Refractive surgery

WHAT IS REFRACTIVE SURGERY?

Refractive surgery defines surgical methods through which refractive errors such as myopia, hyperopia or astigmatism are corrected.

WHAT ARE THE REFRACTIVE SURGERY METHODS?

The surgical methods through which refractive errors are corrected, target the two lenses of the eye: cornea and lens.

Refractive errors can be corrected either by cornea remodelling - corneal refractive surgery, or by lens surgery for refractive purpose - implantation of medical devices, phakic implants in the anterior chamber of the eye or lens replacement.

HOW ARE DIOPTRES DECREASED BY LASER?

There are ways to shape the curvature of the cornea with an excimer laser.

The methods are differentiated by a different approach on the corneal epithelium:

PRK, Photorefractive Keratectomy - the front of the cornea (epithelium) is mechanically removed, the corneal curvature is reshaped, and finally a contact lens is placed. This contact lens must be maintained for a period of 3-5 days after surgery. The PRK process makes the visual recovery of the operated eye to be longer (1-3 months)
LASEK (Laser Assisted Sub-Epithelial Keratomileusis) - is a method of removing the corneal epithelium with an alcohol solution, laser ablation repositioning epithelium and CL
LASIK (laser-assisted in situ keratomileusis) - a method that creates a flap in the corneal epithelium which remains secured to the cornea by a hinge, then the flap is raised, ablation is performed at the stromal level, the flap is put back in place, and the operation ends here.

WHAT IS THE NEW LASER TREATMENT METHOD AT CORNEAL LEVEL?

iLASIK THE NEWEST METHOD.

It is a lasik method with a combination of intraLase and Advanced Custom Vue technology, where the flap is not created by a mechanical method, i.e. microkeratome, but using a femtosecond laser of INTRALASE TECHNOLOGY. This is a technology approved by NASA for use by pilots and astronauts and has a very high accuracy.

With INTRALASE technology other types of operations can be performed: intra-corneal tunnels for implantation of corneal rings for keratoconus, cxl, lamellar keratoplasty.

WHAT DOES SURGERY INVOLVE?

STEP I: measuring dynamics of personal vision (wavefront measurement)

The first step for the iLASIK application is to determine personal vision characteristics as a result of tests using Wavescan technology. Wavescan system performs three-dimensional diagram of the patient’s vision errors. Each eye varies from one patient to another, being specific like the fingerprints. Therefore, each laser surgery will be planned specifically and fit to eye and patient. The most spectacular results are obtained using this approach.

STEP II: flap creation with intraLase

In iLASIK method, the technology called INTRALASE is used. Through INTRALASE method, the process of creating the FLAP in the transparent part of the eye (like the dial of a watch) is conducted by femtosecond laser. This enables very high accuracy and the possibility of making a thin flap of 90-100 microns. Thus, the remaining cornea can be ablated to lower a higher refractive error.

STEP III: customized laser treatment

By the application of this step, a special investigation program runs with the Wavescan. Thus the patient’ vision can be corrected by Advanced CustomVue a special type of ablation with the excimer laser as a last step.

WHAT ARE iLASIK INDICATIONS?

People who wear glasses or contact lenses and are aged over 18.
Patients with myopia, hyperopia or astigmatism (myopia up to -9d, hyperopia up to + 6d, astigmatism up to 4d)

It depends very much on investigations that are needed. They give us information about the corneal architecture, corneal thickness, corneal hysteresis.

WHAT ARE THE CONTRAINDICATIONS?

Diabetes
Patients with collagen disease, immunodeficiency autoimmune disease;
People who have a history of eye conditions e.g. herpes simplex or herpes zoster, severe allergies, keratoconus or high intraocular pressure
Pregnant or lactating women;
Patients with amiodarone or cutaneous treatment;