Electromechanical reshaping, an alternative to laser eye surgery
medicalxpress.com295 points by Gaishan 3 days ago
295 points by Gaishan 3 days ago
Just for context and as this article only mentions LASIK and not other options such as (Trans-)PRK and SMILE, the majority of negative side effects one experiences post LASIK are not linked to the ablation/"carving" of the cornea, as they call it, but rather is a result of the need to sever the subbasal nerve plexus in the anterior stroma, which tends to be regenerate in a less comprehensive manner and significantly slower around the margins of the flap compared to other methods.
Flaps aren't inherently dangerous either (flap detachments are very rare, even more so with modern systems that create essentially a cavity where the flap can rest in), but the difference in healing post OP is a lead cause of heightened dry eye after LASIK. Both PRK and SMILE, due to the way they work, are less likely to suffer from this, but every procedure has trade-offs naturally.
With PRK, the epithelium in the area is removed and has to regrow, a process that takes a few days (to get the initial part done, full regrowth takes far longer but isn't noticeable in general). This regrowth can be both rather painful and also rob you of the "instantly perfect sight"-effect many people desire from their laser eye surgery. As the epithelium does regrow naturally however, it is less likely (both in theory and in medical literature) to lead to dry eye and other side effects in the short and long term, making it the preferred choice by many ophthalmologists when choosing such surgery for themselves.
SMILE, on paper, might be able to offer the best of both worlds, but is severely more expensive than either and there is not a sufficient degree of long term research to make a definitive statement that the side effect amount and severity is comparable to PRK, simply because it is rather new. What research is out there is promising though.
Overall, each option is very well tolerated, leads to major QOL improvements and we need to keep in mind that even the more common side effects one may face with LASIK may not affect everyone and still are comparably small considering other medical fields and their elective procedures.
In this context, I'm very excited to see whether this method might have even fewer short and long term side effects than PRK, but like with SMILE, it may take decades to have a conclusive answer.
Edit: Another thing I missed and which was not covered in the article, is the potential that this new method could be applicable to people who, because of a variety of factors, are not eligible for any ablative eye surgery. I myself was at the upper limit for Trans-PRK in regard to the severity of my Myopia and the thickness (or lack there off) of my Epithelium. In that regard, I see far more potential than just reducing already low side-effect risks further.
> [re: PRK] This regrowth can be ... rather painful
I'm here to tell everyone to listen to the doctor about pain medications and sleeping after PRK. I have a repeatedly-demonstrated very high tolerance for pain, and didn't bother to follow the directions.
As a result, I spent about an hour seriously considering whether it would hurt less if I physically scooped out my eyeballs by hand. That's not a metaphor -- I had to mentally restrain my hands.
And the punchline is that 12 years later I again need glasses for computer work, which is what I do all day.
I had PRK a few months ago and left mindblown; completely painless and insanely quick.
First 30 hours after the surgery weren't the most pleasant but to me it wasn't painful—at least not as painful as a migraine.
I thought I generally had dry eyes but after the surgery I didn't notice any dryness at all.
My right eye is not fully healed yet so I don't see perfectly. But still very happy and overall a good QOL improvement.
What if your eye never returns to normal? How did you think about the risk reward of a cosmetic procedure that can make you blind?
LASIK etc. are not "cosmetic". Being able to see properly without glasses is a substantial thing for some people, from sports participation to not worrying about fogging to not groping around to find your glasses in the middle of the night.
The Doctor clearly saw that my eye hadn't fully healed and therefore diagnosed that it was the reason I wasn't seeing perfectly. Don't get me wrong, it is still far better than when I didn't wear my glasses. So even if it doesn't go back to normal it would still be an improvement.
As I understood it, the procedure in itself won't make you blind—ever. If you get complications—like an infection—then that's another story. I didn't have any.
So I didn't think about the risk-reward as everyone around me just had eye dryness or halos at night. Both of which are very easy to live with.
Thanks for sharing. I don't know anyone that did it first hand and online its hard to trust most websites because there's a whole industry behind it.
If you have other questions, I would be happy to answer them. But I'm just one of many thousands person.
I think all Doctors would tell you that you should do the surgery because they have a financial incentive to tell you so. However, I don't live in the USA and a lot of things I read didn't apply to where I went. For example, they prescribe bandage lens for at least 7 days in the USA but I only wore mine for 40 hours. Then a bunch of eye drops and all was fine.
Same here. Three days of absolute hell. Even a single blue led was too much to bear. And like you I now need reading glasses, but I don't really care: I can see well enough in the distance, I'm not visually crippled throughout the day without my glasses.
I used to have dry eyes afterwards for quite some time (years) as well, but that seems to have gone away at some point.
From my experience it was hell of a whole week, specially the first 5 days. And every kind of light was aggressive for me. My eyesight took ~3 weeks to be able to read properly on screen without zooming 400%. I didn't freak out because my doctor told me that the healing process really depended on everyone's body. 2 years later I have absolutely not regrets from doing that surgery despite probably still always reminding myself as one of the worst week of my life during recovery.
I had a completely different experience.
First 30 or so hours were pretty inconvenient: dry eyes, bandage lens that would cause itching and general photophobia. The Doctor removed my bandage lens after less than 48 hours and the same day I resumed my normal life. I was still sensitive to light but I could read screens without issues at all.
Something I wonder is whether bring very overweight can cause changes in eyesight, and whether weight loss might restore it.
Being very overweight usually causes high blood sugar, which itself causes changes in eye shape, as well as damage to the retina.
The eye shape changes are reversible, but not the retina damage.
> As the epithelium does regrow naturally however, [PRK] is less likely (both in theory and in medical literature) to lead to dry eye
This is exactly opposite to how I understood and experienced healing after Trans-PRK. My eyes are still very dry 6 months post surgery. Being at the upper limit of Trans-PRK yourself, did you actually go through with the surgery? If yes, how was your healing process? I would be very interested in chatting about it, since I am not particularly happy with mine, and wondering what can be done (and whom to blame).
Sorry to hear that it did not go well for you. Yes, I did go through with it, was in April of 2024 (Trans-PRK via a Schwind AMARIS) and I did have a rather painful recovery, especially on day two and three after the surgery.
From there on, the pain and foreign object feeling quickly subsided alongside the remaining "haze" and by day five, I neither had any subjective pain, nor any major issues reading text (both typed and digital). Had multiple check-ins of course, both at the clinic which performed the surgery and with my decades long ophthalmologist, no issues were found there either. Subjectively, I do not experience a heightened severity in dry eye symptoms for what that is worth.
Also had a clinical rotation in Ophthalmology just this month (small world, though was why I felt the urge to comment) and the attendings did assess my epithelium as having regrown evenly too.
What could have gone wrong for you and how to go about this, I really can't say and I am sure you have already considered /pursued it, but I can only suggest getting a second opinion from another established ophthalmologist, including looking at the eye drop regiment prior to the surgery and during, as well as post recovery.
Thanks for the elaborate answer. Reading about Schwind AMARIS it seems to be using SmartSurf which claims faster healing than conventional TransPRK. I can't assess how much of this is marketing speech or if it's basically the same as TransPRK.
In any case, I agree that a second opinion would be most helpful.
I couldn't tell one way or another, but honestly didn't choose that particular system for any reason beyond that being what was on offer where I live. My very limited reading prior to surgery though would indicate that currently there is no source showcasing a difference in subjective recovery experience between TransPRK and this Smartsurface. What has been used as a source when covering the technology is mainly focused on the first three months [0], rather than longer term as you are describing and does in my opinion not actually showcase a difference between Smartsurface and TransPRK specifically [1]. Full disclosure, I only include the name of the system because it felt like an HN thing to do. It wasn't some value judgement that these machines are superior or that others are inferior.
[0] https://crstodayeurope.com/wp-content/uploads/sites/5/2019/0... referenced from https://pubmed.ncbi.nlm.nih.gov/26871764/
[1] If you look at the source they are referencing, it compares TransPRK to aaPRK after three months and they were using Schwind machines, though did not clarify whether this was using Smartsurface. Very cursory search engine use tells me that this is toggleable, so an option on these machines. Even if this study did use Smartsurface though, that doesn't answer whether outcomes are different in TransPRK with Smartsurface vs TransPRK without Smartsurface. Additionally, I do not know whether this option was used in my case.
This is why I decided to go with PRK. Recovery time is rough, but after a week I was able to go back to work as a programmer. Well worth it to avoid the complications of severing the nerves in my cornea.
> SMILE... is severely more expensive
This is the first I've heard of this. In my area it seems comparable in price, within 1.5x the cost of LASIK. Considering how relatively cheap it is (a couple months' rent, or a fraction of the price of a car, to correct your vision for decades) I've never seen cost mentioned as reason to choose one over the other.
I can only speak for Austria, but the difference, if SMILE had been an option, would have been at the lower end € 3400,- compared to the PRK I got and roughly € 3200,- compared with LASIK, for what that’s worth, more than double the cost. Yes, that falls under multiple months rent, but to me that is more reason why one would consider the cost as well.
Maybe “severely more expensive” wasn’t the best wait to phrase it, but the difference is still quite steep and this can be a decision maker for many people. Especially as currently it appears that medium term/6-month outcome between PRK and SMILE are very comparable, or even slightly better in PRK [0].
I have had multiple PRK treatments. I completely understand why it is not mainstream.
It is an unpleasant procedure and the recovery is quite painful. There is a reason why it is almost never done today.
The rates of people getting PRK compared to LASIK seem to be raising.
https://moskowitz-eye.com/blog/most-popular-laser-eye-surger...
I'm very doubtful about the presented figures there. The author clearly has an agenda and does not present any sources. Additionally it is completely missing ReLEx/KLEx (SMILE etc) methods which afaik are pretty popular.
I wonder how much of that is PRK vs. ASA?
It seems that ASA is a wide term for methods of moving the epithelium and replacing it after the procedure. I had this with one of my treatments. It is far more pleasant. It makes sense that it is growing in popularity.
Wait, you can get PRK more than once?
I had it done about fifteen years ago. My vision was perfect for a decade, but now I'm back in glasses.
PRK recovery was certainly uncomfortable, but I'd gladly do it again for another decade without glasses.
> Wait, you can get PRK more than once?
Yes, if the ophthalmologist messes up. Sadly!
My opthalmologist told me I had enough corneal thickness to get PRK done again if I wanted.
As of two years ago it was the preferred option at moorfields eye hospital private eye clinic. The caveat being the slightly longer recovery period.
I'm not candidate for LASIK or any other eye surgery due to the thinness of my cornea :( I would love to see this new approach. Maybe I'll be a candidate for it.
I had PRK 15 years ago. I also woke up multiple times last night because my eyes felt like they had a bad sunburn (eyes so dry they stick to your eyelids + REM sleep.)
Some unsolicited advice: wait for widespread adoption, and review data on long term side effects from sources without a conflict of interest before you have a procedure like this. I went from 20/150 to 20/15 for a few years (which was pretty cool) but they're 20/40 now so I wear glasses/contacts when I leave the house anyway. Glasses and/or contacts aren't that bad.
If it makes you feel better, your dry eye is more likely caused by genetics than it is PRK. Many people end up with dry eye without having had any kind of laser eye surgery. I highly recommend putting some Hylo-Night / VitA-POS gel in just before bed. It lasts well into the next day.
Yeah it's probably a combination, which might explain why my experience isn't the norm. Ever since I had it done, any poke, foreign objects like sand, etc. is much more painful than before, so the pain from dryness gets amplified. I've used eye drops and gels, but the most effective thing is just avoiding things that mess with electrolyte levels, like alcohol, medications, and certain foods.
My wife wasn't a candidate for LASIK due to her eyes being so bad they would have had to burn off the entire cornea to fix it. But she got ICL surgery, which is when a new lens is inserted into the middle of an eye, similar to the surgery for cataracts. $9k out of pocket, but she has 20/20 vision now.
I am wondering whether EMR could help people with keratoconus (degenerative cornea condition). Due to cornea thickness laser correction surgery is not performed in such case.
I saw a Japanese YouTuber talk about her ICL procedure. https://my.clevelandclinic.org/health/treatments/25050-impla...
She said a Collamer lens was inserted into her eye and the procedure was reversible. I assume this is also available in the US?
There are also intrastromal corneal rings to correct myopia (but not astigmatism) -- in the US (Intacs) for -1 to -3 diopter, while in the EU they go up to -6. They're inserted though a small hole to surround the cornea, and they can be removed. So overall less effective than lasers, but also more safe (though much less common, so harder to find a high-traffic expert surgeon).
I had PRK. It took exactly 6 months to see clearly again. Wild experience. Glad I did it. Wouldn't necessarily recommend it.
I have keratoconus, which is where a lack of strength in my corneas has resulted in their losing their proper shapes.
I have several focal points in each eye, randomly clustered together. And unfortunately, there is no correlation (or reason for a correlation) between my eyes.
Imagine not being cross-eyed with two focal points, but with well over a baker's dozen. Even if I could line up one pair of points between my eyes, any improvement would be indiscernible in the mess I see.
Because the focal points are clustered close together, their impact is less at a distance (it just feels hard/impossible to properly focus, like looking through very slightly warped glass), but it is devastating up close. For reading.
Without help, I see so many copies of all the letters, randomly and tightly stamped all over each other, I could stare at a short line of text all day and never figure out what it said.
And this after having better than 20-20 vision at all distances, for most of my life.
(Fun fact: if I am in a dark room, and look at one of those tiny power-on LED lights on some media equipment with enough distance that it is basically a point, I can clearly see all my focal points - and also a dimmer curvy, spaghetti crossover mess of focal Beziers between and around them. My corneas are neither convex or concave. They are chaotic. Evil.)
Fortunately, I have hard gas-permeable "scleral" contact lenses. They form a near perfect cornea for me, so when I wear them, my awesome vision and glyphs live once again. "Scleral" refers to the fact that they are wide enough to rest on the whites (sclera) of the eyes, to completely cover and fill out my lame natural corneas.
So I am in pretty good if inconvenient shape.
But I would absolutely love it if this new method allowed my corneas to be reshaped. Any improvement would be a big deal.
(There is surgery where corneas are soaked with a binder, which is fixed with a laser, that strengthens them and stops/slows Keratoconus from getting worse. But it cannot recover what has already been lost.)
I've heard good things about sclerals and am planning to get them. Small triple images in the left eye and triple in the right eye with a major image further away, like 3 lines on my computer screen away. It doesn't sound nearly as bad as the many images but good to hear sclerals work with worse cases!
They work fantastically for me. I feel incredibly lucky that they do.
Every morning I put them in, look out my window at the high leaves of a garden tree. Then rotate them until the leaves are sharp,
I am still using my first pair, which are nine years old now. No irritation unless I wear them overnight sleeping.
I highly recommend giving them a try!
I wouldn't trust it, myself. I was laying out a new circuit board design for a client when my eyesight went all wonky. It turns out I had a detached retina. Yhe first repair procedure failed. The second procedure went well. Then I got a cataract in that eye. My retina specialist sent me to a cataract specialist. The cataract specialist told me "I was allergic to laser beams" and didn't recommend cataract surgery. And also to get used to audiobooks. Like I could write program code and design GUI's by listening to audiobooks. For "fun" I read. Sometimes I write books. I put up with a 'weird' double vision and gave up driving a car. Audiobooks indeed.
What does any of what you wrote have to do with not trusting this new technology?
How did the doctor diagnose allergy to laser? So you didn't do catract surgery? Catract surgery can be done without using laser.
How horrifying. I have lattice degeneration, which makes me very nervous. What were your 'wonky' symptoms?
It was as if a dark gray curtain fell slowly and I couldn't see through it. This was the retina coming off from the top edge and folding down over the bottom half.
Finally some news regarding this research. I first heard about it back in 2019 when there was an ACS panel featuring it:
https://www.youtube.com/live/Dw9D7C8CpM0?si=e-KJ8J2u_oVy4RvM
Originally there was a mention of developing a less invasive method of correcting a deviated septum, but I guess they went with the harder problem first.
In any case I'm up for both, because while my vision is not terrible, it's slowly, but consistently getting worse, so max-twice-a-lifetime interventions like laser eye surgery won't cut it for me.
Agreed, going from 20/10 vision to "I've given up trying to read small text 50m away" as I age over 40 doesn't affect my quality of life, but it doesn't help my self-esteem.
I'm between +3 and +4 now depending on how tired I am. I used to be able to read the print on the smallest SMT packages :(
And it does affect my quality of life: forget glasses? Good there goes your day until you've found a replacement. The best improvement so far has not been the glasses but a simple string to make sure I don't put them down but they stay around my neck. That has made a massive difference and it also helps when looking down (so the glasses won't fall off) and it has cut the rate at which I was losing them to zero from about one pair per month (which really was not sustainable).
My in-laws all love their reading glasses with a split-bridge joined by magnets, and a built-in loop around the back. I think it’s these: https://cliceyewear.com/
If you don’t mind the aesthetics (though I personally can’t get past them), they solve the same problem as your string in an integrated way. Plus they rest more like a necklace, since it doesn’t require as long of a loop.
That's interesting. I won't be trying them though, I hate frames, it is bad enough with frameless but frames really spoil it for me. One brand in particular that I've found makes glasses that are almost invisible to me when I'm wearing them and that's the one that I've stuck with for the last couple of years. If the tech described here comes to general availability I'll be super happy.
Which brand is that? I also hate frames but have a huge head so I’m limited on options!
I buy them whenever I'm in Latvia, they're called Silac and they're sold in one particular chain of apothecary that I forgot the name of.
On the web they are at:
https://silac.eu/fr/nos-lunettes/597-643-lunettes-de-lecture...
But they're quite a bit more expensive online than in the store.
Pro-tip: I you never want to forget your glasses again just make your vision slightly worse! At +4/+5 it's impossible to forget glasses, to the point I forget almost everything yet have not forgotten my glasses a single day of my life since I started using them as a kid.
You might want to look into UNR844-Cl. Research was dropped by Novartis, but it's available as a research chemical.
https://modernod.com/articles/2020-sept/coming-soon-presbyop...
(This is assuming your farsightedness is due to age-related presbyopia, hardening of the lens, and not true farsightedness from a change in eyeball shape)
I had high hopes for this, but according to an executive summary of the last clinical trial:
"However, the difference in the eye exam scores after 3 months of taking UNR844-Cl was not large enough to be considered better than placebo, and may have been due to chance."
Which is a shame, because it seemed like a great alternative to pilocarpine, which in turn kinda sucks because the only thing it does is create a temporary pinhole effect.
I usually fold the arms, and hook them over my t-shirt, but they do tend to fall off that way when I bend over. I might have to go with the string approach as well.
Yeah :( I can still read tiny print, but only for a few seconds, and with a lot of light. Getting old sucks.
I got one of these a year ago and it has been a very nice experience so far:
https://www.elektor.nl/cdn/shop/files/andonstar-ad409-101-hd...
It is also one of those things that you find more and more uses for over time.
Is it really? I tried one of the USB microscopes with a screen, and the lack of depth perception was a massive hindrance when soldering. I solved it with a pair of jeweller's loupes:
Yes, that took a while to get used to. Jeweller's loupes are an interesting fix, I should try that, thank you.
I'm an EE in my 40s, have 20/20 vision, and never solder without a microscope no matter how large the packages are. The ergonomic advantages are worth it.
I really only learned to appreciate how useful this is when debugging a PCI express extender cable and seeing the tiniest little solder ball shorting out two wires adjacent to each other.
I remember being able to read the timer on the other end of the subway station(120m) in my city, so in low light conditions at that. The numbers were maybe 20cm in height.
In my case it's not even the defect itself, but the associated astigmatism. For a long time I was unaware of the issue because it started in one eye, so the other compensated until it couldn't.
Now I get around two weeks of perfect vision upon getting a new glasses prescription and it's back to "normal".
Would anyone know could they use this to fix the glares and halos from lights at night in person's vision, I understand cannot be fixed with any technology now? Including risk of making worse by laser surgery.
I only have wore glasses, i dont care about trying contacts. Its the glare with or without thats pretty bad driving at night in US
Halos and glare at night are usually a sign that something in the eye is scattering light. Sometimes it’s just uncorrected prescription, but it can also come from things like dry eye, early cataracts, or the way the cornea focuses light. Glasses can’t always fix that because they only correct the main focusing errors, not the little imperfections that cause glare.
Contacts (especially the rigid or scleral kind) can sometimes smooth out those imperfections, but if you’re not interested in them, the next step is usually an eye exam to look for things like lens changes or surface dryness. Cataracts, even very early ones, are a common culprit for glare driving at night in the U.S.
Laser surgery can sometimes make halos worse, especially if someone already has them, so you’re right to be cautious. But it’s not the only option. Treating dry eye, using anti-reflective coatings on your glasses, or addressing cataracts (if present) can all help a lot.
In short: it’s not hopeless, but the “fix” depends on what’s causing the scatter in the first place. A detailed eye exam is the best way to pin that down.
Sounds like astigmatism, which I also have. I don't know if this procedure, unlike LASIK, can correct astigmatism. I know you said you weren't interested, but for me personally, wearing contacts (not glasses) completely fixes my astigmatism and makes it much easier to drive at night.
LASIK can absolutely correct astigmatism.
Source: Had LASIK in 1999. Severe myopia and astigmatism, corrected to 20/10 and 20/15 (right and left eye).
My night vision was definitely worse after the surgery, but improved over a year or two. I still get blurry when my eyes are dry and tired, but otherwise remain glasses-free at 50+.
That's when I had my eyes done but not for astigmatism. Have you noticed your eyes getting drier lately? Mine started a couple of years ago and it's somewhat of an issue now having to keep drops around.
To my knowledge LASIK can correct astigmatism. A quick Google search confirms this pretty clearly. Do you have a source that claims otherwise?
Sorry, I guess I was mistaken, and now my comment is past the edit window so I can't correct it.
Oh, I wonder what about the contact lens makes it different. I should try then I suppose
Contacts for astigmatism have a tiny weight on one side which keeps them oriented (enough) that they can cancel out mild to moderate asphericity.
I'm surprised LASIK still can't correct for astigmatism though, I know that was the case when it first came out but in principle I can't see why it wouldn't work.
As in, you have this without any eye surgery? My dad had LASIK and that gave him 20/20 vision but also what he described as horrible halos around all lights at night, to a point where he really found it difficult to drive in the dark. He had it done about 15 years ago so I wonder if the state of the art has improved in that area.
When I looked into it last year, it´s still an under-acknowledged issue. The impression I formed was that it was a bit of a crapshoot - along with some bad practitioners, there didn´t seem to be much information on when and why it would or would not occur.
If it can reshape cartilage, i can imagine the queue outside of doctor's office for nose jobs.
This seems ideal. The only question I had was whether it's permanent on living cells, "Potentially reversible" at the end makes me think it is.
There’s a current product that does simple mechanical remodeling: sleep with this chunky contact lens in and the next morning you see better. But it wears off in ten hours or less.
Night lenses! Yeah they're pretty crazy (I'm in the process of getting them and a friend of mine has them). 10 hours is low though - they're supposed to easily make your vision last all day, even two. My friend says he only really stops seeing well after 3 nights of not wearing them.
It depends on your prescription.
I tried them and they were awful for me. Didn't last the full day, caused terrible halos while driving (and that was BEFORE 90% of cars drove with LED high beams), were generally too uncomfortable.
Same results for me. Absolutely awful, vision consistently began failing by becoming noticeably blurry about 8 to 9 hours after taking night lenses out, and I couldn't drive at night because of headlight and streetlight halos even after "topping off" with those uncomfortable lenses during the day. As an enthusiastic night sky observer, trying to use those lenses was depressing.
I gave up after extended tries with three different lenses (I think it was six to nine months total), with my highly experienced doctor consulting with different manufacturers and researchers from around the country. Turns out my pupils naturally open up too wide, made worse by corneas that apparently are not thick enough to retain the reshaping all day. These issues, incidentally, make me ineligible for the popular cut-n-burn style of eye surgery.
On the bright side, it was indeed completely reversible and I've suffered no effects of any kind after about two days of non-use. That was a bit over a decade ago.
Interesting article. For myopida, there is also this Ortho-K and a specialized version of it from a Canadian optometrist, where one get a K test and then they make a set of customized lens based on the test, and there are these daily exercise that one needs to do while wearing them the lens. Many testimonies claim that they corrected their vision after 6 months.
> Though the next steps are planned, uncertainties in the team's scientific funding have put them on hold
take my money!
Every time I consider LASIK or other procedures that would remove my need for glasses, I recall that in 23 years, my obligate glasses have saved each eye once. Two dead center strikes from disintegrating server cooling fan blades. I'd have lost both eyes.
I think they'll have to come up with a less scary name for it though.
Yeah, but knowing the analagous name for lasik is 'slicing off your cornea then gluing it back on', this one is immediately more appealing.
Is it even glued on I thought it just put there and sticks through adhesive forces
it's placed into a flap that is cut into corneal tissue.
the flap size itself keeps the lens in place; the elasticity of the underlying tissue itself, until it heals into an encapsulation.
the surgery videos of that procedure make me squeamish unlike other surgery videos. Watching an eyeball get deflated/inflated with liquid pressure from the surgeon is just un-nerving to me; not as bad as watching a glaucoma surgery -- but up there.
The place I had it done cuts the flap in one room, then has you walk (suddenly legally blind) to another room for the actual correction. A very interesting experience that cannot be adequately captured on video.
That would be a huge red flag for me. How is that even sterile or safe? What happens if you fall and need hospital care on the walk from one room to the other? Are you now blind until the hospital care is complete?
Short walk to a connected room and someone held my hand. That said, was definitely a surprise to me.
I heard about this research six years ago and at the time it was called "molecular surgery".
i mean the competition is lasik, which sounds like beaming a laser into you eye, doesn't really sound safe either
The long name (Laser assisted in Situ Keratomileusis) can sound a bit scary too... :p
I use ortho k, I exclusively sleep in my contact lenses, take them out when I wake up and enjoy 20/20 vision for 24+ hours. I don't have to sleep in them every night to maintain 20/20, but I do anyways.
They are basically retainer contact lenses that reshape your cornea as you sleep. It's what's described here minus the pH change and electric potential.
That's great news. I was discouraged of laser correction when I read some research that the layer they cut off and put back on doesn't really fuse back with the rest of the eyeball. The adhesion force is if I remember correctly 8% of the original. I wouldn't want to risk accidentally rubbing off an important chunk of my corona. The other option is just to cut it off completely and shape what's underneath but that heals slower and is also not great because the top layer is not the same as what's below.
I'm reading that flap detachment is very rare. It very well might be. Maybe the eye is vastly over-engineered and 8% is sufficient for most modern humans. But I'm sceptical.
As we age, most of us will have to deal with farsightedness. What's the best treatment option nowadays, besides prescription glasses?
As both Presbyopia and Cataracts come for us all, it is generally not advisable to do laser eye surgery once the former has set in. Both are a result of changes to the lens (and the ciliary muscles to some extend), so long term, a lens exchange, whether partially covered by (public) insurance as part of cataract surgery or as an expensive elective procedure is the only effective surgical option we have currently available.
That brings me to one of my personal pet peeves which is selling pensioners that qualify for cataract surgery on an expensive, but in fact identical but privately paid for IOL.
Same with selling some Myopic+Presbyopic person on laser eye surgery of any kind. At best you get a few short years out of the expense before it catches up with you or you tolerate mono, at worst you spend thousands to suddenly need reading glasses you didn't require before.
Course, if you are financially solid and Presbyopia is starting, getting a high quality lens exchange can be a very neat luxury, with the added benefit of not needing Cataract surgery later in life. Do note though that artificial lenses, while incredibly advanced, still cannot accommodate as well as the real deal as of now.
> As both Presbyopia and Cataracts come for us all, it is generally not advisable to do laser eye surgery once the former has set in.
I had a conversation with my ophthalmologist about this. She said the same thing. Then I said, I don't understand, right now I have to wear glasses for far vision and glasses for near and mid vision. If I got the surgery, I would still be presbyopic, but I wouldn't need glasses for far vision, only for near vision? and she said yes. So I said, that sounds like in improvement. What's the catch? She said it's mostly a matter of expectation. People think that LASIK means they don't have to wear glasses again, period.
But I keep hearing this, so I'm wondering if there's something more to it that she didn't explain? Is there some other disadvantage?
As someone who had perfect vision until 40 but now must wear reading glasses, I am super intrigued to hear about lens exchange!
When I heard that LASIK is not a solution to farsightedness, I specifically asked my eye doctor if there are other solutions for this. The only one mentioned was monovision (getting two different prescriptions for different eyes).
> Do note though that artificial lenses, while incredibly advanced, still cannot accommodate as well as the real deal as of now.
Cannot accommodate what as well?
"Accommodate" means change focus, like your natural lens does when you focus on objects at different distances. Most artificial lenses implanted today have zero ability to change focus. There are newer "accommodative" lenses that have a limited ability to change focus, but from what my ophthalmologist told me, they're still primitive and not even close to what natural lenses do, which is why fixed focus lenses are still more common.
"Eye accommodation is the eye's ability to automatically adjust its focus to maintain a clear image as the distance to an object changes. This process involves changes in the shape of the lens, the constriction of the pupil, and the convergence of the eyes. It's a reflex action that allows us to see objects clearly both near and far" (Google)
Have you tried being severely myopic to begin with? :D My presbyopia has kicked in surprisingly quickly (at a guess, 1.5 diopters over 2-3 years) but that just means I can look past my glasses at close things, like the opposite of your stereotypical half-moon reading glasses. Hey, I should make some of those out of an old pair...
This is amazing!
Let's hope it pans out for eyesight, and I'm sure there must be a whole lot of other things this could apply to.
I always wondered why we don't reshape eyes somewhat like we do for teeth. I guess this is coming. I can't wait to have more news about this as my severe myopia can't be treated by (most?) laser methods.
Reshape as in grind down and fill? Or reshape as in all of them with braces?
LASIK is almost the same as grind down and fille, isn't it? In the sense that the lens is a new shape when it's over. We replace lenses too.
Braces are essentially forcing teeth into new positions mechanically. Once they're in those new positions, we glue on wires and wear retainers to keep them in place, often for the rest of our lives. This doesn't sound like a comfortable eye procedure.
There are brace equivalents for eyes: https://en.wikipedia.org/wiki/Intrastromal_corneal_ring_segm...
In the past, people used to fix bad eyesight by walking in nature and constantly focusing on near and distant objects which forces the eye to constantly work and fix itself in some cases. People nowadays sit behind a computer screen and therefore their eyes are quite passive in the range of use and eyesight problems never get fixed naturally.
I don't think this actually fixed actual eyesight problems, at all.
If I understand, it may have some mild effect on the impact of near- or far-sightedness (focusing exercises somewaht improve the range of distances at which you can effectively focs), and doesn't do anything for astigmatism or other vision issues.
In the past people were blind as moles and still not wearing glasses just because, and/or of course because they perceived it as something that makes you look weak. Ask all the great generation. Has nothing to do with fixing anything. Another thing would be to say that they developed less eye-sight issues because they gazed in the distance more often as kids. Still debatable, but holds more water.
People should definitely spend more time outdoors and expose themselves to a moderate amount of sunlight. In addition, in my opinion, people shouldn't even use computer monitors or read physical books anymore. You can instead use AR glasses, VR headsets, or TVs/projectors. All of these options require much less eye accommodation.
What a ridiculous claim. Is "bad eyesight is fake" the new "allergies/gluten intolerance/lactose intolerance/vaccines are fake"?
You can’t reshape your cornea with focus exercises, that’s simply not true.
Oh and in the past people had diseases whithout a vaccine and sometimes got immunity (and didn't straight up die), hence vaccines are not needed? The logic in this comment is poor.
One thing I am curious about is if the platinum shaping lens would be the same for everyone or is it custom made?
The eyewear industry might not like this.
So, electrochemical ortho-K but better?
