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 DEFINITION
The surgery of the refraction is an alternative method for the correction of problems of refraction of the sight to the traditional methods as there are the glasses or the contact lenses.
INDICATIONS
The possible candidates are:
- major than 21 years
- to have an alteration of stable refraction
- to have the cornea in perfect conditions
- to have a clear information about the expectations and targets of the intervention.
- to have problems with the normal correction of glasses or glasses of contact
SURGICAL PROCEDURES
Radial Queratotomía
The radial queratotomía is carried out by means of radial courts in the cornea of different lengths setting off from the periphery of the cornea, this produces a central leveling of the cornea, which improves the vision in short-sighted persons from 1.7 to 7 diopters.
Advantages:
- Rapid recovery
- Little inconveniences
- Long-term good evolution
- Progress of 90 % in the visual keenness
Disadvantages:
- The cuts are deep and they can give traumatic complications
- The results are unpredictable and fluctuating
- Something of dazzle can stay
- It is possible to alter the background vision for a long period
Laser Excimer
Advantages:
- Only small portions of the cornea falter, therefore the trauma is small
- Ideal results in 95 % of the cases with 20/40 improvement in the visual keenness
- Scarce changeability for the use of a computer to realize the incisions
Disadvantages:
- Slow recovery, more than 6 months
- Major discomfort of the recovery
- Haze in the cornea in some cases
- There is not had long-term experience (only it takes 10 years being realized)
Automated Queratoplastia lamellar
It is indicated in patients with moderate and intense grades of alteration of the refraction. It is realized with a microqueratomo (faced horizontally) by what cuts a small portion of the cornea.
A change of this skill is to realize the cut with the laser excimer.
Queratomileusis with laser Excimer
With the use of the laser Excimer (instrument that allows to polish the cornea) the curvature of the same one is modified without big scars or spot. This treatment is done in patients with miopías falls, is realized by local anesthesia and of ambulatory form.
The Laser Excimer has good perspectives for patients with bad moderate background vision.
The glasses implant intraoculares pre-cristalinianas
The operation is like that of cataracts, it is realized by revenue in Hospital and under postoperative control. The lens is placed inside the eye, placing it in the later camera, behind the iris and of the crystalline one and centred with the pupil. The cataract is not extracted. The lens is placed ahead.
ELECTION OF THE METHOD
Pacientes with low grade of alteration of the vision of background recommends to himself the radial queratotomía, for having better recovery and an acceptable predictividad in low correction grades
For patients with grades moderated in intense the laser will be better excimer.
But if he wants a perfect vision it will be better that one puts a few glasses or with contact glasses.
COMPLICATIONS AND RISKS
- The risks of any intervention under anesthesia:
- Reactions to the medication.
- Respiratory problems.
- Hemorrhages.
- Infections.
- The additional risks include:
- Fluctuating vision.
- Scarce or excessive correction.
- Infections of the cornea.
- Make difficult to see at night due to the brilliancy (sensibility to the light).
- Traumatic rupture of the cornea (rare).
In general the complications of the corrective surgery can be:
- the mistake in the correction of the vision
- pain
- ulcers in the cornea
- infections.
WHAT DOCTOR CAN TREAT ME?
OPHTHALMOLOGISTS
Consult the Ophthalmologist
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DEFINITION 
