Eye diseases have serious consequences for those affected: Reduced visual acuity, halo effects, reduced contrast vision and a narrowed field of vision can even lead to accidents. If even glasses and contact lenses no longer help, the only option left for the affected person is surgery. Eye surgery is also absolutely necessary for degenerative eye diseases (cataracts or glaucoma) and emergencies (retinal detachment).
What is eye surgery?
Eye surgeries are surgical procedures used to restore the eyes to full function. Eye surgeries are surgical procedures that serve to restore the eyes to full function. For example, parts of the eye are removed and foreign material is transplanted. Sometimes misalignments (strabismus) must also be corrected. Eye operations are performed under general anesthesia or partial anesthesia with twilight sleep. For anxious patients and children, general anesthesia is usually used. Elderly patients and people with heart and blood pressure problems are given only local anesthesia. Before the operation, a non-binding consultation is held in which the patient is informed about all the details of the operation and the surgical procedure indicated for the present condition is determined. During the preliminary examination, corneal thickness and corneal surface are checked. Pupil size and visual performance are also closely examined. Any pre-existing conditions, such as hypertension and diabetes mellitus, are taken into account when choosing the surgical procedure.
Function, effect, and goals
Eye surgery is intended to enable the patient to do without visual aids as much as possible. It also corrects movement disorders and misalignments of the eyes. If the patient needs surgery on both eyes, one eye is treated first, and then the second is treated after full vision is restored. The choice of surgical method depends primarily on the type of eye disease present. For refractive errors between -10 and +4 diopters, the LASIK (refractive surgery) procedure is usually used. With this very gentle laser procedure, the patient can usually see sharply just a few hours after the surgical procedure. The small bruises on the eye also usually disappear soon after. If the patient has cataracts, the clouded lens is removed and replaced with an artificial lens (clear lensectomy). In another procedure frequently used today, the artificial lens is integrated into the existing lens capsule. The natural lens is previously destroyed and removed using ultrasound. Most cataract surgeries are performed with the femto-second laser. It enables the most precise incisions ever. After the operation, however, the patient must wear slightly corrective glasses (near and distance vision). Glaucoma surgery (glaucoma) is intended to preserve the remaining vision. If both eyes are affected, the operation must be performed as an inpatient and under general anesthesia. If the slowly progressing degenerative disease is not operated on in time, the excessive intraocular pressure will cause damage to the retina and the optic nerves. In the case of narrow-angle glaucoma, the eye surgeon makes a tiny opening in the iris (iridotomy) to allow the aqueous humor to circulate better and to lower the intraocular pressure. With the help of iridectomy, the edge of the cornea is incised and a tiny piece of iris is removed to create an aqueous humor flow. In corneal surgery, the clouded cornea is replaced with a donor cornea (penetrating keratoplasty, PK). Sometimes only one layer is replaced by the donor cornea: The damaged lamella is vaporized with a laser (phototherapeutic keratectomy, PTK). Corneal transplants are among the most commonly performed eye surgeries today. In certain cases, surgery must be performed immediately: If the retina detaches or if diabetic retinopathy is present, the retina must be reattached to prevent the patient from going blind. This is the case, for example, with macular degeneration. The macula is the retinal area with the highest concentration of sensory cells. The detached retina is fixed by sewing on a silicone seal. Another method is to fix it to the eye wall with a laser. Eye muscle surgery is required if the patient has squinting, eye tremor, or eye-related forced posture of the head.The entire eyeball is removed when a blind patient experiences severe eye pain. Before an artificial eye is inserted, a guide seal must be sewn in. If there is a malignant tumor on the eye, additional connective tissue and fat are removed.
Risks, side effects and dangers
After eye surgery, patients may experience decreased night vision and increased sensitivity to glare during the first few weeks. These aftereffects are completely normal and usually disappear without patient intervention. Although most eye surgeries today are routine and are performed by experienced specialists using the latest technology, many patients are afraid of such a procedure. They fear that they will never be able to see properly again. Their fears are not entirely unfounded, since eye surgery is associated with a risk of 1:1,000. Permanent damage cannot be ruled out one hundred percent. Therefore, the operating physicians are constantly available even after the surgical procedure. The most common complications include retinal detachment, cystoid macular edema, decreased visual acuity, infection, decreased contrast vision, halos around light sources, and increased glare sensitivity. If these surgical sequelae occur, follow-up treatment is required. To reduce the risk of complications, it is recommended to stop wearing contact lenses several weeks before the surgery date and to use the prescribed eye drops after the surgery. Also, under no circumstances should the patient put their hands in their eyes or rub them. Rooms where people smoke are best avoided, as tobacco smoke delays the wound healing process. In addition, scheduled follow-up visits must be adhered to.
