Methods to Get Rid of Glasses

Defects caused by problems in the ability of our eyes to refract light, such as myopia, hyperopia and astigmatism, can be compensated by wearing glasses or lenses. However, being dependent on glasses or lenses for a clear vision inevitably reduces our comfort. The development of health technologies allows laser eye surgeries to be performed. Methods of getting rid of glasses determined specifically for patients make a more comfortable life possible.

Today, methods of getting rid of glasses can be examined under two main headings: eye surgery with Excimer laser and intraocular lens applications. Both methods allow patients to have a perfectly clear vision by dividing them into sub-branches according to the refractive disorder and the degree of refractive disorder. In this article, I will give you information about both Excimer laser and intraocular lens applications. However, first of all, I would like to give brief information about the refractive disorder of the eye.

Refractive Disorders

Refractive Disorders, which cause the light coming into our eyes to not be able to focus correctly on the retina, can be defined as a very common eye disorder that affects millions of people around the world.

Refraction Disorders can be considered in three different groups:

Myopia: The refractive disorders that causes farsightedness is called “myopia”. Myopia occurs when the light coming into the eye is focused in front of the retina layer and usually occurs when the anterior posterior axis of the eye is longer compared to normal values. Myopia, which is usually genetically transmitted, shows a progressive feature over time.

Hyperopia: Hyperopia is a refractive disorders that causes nearsightedness. Hyperopia is a refractive disorder characterized by the focusing of light on the back of the retina. Symptoms such as blurred vision of nearby objects, squinting, pain in the eye or head when performing close-up tasks, and increased frequency of blinking are among the most common symptoms of hyperopia.

Astigmatism: Both the cornea and the intraocular lens must have a perfect shape and texture in order for the light coming into the eye to be focused correctly on the retina layer. Astigmatism is defined as the condition where light is not focused correctly on the retina as a result of irregular curvatures in the cornea or lens. Headache, decreased visual acuity at all distances, difficulty driving at night, squinting and eye strain are among the most common symptoms of astigmatism.

Apart from Myopia, Astigmatism and Hyperopia, we can also talk about a refractive disorder called “presbyopia”. This refractive disorders usually occurs as a result of decreased accommodation ability of the intraocular lens in people over 40 years of age. People with presbyopia disorder later begin to be unable to see far.

Refractive disorders cannot be prevented, but they can be easily diagnosed with routine eye examination and treated with different methods such as glasses, contact lenses, refractive surgery or intraocular lens applications. While the use of glasses was the only alternative for people with refractive disorders in the past, there have been revolutionary changes with the emergence of contact lenses. Today, the most commonly used method in the treatment of refractive disorders is eye surgery with Excimer Laser. With this method, patients are provided with a clear vision. If the Excimer Laser cannot be used, intraocular lens applications are activated. Regardless of which treatment method is preferred, I would like to remind once again that it should not be forgotten that eye examinations of patients should be performed using the latest technologies and in the most comprehensive way.

I- Get Rid Of the Eyeglasses with Excimer Laser

Excimer laser, which has been used in the treatment of refractive disorders of the eye in the last 30 years, is preferred by millions of patients who want to get rid of glasses or contact lenses, can create the necessary conditions for Excimer laser application and have realistic expectations.

With Excimer laser technology, which enables the shaping of the corneal layer, both myopia, hyperopia and astigmatism can be treated. The method of getting rid of glasses is decided as a result of eye examinations performed before eye surgery with the Excimer laser, whose effectiveness and success is accepted worldwide.

The excimer laser is applied to the stroma layer, which is located under the corneal epithelium. How this layer is reached causes differentiation between excimer laser and treatment methods.

1. (Laser – Assisted in Situ Keratomileusis): How is LASIK Applied?

LASIK; It is the most common type of refractive surgery in the treatment of hyperopia, astigmatism and myopia. Before shaping the stroma layer of the cornea, a valve is created in the cornea with a special blade called a microkeratome. Then excimer laser is applied. This method is not applicable to everyone.

Before LASIK eye surgery, eye drops are used to anesthetise the eyes of patients. The patient’s face is covered by disinfecting the eye area and eyelids. In order to keep the eyes open, the eyelids are opened with a special tool called a blephorasta. Next, surgeons cut the corneal valve with a knife called a microkeratome. The cut valve is removed and excimer laser is applied to shape the cornea. Then the cut valve is closed and the procedure is terminated by dripping antibiotic drops into the eye. It is normal to experience complaints such as blurred vision, pain, burning and stinging in the eyes for the first 3-4 hours after LASIK surgery, which takes 10 to 15 minutes in total for both eyes.

2. FemtoLasik: How is FemtoLasik Applied?

FemtoLASIK is carried out completely under computer control and is popularly called “nonsurgically LASIK”.

FemtoSaniye laser and Excimer laser technology are used simultaneously. The only difference of FEMTOLASIK application from the classical LASIK application is that femtosecond laser technology is used instead of microkeratome (knife) while the valve is formed before the cornea is shaped with Excimer laser.

Thanks to the femtosecond laser, valve can be carved out in the desired width, shape or depth, specific to the person’s refractive error. Due to the fact that the valve is carved out with a laser instead of a blade, the risk of complications after FemtoLASIK is almost non-existent.

Advantages of FemtoLASIK include the almost elimination of possible complications in the FemtoLASIK technique after classical LASIK, the ability to create a personalized flap, the safe application to patients with corneal thickness limit values, and better preservation of corneal biomechanics.

General Rules for LASIK and iLASIK

• Myopia below 10, astigmatism and hyperopia below 5-6,
• The degree of refractive disorder remained stable in the last 1 year,
• over 18 years old,
• Corneal thickness, inclination and biomechanics, which have the requirements for Excimer laser application,
• Do not have problems such as severe dry eye, cataract, herpetic keratitis, eye pressure, uveitis,
• It can be safely applied to people who do not have diseases such as keratoconus, which causes progressive deterioration in the corneal tissue.
• With FemtoLASIK, which increases the effectiveness and safety of laser eye surgery, patients can get rid of their glasses and contact lenses effectively and safely.

“In all refractive surgeries, the surgeon’s experience is critically important as well as comprehensive pre-application examinations. Like all other health problems, refractive disorder  can have a personal nature. When the patient is evaluated correctly, the success of the treatment will increase.”

3. PRK and LASEK: How are PRK and LASEK Applied?

In the PRK method, unlike the LASIK and FemtoLASIK methods, no valve is created in the cornea. Therefore, PRK can be applied to patients who do not have sufficient corneal thickness for LASIK. PRK; It is performed with the principle of scraping the corneal epithelium with the help of a spatula and applying Excimer Laser to the underlying tissue. After PRK, which is included in the classification of surface treatments together with LASEK, the patient’s vision is blurred for the first week. For definite vision quality, 2-3 months should be waited after PRK or LASEK. Unnumbered contact lenses are placed on the patients for rapid healing of the scraped epithelium during the operation.

Another refractive surgery method is LASEK surgery. During LASEK, no incision is made in the cornea, the corneal epithelium is loosened with the help of alcohol and folded away. Then the cornea is shaped with excimer and the epithelial tissue is covered in place. A contact lens is worn to stay in the eye during the epithelial healing process.

4. No-Touch Laser

 No-Touch Laser, a new generation technique used in the treatment of Myopia, Hyperopia and Astigmatism without making any contact with the eye, provides great comfort to many patients who are afraid of laser eye surgery. In the No Touch Laser method, which is completed in approximately 30 seconds for each eye, only the Excimer laser device is used. A surface treatment similar to PRK and LASEK methods is performed. In PRK and LASEK methods, the epithelial layer is removed by the surgeon’s hand. In the No-Touch laser, the epithelial layer is first destroyed with the Excimer laser, without the surgeon’s hand, and then the cornea shaping laser is applied without waiting. As with all laser eye surgery, topographic analysis of the cornea should be done before No Touch laser.

This treatment, which can be applied even to patients whose corneal structure is not thick enough for LASIK and/or who do not want their eyes to be touched, is based on evaporation of the epithelial tissue of the cornea with an excimer laser and then shaping the cornea with an excimer laser.

5. ReLEx SMILE with FemtoSecond Laser

Relex Smile, which I can describe as the 3rd generation laser eye surgery, is a method that provides very successful results in the treatment of refractive disorder. Unlike PRK, LASEK, LASIK and FemtoLASIK techniques, RELEX SMILE uses only FemtoSecond Laser, not Excimer Laser, during eye surgery.

During the Relex Smile surgery, which is performed without caused a flap in the cornea or removing the corneal epithelium, a micron-level piece called the lenticule is removed from the stroma layer of the cornea in order to eliminate refractive disorders.

In the treatment of myopia and astigmatism, up to 10 degrees of myopia and up to 5 astigmatism can be treated with the personalized Smile Laser. RELEX Smile, which ensures the protection of corneal biomechanics, is completed in one step. First, a disc-shaped tissue called lenticule is created in the cornea. Then, this lenticle is removed through a 2 mm opening created in the cornea. The thickness and shape of the created lenticule is planned individually to correct the visual impairment of the person. Relex Smile, in which corneal stability is largely preserved, can be completed in a short period of time such as 30 seconds for one eye.

ReLEx SMILE;

over 18 years old

Having myopia between 0.50 and -10 degrees or astigmatism between -0.50 and -6 degrees,

The refractive disorder degrees remained constant in the last 1 year,

It can be applied to patients who are determined to be suitable for the operation as a result of the examinations.

Especially for people who are at risk of being exposed to high pressure and/or impact, Relex Smile provides more safety in the post-operative period compared to other methods.

II- Intraocular Lens Applications

Excimer laser surgeries do not always give effective results in the treatment of refractive disorders. Patients who want to get rid of their glasses or lenses, who do not have the appropriate criteria for laser treatment, and whose intraocular lens tissue and / or functions are impaired; If a comprehensive evaluation is found appropriate, these patients can apply for intraocular lens applications.

Intraocular lens applications are generally performed with the same technique, except for Add-on (second) lens and phakic intraocular lens application. The same steps are followed with femtosecond laser cataract surgery; The type of artificial lenses to be placed after the natural lens is removed may vary depending on the type of refractive disorder, expectations and lifestyle of the patient.

1. Phakic Intraocular Lens

One of the types of artificial lenses placed in the eye to eliminate the need for glasses or contact lenses is phakic intraocular lenses. Phakic intraocular lenses can be produced from plastic or silicone and offer solutions to refractive disorders.

During phakic intraocular lens surgery, the natural lens of the eye is not removed. In this method, a phakic intraocular lens is placed just behind the iris, over the patient’s own natural lens. ICL phakic lenses can eliminate all eye defects. Phakic intraocular lenses are produced in a way that does not harm the natural lens.

Phakic intraocular lenses, which can be applied to patients who do not have the appropriate criteria for laser eye surgery but want to get rid of their glasses, are effective in the treatment of the following defects.

– Myopia from 0.5 to 20 diopters,

– Myopic astigmatism from 0.5 to 6 diopters,

– Hyperopia from 0.5 to 10 diopters, and

– Hyperopia astigmatism from 0.5 to 6 diopters

During phakic intraocular lens surgery, the eye is anesthetized with drops and a minimal incision is made in the eye. A phakic intraocular lens is placed. After phakic intraocular lens implantation, both the natural intraocular lens and the phakic intraocular lens are in existence in the eye at the same time.

2. Add – On (Secondary Lenses)

The second artificial intraocular lenses placed on the upper part of the existing artificial lenses of the patients (people who have previously had cataract surgery) in place of the natural intraocular lens in the past are defined as “add-on” intraocular lenses.

In the previous period, patients who had their natural lens removed by cataract surgery and replaced with a “single vision” intraocular lens can see far without glasses, but they need glasses for close work. In this case, there are two options for completely eliminating the patients’ need for glasses.

The first of these options is to remove the artificial lens from the eye and replace it with a new artificial intraocular lens, which removes all refractive errors and allows the patient to see near and far distances without glasses. However, it is not always possible to apply this method; If removing the artificial lens causes complications, the second method, Add-On intraocular lens implantation, is preferred.

A small incision is made in the eye and refractive disorders are corrected by placing multifocal add-on lenses on the artificial lens. After the add-on lens is attached, the patient’s eye has two artificial lenses at the same time.

3. Achromatic  Lens Replacement

Patients who have refractive disorders such as hyperopia, myopia and astigmatism but are not suitable for laser eye surgery can get rid of their glasses with achromatic lens replacement. Single-focal intraocular lenses, multifocal intraocular lenses, smart intraocular lenses and toric intraocular lenses can be shown as examples of intraocular lenses that have become increasingly functional with the development of technology.

Achromatic lens replacement surgery and cataract surgery have the same characteristics. Today, femtosecond cataract surgery offers a great advantage for increasing the comfort of patients.

The eye is anesthetized with drops, then a controlled opening is created with a femtosecond laser in front of the membrane surrounding the lens, and the natural lens is fragmented and absorbed. Then, the intraocular lens is placed in place of the natural intraocular lens using a special injector.

During the achromatic lens change, the one that will best respond to the needs of the patients is preferred among the lens types with many different properties. Although I have specified the details in my “Intraocular Lenses” article, I would like to give a very short summary about the types of intraocular lenses.

Monofocal Intraocular Lenses: These lenses have only a single focus. It is usually planned in such a way that patients can see the long distance without glasses.

Multifocal (Bifocal) Intraocular Lenses: They are bifocal intraocular lenses, bifocal intraocular lenses allow patients to have clear vision both at close and far distances.

Smart Intraocular Lenses: They are trifocal intraocular lenses. Patients with high degrees of refractive disorder, who are not suitable for laser eye surgery, and who are planned for cataract surgery, can have clear vision at both near, intermediate and far distances with smart intraocular lenses.

Toric Intraocular Lenses: In patients with corneal astigmatism of 0.75 diopters and above, artificial lenses to be worn instead of natural eyepieces are preferred to be toric in order to eliminate astigmatism at the same time. It is planned according to the position and angle measurements of the toric intraocular lenses.

The choice of methods of getting rid of glasses should definitely be planned with the patient. Since the conditions required for the application of each method may vary, eye examinations of the patients should be performed completely before the method of getting rid of glasses is determined. The success of the operations may vary depending on the scope of the examinations, the technologies used and the experience of the surgeon.

FAQ About Methods to Get Rid Of Glasses