Different Types of Eye Surgery: Basics and How They Impact Your Vision

Eye Surgery: An Overview

The surgical procedures carried out in one or both eyes or in their vicinity are considered ophthalmic or eye surgical procedures. The most commonly performed eye operations involve adjusting, repairing, and removing eye tissues or implantation of devices like lenses. Its overall agenda is to alleviate discomfort, improve vision, and prevent further damage to eye structures and tissues. Qualified and certified ophthalmologists, the medical doctors specializing in the diagnosis and treatment of vision-related problems, perform eye surgery. They receive extensive training that includes a medical graduation, followed by specialized residency training in eye care. Further, some receive fellowship training in specific subspecialties related to the retina, cornea, or glaucoma treatments. 

Which Eye Disorders Require Surgical Treatment?

Problems related to the eye manifest in various forms. Non-surgical measures manage some of them. However, a few other issues are severe. They require surgical intervention to prevent further damage or restore vision. Below, we listed the common eye problems that require eye surgery. 

• Macular degeneration: Macular degeneration is the damage to the macula(a part of the retina). The retina is the light-sensitive cell layer at the back of the eye, and the macula controls the sharp vision. Macular degeneration typically manifests as blurred or distorted vision. Candidates face difficulty in seeing dim light, and even the straight lines appear wavy.^[1]
• Refractive errors: Refractive errors in the eye cause problems in focusing light accurately. These happen when the eye shape prevents light from focusing on the retina. The underlying causes leading to refractive errors are diverse. Most commonly, it can be due to too short or too long eyes or an abnormally shaped retina, cornea, or eye lens. Candidates experience blurred and distorted vision, with occasional headaches and strained eyes. Vision problems due to refractive errors are most common, with around 150 million Americans suffering.^[2] 
• Retinal detachment: Retinal detachment is a critical emergency eye problem and occurs when the retina pulls away from the back of the eye. This is typically sudden and can happen due to a previous eye injury or aging. Candidates experience dark spots or lines across their vision, with flashes of light in one or both eyes.^[3] 
• Glaucoma: Glaucoma is a serious eye disorder caused due to the damaged eye nerve. It is associated with eye pain, reduced vision, and blind spots. An abnormality in the eye's drainage system causes fluids to build up in the front part of the eye. Overall, it poses excessive pressure, damaging the optic nerve and causing vision problems.^[4]
• Crossed eye: Crossed eye condition, also called strabismus, where both eyes do not look in the same direction at the same time. It occurs due to nerve damage or dysfunction of the muscles controlling the eyes. The eyeballs are either inward or outward with an intermittent or constant condition. While its severity varies with the case, candidates experience double or blurred vision and difficulties in perceiving depth.^[5]   
• Cataract: While blurry vision is the most common symptom of cataracts, the eye problem is prevalent among seniors. Candidates experience a vision similar to looking out of a cloudy window. It happens when some proteins in the eye lens break and build up, forming a cloudy portion. It usually happens due to advancing age, radiation exposure, previous eye surgeries, or certain medications.^[6] 
• Eye cancers: Eye cancers occur when the tumors or abnormally dividing cells multiply too quickly and form a tissue mass within the eyeballs or outer parts. It can be due to genetic causes, radiation exposure, or due to certain viral infections. Symptoms range from partial or complete vision loss, seeing floaters or squiggly lines, flashes of light,  and loss of peripheral vision.^[7] 
• Abnormal corneal conditions: Inflammation or infection of the cornea causes conditions like keratitis, photokeratitis, corneal dystrophy, abrasion, keratoconus, or astigmatism. Symptoms typically range from moderate redness and watery eyes to severe eye pain and blurred vision. It happens due to deeper scratches on the cornea, dry eye, and allergies.^[8] 

Having identified the types of eye problems that require corrective surgeries, let's focus on understanding different eye surgery options. 

Types of Eye Surgery for Vision

Cataract surgery, LASIK, and glaucoma surgeries are the most commonly performed surgical procedures among those aimed toward vision correction. We have detailed them along with a few other advanced and popular treatments. 

Refractive Laser Eye Surgery

The refractive errors of the eye arise when the candidate's eye cannot refract or bend the light properly, causing vision problems. LASIK and PRK are the common laser eye surgery types corrective vision. These procedures use lasers to correct vision problems due to refractive errors like myopia (short-sightedness), hyperopia (far-sightedness), or astigmatism. 

LASIK Eye Surgery

LASIK, or “laser-assisted in-situ keratomileusis,” aims at modifying the refractive power of the cornea. The ophthalmologist will use a blade-like device, the microkeratome, or a laser keratome, to cut a flap in the cornea, leaving a hinge at one end of the flap. They fold back the flap to reveal the stroma to vaporize a portion of it using computer-controlled lasers. They replace the flap, and the procedure hardly takes 20 minutes. Although rare, candidates may develop light sensitivity and scratchy or dry eye problems. ^[9] Depending on the technology used, various types of LASIK eye surgery are available. The most common types include standard LASIK, bladeless LASIK, intra-LASIK, wavefront-guided LASIK, femtosecond LASIK, and topography-guided LASIK. Your ophthalmologist will help you choose the best type of LASIK eye surgery based on the requirements. 

Photo Refractive Keratectomy (PRK)

PRK varies with LASIK in the way the patient's cornea is accessed. The ophthalmologist will hold the eyelids open using special tools so the patient can focus on the target light. The surgeon removes the corneal surface using a brush. They reshape the cornea using computer-controlled pulses of light energy. Excimer lasers are an effective way to reshape the cornea. Eye surgery types PRK are ideal for candidates with thin cornea or dry eyes. This is because this procedure avoids microkeratomes and leaves a large portion of the cornea untouched. ^[10] 

Cataract 

Cataracts are the cloudy areas on the eye lens caused due to the breakdown and clumping of protein and fibers in the eye lens. It may occur due to aging or an eye injury. Naturally, the eye lens focuses the light, producing sharp, clear images on the retina. However, the cloudy cataracts block and scatter the light rays, causing blurred or foggy vision. Cataract eye surgeries are a common eye surgery for adults, as more than half of American adults aged above 80 either suffer from cataracts or have to undergo the procedure.^[11]  The ophthalmologist removes the cataracts to place the artificial lens or the intraocular lens (IOL). IOLs are clear and behave like a natural eye lens. Cataract eye surgery type of anesthesia can typically be local or general anesthesia, depending on the patient's requirements and the surgeon's choice.   

Refractive Lens Exchange

The refractive lens exchange involves replacing the patient's natural eye lens with an artificial one is referred to as the refractive lens exchange or lens replacement surgery. It corrects the vision problems in myopia, hyperopia, and cataracts.  The eye surgeon replaces the natural eyelens with an artificial intraocular lens (IOL) by making a small incision. The intraocular lens placement behaves like a natural lens and reduces the need to wear glasses or contact lenses. This method is suggested for candidates with high refractive errors of the eye and for those who are not suitable for refractive laser eye surgeries. 

Glaucoma Surgery

Glaucoma eye surgery or trabeculectomy corrects the underlying cause of glaucoma. Glaucoma candidates experience vision issues due to optic nerve damage caused by excessive pressure due to the eye’s abnormal drainage system. Ophthalmologists create a flap in the white part of the eye below the upper eyelid. They create an alternative pathway using a laser to drain out the fluid, thereby reducing pressure. Candidates will experience a small bump called “bleb” on the eye surface. The human body will reabsorb this fluid over time.  Argon laser trabeculectomy, selective laser trabeculoplasty, and laser peripheral iridotomy are the various types of laser eye surgery for glaucoma. Cyclophotcoagulation is the other type of glaucoma surgery that destroys some amount of fluid-generating eye tissue. Glaucoma eye surgery cannot restore the lost vision. It can prevent further loss of vision by optimizing the internal environment of the eye. ^[12] 

Corneal Transplant

The corneal transplant is also called corneal graft surgery or keratoplasty. It involves replacing the damaged cornea with healthy corneal tissue obtained from the donor. Typically, corneal grafts are obtained from deceased donors after meticulous scrutiny. Corneal transplants are recommended for patients with damaged, swollen, or abnormally shaped cornea (keratoconus). The cornea is the transparent, dome-shaped front layer of the eye through which the light enters the eye. Having a damaged cornea can interfere with normal vision. Endothelial keratoplasty, penetrating keratoplasty, and deep anterior lamellar keratoplasty are the most commonly performed types. These vary with the corneal layer being targeted. ^[13] 

Vitrectomy 

Vitrectomy addresses vision loss and problems like retinal detachment, diabetic retinopathy, and vitreous hemorrhage (bleeding of vitreous humor). Vitreous humor is a gel-like substance within the eye behind the retina. It provides nutrients to the eye while maintaining its shape. Normally, vitreous humor is a clear liquid. However, certain conditions lead to the accumulation of blood and debris, blocking the light from passing freely.

Among other eye surgery types vitrectomy, is slightly different. It involves the surgical removal of vitreous humor and replacing it with another solution. Your ophthalmologist will make tiny incisions within the white portion of the eye. They insert small tools or blades to remove the cloudy- vitreous, and scar tissues (if any). Patients suffering from leaking or overgrowing blood vessels require lasers. They will place a gas bubble or silicone oil bubble in place of the removed vitreous humor. While the gas bubble leaves on its own, the silicone oil will be removed during a second surgery. ^[14] 

Retinal Surgery

Retinal surgery addresses vision issues due to retinal detachment, where the retina is pulled back from its normal position. The retina in the human eye is the thin, light-sensitive layer lying at the back eye. The light rays coming through the lens fall on the retina. The retina converts them to electric signals and sends them to the brain through optic nerve. Retinal detachment causes severe problems of vision. Ophthalmologists perform three different types of retinal surgeries. They are 

• Scleral buckle surgery (placing tiny, flexible bands around the white portion of the eye or the sclera to push the retina inward, helping its reattachment) 
• Pneumatic retinopexy (injecting a small air bubble into the retina to push the retina back into its position)

Note that retinal detachment is different from retinal tear. Some candidates suffer from retinal tears, which are holes or breaks in the retina. Laser photocoagulation involves using lasers to create microscopic burns, creating scars around the torn portion. The scar seals off the retinal tear. Cryotherapy or cryopexy is also effective for treating retinal tears. A freezing probe freezes the torn portion of the retina, forming a scar that can seal off the tear. 

Eye Surgery Types Cosmetic

Other eye surgeries, such as cosmetic eyelid surgery and lazy eye surgery, are also performed. However, they do not correct vision problems and primarily address aesthetic concerns and muscle-related problems.  

Strabismus Surgery

Strabismus surgery corrects eye alignment issues and offers a solution for a special condition called “crossed eye.” Strabismus occurs due to problems with the eye muscles, nerves sending information to the brain, or the part of the brain controlling eye movement. While candidates with crossed eyes show some extent of compromised vision, the surgical intervention generally enhances eye alignment and the candidate's confidence. Your ophthalmologist will make incisions near the conjunctiva of the eye. Further, they loosen or tighten the eye muscle that controls eye movement using an adjustable or permanent knot.^[15]  

Eyelid Surgery 

Eyelid surgery offers relief in candidates suffering from upper eyelids drooping below the normal position. While eyelids protect the eyes from dust or bright light, drooping or falling eyelids obstruct the normal vision field. This condition is called ptosis and can be due to a normal aging process caused by fat build-up in eyelids. In others, it can be due to injury damaging the muscles or ligaments holding the eyelid. Eye surgeons cut along the eyelid fold to remove excess fat, skin, or muscle during eyelid surgery or blepharoplasty. While this surgical procedure improves the vision field, blepharoplasty is indeed considered a popular eye plastic surgery type, as it enhances the facial appearance. 

Choosing the Right Eye Operation Type

Your ophthalmologist will suggest the appropriate eye surgery to address your problem. They prioritize the surgical goals (whether correcting vision issues or improving aesthetics). Below are the two main pointers they consider when choosing the right eye surgery type. 

• Type of vision problem, whether it's nearsightedness, farsightedness, blurred vision, or total loss of vision. 
• Patient's age and overall medical condition.

Below, we categorized the common eye surgery types based on surgical goals to understand them better. Note that surgical goals are patient-specific and address the exact cause of vision problems.    

Addressing the Common Vision Issues

Common vision problems include difficulty in seeing near and far objects, trouble focusing, blurred vision, double vision, halo formation, and loss of peripheral vision, either due to age, eye injury, trauma, or congenital issues. 

Types of Eye Surgery To Remove Glasses

A person requires glasses or contact lenses due to refractive errors in their eye lens. In these cases, the eye lens cannot focus light onto the retina. This can be either due to the lens losing its flexibility or curvature or being too curved to focus light on the retina. Finally, candidates experience blurred vision. Wearing glasses enhances their vision by bending light properly to focus on the retina. 

Eye surgeries to remove glasses or contact lenses correct the refractive errors causing general eyesight problems like nearsightedness, farsightedness, astigmatism, and presbyopia. Ophthalmologists consider the specific refractive error type, its severity, and the patient’s age to decide the right type. Here, we listed the common eye surgery types to reduce the candidate's need for glasses and contact lenses. 

• Refractive lens exchange surgery
• Refractive laser eye surgeries 

The refractive lens exchange relies on the exchange of lenses involving an IOL placement. The eye surgery types LASIK and PRK are the two different types of laser eye surgery. They rely on reshaping the cornea using advanced lasers. Your ophthalmologist will decide the right type of LASIK or PRK based on the corneal thickness and other eye conditions. 

Types of Eye Surgery for Astigmatism

Astigmatism happens when the cornea or the eye lens is not perfectly curved, posing problems with focusing light on the retina. The result is distorted or blurred vision at all distances. The cornea is the external layer covering the iris and pupil. It reflects the light entering the eye and focuses it on the retina, which sends nerve signals to the brain. Both the cornea and eye lens work with a similar goal. However, the eye lens is located behind the iris while the cornea lies in front, covering the iris. Here are the common eye operations to restore vision due to astigmatism.

• Refractive laser eye surgery (various types of LASIK eye surgery and PRK)
• Refractive lens exchange surgery
• Cataract surgery

Vision Problems and Eye Surgery Type 2 Diabetes

Diabetic retinopathy is a damaged retina due to high blood sugar and can lead to complete loss of vision. Vitrectomy is a common solution to address this issue. Further, candidates who have type 2 diabetes can undergo laser-assisted eye surgeries for better outcomes. The best type of laser eye surgery specific for the patient varies with the exact root cause of the vision problem. Laser-assisted procedures are generally safe. They offer improved healing and have shorter recovery, reducing the chances of surgical complications. People with diabetes typically suffer from issues related to the insulin mechanism. Note that they experience increased blood sugar levels, and it is important to manage the blood sugar levels and other medical conditions for ensured success. Here are the most commonly suggested eye surgery types for people with diabetes. Note that the right surgery varies with the root cause. 

• Vitrectomy 
• LASIK
• Cataract

Vision Problems and Types of Eye Surgery for Aged

Eye problems such as cataracts, diabetic retinopathy, age-related macular degeneration, glaucoma, and presbyopia cause vision loss in aged individuals. Note that it can be partial or complete vision loss in aged individuals. Many experience refractive errors with

• Gradual decline in their ability to see clearly
• Difficulty in focusing on near objects
• Reduced peripheral vision

The common corrective eye surgeries offer relief for vision-related problems in aged persons. However, eye surgeons need to be careful about the choice, as aged individuals commonly suffer from other health conditions like diabetes, hypertension, or cardiac problems. Suffering from any of these problems can reduce their overall healing and post-surgical outcomes. Qualified and experienced eye surgeons should make a comprehensive pre-surgical evaluation, and deal with a tailored approach. Below are the common eye surgery types for aged persons:

• Refractive laser eye surgeries such as LASIK and PRK
• Corneal transplant
• Refractive lens exchange 
• Glaucoma surgery
• Cataract surgery
• Retinal surgery
• Vitrectomy 

Deciding on the right eye care can be daunting. If doubts are holding you back, a second opinion can make all the difference. Let Envoy Health help you see your options clearly and confidently. Sign up with us and reach out to the finest ophthalmologists—because your vision deserves nothing less!

How Can Eye Surgery Be a Game-Changer for Your Vision?

Getting an eye surgery is a worthy choice. Candidates who opt for eye surgery experience enhanced quality of life with improved vision and reduced dependency on glasses or contact lenses. Below, we listed the benefits of getting an eye surgery.

• Improved vision: Eye surgery improves vision and helps you see objects better and clearly without focus issues. This is particularly true for aged individuals who often struggle with vision problems and are prone to injuries. 
• Reduces dependency on glasses or contact lenses: Candidates with severe refractive errors can avoid the hassles of wearing glasses or maintaining contact lenses and lead a soulful life with better vision. 
• Better quality of life: Eye surgery enhances vision and makes it easy to carry out daily life tasks. People with refractive errors can say goodbye to glasses or lenses allowing them to engage actively in sports and other hobbies without limitations.
• Safe procedures: Thanks to advanced screening tools and sophisticated, state-of-the-art technology, many recent eye surgical procedures are safe and effective. 
• Pain-free experience: Most eye surgeries are performed under anesthesia so that you can expect a comfortable, pain-free procedure. Advanced techniques, such as laser surgery, are quick and efficient, using only local anesthesia to ensure minimal discomfort. 
• Enhances confidence: Wearing glasses negatively affects the confidence of many youngsters by diminishing their facial appearance. Getting eye surgery can restore confidence and a natural look without the need to wear glasses. 

Are you wondering about the pricing to avail of these benefits? We have covered this for you in the upcoming section.

Eye Surgery Types and Cost

Different types of eye surgical procedures vary with their pricing. Typically, the eye surgery cost varies with the: 

• Surgical method and technology used
• Clinic where it's performed
• Surgeon’s expertise and skillset 
• Patient’s eye problem and severity

Typically, advanced surgical methods using sophisticated laser technology are expensive. For instance, the most commonly performed cataract surgeries cost between $5,000 and $10,000 per eye in the United States. On the other hand, the expensive corneal transplant costs between $13,000 and $27,000 per eye. We covered the popular eye surgery price range in the table below. 

Eye surgery types and costs

#Prices vary with the case.

While these prices apply for candidates not covered by health insurance, holding health insurance or financing can ease the cost burden. Note that getting eye surgery incurs some additional costs as well. These include the charges for pre-surgery consultations, post-operative visits, medication, and eye drops. Some clinics offer comprehensive packages by including these prices. 

Ask for the costs associated with these before planning for your eye surgery. It's always important to inquire about hidden or unexpected expenses. Knowing the complete cost breakdown will help you plan better and also avoid last-minute surprises. We recommend that you compare the costs among a few providers and check if your insurance covers any part of the procedure or related expenses. In case your health insurance does not cover the eye surgery costs, check out for financing options. Getting eye surgery has lasting benefits by reducing your dependency on glasses. Many indeed see it as a long-term investment for improving their quality of life. 

How To Prepare for an Eye Surgery?

Your eye doctor carries out a detailed eye examination to rule out the underlying cause. Further, they conduct a series of eye function tests to understand the severity of vision problems. Some common eye diagnostic tests include 

• Visual acuity test
• Eye muscle function test
• Slit-lamp examination
• Intra-ocular pressure test
• Visual field test
• Corneal topography
• Retinal examination

Further, the eye specialists will explain the pros and cons of the recommended procedure along with the treatment timeline and cost. Factoring in eye surgery cost as per the candidate’s budget expectations is indeed a crucial point.

While most eye surgeries are planned on an outpatient basis, you need to plan for the stay and travel. It’s better to have a friend or a family member by your side on the day of surgery. You should stop using certain medications before a specific period. This is case-dependent and not mandatory. However, you should stop taking food a few hours before the surgery. Your eye surgeon will explain the pre-surgery dos and don’ts before surgery. 

What Happens During Eye Surgery?

Most eye surgeries are carried out under local anesthesia, where you are awake and will be aware of the surroundings. In other simpler procedures, eye surgeons use topical anesthetics in the form of gels or drops. Some intensive procedures of the eyeball will be carried out under general anesthesia. Its recommended to discuss the anesthesia options with your eye surgeon before planning your surgery. During the eye surgery, your eye surgeon will cover the other eye that doesn’t need the surgery. You will lie in a flat position during the surgery.   

What Happens After the Eye Surgery?

Most eye operations are performed on an outpatient basis, and you will return home on the same day of the surgery. Avoid self-driving and rely upon an adult driver to get back home. In case the procedure is carried out on an inpatient basis, and you are required to stay in the hospital for a night. We recommend that you opt for eye hospitals with comfortable, safe, and hygienic stays.  

Remember to get the post-op medicine and eye aftercare measures when you return home. Attend the follow-up sessions for early recovery and to ensure your eye health is on the right track. This also helps in the early detection of issues, allowing a chance to act early to reduce complications. 

Risks and Side Effects of Eye Surgery Procedure

While every medical procedure carries its risks, eye surgeries also have some side effects. Further, every eye surgery is different, and so are the side effects. Talk to your eye surgeon about the side effects before planning your eye surgery. Below are some common risks of getting eye surgery. 

• Bleeding
• Pain and infection
• Vision changes (rarely causes vision loss)

While it's crucial to understand the potential risks and side effects of eye surgery, it's equally important to focus on the life-changing benefits. Imagine waking up each day without the need for glasses or contact lenses and enjoying a clearer, more vibrant view of the world. While choosing the right eye surgery type is crucial, success depends on getting treated by the right eye surgeon. 

If you're ready to move forward with confidence, consult with the finest eye specialist today. Experience world-class care by signing up with Envoy Health. 

References

1. Age-Related Macular Degeneration (AMD)
2. Refractive Errors
3. Retinal Detachment
4. Glaucoma
5. Strabismus
6. Cataracts
7. Cancers of the eye
8. Corneal Conditions
9. Laser In Situ Keratomileusis (LASIK)
10. Photorefractive Keratectomy
11. Cataracts
12. The Role Of Trabeculectomy In Enhancing Glaucoma Patient's Quality Of Life
13. Cornea Transplantation
14. Vitrectomy
15. Strabismus
16. Vision 2020: The Cataract Challenge