A variety of conditions can impact the health and functionality of our eyes, such as cataracts, glaucoma, and refractive errors. In some cases, your doctor may recommend a surgical procedure to address these issues and to improve vision.
As surgical procedures continue to advance, it helps to understand each of the different types of eye surgery, their specific purpose, and what to expect during and after each of the procedures.
Cataracts are a common condition that affect the lens of the eye, causing it to become cloudy and impairing vision. Cataracts generally develop slowly and don’t initially disturb your eyesight. But over time, and especially after age 60, cataracts will progress and eventually interfere with your vision.
With over 10 million procedures carried out each year, cataract surgery is one of the most commonly performed surgeries in the world and is typically done on an outpatient basis.
During the surgery, the cloudy lens is removed and replaced with an artificial lens, called an intraocular lens (IOL). This procedure can be done using traditional surgical techniques or with the assistance of advanced laser technology. The surgery typically takes about 30 minutes to complete, and most patients report experiencing little to no pain during the procedure.
After the surgery, patients will typically need to wear a protective eye shield for a few days and use eye drops to prevent infection and reduce inflammation. Most patients are able to return to normal activities within a few days of the procedure.
Cataract surgery is considered a low-risk surgery and has been found to improve vision in over 97% of patients who undergo the procedure.
Glaucoma is a condition that occurs when the pressure inside the eye becomes too high, causing damage to the optic nerve. Left untreated, glaucoma can result in permanent vision loss. Currently, it’s estimated that over 3 million Americans have glaucoma. Since glaucoma is progressive and nearly without initial symptoms, 50% of people with glaucoma are unaware they have the disease.
There are several types of glaucoma surgery, including trabeculectomy, laser trabeculoplasty, and aqueous shunt surgery. The specific type of surgery recommended will depend on the severity of the condition and a number of other factors involving the health of the eye.
During trabeculectomy, a small piece of tissue is removed from the eye to create a new channel for fluid to drain out of the eye. Laser trabeculoplasty involves using a laser to create tiny holes in the eye’s drainage system to help fluid drain more easily. Aqueous shunt surgery involves implanting a tiny device in the eye that helps to drain excess fluid and lower eye pressure.
After any type of glaucoma surgery, patients will need to use eye drops to prevent infection and reduce inflammation. They will also need to maintain normal eye pressure and avoid strenuous activities and heavy lifting for a few weeks after the surgery.
According to the Glaucoma Research Foundation, glaucoma surgery is successful between 70% and 90% of surgeries. One of the most commonly reported issues after surgery is the drainage holes created during laser trabeculoplasty heal, or close, over time and again cause pressure in the eye to increase.
LASIK (laser-assisted in situ keratomileusis) is a very common type of refractive surgery that is used to correct nearsightedness, farsightedness, and astigmatism. During the procedure, a laser is used to reshape the cornea, the clear, front part of the eye, to improve vision.
Before the surgery, patients will have a comprehensive eye exam to determine if they are a good candidate for the procedure. LASIK is not recommended for everyone, and certain factors, such as age, corneal thickness, and overall eye health, will be considered before the procedure is recommended.
Although not everyone is a candidate for LASIK surgery, the American Refractory Surgical Council estimates that 75% to 80% of adult patients are eligible for the procedure.
During a LASIK procedure, the patient will be given local anesthesia to numb the eye. A small flap is created in the cornea and a laser is used to reshape and correct the underlying tissue. The flap is then replaced and left to heal on its own.
After LASIK surgery, it’s common for patients to experience some discomfort and dryness in the eye, but these symptoms typically subside within a few days. Most patients are able to return to normal activities within a few days of the procedure.
Roughly 96% of LASIK patients report significant improvements in their vision after surgery. Additionally, 80% to 90% of patients experience 20/20 vision after LASIK surgery. However, it’s important to realize that the benefits achieved through LASIK surgery typically only last between 10 and 15 years before natural aging again causes vision to worsen.
PRK (photorefractive keratectomy) is another type of refractive surgery that is used to correct nearsightedness, farsightedness, and astigmatism. While the procedure is similar to LASIK, rather than creating a corneal flap, PRK involves completely removing the epithelium (outer layer of the cornea).
Once the epithelium is removed, a laser is then used to reshape the underlying cornea, correcting vision problems. The epithelium will regrow over time, and a bandage contact lens is placed to protect the eye while it heals.
PRK may be a better option for individuals with thin corneas, as it does not require a corneal flap like LASIK.
PRK has a high success rate with 90% of patients experiencing improved vision within a week or two and 95% after a month. However, PRK has a more extended recovery time, and patients may experience discomfort and sensitivity to light during the healing process.
Retinal surgery is a specialized surgical procedure performed on the delicate nerve tissue of the retina, the light-sensitive layer found at the back of the eye.
While not all retinal issues can be fixed with retinal surgery, the procedure is typically used to repair or remove abnormal growths, tears, detachment, or holes in the retina that can cause vision loss or other complications.
Retinal surgery may be performed under local or general anesthesia and may involve the use of lasers, cryotherapy, or other techniques to repair or remove damaged tissue.
Depending on the severity of the retinal condition, recovery time can vary from a few days to several weeks.
Retinal surgery has demonstrated very high success rates, including over 99% reattachment rate when treating detached retina.
Other common types of eye surgery
In addition to the surgical procedures described above, your doctor might also recommend specific types of surgical procedures to correct issues around the eyes or issues involving the muscles of the eyes.
Plastic or reconstructive surgery is often recommended to correct a wide range of issues occurring around the eyes, including removing or repairing drooping eyelids (ptosis), treating certain types of eye cancer, correcting issues involving the tear ducts, and reconstruction after orbital fractures.
Eye muscle surgery is a procedure that aims to correct the alignment of the eyes by modifying the position or length of the muscles that control eye movement. This type of surgery is typically performed to treat strabismus, a condition where the eyes do not align properly and may appear crossed or misaligned.
The surgery involves making small incisions in the eye to access the muscles, which are then repositioned or adjusted to improve eye alignment.
Eye muscle surgery can be performed on both children and adults and is usually done on an outpatient basis under local or general anesthesia. Recovery time varies, but most patients are able to resume normal activities within a few weeks after the surgery.
Consider all available surgical options
As medical technology, including surgical procedures for the eyes, continue to advance, it’s likely that an increasing number of eye conditions will be treated by using surgical procedures. Should your doctor recommend one of the surgical treatments mentioned above, make sure to discuss all available options, including non-invasive surgical procedures, that are available to treat your specific eye condition.