Laser Eye Surgery

Laser eye surgery has transformed the landscape of ophthalmology, offering millions of people around the world the opportunity to achieve clearer vision without relying on glasses or contact lenses. Using precise laser technology, this procedure reshapes the cornea to correct refractive errors such as myopia, hyperopia, and astigmatism. With advancements in minimally invasive techniques, laser eye surgery has become one of the most popular and effective options for vision correction.

Why Cuba

Cuba is increasingly recognized as a trusted destination for high-quality and affordable healthcare, including ophthalmic surgeries. The country offers:

• Highly trained ophthalmologists with international experience.
• State-of-the-art medical facilities specializing in advanced laser technologies.
• Comprehensive pre- and post-operative care
• Cost-effective solutions without compromising quality

Importance of Correct Vision

Clear vision is vital for maintaining quality of life, safety, independence, and productivity. Poor vision can impair daily tasks such as reading, driving, and recognizing faces, and can significantly reduce personal and professional functionality. Vision correction not only restores visual clarity but also boosts self-confidence and overall well-being.

Laser eye surgery enhances quality of life by:

• Directly correcting visual impairments that impact quality of life, personal safety, and daily functionality.
• Improved visual acuity (often 20/25 or better).
• Reshaping the cornea with precision to restore the eye’s natural ability to focus light correctly.
• Reducing or eliminating dependence on eyeglasses or contact lenses for clear vision at various distances.
• Improving performance in essential tasks, such as reading fine print, driving safely, especially at night and recognizing faces and visual cues
• Enhancing independence, allowing individuals to function without reliance on visual aids.
• Boosting efficiency in both professional and personal settings by reducing visual strain.
• Promoting self-confidence and psychological well-being, especially for those who previously felt limited by poor vision.
• Contributing to long-term improvements in lifestyle by restoring functional and stable unaided vision.

Conditions Treated by Laser Eye Surgery

Laser eye surgery primarily treats the following refractive conditions:

• Myopia (Nearsightedness)
• Hyperopia (Farsightedness)
• Astigmatism
• Presbyopia (Age-related Farsightedness)

These procedures can also address specific corneal irregularities and, in some cases, early keratoconus.

Criteria for Laser Eye Surgery

Not all patients with refractive vision errors are ideal candidates for laser eye surgery. Determining eligibility involves a detailed assessment of ocular anatomy, general health status, and individual visual needs. Proper patient selection is essential to minimize risks and ensure optimal surgical outcomes.

Candidates Who Qualify

• Individuals Aged 18 or Older with Stable Vision for at Least One Year: The eye must reach a point of refractive stability—usually in early adulthood—before laser surgery can be safely performed. Fluctuating prescriptions may indicate ongoing ocular development or instability, increasing the risk of post-surgical regression.

• Patients with Mild to Moderate Myopia, Hyperopia, or Astigmatism: These refractive errors are commonly corrected through procedures such as LASIK, PRK, or SMILE. Patients with very high refractive errors may still qualify, but may require additional assessments or alternative approaches.

• Those in Good General and Ocular Health: Candidates should be free of systemic conditions or eye diseases that could impair healing or compromise surgical outcomes. A healthy immune system and absence of ocular pathology help reduce the risk of complications.

• Non-Pregnant and Non-Breastfeeding Individuals: Hormonal fluctuations during pregnancy and lactation can temporarily affect corneal shape and tear film stability, making refractive measurements unreliable. Surgery is typically postponed until several months after breastfeeding has ended.

Candidates Who May Not Qualify

• Patients with Thin or Irregular Corneas: A minimum corneal thickness is required to safely perform reshaping without compromising structural integrity. Conditions such as keratoconus, corneal ectasia, or severe corneal scarring often disqualify patients from standard procedures like LASIK.

• Individuals with Autoimmune Disorders or Uncontrolled Diabetes: Autoimmune diseases (e.g., lupus, rheumatoid arthritis, Sjögren’s syndrome) may interfere with corneal healing and increase the risk of inflammation or surgical complications. Poorly managed diabetes can also delay wound healing and raise the risk of infection or fluctuating vision.

• Those with Active Eye Infections or Severe Dry Eye Syndrome: Pre-existing conditions like blepharitis, conjunctivitis, or chronic dry eye can compromise the ocular surface, affect healing, and cause post-operative discomfort or visual instability. These issues must be addressed and stabilized before proceeding.

• People with Cataracts, Glaucoma, or Retinal Disease: Refractive surgery is not suitable for individuals with progressive cataracts, uncontrolled intraocular pressure, or retinal conditions such as diabetic retinopathy or macular degeneration. These conditions often require specialized medical or surgical treatment and may influence visual outcomes independently of refractive error.

• Patients Taking Certain Medications: Long-term use of medications such as corticosteroids or immunosuppressants can affect healing or elevate the risk of infection. A full medication review is part of the pre-surgical evaluation.

Pre-Surgical Diagnosis

Before undergoing laser eye surgery, a thorough and individualized pre-surgical diagnostic evaluation is essential to determine a patient’s eligibility and ensure optimal surgical outcomes. This comprehensive ophthalmic assessment allows the surgeon to accurately diagnose the type and severity of refractive error, evaluate corneal health and thickness, and identify any underlying conditions that may impact the success or safety of the procedure.

Key components of the diagnostic workup typically include:

• Corneal Mapping (Topography): This non-invasive imaging technique creates a detailed, color-coded map of the curvature and shape of the cornea. It is critical for identifying irregularities, such as keratoconus or asymmetry, which may contraindicate certain laser procedures.

• Pachymetry (Corneal Thickness Measurement): This test measures the thickness of the cornea using ultrasound or optical methods. Corneal thickness is a vital parameter in determining candidacy for surgery, as excessively thin corneas may not safely support certain types of laser reshaping.

• Refraction Testing: This evaluates the eye’s refractive error—how it focuses light—by determining the degree of myopia, hyperopia, or astigmatism. It provides a baseline for the corrective prescription to be achieved during surgery.

• Pupil Size Assessment: Large pupils, especially under low-light conditions, can increase the risk of postoperative visual disturbances such as glare and halos. Measuring pupil diameter helps in customizing treatment parameters and selecting the appropriate surgical technique.

• Tear Film Analysis: A stable tear film is essential for corneal healing and visual clarity. Tests such as tear break-up time and ocular surface staining are performed to evaluate for dry eye syndrome, which can affect surgical results and recovery.

• Dilated Retinal Examination: Using eye drops to dilate the pupil to examine the retina, optic nerve, and macula to rule out retinal tears, detachments, or degenerative changes. This ensures that any retinal or vitreoretinal conditions are addressed prior to surgery.

In some cases, additional testing such as wavefront aberrometry, epithelial thickness mapping, or optical coherence tomography (OCT) may be employed to further assess the visual system and enhance treatment customization. The results of these diagnostic tests guide the surgical plan, ensuring the procedure is safe, precise, and tailored to the patient’s unique ocular anatomy and visual needs.

Laser Eye Surgery Procedures

Laser eye surgery includes several advanced techniques, each designed to correct refractive errors by reshaping the cornea. The choice of procedure depends on individual eye anatomy, corneal thickness, lifestyle, and vision goals. Below are the most commonly performed laser procedures in modern ophthalmology:

LASIK (Laser-Assisted In Situ Keratomileusis)

• Uses a femtosecond laser to create a thin flap in the cornea and an excimer laser to reshape the underlying tissue.
• Offers rapid visual recovery, often within 24 to 48 hours.
• Minimally invasive with little to no discomfort postoperatively.
• Ideal for patients with adequate corneal thickness and mild to moderate refractive errors.

SMILE (Small Incision Lenticule Extraction)

• Removes a small disc-shaped piece of tissue (lenticule) through a tiny incision in the cornea, without creating a large flap.
• Preserves more of the corneal biomechanical strength, making it suitable for patients with active lifestyles or mild dry eye.
• Associated with lower incidence of postoperative dry eye and reduced nerve disruption.

Offers precise correction for myopia and mild astigmatism.

PRK (Photorefractive Keratectomy)

• Involves removing the outermost layer of the cornea (epithelium) to access and reshape the underlying stromal layer using an excimer laser.
• Best suited for patients with thin or irregular corneas where flap creation is not advisable.
• Healing takes longer than LASIK or SMILE (several days to a week), but results are similarly effective.
• Often recommended for individuals with high-risk occupations or sports where corneal flap dislodgement could be a concern.