The key issue is not age but astigmatism stabilization; at least 2 years of stable refraction are required prior to surgery decision. Astigmatism seems to appear and progress lately; in fact hyperopia reaches stability much earlier, usually during childhood or adolescence, but is compensated by the eye focus ability. Delayed astigmatism apparent appearance and progression simply witness regression of this focus ability. An astigmatism that continues to evolve is extremely suspect for it can reveal a corneal disease called keratoconus.
No there is no limit in age.
However age and potential concomitant presbyopia may influence surgical feasibility as well as the choice of the surgical technique.
No, there are several contraindications, especially asymmetrical and evolving astigmatisms that can reveal a keratoconus. It is the main purpose of preoperative consultation to detect and eliminate inappropriate candidates.
Some patients are not operable at all; others are only eligible for specific techniques. For instance too thin corneas contraindicate LASIK but allow PRK or placement of an intra ocular lens. Therefore, your surgeon must have the ability to indifferently perform all surgical procedures in order to let you benefit from the most appropriate one.
Yes, in a vast majority of astigmatisms, in contrary to the misconception that pregnancy would influence the refractive error.
In fact pregnancy never creates per se astigmatism progression. Hormonal changing during pregnancy may simply have a transitory and reversible effect upon vision.
On the other hand, it is contraindicated to operate a woman during pregnancy and breastfeeding until normal menstrual cycles return.
Contact lens removal is mandatory 48 hours before surgery in case of soft contact lenses, 1 month in case of rigid contact (it is possible to temporarily replace them by soft ones which will be removed 48 hours before surgery).
In all cases yes, insomuch astigmatism is rarely isolated and usually correlated with hyperopia or myopia.
Surgery is performed under local anaesthesia, by anaesthetic drops instillation. In contrary to popular belief there is no injection in the eye. Oral sedation is given two hours prior to surgery, in order to manage legitimate apprehension.
Both eyes have surgery in the same operative session. The procedure is fully painless and lasts about 30 minutes. The patient is discharged one hour later and should be taken home back by a relative. Driving is not permitted the day of surgery.
Astigmatism refractive surgery is extremely safe, provided common sense rules are respected, rules that I have been uncompromisingly following during all my practice: rigorous and appropriate patient selection with absolute respect of all contraindications, use of last generation measurement devices and lasers, operating rooms with highest security standards.
Side effects may happen in the following weeks (glare, vision fluctuation, halos); usually minor and impermanent, they do not impact final visual result, even if rarely a touch up may be needed. Surprisingly surgery is less risky than contact lens wearing, especially in terms of infectious risk. This type of surgery has now a long follow-up and has demonstrated its maturity and safety.
These issues are correlated to the procedure.
LASIK and intra ocular lenses cause more discomfort than true pain; visual rehabilitation is fast, taking several hours to one day.
Visual recovery is longer for PRK and can take about a week. With this technique discomfort may be more pronounced; in order to prevent true pain a bandage contact lens is placed for a couple of days, and the patient is given oral analgesic pills.
Visual result is stable with time.
Resume work and driving are fully permitted the day after surgery for LASIK and intra ocular lenses. Both are one week delayed after PRK. Swimming and combat sports should not be practiced during a month regardless the technique.
Make-up is permitted after a week, as well as sun exposure, provided sunglasses are worn.
Rehabilitation is therefore extremely fast, for patient major happiness and satisfaction.
