Dr. Orwa Nasser MD MPH - Laser surgery for strabismus

Laser surgery for strabismus

Strabismus is a mismatch in the position of the eyes between the two eyes. In this case, the eyes do not look in the same direction. In other words, one eye looks in one direction and the other in another.

Can a laser operation be performed to treat strabismus?

It depends on the type of strabismus. In cases of accommodative esotropia, a laser operation can be performed, which simultaneously corrects the strabismus and removes the glasses. This type of strabismus is an inward strabismus of both eyes.

In this type of strabismus (accommodative esotropia), glasses with positive numbers (not negative) are usually needed, and these numbers are usually high and cause poor vision in both eyes. As a result of poor vision, the eye tries to compensate for this weakness by trying to focus more than normal. This increased focusing mechanism causes both eyes to turn inward and to squint inward. Once the vision is corrected with glasses or contact lenses, the need for focusing and thus also the strabismus disappears. Therefore, correction with glasses, contact lenses or laser to remove glasses treats strabismus in this type and hides it.

The laser eyeglasses removal procedure for this type of strabismus is very successful and removes the strabismus and the patient gets rid of glasses and contact lenses.

Based on a special suitability examination for strabismus patients, which includes a complete eye examination and additional imaging tests, it is possible to determine the type of strabismus, whether the strabismus can be treated with a laser, and whether the patient's cornea is suitable for the laser procedure or not.

What types of surgery can be performed to remove glasses for strabismus patients?

There are several types of laser eyeglasses removal procedures that are suitable for strabismus patients of the Accommodative Esotropia type. The type of surgery will be selected individually and based on the data in the eye examination, vision capabilities and lifestyle. The most suitable types of surgery for people with strabismus are Femto-LASIK, PRK, Trans-PRK and SMILE.

Femto-Second LASIK: In femto-LASIK surgery, a very thin layer of the outer corneal surface is designed using a laser. Next, the laser is applied to the corneal epithelium to reshape its topography and the thin layer is then replaced.

SMILE procedure: In SMILE, a very thin disc-shaped layer of the cornea is created using a femtosecond laser without using surgical knives or blades. The disc is then removed from inside the cornea through a small incision.

PRK and Trans-PRK: In PRK and Trans-PRK, a laser is used to reshape the corneal topography, but no partial layer of the cornea is removed or a disc is formed. Instead, in PRK, the outer corneal tissue is removed to allow the laser to reach the inside of the cornea.

In Trans-PRK, the outer corneal tissue is not removed but rather the laser is applied directly to the corneal epithelium, but the outer corneal tissue is removed at the end of the procedure. This tissue will grow back within three to five days on average.