or contact lenses cannot do so.
• Monocularity. When a patient can only see with one eye or uses only one eye or has one eye, the surgical risk is not taken on the healthy eye. Such a procedure is much riskier and may represent a deterioration of the patient's vision. While the correction is only inserted in one eye, it is a very difficult task to compensate one eye with the other. After such a procedure, it is likely that the patient would experience the effect of uneven vision, which could significantly worsen his or her vision under different conditions.
• Diabetes, rheumatic diseases such as rheumatoid arthritis and a weakened immune system. The health of the patient undergoing laser vision correction should be at least good. Active infections or autoimmune diseases that could negatively affect the effectiveness of the procedure and the course of recovery are excluded.
• Ciąża i karmienie piersią. Zmiany hormonalne w czasie ciąży i po porodzie mogą powodować pogorszenie wzroku i zespół suchego oka zaś jednym z warunków przeprowadzenia laserowej korekcji wzroku jest stabilna kondycja oczu. Zabieg można wykonać min. 3 miesiące od zakończenia karmienia. Okres karmienia piersią jest uważany za przeciwwskazania względne do przeprowadzenia laserowej korekcji wzroku. W tym czasie, zmiany hormonalne mogą wpływać na grubość i kształt gałki ocznej, co stanowi przeciwwskazanie do zabiegu. Ze względu na potencjalne fluktuacje w wadzie wzroku, lekarze zalecają poddanie się zabiegu laserowej korekcji wzroku po okresie karmienia piersią.
• Various types of corneal scarring that could inhibit vision correction at the site of the former injury.
• Inflammation of the eyes following inflammation with the Herpes virus, which is also known as the herpes virus.

Laser vision correction and diabetes

Unfortunately, diabetes is a factor that is a contraindication for a patient who wishes to proceed with laser vision correction. This condition weakens the body to such an extent that the procedure itself becomes hazardous to health. The same is true for infections of any kind, or suffering from autoimmune diseases, which can negatively affect the recovery process. Remember, however, that the attending doctor will provide you with all contraindications during your appointment. Unfortunately, laser vision correction is a procedure that is only carried out quite strictly for qualified patients whose physical health will allow the eye's recovery process to improve. Which is tantamount to the doctor not being able to carry out a refractive lens replacement.

Laser vision correction and glaucoma

Glaucoma is another factor that we count as an absolute contraindication for laser vision correction surgery. This is because glaucoma affects high intraocular pressure, which in turn negatively affects the accuracy of the measurements taken during the patient's qualification. In addition, the condition itself can damage the optic nerve, which laser vision correction unfortunately does not remedy. If necessary, however, you will receive more instructions from your ophthalmologist during your vision correction qualification appointment. What is certain is that a patient with this condition is disqualified from laser vision correction.

Laser vision correction one eye

Some patients suffer from so-called monocularity. Unfortunately, this feature can also be a point that prevents laser vision correction from being carried out. It is a procedure characterised by high risk and difficulty of performance. Laser correction in this case requires the use of other, special parameters, as the eye with the defect has to be compensated, in a way, with the healthy eye. Our clinic does not take the risk of carrying out the procedure on the healthy eye if only one eye has a defect, as this can result in a consequent deterioration of vision. You can, however, go for a medical consultation to seek further advice and find another solution.

In summary, contraindications to laser correction can be manifold and very often pose certain risks. Many of them could contribute to the failure of the procedure or lead to complications of various sorts. The laser vision correction procedure is not a simple task and is quite restrictive, as you could certainly find out after reading the above post. However, it is not impossible and nowadays an increasing number of people with visual impairment are enjoying life without the use of glasses or contact lenses. It is therefore worth making an appointment for an eye examination to find out whether a vision correction procedure is possible in your case, if you want to regain your visual acuity.