Femto-LASIK is one of the newest methods of correcting myopia, hyperopia and astigmatism. Femtosecond laser is widely applied in ophthalmology, which includes all kinds of cutting the cornea and lenses, treatment of glaucoma and retinal deficiencies. Currently, it is mostly used in cutting the cornea during LASIK and it can be considered the superior LASIKmethod. Femtosecond laser is a megatrendcutting technology. Each Infrared femtosecond laser pulse is a few seconds (15-10 seconds), thus it causes no damage to the peripheral areas.
Femtosecond laser devices are equipped with soft wares by which the number, size, amount of energy and frequency of the radiatedpulses can be adjusted. This software can also determine the exact location of the radiation according to the required breadth and depth. So while using Femtosecond laser in cutting the cornea, laser is focused just below the surface of the cornea. Each laser pulse creates a tiny bubble there A pattern of many overlapping bubbles is created, allowing lifting off a flap off the cornea. This process is called" "photo disruption". By putting together thousands of bubbles, a very elegant cut can be made in the cornea tissue.
The surgical procedure of Femto Lasikis very similarto LASIK and both are done in 4 stages. The basic difference between LASIK and Femto Lasikis the method by which the first step, creating a corneal flap, is performed. Currently, the most popular method of correcting refractive errors in Europe and America is Femto Lasik.
Femtosecond laserWave Light FS200 characteristics:
Excimer laser Wave Light Concerto characteristics:
LASIK- Femto Lasik advantages:
LASIK- Femto Lasik disadvantages:
LASIK- Femto Lasik Results:Almost everyoneundergoing a surgery wants to know what the chance of obtaining a satisfactory result is. For low and moderate myopia (up to 7 - D) approximately 95% of the patients achieve 5/10 to 6/10 or better vision without glasses and 85% of the patients achieve 8/10 to 9/10 or better vision. This means that people are a lot less dependent on their glasses, but some patients may still need to wear eyeglasses for more accurate visual tasks such as driving, especially at night. For high myopia (over 7 - D) about 85% of patients achieve 5/10 to 6/10 or better vision without the glasses without glasses, and 70% of patients achieve 8/10 to 9/10 or better.
LASIK- Femto Lasik Complications:
Laser vision correction, like any other surgical method, is subject to complications. By far the most common complications of laser vision correction are under-correction, over-correction, and loss of best-corrected vision. This occurs because the patient absorbs slightly less or more of the laser energy than anticipated. Under-correction can be corrected surgically, but it is more difficult to treat Over-correction. While removing the thin corneal flap by the microkeratome, some problems may occur including flap damage, irregular or incomplete flaps, postoperative slipped flap, and infections. Aside from infections, other complications can be treated, usually without causing any problemfor thevisual acuity of the patient.The incidence of infection responsive to treatment has been estimated at one of five thousand and is much less than it is in contact lenses. Contrary to wearing contact lenses, where eyes are in constant risk of infection, in LASIK infection may only occur during the first 1-4 weeks after surgery.
Whereas the quality of vision after LASIK is usually superior to vision with contact lenses or glasses, some patients may experience one or some of the following side effects.
In the first 4 to 6 weeks after the operation, best vision loss occurs (especially near vision) but it improves gradually and spontaneously. Near vision dysfunctions usually are more common in patients who suffer from presbyopia and undergo operation. As mentioned before, these patients will need reading glasses after surgery.
Instructions before LASIK - Femto-Lasik
Instructions during the LASIK - Femto-Lasik
Medication after LASIK – Femto-Lasik
Follow up visits afterLASIK- Femto Lasik surgery
How to start normal activities after LASIK - Femto-Lasik
Instructions before LASIK - Femto-Lasik:
Instructions during the LASIK - Femto-Lasik:
Note that these procedures are not painful and your cooperation has a very important role in achieving the perfect result. So stay calm and pay attention to the instructions of the doctor during surgery.
Medication after LASIK – Femto-Lasik:
How to Use Eye Drops Properly:
Follow up visits afterLASIK- Femto Lasik surgery:
At each visit to the doctor, carry aroundyour medication with you.
How to start normal activities after LASIK - Femto-Lasik:
DAY OF LASIK SURGERY
What is LASIK?
How long has LASIK been performed?
How does LASIK correct astigmatism?
Who does this surgery?
What surgeries are performed at Noor Hospital?
How long does the procedure take?
Does it hurt?
What are the restrictions following surgery?
When can I go back to work?
Can the procedure be performed on both eyes at once?
How do I know if I am a candidate for LASIK?
Is the vision correction surgery right for me?
When is refractive surgery not good for you?
Do Laser and LASIK surgeries create an obstacle for other surgical procedures that may be necessary for the eye?
Can pregnant women have Laser or LASIK surgeries?
PRK (Laser) or LASIK?
I 'm told that my eye has some degree of irregular astigmatism and it is better not to do LASIK or Laser surgery, why?
Does Laser or LASIK cause night blindness or colour blindness?
Can I wear coloured contacts after laser or LASIK eye surgery?
My myopia rate is higher than 15-D. Why am I not a suitable candidate for LASIK?
Is it possible for everybody to use intraocular lenses for correcting refractive errors?
Will eyes become more vulnerable to impact after Laser or LASIK?
What is the appropriate age for LASIK and Laser?
Can laser eye procedures treat amblyopia (lazy eye)?
My eye is myopic and I have been told that it has a little cataract, too. Can I do laser surgery or LASIK?
Would doctors, particularly ophthalmologists, ever have LASIK performed?
Are doctors willing to do the same operation for their close family members?
May regression happens after LASIK?
If I don't get full correction, can I be retreated?
My eyes were - 11 D myopic and - 3.5 D astigmatic. I've had an operation 4 years ago, and 6 months after the operation, I needed 2.5-D glasses. I have no interest in enhancement surgery and I do not like wearing eyeglasses. Does it cause any problem for me?
Are surgeries performed to correct refractive errors affect retina which is thin in myopic people or not?
What is LASIK?
LASIK is a laser surgery that is capable of correcting a wide range of myopia, hyperopia, and astigmatism. This surgical method, promotes a very rapid recovery of vision and minimize discomfort. On the cornea surface, the LASIK surgeon creates a tiny "flap" (with a thickness of about 160 microns). Then the computer controlled Laser Excimer gently reshapes the exposed cornea in accordance with the prescribed eyeglasses.
The first similar action (keratomileusis) was performed on humans in 1963. This method has gradually developed and improved. The Excimer laser has been used for over 20 years in P.R.K. Eye surgeons have been creating a protective flap of tissue for over 30 years. These 2 techniques (creating a corneal flap and performing laser therapy under this tissue) were first combined in 1991 to create a new form of refractive surgery known as LASIK. Noor Clinic has been performing P.R.K since 1994, and in the second half of 1995, for the first time in Iran and the Middle East, began performing LASIK.
Special software has been designed that is capable of ablating an oval pattern on the cornea to correct all levels of astigmatism.
Noor Eye Hospital doctors are all capable of performing these surgeries. All doctors in Noor Eye Hospital are experienced and have undergone special LASIK courses. Many modern methods of refractive surgery such as LASIK surgery is performed for the first time by Noor ophthalmologists. The hospital doesn’t restrict your choice of doctors. The choice is yours. You could be examined by an ophthalmologist and do the filing process, but for the operation, you may choose whom you think is the best.
In Noor Hospital, RK is considered out dated and has not been performed since 1995, because PRK (laser) and LASIK are much better than RK. PRK (laser), SLR, epithelial LASIK , LASEK, negative intraocular lens implantation to correct myopia, cataract surgery with small incision and no sutures, eyelid cosmetic surgery, ocular aberration correction, corneal transplantation and all other types of eye surgeries are performed in this hospital. In many cases, Noor ophthalmologists have been the founders of modern surgical methods in Iran and even Middle East.
In LASIK the actual procedure usually takes less than 10 minutes per eye. The time needed for Laser (PRK) operation is slightly less than LASIK.
No. Anaesthetic drops allow the operation to be performed without pain. After LASIK, the eye is a bit watery, scratchy or gritty, like there is something in the eye, for a few hours, but patients typically do not require any pain medications and are often able to return to work the day following the procedure. But after laser (P.R.K), postoperative pain is greater and stronger painkillers are used.
Avoid rubbing your eyes the first few days. You should not swim or get water in your eye for one week after surgery, although bathing and showering, in LASIK after 1 day and in P.R.K after the healing of epithelium, are fine. Avoid eye makeup during the first postoperative week.
The day after the LASIK procedure and 3-5 days after P.R.K, if your vision permits, you can go back to your daily routine.
Yes. The results in patients who had one or both eyes done together are studied. The outcomes were the same, and most patients found it more convenient to have both eyes operated at the same time.
Patient inclusion criteria for LASIK investigation are:
The decision to have laser vision correction depends on the results of a thorough preoperative evaluation.
Rate of refractive error, career, sports and recreational activities, age and personal expectations determine whether or not you are a good candidate for surgery. You must have realistic expectations and know that surgery has not always the ideal results. Shaping a piece of plastic or glass in order to make glasses or contact lenses is much easier and more accurate than shaping a living tissue, such as cornea. In most cases, there is a 90% or greater chance of obtaining normal or near- normal vision; however, it is not possible to guarantee that every patient will have a perfect result, especially patients who are severely or extremely myopic may still require a thin pair of glasses for some tasks such as night time driving. Refractive surgery does not prevent presbyopia (age-associated loss of perfect vision). If you are over 40 years old, you may need to wear reading glasses afterwards, despite the fact that your vision has been dramatically improved. Do you want to see the clock hands when you wake up in the morning, dress, and be active whether at home or out at work without wearing your eyeglasses? Do you want to enjoy sport .especially water sports, without wearing eyeglasses or contact lenses? Do you wish that you could protect your family and yourself in emergencies without depending on eyeglasses or contact lenses? These are reasonable goals and accessible in refractive surgery.
If you expect an ideal result: Surgeries bring no guarantee! You shouldn’t expect an ideal, perfect result. In Noor Eye Hospital, we benefit from the best doctors , instruments, and technology, and we try our best to achieve the best possible result of our refractive surgeries and we perform various methods including Lasik, intraocular rings (INTACTS) and intraocular lenses to make you satisfied.
If you expect a perfect vision (20/20): As explained before, in refractive surgeries ,cornea undergo some changes. It is not possible to re-shape the cornea anatomically, thus when your pupil widens naturally at night, the light may enter from an untouched part of cornea and it causes halos or glares. Therefore you may need a thin eyeglass for night time driving.
If you expect an immediate result: Most of the time, the recovery period after LASIK is fast and painless, however for those patients who have more than -5 scores of myopia, The cornea may take 3 month or more to stabilize. You should be patient and wait for 3 month (after PRK) to regain your vision.
If you expect a better vision than with your glasses or contact lenses: If your current glass or lenses is prescribed correctly, you shouldn’t expect to gain a better best vision after surgery. Refractive surgery ends or minimizes your reliance on glasses and lenses. You will get rid of the difficulties and hardships of wearing glasses or lenses. After surgery, you should be satisfied with your current best vision.
No. All kinds of eye surgery can be done after these operations.
Laser Excimer is used in laser surgery (PRK) and LASIK, and this type of radiation does not have any adverse effects on the fetus. Also , drugs used after surgery are often simple analgesics such as acetaminophen (which is allowed to be used during pregnancy) and topical drops .Since their absorption into the circulatory system is very limited, they cannot have a negative effect on the fetus. Therefore Laser and LASIK are allowed during pregnancy, however, we should have in mind that hormones may affect the stability of the prescription. These effects are stronger in PRK (laser) than LASIK, so it is better to have these operations after pregnancy.
Decision depends on the eye score, topography condition and corneal thickness. Among them, eye score has the least effect on the decision. In low myopia(up to 3D),if corneal thickness is appropriate, both laser and LASIK are done(although usually PRK is preferable).We should know that in low myopia, The ultimate success is equal in both of these methods, and it is achieved after 2 to 3 months. However, the first days following the treatment are significantly different in these two procedures. There is more pain and discomfort after laser procedure (PRK), since the cutting takes place on the surface of the cornea where the pain sensation is very high. On the other hand, LASIK is performed on a surface underneath a thin, protective corneal flap, in the depth of cornea, so there is less pain and comfort. Finally, in low myopia (up to 3D), the final decision on the procedure will be made in consultation between physician and patient.
Normally, our cornea has a dome shape, like a ball, and a smooth surface. These eyes can undergo refractive surgeries. Rarely; however, the structure of the cornea is just not strong enough to hold this round shape and the cornea bulges outward like a cone. This condition is called Keratoconus. There is always the possibility of irregularity development in these eyes, therefore Laser and LASIK that are designed for regular cornea cannot correct the refractory error of these eyes or prevent the progress of this disease in the future.
Night Blindness and Colour Blindness are two hereditary retinal diseases and cannot be caused by LASIK or Laser. Of course we should know that in the first weeks after surgery, night vision problems may occur such as Glare or Halo Vision that are temporary and will gradually disappear.
Yes, but it is better to refrain from wearing them for three to six months after undergoing LASIK.
To correct any eye score, some part of corneal surface has to be ablated. On the other hand, the corneal thickness is limited and after surgery 250 micron of the cornea should stay untouched. So, only up to 12 D of myopia is correctable with LASIK. Of course in some people whose corneal thickness is less than usual, the amount of correction may decrease to 10 D or even less. Corneal thickness is measured before surgery. (Corneal Pachymetry)If you do LASIK on an eye which has a score more than -12 D, less than 250 micron of corneal thickness will remain, so you may confront the risk of Keratoconus in future. For this type of eyes, the best correcting method is implanting negative powered intraocular lenses (IOLs).Of course in cases with extreme myopia of -20 D or more, IOLs is accompanied with intraocular rings or LASIK to perform a better result.
Because of higher operating costs and the need for an eye surgery that requires general anaesthesia and a hospital, intraocular lenses to correct refractive errors are used only when simpler procedures such as LASIK, laser surgery or implantation of intra-corneal rings cannot be done. Furthermore, due to some diseases such as cataracts, glaucoma, and eyes with decreased anterior chamber depth, some eyes are not appropriate candidates for this operation.
It has been proved that there is not any difference between the strength of the cornea after LASIK or Laser surgery compared with normal corneal strength against impact. But we should know that, fundamentally, the myopic eyes are by nature more traumatic vulnerable than normal eyes (whether operated or not). In moderate, high and extreme myopia, patients should undergo regular eye examination every 6 month to once a year, whether those who wear glasses and contact lenses to correct refractive errors or those who chose to have surgery due to retinal changes, So that timely treatment of lesions of the retina such as retinal holes and severe thinness is done and thereby prevent retinal tear and detachment Also, these people should be careful to avoid direct blows to the head or eyes that may occur, for example, in some martial arts.
Minimum age for this surgery is 18 years and it is necessary that there has not been a perceptible change in the score of eyeglasses during the previous year There is no maximum age for their appliance and they can be performed as long as there is no diseases such as cataracts or glaucoma or other diseases that could hinder the operation. But it should be known that if these treatments are done after 40, the patient is to wear eyeglasses for reading. The oldest person, who has ever been operated by Noor ophthalmologists, was 73 years old with an eyes score of 5.1 -D.
No, Laser and Lasik can only correct refractive errors and they cannot correct Lazy eye. In the other words, refractive surgeries cannot give a better corrected visual clarity than eyeglasses or contact lenses.
Cataract is not a prohibitive for Laser or LASIK, and doing these surgeries would not cause any problems for having cataract surgery in the future.But we should keep in mind that refractive surgery will be effective only if cataract doesn’t develop. Therefore, if the patient has fast developing cataract, it is better not to do laser or LASIK. On the other hand, by doing cataract surgery and implanting intraocular lenses at the same time, refractive error will be treated.
LASIK is internationally accepted as a scientific practice. In recent years, more than 2000 doctors, dentists, and pharmacologists have undergone LASIK in Noor Eye Clinic, including eye surgeons and heart surgeons. Of course they don’t wear glasses! But if you know any doctor or ophthalmologist who still wears glasses, take note that it is completely by choice and there may be a couple of personal or practical reasons why some people might or might not want to undergo LASIK.
If there is no prohibition for the surgery, doctors won’t discourage their family members who request such operations. Our surgeons have performed the procedure on their own family and other doctor friends close relatives.
Depending on the eye score, a small percentage of patients might experience regression (although not as much as before surgery).It happens for less than 5% of patients. If the eye score is low, the eye stabilizes, i.e. after 3- 6 months. In higher eye scores, particularly higher than -8 D, it takes more time, usually 6 months to 1 year. Of course there are some myopic people whose nearsightedness never stops and increases by 0.5 to 1 score or even more each year. We should know that Laser cannot prevent this increase in eye score and even after Laser procedure; their myopia will be enhanced by time. This shouldn’t be considered regression or lack of Laser effectiveness.
If your corneal thickness is enough, correction may be fine-tuned with retreatment, known as enhancement, and is generally performed after the first 3 months. The side effects are the same and it is not more dangerous for the patient. Although retreatment may further improve your ability to see, perfect vision is still impossible to guarantee. It is not scientific or logical to have an enhancement just to achieve a perfect vision.
You will have a blurry vision, if you don’t wear your glasses, but it is the only problem. If you’re eye score is going to change after surgery, wearing or not wearing glasses doesn’t make any difference. So, if you are satisfied with your current vision, there is no need for an enhancement surgery.
Laser and non-laser surgeries, which are performed on these patients, don’t affect thinning of the retina. In other words, these operations make retina neither thinner, nor thicker. Patients should be aware that despite getting rid of eyeglasses by performing one of these operations, the problems in other parts of the eye, including the retina, remains untreated. Patients who experience floaters or light flashes after LASIK should consult their doctor immediately to have a thorough examination of their posterior eye chamber.