2015 03 31

From eye surgery straight to shooting practice

Eye diseases

Po akiu operacijos i saudymo pratybas

From ophthalmic surgery straight to shooting practice

Mantas (26) purchased his first pair of spectacles soon after reaching adulthood. The last year of school is stressful for many pupils, but Mantas also had something else to worry about – his deteriorating eyesight. It has been eight years since Mantas put his glasses on. He now serves in the Lithuanian Air Force, and his glasses are a huge inconvenience. In spite of everything, the young man’s dream came true when his mum secretly completed the Medical Diagnostic and Treatment Centre competition form. Thanks to this, Mantas will undergo laser vision correction and will be able to forget about his glasses.

Spectacles are an impediment for the soldier

“It was a coincidence. Mum sometimes reads news online and she accidentally came across this competition. She was aware of my wish to be able to see with my own eyes, so she filled in the form, and even wrote a poem. It worked,” says Mantas.

According to him, glasses can cause major misunderstandings and inconvenience at work. “I am a soldier and I frequently take part in military exercises. As you know most exercises usually take place outside. We have to move a lot and it is difficult when you are wearing glasses. They steam up and fog up, and become wet with rain. I have lost and never found several pairs. This has so many disadvantages. I work at the Air Defence Battalion of the Lithuanian Air Force, and my job involves surveillance of the airspace. Needless to say, good vision is very important for my job,” Mantas explains the reasons behind his wish to give up glasses.

Mantas, who became the winner of the competition organized by the Medical Diagnostic and Treatment Centre in Vilnius says that he had been interested in this surgery before. “I read some reviews. Despite having accepted the idea of wearing glasses, I did think about laser correction but kept putting it off,” Mantas admits.

He was calm before the operation. “I know that experienced and highly qualified doctors work here,” smiles Mantas.

A safe surgery

Dr. Paulius Rudalevičius, head of Ophthalmology Centre at the Medical Diagnostic and Treatment Centre says that motivation is one of the main elements when preparing for laser vision correction. When selecting the best surgery for Mantas’ case, we took into consideration the physiology of his eye and his work profile.

“During his exercises, Mantas needs to shoot and run, he goes on night-time expeditions and is strongly motivated to give up wearing glasses. He was diagnosed with first-degree near-sightedness, meaning that he has to wear glasses full time. We are going to perform the surgery using the special TransFRK method when the eye is not touched at all and no incisions are made. Not all patients are suitable for this method. However, not only is Mantas a suitable candidate, but this method is also the best option for him, as considering his profession there is, at least in theory, a likelihood of trauma. This type of surgery leaves no markings in the eye,” Dr. P. Rudalevičius explains.

The doctor says that this laser eye surgery is particularly safe. Nevertheless, it takes a little longer for the vision to recover compared to e.g. the LASIK surgery method.

Preparation takes longer

Laser eye surgery may take from five to fifteen minutes but the entire preparation takes much longer. “At first patients come to see us. Then we collect and analyze their health history and expectations, the reasons behind wanting and needing this surgery. Everything is important to us – patient’s hobbies, their work, future life expectations, as well as their age. Information on systemic diseases, sustained trauma and surgeries are of utmost importance, as is the patient’s working environment,” says Dr. Paulius Rudalevičius.

Pre-operatively not only are standard vision screening tests performed but specific tests such as night vision simulation, are also done. “We test visual acuity with and without glasses and assess the cornea and possible changes in it, iris, pupil, lens, and its transparency. The retina, its structures, and retinal nerve fibers are also analyzed. It isn’t just the optics of the eye which we plan to change during the surgery that is important in this case, but also all the other elements that I have mentioned before. All this has a direct impact on vision. Eyesight is all the components of the eye working in harmony,” says Dr. Rudalevičius.

Individual planning

We also carry out some other specific screening tests before the surgery, corneal topography being one of them. “In plain words, we appraise the appearance of the surface of the eye. We check for pathology which could make the surgery unsafe,” says Dr. P. Rudalevičius.

 

Laser vision correction

Pupil diameters in different lighting conditions are also assessed: in the light, twilight, and in the dark. It is important because the maximum dilation of the pupil at night determines the quality of vision. “In case of laser vision correction the cornea is not touched from one edge to the other, it is only a certain optical zone that is touched. The idea is that the pupil should be wider than that optical zone. Otherwise, there is an additional risk of inducing aberrations (visual distortions). In such cases, patients report seeing well during the day but would like to see better at twilight or at night. That is why we plan each treatment individually for each patient and for each eye separately. Our aim is to ensure high-quality vision including night-time vision,” assures the ophthalmic microsurgeon.

Time to talk

Before the surgery, we test the eyes for visual acuity after administering certain eye drops. The suitable correction method is finally selected after administering the drops and relaxing the eye muscles. However, specialists agree that talking with the patient is a crucial element in preparing for surgery. “Prior to the surgery we normally have all the information that we need. We know what type of surgery we can perform but we also need to answer patients’ questions. Sometimes we also have to ask them questions. We arrive at the decision together. Sometimes patients need time to prepare. Moreover, the surgery is relatively expensive, and patients need to have enough time to think over everything after our conversation,” explains Dr. P. Rudalevičius.

Test at the shooting range

“As soon as I can see without glasses, I will go for shooting training. My vision with glasses is poor, and so are my shooting results. I think they should considerably improve after the surgery. This will be the first test for my eyes,” Mantas, the winner of the Medical Diagnostic and Treatment Centre competition, was saying before his surgery.

The young man did not feel any pain during the operation. He says that everything was comfortable enough. “It was only later that it felt as if my eyes were filled with sand, but it soon went away,” he assured.

When we met a week later, Mantas couldn’t contain his joy despite his vision still not being 100%. “I know that my eyesight is still not what it is going to be a week later but I can already see well enough. My vision has totally changed. I have taken leave from work for my eyes to recover. I keep testing my eyes every day,  I look in the distance. It’s all very interesting to me. I just look around and enjoy myself,” smiled Mantas.

“Due to the selected method, Mantas’ eyesight during the first week is 60-70%. There are slight fluctuations which are normal. The vision improves, gets less blurry, and visual acuity increases in the course of the month,” explained Mantas’ doctor Dr. P. Rudalevičius.

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