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Careful home care supports healing, helps relieve any temporary discomfort and contributes to the best possible surgical outcome. At Silmäasema, you will receive clear home care instructions, which we will go through with you to make sure you know how to care for your eyes after surgery.
If you fall ill before surgery, please contact our customer service, tel. +358 10 190 200 (nationwide appointment and surgery help line, service hours: Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm)
Bring with you to the surgery
Procedure
If necessary, you will be given a relaxant before surgery. In the operating room, the eyelids are cleaned, an anaesthetic drop is applied to the surface of the eye and a lid speculum is put in place to keep your eyelids open. The method involves the painless creation of a flap on the surface of the cornea, after which your vision will be blurred before the next stage.
The actual lasering of the refractive error is performed under the flap. The duration of the lasering stage is a few tens of seconds. The laser equipment ensures that the direction of your eye remains correct to prevent any movement of the eye from interfering with the operation. The procedure is painless. After lasering, the flap is repositioned and it attaches to the cornea within minutes.
After the procedure, your ophthalmologist will check your eyes.
You may feel like there is something in the eye, and they may water. Your vision will improve in about 24 hours. After the procedure, goggles should be worn until the next morning and for one week at night to protect the eyes.
The post-operative symptoms and potential risks are described below.
Risks of surgery
While the risks associated with refractive surgery are rare, there is no such thing as a risk-free surgical procedure. Femtolasik surgery involves the following risks:
Flap creation
The equipment is always inspected before each surgery, but nevertheless the flap creation may be incomplete. Laser treatment will not be continued under an incomplete flap.
Epithelial erosion, or surface abrasion, is possible during the creation of the flap. The greatest risk is for people whose corneal surface layer is naturally loosely attached. This eye characteristic cannot be predicted in advance. Surface abrasion does not prevent laser treatment and does not significantly worsen the outcome, but slows down the healing of the eye. Recovery is individual, taking anything from a week to a few months. Sick leave is may be needed for longer than the usual 1–2 days. The treatment consists of the use of a protective contact lens for a few days.
Corneal epithelium, or surface tissue, is able to grow under the flap during the first few weeks. Minor changes will not impair vision and often disappear spontaneously. If necessary, the epithelial tissue under the flap is rinsed away. The rarest problems are folds in the flap affecting vision, which can reduce visual acuity and visual quality. The treatment consists of lifting and flushing the flap.
Dry eyes
Your eyes will be more susceptible to dryness after the surgery. After the operation, you will receive instructions on how to use moisturising eye drops, which are useful when applied regularly.
Abnormal response to treatment
Nearly all patients can stop using their glasses, and most of our customers can see without glasses as well as or better than they did with glasses before the procedure. However, we cannot promise with 100% certainty that all patients can stop using glasses, because the response to treatment and the ability to stop using glasses will always depend on the initial amount of needed correction as well as on individual vision requirements. There is a higher risk of the refractive error returning after the correction of farsightedness and large astigmatism. The refractive values should be allowed to stabilise for a few months after surgery and, if necessary, laser surgery to improve the result is usually performed after 6 months. Age-related farsightedness is a normal age-related loss of near vision, and surgery does not prevent it from occurring later in life.
At Silmäasema, the need for operations to repair the results of laser surgery is less than 2%.
During pregnancy and lactation, women often experience hormone-induced changes to their vision and refractive surgery is not advised. The thickness and curvature of woman’s corneas can increase due to hormonal changes in pregnancy thus vision correction could be inaccurate. Surgery can accurately be carried out before pregnancy or 3 months after lactation.
Infection
The risk of bacterial infection in refractive surgery is minimal: less than 1 in 10,000 operations. Infections are prevented by means of aseptic surgical technique with sterile surgical equipment and antibiotic eye drops. Antibiotic-cortisone eye drops are used for one to two weeks after surgery. After surgery, a sterile inflammatory state may develop in the cornea, in which case the inflammatory cells cloud the cornea and reduce visual acuity. This type of post-operative irritation is extremely rare and usually mild change that is managed by increasing the amount of cortisone eye drops.
Corneal ectacia
Pre-operative examinations are performed to determine the structure of the cornea. If the cornea is abnormally thin or irregular prior to laser surgery, the surgery may cause corneal ectasia. As the ectasia progresses, visual acuity will be severely reduced. Ectasia can be treated with corneal hardening therapy. To avoid ectacia, we never thin the cornea below the safe minimum level. The choice of the method of surgery can also affect the risk.
After surgery, it is important to follow the instructions to avoid complications.
On the day of surgery, your vision will be blurry. During the first days, your eyes may water, sting
and be sensitive to light. Your vision will become clearer within the first few days. Visual quality (contrast sensitivity) will be somewhat reduced, but it will improve over the next few months.
Your ophthalmologist will issue electronic prescriptions for drops
Antibiotic drops prevent inflammation and promote the healing of the cornea. Your eyes may be dry in the first few weeks after surgery. Dryness can cause foreign body sensation in your eyes and temporarily impair the quality of vision. Moisturising eye drops will help to reduce dryness and the stinging sensation. Moisturising eye drops should be used frequently, approximately every 1–2 hours, especially at the beginning.
During the first week after surgery, avoid:
You should wear protective goggles until the next morning and at night for one week.
Avoid the following for one month after surgery:
Sick leave
Your surgeon will usually give you sick leave for 1–3 days, if necessary. Note that, when granting sick leave, the surgeon cannot determine whether you are remunerated or not. Customer is responsible to notify the surgeon before the surgery of possible occupational vision requirements and restrictions to surgical treatmens.
Follow-up examination
One or two post-operative follow-up appointments will be necessary. The first one will be agreed at the time of surgery, as directed by your surgeon. Please note that no reminder will be sent for the control appointments.
If you feel an intense ache in the operated eye, your vision deteriorates, or if you experience eye discharge or feel pain or nausea:
Silmäasema’s nationwide appointment and surgery help line, tel. +358 10 190 200 (Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm)
If you have any concerns, you can call Silmäasema customer service, tel. 010 190 200 (national appointment and surgery help line, service hours: Mon–Fri 8 am – 6 pm, Sat 9 am – 4 pm)
On the day of surgery, your vision will be blurry. During the first days, your eyes may water, sting and be sensitive to light. Your vision will become clearer within the first few days. Visual quality (contrast sensitivity) will be somewhat reduced, but it will improve over the next few months.
PRK is a form of surface laser, which removes a thin layer of cells from the surface of the eye before laser treatment to correct a refractive error. PRK is used for the treatment of moderate myopia when the cornea is too thin to create a flap.
If necessary, you will receive a relaxant before the surgery. The procedure is very mildly, if at all, unpleasant. In the operating room, the eyelids are cleaned, an anaesthetic drop is applied to the surface of the eye and a lid speculum is put in place to keep your eyelids open. The lights of the laser device are bright and may dazzle slightly at the beginning. You will be looking straight up at a flashing green light. The surgeon marks the area of the cornea to be lasered and removes a layer of surface cells. The procedure is painless, but you can feel the surface of your eye being touched.
After the surface tissue has been removed, it is time for the actual laser treatment to correct the refractive error. An eye tracker will make sure that the direction of your eye is correct, so any movement of the eye will not interfere with the procedure. During lasering, you will hear a clicking noise, and all you do is look at the middle of a foggy cloud of light. The laser treatment lasts from a few seconds to a few tens of seconds depending on the level of refractive error.
After the laser treatment is complete, the surgeon rinses the eye and finally puts on a therapeutic contact lens to protect the eye. An antibiotic is dropped into the eye and the eyelid support is removed.
You will receive home care instructions from the nurse, and you can go home as soon as you feel comfortable. Driving is not permitted after the surgery. If you do not have anyone with you to drive you home, you can take a taxi. Follow-up appointments usually occur one month and six months after surgery.
While the risks associated with refractive surgery are minor, there is no such thing as a risk free surgical procedure. The following potential risks are associated with laser surgery:
Nearly all patients can stop using their glasses, and most of our customers can see without glasses as well as or better than they did with glasses before the procedure. However, we cannot promise with 100% certainty that all patients can stop using glasses, because the response to treatment and the ability to stop using glasses will always depend on the initial amount of needed correction as well as on individual vision requirements. In the case of large refractive errors, there is a higher risk that spectacles will have to be worn from time to time even after surgery. It is advisable to wait a few months after the surgery for the refractive values to stabilise. Age-related farsightedness is a normal age-related loss of near vision, and surgery will not prevent it from occurring later in life.
Corneal ectasia
If the cornea is abnormally thin or irregular prior to laser surgery, the surgery may cause corneal ectasia. As the ectasia progresses, visual acuity will be severely reduced. Ectasia can be treated with corneal hardening therapy. To avoid ectacia, we never thin the cornea below the safe minimum level. The choice of the method of surgery can also affect the risk.
Haze
Haze refers to scarring of the surface of the cornea after PRK surgery. Sunlight has been shown to increase the risk of haze. In addition, when major refractive errors are corrected, the risk of haze is higher. Post-operative cortisone drop treatment is used to prevent haze formation. The use of sunglasses is important during the first year after surgery. It is particularly important to use UV-protected sunglasses when skiing in the spring, by water and when the sun’s UV radiation is strong.
Pain
After surgery, it is common that the eyes are sensitive to light, and they may water. Pain is also common. These symptoms will ease after about three days as the surface epithelial layer removed during surgery grows back. Painkillers (such as ibuprofen) can be used to treat the pain. Dim lighting and keeping the eyes closed can also help relieve symptoms.
After surgery, it is especially important to follow the instructions to avoid complications.
Your surgeon will issue electronic prescriptions of eye drops.
Antibiotic drops prevent inflammation and promote the healing of the cornea. Your eyes may be dry in the first few weeks after surgery. Dryness can cause foreign body sensation in your eyes and temporarily impair the quality of vision.
A contact lens has been placed in your eye after the operation and it must remain in place continuously for 3–5 days. The contact lens may be removed in the evening of _________ / _____. Before removing the contact lens, take a painkiller, wash your hands and apply a drop of antibiotic. The eye may get a little sore after the contact lens is removed and feel rough for another 24 hours. If the contact lens falls out of your eye earlier, keep your eye closed and use moisturising eye drops every 1–2 hours.
It is important that you wear sunglasses during the first year after eye surgery.
Wear sunglasses outdoors, as UV radiation from sunlight has been shown to increase the formation of haze. Particular care should be taken when skiing in the spring, by water and when the sun's UV radiation is strong.
Remember to apply moisturising eye drops often enough.
A moisturising eye drop will help to reduce dryness and the stinging sensation in the eyes. Moisturising eye drops should be used frequently, approximately every 1–2 hours, especially at the beginning. Moisturising eye drops are safe to use even after the first few days.
One or two follow-up appointments will be necessary. The first one will be agreed at the time of surgery, as prescribed by your surgeon. Please note that no reminder will be sent for the follow up appointments.
If your vision deteriorates after an initial improvement, if it does not clear up within a few days, or if there is a clear difference between the eyes, contact the operating unit.