We spoke with Dr. Nuno Moura (Department of Cornea, Cataracts and Refractive Surgery, IMO Grupo Miranza) on refractive and cataract surgeries, as well as presbyopia correction and the most advanced surgical techniques.
What is refractive surgery?
We call refractive surgery surgical techniques that aim to remove dependence on glasses and correct refractive defects such as myopia, hyperopia, astigmatism and presbyopia or tired eyesight. To do this, we have many techniques, and the best-known techniques use lasers and intraocular lenses, which allow us to provide a solution to most patients who come to ophthalmology consultations requesting this type of intervention.
Latest technologies in this field?
As I said, most surgical techniques use lasers and intraocular lenses.
The most advanced technologies are the so-called excimer laser, which, although redundant, allows us to conduct refractive surgeries with laser. In this sense, ophthalmologists divide them into two groups: LASIK and PRK, according to the area of the cornea in which we work, among other aspects.
Another widely used laser is the femtosecond laser. We use this laser to conduct a surgery called ReLEx SMILE, which allows the surgeon to change the graduation of the cornea through a microincision of only 2mm.
Concerning intraocular lenses, which is the other large group of surgical techniques, there are many distinct types that allow the surgery to be personalized to the maximum extent. In the case of correcting presbyopia (tired eyes), there are many options, such as premium lenses, multifocal lenses or those with an extended range of vision (with which you can have greater independence from glasses at all distances).
Whom is refractive surgery recommended for?
In general, the main requirements are that the candidates are over 20 years of age and that their refractive error (myopia, astigmatism or hyperopia) has remained stable in recent years.
It is also important that the patient fully understands what the surgery consists of and what we can do, if any, as ophthalmologists to help them get rid of their dependence on glasses. In addition, although experts conduct the surgery safely and professionally, it is still a surgical procedure that can carry some risks and contraindications. At this point, ophthalmologists must manage to correctly explain all these details to the patient.
At the same time, I would like to point out that we have many refractive surgery techniques, which allow us to individualize the intervention in almost all cases. Along these lines, I would like to highlight that a key aspect is an ophthalmological examination to assess the type of refractive error and the number of diopters that need to be corrected. During the scan, we also do tests to look at features, such as the thickness of the cornea and its shape. All this, we consider the visual needs of patients (for example, knowing their professional activities and hobbies).
Why choose IMO Grupo Miranza Andorra?
At the Andorran headquarters of IMO Grupo Miranza, we have expert ophthalmologists in refractive and cataract surgery. Likewise, throughout the year, we conduct a multitude of interventions of this type and we also have advanced diagnostic and surgical technology.
We also participate in many congresses and meetings associated with our specialty so that we remain up-to-date and at the forefront of medical-scientific knowledge.
What is the postoperative period of the operations?
In most cases, it involves applying drops (eye drops) to the eyes for three to four weeks. As far as visual recovery is concerned, it is progressive and quite fast and takes a few days in the case of LASIK surgeries and with intraocular lenses. If we perform PRK surgery, visual recovery is approximately one week.
I would clarify that there is a type of intraocular lens for presbyopia, which requires an adaptation period, in the weeks following the operation.
Are intraocular lenses reversible?
There are two large groups of intraocular lenses: the phakic, which are implanted in young patients who do not yet have presbyopia, and the pseudophakic, which are usually implanted when we are already a certain age and which replace the lens (natural lens of the eye that becomes opaque due to aging), providing a solution to diseases such as cataracts and tired eyes.
Phakic lenses are reversible; that is, they can be removed if the patient does not adapt to them or when a cataract or presbyopia develops and a pseudophakic lens is needed to solve these conditions.
Can presbyopia or tired eyes be operated on?
Presbyopia is a natural process that usually manifests itself after 40-45 years.
It is due to a refractive defect and the loss of elasticity of the lens, which decreases the ability of the eye to focus and blur (what we call accommodation).
There have been many advances in refractive surgery and presbyopia is now corrected with two types of techniques: intraocular lenses and laser refractive surgery. In addition, for the correction of presbyopia, we have monofocal pseudophakic lenses, which use monovision, and premium pseudophakic lenses, which use an extended range of vision technology (EDOF) or multifocal technology.
Presbyopia correction surgeries are safe and effective. Likewise, we can employ surgical techniques to significantly reduce dependence on glasses or contact lenses in many patients.
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