Reader Question:
“I’m 28 years old with nearly –6 diopters of myopia and 1 diopter of astigmatism. Which surgical methods are suitable, and what should I prepare?”
— Anh Thi, Lâm Đồng
Answer:
Myopia surgery corrects nearsightedness by reshaping the curvature of the cornea, enabling clear vision without glasses.
1. Age and Stability Requirements
Ideal candidates are at least 18 years old.
Your prescription must be stable, changing by no more than ±0.5 diopter within the past year.
2. Corneal Thickness and Health
Higher myopia requires more corneal tissue removal.
The cornea must be at least 450 micrometers thick to ensure surgical safety.
You must be free from acute or chronic eye diseases—such as keratitis, corneal dystrophy, keratoconus, or retinal hemorrhage.
Pregnant or breastfeeding women should wait at least 6 months after childbirth to allow stable hormone levels and refractive error.
3. Surgery Methods
✔️ Corneal Procedures
SMILE Pro (Small Incision Lenticule Extraction Pro):
The most advanced, creating no flap, which avoids associated risks like flap dislocation or wrinkles.
Laser time is only 10 seconds per eye, with a small incision and minimal scarring.
Offers reduced dry eye and a more comfortable recovery.
✔️ Other Corneal Lasers – FLEx, LASIK, Trans-PRK
These involve flap creation or stromal reshaping.
Useful for patients with less severe myopia but involve more postoperative discomfort and transient dryness.
✔️ Phakic ICL (Implantable Collamer Lens) – Intraocular Method
Instead of reshaping the cornea, a thin, customized lens is inserted behind the iris, in front of the natural lens—through a 2–3 mm incision.
Safe for high myopia or thin corneas, preserving corneal strength and avoiding dry eye issues.
The lens is long-lasting and can be replaced or adjusted over time.
4. Diagnosis & Preoperative Testing
To qualify, you’ll undergo:
Refractive measurement (sphere and cylinder).
Corneal topography (e.g., Pentacam), assessing thickness and structure.
Biomechanical evaluation (e.g., Corvis ST) to test corneal strength.
Retinal exam (Optos) to check for thinning or degeneration—especially with high myopia.
Blood tests, ultrasound, and anesthesia evaluation.
After clearance, the process from pre-op to discharge can be completed within an hour at top eye centers.
5. What to Expect After Surgery
Temporary discomfort like watering or grittiness is common just after the procedure.
You’ll need a protective eye shield for 24 hours, even during sleep.
By 24 hours post-op, most patients can drive or fly—but avoid dusty places and strong light for the following weeks.
Vision generally stabilizes rapidly, often within a day with SMILE Pro.
✔️ Summary of Candidacy and Procedures
| Requirement | Details |
|---|---|
| Age | ≥ 18 years |
| Stable glasses prescription | ≤ ± 0.5 D change per year |
| Corneal thickness | ≥ 450 micrometers |
| Free of eye disorders | No active keratitis, keratoconus, etc. |
| Postpartum wait time | ≥ 6 months if breastfeeding |
🏥 Best Candidates & Methods
SMILE Pro is favored for its fast laser time (~10 seconds) and quick recovery.
Phakic ICL is best for severe myopia or thin corneas, preserving corneal integrity.
Other laser methods (LASIK, Trans-PRK) remain applicable for certain prescriptions.
Expert**
Dr. Đinh Trung Nghĩa, Deputy Director, High-Tech Eye Center, Tam Anh General Hospital, Ho Chi Minh City.
Considering Myopia Surgery in Vietnam?
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