Eye laser surgery (eye correction) is a treatment method in which refractive errors such as myopia, hyperopia, and astigmatism are corrected through laser reshaping of the cornea. The aim is to reduce or completely eliminate the need for glasses and contact lenses.
Quick Overview
- Procedure duration: Average 15-20 minutes including preparation, both eyes in the same session
- Anesthesia: Drop anesthesia, no needle or general anesthesia required
- Age limit: 18 years and older, for people whose prescription has been stable for the last 1 year
- Methods: TransPRK (No Touch), PRK, LASEK, LASIK, iLASIK, SMILE, SMILE Pro, SILK
- Return to work: 1-2 days for flap methods, 3-5 days for surface methods
What is Eye Laser Surgery (Eye Correction)?
Eye laser surgery, commonly known as eye correction among the public, is applied to correct refractive errors such as myopia, hyperopia, and astigmatism following a personalized suitability assessment.
The cornea, the transparent layer on the front surface of the eye, focuses light on the retina by bending it. When the cornea's curvature or the eye's length deviates from ideal measurements, the image falls in front of or behind the retina; this appears as blurred vision. Laser treatment corrects this focusing error by removing corneal tissue at the micron level.
In the past, glasses were the only option for people with refractive errors. Later, contact lenses became widespread; however, the need for regular insertion and removal, hygiene requirements, and the increased risk of dry eyes, irritation, or infection with prolonged use created various difficulties. Developments in laser technology over the past 20-25 years have made refractive surgery much more personalized and controlled.
Which Vision Defects Does It Correct?
| Refractive Error | Definition | Laser Treatment Range |
|---|---|---|
| Myopia | Inability to see distance clearly | Usually up to -10 diopters |
| Hyperopia | Inability to see near and advanced distance clearly | Usually up to +5 diopters |
| Astigmatism | Shadowy vision due to irregular corneal curvature | Usually up to 5-6 diopters |
| Presbyopia | Age-related loss of near vision | Not directly with laser; with monovision or lens treatments |
Limit values vary depending on the method, corneal thickness, and overall eye structure; the above ranges are general guidelines, not absolute rules.
Who Is It Suitable For, Who Is It Not?
Suitable Candidates
- Must be 18 years old or older, eye development completed
- Eye prescription must have been stable for the last 1 year
- Corneal thickness must be sufficient (generally 480-500 microns and above)
- Corneal topography must be regular, no keratoconus suspicion
- Must have realistic expectations
Unsuitable Conditions
- Advanced keratoconus or significant corneal thinning
- Patients whose prescription is still changing
- Pregnancy and breastfeeding period (hormonal changes may affect prescription)
- Uncontrolled diabetes, rheumatologic or autoimmune diseases
- Advanced dry eye, cataracts, or active retinal disease
What Tests Are Performed Before Surgery?
Suitability assessment is the most critical stage of treatment. The correct method can only be determined after detailed measurements.
- Refraction measurement: Determining eye prescription with and without drops
- Corneal topography: Mapping the cornea, detecting irregularities
- Pachymetry: Measuring corneal thickness at the micron level
- Intraocular pressure: Assessment for glaucoma
- Tear tests: Determining the level of dry eye
- Pupil diameter measurement: Particularly important for night vision quality
- Retinal examination: Checking the retina with dilated pupils
What Are the Eye Laser Methods?
Refractive laser methods are basically grouped into three main categories: surface ablation, flap methods, and lenticule extraction techniques.
1. Surface Ablation Methods
PRK (Photorefractive Keratectomy): The outermost layer of the cornea, the epithelium, is removed and excimer laser is applied to the underlying tissue. Since no flap is created, the cornea's biomechanical strength is preserved; however, since epithelial regeneration takes several days, the healing period may be longer compared to flap methods.
LASEK: Instead of completely removing the epithelial layer, it is loosened with diluted alcohol and folded to the side, then repositioned after laser treatment. It is considered a technique between PRK and LASIK and is generally preferred for patients with thin corneas.
TransPRK (No Touch Laser)
The most current surface ablation technique in which the epithelium is removed with the laser itself, in a single step and without any device contacting the eye. No blade, suction ring, or spatula is used; the procedure is completely contact-free. This feature reduces infection and mechanical trauma risks. Laser application usually takes less than a minute.
SmartPulse and similar advanced software technologies keep the corneal surface smoother, improving healing comfort. It is a prominent option for those with thin corneas or those whose profession or sports activities carry a high risk of trauma.
2. Flap Methods
LASIK: A classically performed method for many years. A thin cap (flap) is created in the cornea using a device called a microkeratome, the flap is lifted and excimer laser is applied to the underlying tissue, and the flap is repositioned. The greatest advantage is the speed of healing; vision typically improves significantly within the first 24 hours and there is almost no pain.
iLASIK / Femto-LASIK (Bladeless LASIK): The flap is created with a femtosecond laser in a computer-controlled manner rather than a mechanical blade. With wavefront technology and the personalized corneal map extracted from it, not only the prescription but also subtle optical defects of the eye can be included in the treatment plan. This method is also used for channel preparation for corneal rings used in keratoconus treatment.
3. Lenticule Extraction Methods
SMILE (Small Incision Lenticule Extraction): A flapless and minimally invasive method. A femtosecond laser creates a thin tissue disk called a lenticule within the cornea; this disk is extracted through a small 2-4 millimeter micro-incision. Since no large cap is created, the cornea's natural integrity and nerve structure are largely preserved.
- Flapless and bladeless application allows preservation of corneal biomechanics
- Since corneal nerves are preserved, the risk of dry eye is lower
- Flap-related complications such as slippage or wrinkling do not occur
- A comfortable option for those engaged in contact sports or with an active lifestyle
SMILE Pro: A newer generation version of the method with enhanced automation. Laser application time has been reduced to seconds level; eye centering and rotation compensation have been automated.
SILK: Another current method working on the lenticule extraction principle. Through its different lenticule geometry and software targeting softer tissue separation, rapid visual acuity gain is aimed for in the early period. It is used in myopia and astigmatism treatment.
Comparison of Methods
| Method | Flap | Contact | Treatment Area | Healing | Outstanding Feature |
|---|---|---|---|---|---|
| TransPRK / No Touch | No | No | Myopia, hyperopia, astigmatism | 3-5 days | Completely contact-free, suitable for thin corneas |
| PRK / LASEK | No | Yes | Myopia, hyperopia, astigmatism | 3-7 days | Classic alternative for thin corneas |
| LASIK | Yes | Yes | Myopia, hyperopia, astigmatism | 24-48 hours | Fastest visual improvement |
| iLASIK / Femto-LASIK | Yes (laser) | Yes | Myopia, hyperopia, astigmatism | 24-48 hours | Bladeless flap, personalized mapping |
| SMILE / SMILE Pro | No | Yes | Myopia and astigmatism | 1-3 days | Small incision, lower dry eye risk |
| SILK | No | Yes | Myopia and astigmatism | 1-2 days | Next generation lenticule technique |
Which Is the Best Eye Laser Method?
The best method is not the newest method, but the method most suitable for the individual's eye structure.
The main factors determining method selection are:
- Corneal thickness and regularity of topography
- Degree and type of eye prescription
- Level of dry eye and tear quality
- Pupil diameter and night vision needs
- Profession and lifestyle (activities with impact risk such as contact sports, military service, piloting)
For example, in a person with thin corneas, surface ablation may be preferred over a flap method; while in someone who needs to return to work quickly and has adequate corneal thickness, flap methods may stand out. For someone engaged in contact sports, flapless techniques may be a safer choice.
Is Eye Laser Surgery Safe?
Refractive laser surgery is a field that has been applied for decades worldwide and has extensive scientific literature. When appropriate patient selection is made, patient satisfaction rates are quite high and the frequency of serious complications is low. However, no surgical procedure is completely risk-free.
Common Temporary Side Effects
- Dry eyes, irritation, and foreign body sensation in the first days
- Temporary blurred or wavy vision
- Light sensitivity and tearing
- Halo and glare perception around light sources at night
More Rarely Seen Conditions
- Incomplete correction of prescription or partial regression over time
- Temporary corneal haze after surface ablation
- Flap-related problems in flap methods
- Infection (very rare; risk decreases further with drop therapy compliance)
Important: Most of these risks can be prevented through detailed pre-operative assessment and full compliance with post-operative drop therapy.
How Is Eye Laser Surgery Performed?
While details vary by method, the general flow is as follows:
- The patient is brought to the laser room and lies supine on the laser bed.
- The area around the eye is covered with a sterile drape; the eye to be treated is left exposed.
- Anesthetic drops are used to numb the eye; no pain is felt during the procedure.
- If needed, a mild sedative may be given for patient comfort.
- The area around the eye is cleaned with an antiseptic solution.
- An eyelid speculum is placed to keep the eye open.
- The epithelium is removed, a flap is created, or a lenticule is prepared depending on the method.
- Laser application is performed; this step is usually measured in seconds.
- A protective contact lens may be placed on the eye and drop therapy is started.
Both eyes are usually treated in the same session. The total time including preparation is approximately 15-20 minutes; hospitalization is not required.
What Should Be Paid Attention to Before Surgery?
- Contact lens use should be discontinued before examination and surgery. Generally 1-2 weeks for soft lenses, longer for rigid lenses.
- No eye makeup should be applied on the day of the procedure; perfume or scented products should not be used.
- All medications used should be disclosed to the doctor; blood thinning medications should not be used without doctor's approval.
- Since the patient will not be able to drive after the procedure, a companion must be present.
- Comfortable clothing should be preferred; fasting is not necessary before the procedure.
Post-Operative Recovery Process
| Period | Expected Situation | Recommendations |
|---|---|---|
| First 4-6 hours | Irritation, tearing, light sensitivity | Rest with eyes closed |
| Days 1-3 | Progressive improvement in vision, fluctuation | Do not rub eyes, do not skip drops |
| Week 1 | Return to daily activities | Avoid dust, smoke, and crowded areas |
| Weeks 2-4 | Vision significantly stabilizes | Avoid swimming, sea, sauna, and eye makeup |
| Months 1-3 | Reaching final visual acuity | Attend regular follow-up examinations |
Recovery speed varies by method: in flap methods, vision typically becomes significantly clear on the first day, while in surface ablation methods, epithelial renewal takes several days and complete clarity may take several weeks.
Factors Affecting Pricing
Prices depend on multiple variables, not just one factor:
- The laser method used (surface ablation, flap techniques, or lenticule extraction)
- Laser device and software technology used
- Degree of eye prescription and complexity of treatment
- Scope of pre-operative tests
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