Advances in Laser Eye Surgery: What Patients Need to Know - Insights from Shri Venkatesh Eye Institute

Laser technology has transformed eye care by offering precise, faster, and minimally invasive treatment options for various conditions. Compiled by the Team of Doctors at Shri Venkatesh Eye Institute, here’s an overview of the types of laser technologies used for specific eye diseases:

1. Glaucoma Treatment

• Technology: Femtosecond Laser (FLigHT) & Micropulse Transscleral Laser Therapy (TLT)
• Diseases Treated: Glaucoma, especially in patients who struggle with eye drops or have sensitive eyes.

2. Vision Correction (Myopia, Hyperopia, Astigmatism)

• Technologies: LASIK, SILK/SMILE, PRK
• Diseases Treated: Near-sightedness (Myopia), Far-sightedness (Hyperopia), Astigmatism.

A) Must Know

• Femtosecond Laser (FLigHT): This laser creates tiny drainage channels in the eye to help with fluid flow, offering a non-invasive solution for treating glaucoma. It's a safer alternative to traditional surgeries, with minimal side effects. FLigHT has shown promising results in clinical trials, with no major complications such as bleeding or increased eye pressure reported.
• Micropulse Transscleral Laser Therapy (TLT): This laser technique is used to reduce eye pressure in glaucoma patients. It applies less energy, making it safer with fewer risks.

B) Good to Know

• Benefits: These laser treatments offer a great option for patients who find it difficult to follow a daily routine with eye drops. They are particularly helpful for those with sensitive eyes or those who suffer from side effects due to medications.

C) Optional Information (Not Critical)

• These treatments are still relatively new in the market, and while initial results are promising, there may be a need for more widespread, long-term studies to fully understand their long-term effectiveness.

A) Must Know

• LASIK (Laser-Assisted in Situ Keratomileusis): LASIK is one of the most popular laser surgeries worldwide. It reshapes the cornea to improve vision and can treat near-sightedness, far-sightedness, and astigmatism. The surgery is quick, usually painless, and recovery is fast—patients often experience improved vision within one to two days. LASIK has been used successfully for over two decades and has a proven long-term track record.

B) Good to Know

• Wavefront Custom View Technology: This advanced laser technology has been in use for over 20 years and is known for creating a highly detailed map of your eye to correct even minor imperfections. It enhances the precision of LASIK by tailoring the treatment to the unique shape of your cornea. Wavefront technology has a solid history of improving visual outcomes and protecting corneal health over time.
• Long-Term Outlook for Newer Technologies: While SMILE and SILK offer promising results, since they are relatively new, there’s less long-term data available. On the other hand, LASIK (with Wavefront) and PRK have demonstrated over two decades of success and evidence that the corneal health is preserved, making them reliable options for patients considering vision correction.

C) Optional Information (Not Critical)

• SILK/SMILE (Small Incision Lenticular Extraction): A newer alternative to LASIK, this technique uses a small incision and removes a small piece of tissue inside the cornea. It’s a great option for patients who are at risk of developing dry eyes, as it disturbs fewer nerves. However, since it's a relatively new procedure, we don't yet know how the long-term health of the cornea will be affected after 20 years.

Similar to LASIK, but instead of creating a flap in the cornea, PRK removes the outer layer (epithelium) of the cornea before reshaping it. PRK is often recommended for patients with thin corneas and has a proven long-term track record of over 20 years, showing that it protects the health of the cornea.

Laser eye surgery is now available to anyone and across all age groups. Besides, painless, better effectiveness, easier recovery, quick recovery, almost no side effects.

Advancements in laser has broadened the spectrum of treating patients. Though expensive as compared to previous technologies, these modern day lasers are very promising.

Retinal lasers are the mainstay in treatment of diabetic eye disorders along with many other retinal diseases like uveitis, vein occlusions, central serous chorioretinopathy, etc. Below are some of the latest advances in retinal lasers

1. Navigated Laser Treatment: It utilizes an eye tracking system while delivering laser therapy. Thus, the accuracy of laser delivery is very high. When the patient moves the eyeball while laser therapy, the system detects change in position and automatically stops firing beam so as to avoid undesirable laser burns

2. Micropulse Subthreshold Laser: Laser for retinal diseases works on the principle of thermal damage. Micropulse subthreshold technology utilizes lower power to deliver similar results so as to decrease the amount of thermal damage on the retina.

3. 3D Retinal Surgeries: By far the biggest successful innovation in retinal surgeries is the use of 3D technology while operating. It has the following advantages-

• Improved precision – added focus, increased magnification and depth of resolution
• Reduced light exposure during surgery

Key Takeaways

1. Laser Technology for Glaucoma:

• Femtosecond lasers (FLigHT) and Micropulse Transscleral Laser Therapy (TLT) offer safe and effective treatments, reducing the need for eye drops and providing an alternative for patients who find drops uncomfortable.

2. Laser Technologies for Vision Correction:

• LASIK remains a widely trusted solution for refractive issues with quick recovery.
• SILK/SMILE offers a safer option for patients prone to dry eyes, with fewer risks of complications.
• PRK is a great choice for those with thin corneas but involves a longer recovery time.

3. Freedom from Eye Drops:

• For glaucoma patients, laser treatments can help eliminate the need for ongoing eye drops, making daily eye care easier.

4. Post-Treatment Care:

• Most laser surgeries require minimal aftercare, but follow-up appointments and protecting the eyes from strain or bright light are important for optimal recovery.

5. Insurance and Cost Considerations:

• Laser treatments can be costly, but many clinics offer financing options, and insurance may cover the expenses depending on the policy. Always confirm with your insurer.