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Excimer laser correction of myopic, hyperopic refraction, and all types of astigmatism

Photorefractive keratectomy (PRK, LASIK,trans PRK , Epi LASIK)

It is the most "simple" way of excimer laser refractive correction. In the first stage of the procedure local anesthesia is performed using analgesic drops, and then the regenerated surface layer of the cornea - epitely is removed. Removal of the epithelium is possible mechanically (PRK) using ethanol solution destroying it (LASEK), using a special cutting device - epikeratom (LASEK) and laser (transFRK). Then, excimer laser remodels the cornea, evaporating excess of corneal tissue and thereby altering its optical properties. Then protective eye contact lens are applied, which will be there until the complete healing of the epithelium (usually 2-3 days).

" Pros":

  • saving corneal tissue;
  • the lack of profound physical effects on the eye (except for operations with epiLASIK where epikeratom is used) in the form of a vacuum retaining ring, which is especially important in patients with pathological changes in the peripheral retina (dystrophy, microfractures, preruptures).

"Minuses":

  • painful postoperative period (pain within 3-7 days);
  • slow recovery of visual functions (for 2 - 4 weeks);
  • increased risk of infection due to the presence of the damaged surface layer of the cornea;
  • instable futher  (3-5 years or more) refractive outcome.

"Correction range" : correction of

  • myopic refractive error (myopia) from -0.25 to -5 diopters,
  • hyperopic refractive (hyperopia) from +0.25 to +2.5 diopters,
  • astigmatism -0.25 to -2.5 diopters.

Postoperative treatment: staying in hospital is not required follow-up examinations on the 1st, 2nd, 3rd, 7th days after the operation; further observation and correction of assignments are possible remotely. Within 3-4 weeks need eye drops should be taken  prescribed by a doctor, to limit the close visual load (reading, computer) for 2 weeks and exercise within a month (lifting weights more than 8 kg., sauna, swimming, etc.).

Laser in-situ keratomileusis (LASIK ) and SBK

LASIK (LAZIK) - the most common in the world laser refractive surgery, applied since 1991.

It consists of two consecutive stages:

1) formation of the corneal flap (valve) using microsurgical instrument - Microkeratomee;

2) remodeling of the cornea using an excimer laser, and thus changing its optics. After completion of the laser action corneal flap (flap) is returned into place. Microdamages of the surface layer of the cornea, the epithelium are healing within days.

"Pros":

  • the operation takes only 10-15 minutes, and the effect is obvious within 6-12 hours after its implementation;
  • rapid healing of the surgical wound reduces the chance of infection; discomfort is present only for a few hours after surgery;
  • stable and predictable result.

"Minuses":

  • the physical impact on the structure of the eye in the formation of the corneal flap by  Microkeratome (vacuum fixation device);
  • uneven corneal flap formed by Microkeratome can cause the appearance of additional errors in optics after surgery.

"The range of correction": correction of

  • myopic refractive error (myopia) from -0.25 to -12 diopters;
  • hyperopic refractive errors (hyperopia) from +0.25 to 5 diopters;
  • astigmatism of -5 to +5 diopters.

Post-operative mode: The operation is performed on an outpatient basis, hospitalization is not required  inspection is required on the next day after surgery, further observation is possible in place of residence with remote consultation online.

Within 10 days after the surgery should follow a doctor's prescription: eye drops and limit the close visual load (reading, computer) for three weeks, it is desirable to limit exercise (lifting weights more than 8 kg., Sauna, swimming).

SBK is a variation of LASIK, the first stage of which Microkeratome is applied specifically configured for the formation of ultra-thin corneal flap (90-100 microns). 

Laser in-situ keratomileusis using the femtosecond laser to form a corneal flap (femtoLASIK / femtoLAZIK)

Today femto LASIK (Femto LASIK) is the most modern and safe laser refractive surgery. The only, but a fundamental difference from LASIK (LASIK) is the formation of a corneal flap (graft) without using the cutting instrument (microkeratom), but non-contact femtosecond laser.

The corneal flap is formed by the femtosecond laser having a number of advantages over the flap formed by microkeratom: predictability, uniform thickness, and no mechanical damage, prompt and reliable engraftment. As there is a possibility of formation of uniform ultrathin patches similar to procedure of SBK.

"The range of correction": correction of

  • myopic refractive error (myopia) from -0.25 to -12 diopters,
  • hyperopic refractive errors (hyperopia) from +0.25 to 5 diopters,
  • astigmatism of -5 to +5 diopters.

Post-operative mode: The operation is performed on an outpatient basis, hospitalization is not required. Inspection is required on the next day after surgery; further observation is possible on place of residence with remote consultation online.

Within 10 days after the surgery a doctor's prescription should be followed: eye drops and limit the close visual load (reading, computer) for three weeks, it is desirable to limit exercise (lifting weights more than 8 kg., Sauna, swimming).

"Super LASIK" ("Super LAZIK")

The prefix "super" can hardly be applied to the name of the medical procedure, but today the term "superLASIK" firmly entered into the everyday life not only for patients but also for ophthalmologists that has been applied even in ophthalmic journals. Given that the above term is still not officially defined differences in its definitions are possible. Today, the most suitable value of the name "superLASIK" is LASIK with femtosecond laser for highly accurate formation of corneal flap (graft) and the implementation of excimer laser correction on the results of aberrometry research.

Aberrometric study (aberrometry) - is the study of optics of the human eye, having a significantly higher (more than 100 times!)  sensitivity compared to conventional autorefractometry. Based on data of aberrometry (measuring points 250-500) is constructed a three-dimensional map of the individual optics of the human eye, which is subsequently used to calculate personalized (individual) program of laser correction.


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The 10th Minsk City Clinical Hospital