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Eye and Laser: FEMTOLASIK
The new standard of refractive surgery
Is the femtosecond laser operation painful?
Laser treatment is not painful.
With the femtolaser technique you may have discomfort and tearing for a few hours after the surgery. The day after, generally, there is a normal resumption of daily activities. If the treatment is carried out on Friday, you can resume work three days later i.e. on Monday.
With PRK, however, you must use protective contact lenses & take pain medication for five days due to the initial pain for 24-48 hours, accompanied by eye irritation and watery eyes..
It is advisable to return to work no earlier than 10-14 days.
Should both eyes be operated
in the same session?
Yes, because scientific literature is in agreement with the fact that the security level is identical, with respect to intervening in two successive stages, but the discomfort of the patient is double and so is the time commitment in case of 2 separate treatments.
When will I start to see?
After a femtolasik you will be able to see in a few hours. The day after, generally, there is a normal resumption of daily activities.
After an intervention of PRK, it is necessary to use contact lenses for 4-5 DAYS therefore the visual recovery will be slower
When can I return to work?
After a femtosecond laser treatment carried out on Friday, you can resume work three days later, on Monday.
After PRK, the progress will be more gradual, in a few days, but the total recovery may take a few weeks
When can I get back in the pool?
There is a small risk of contracting pool conjunctivitis. Therefore prudence recommends a gap of a month and the use of goggles when swimming.
When can I play sports?
Light physical activities (running, gyming etc) may be resumed after three days, while team sports require a complete healing, not recommended before 2-3 weeks
When can I take a shower?
The day after the surgery, but keeping your eyes closed to avoid contact of the eyes with shampoo and soap which might irritate them.
When can I wear makeup eyes again?
All makeup products use a fatty base, which is an excellent breeding ground for germs. It is advisable to avoid eye makeup for a month.
When can I resume sexual activity?
After 3 days.
Do I need to protect myself from the sun?
For the first month it is advisable to protect yourself from the sun, especially at the sea or in the mountains, by using sunglasses and avoiding lamps, showers and tanning beds.
What is the process followed during the femtolasik procedure?
Lying on your ophthalmologist chair you will be placed under an operating microscope combined with femtosecond laser, controlled by a computer. Within minutes the treatment is performed in both eyes.
The duration of the pulses of the femtolaser is a maximum of 22 seconds per eye. After turning the table 180 degrees you undergo the action of the excimer laser, coaxial to a second operating microscope, which is managed by a specially developed and patented software. It has an average duration of less than one minute.
How long does the laser surgery last?
With the preoperative preparation and the final dressing, one can spend 20-40 minutes for a bilateral treatment.
What happens if during treatment, I move the eye, cough or sneeze?
Nothing, because the eye tracker follows the contour of the cornea with a sophisticated technology from the aerospace industry.
This is a special mechanism, created for the pointing of the missiles and tracking of moving targets, which allows recognition of the patient's irisand is able to move the laser synchronously to the micro movements of the eye, while remaining centered.
What is better PRK, LASIK or LASIK with femtosecond?
LASIK has been the most commonly performed surgery in the world, given the high accuracy, the fast visual recovery and higher acceptability by the patient for the absence of pain and postoperative discomfort.
The PRK is, vice versa, the most widespread intervention in Italy, both for its cost and for surgical simplicity..
Dr. Panic recommend a LASIK treatment with femtosecond laser or FEMTOLASIK as a first option, for more comfort, greater safety and precision as compared to older techniques. As a second option, we will recommend a PRK.
The LASIK with a mechanical microkeratome is no longer recommended.
What is the action most suitable for me?
Dr. PANIC recommends personalized made to measure interventions (custom ablation, evaluated along with clinical situation and accurate imaging studies.
How to choose the center of refractive surgery?
They should be favored with the latest generation of laser centers, compared to those that have old equipment and less reliable. In particular, we must inquire whether the excimer laser is equipped with eye tracker. This is a particular mechanism, which allows the recognition of the patient’s iris and is able to move the laser synchronously to the micro movements of the eye/.
Ensure that the refractive surgery center you choose owns a femtosecond laser, which allows you to perform the surgery more precisely and securely with iLasik technique. Best Femtosecond lasers are those with an operating frequency of 500 kHz which allow their power with better cutting andapplying an energy lower eye. In essence, as the surgeon must be up to date on new techniques, so the center you choose must invest in modern technologies.
The technique to a safer and innovative today is the femtolaser treatment,slowly spreading and supplanting all other previous techniques, making them obsolete.
What type of laser is used?
Dr. Panic uses only the latest generation of lasersin refractive surgery: a fully signed platform CARL ZEISS MEDITEC including a femtolaser VISUMAX ZEISS 500kHz, the most powerful machine on the market, associated with an excimer laser MEL 80 ZEISS, with eye tracker to track eye movements during treatment and a aberrometer CRS MASTER WASCA ZEISS, for a custom WAVEFRONT treatment.
What is the eye tracker?
The eye tracker is a sophisticated technology from the aerospace industry, designed for the sighting of the missiles and tracking of moving targets, which allows the recognition of the patient’s iris and is able to move the laser synchronously to the micro movements eye, while remaining centered.
What is wavefront?
The wavefront is an instrument that measures the imperfections of optical lenses. This technology, created to reduce deformations induced by the lenses in the enormous objectives of astronomical telescopes, is now applied for all aberrations.
What's the difference between a traditional laser treatment and a personalized wavefront treatment?
In the wavefront treatment, the detected data is entered in the data base of the laser to improve the imperfections of the cornea and the final quality of vision. Any intervention becomes personalized, made to measure, because the aberrations of each are unique, like fingerprints and no intervention can ever be equal to one another.
How should one prepare for the day of treatment?
On the day of the treatment it is best to wear comfortable clothes that are not tight, tie long hair, not wear earrings or use perfumes or lacquers. Makeup must be removed thoroughly from the eyes and face at least 24 hours before, and the intake of alcohol must be avoided 24 hours before and 24 hours after the treatment because alcohol dehydrates the eyes Please do not bring children.
On the laser surgery day, is it better to be accompanied?
It is best to bring an escort for driving a car rather than coming alone for the treatment. After the treatment, the vision will be blurred for a few hours.
Do I need to book a hotel near the laser center?
If you live outside of Turin, it can be convenient.
Can I take a tranquilizer or sedative before the laser treatment?
If you’re feeling anxious or nervous before the laser, it is absolutely normal.
Once you arrive at the Dr. Panic’s laser center, the staff will administer any medication that is necessary.
Will the refractive surgery stand the test of time?
Refractive laser surgery has a history of over 20 years and the passage of time does not bring any ocular changes, unlike older techniques using lasers, such as radial keratotomy.
The results obtained from excimer laser are definitive, soon after stabilization, immediate in case of femtolasik and after a few months from the surgical procedure in case of PRK.
The necessary condition for this to occur is that of being in the presence of stable preoperative refractive defects. Only in the case of progressive visual defects variations can occur with time.
Mature age will rise to a certain amount of presbyopia, even when treated simultaneously with other defects of view, because of its progressive nature.
In the future, can there be problems with this treatment in the case of cataract or retinal detachment?
The onset of further diseases, with the passing of years, such as cataracts or retinal detachment will not be affected by the previous laser treatment, nor, will influence the course or treatment.
If I do laser do I have the certainty of eliminating glasses?
In 90% of cases it is possible to eliminate the visual defect entirely. The precision of the intervention is greater when the defect is lower. A treatment with a 10% refractive error remaining is considered a complete success
If after surgery a small visual defect remains what can I do?
In almost all cases you can do a laser retouching to correct any residual defect, regardless of the technique with which it was carried out the first operation.
What is the halo?
The halo is an optical phenomenon in which a point light is perceived by the eye with the help of a bright surrounding gradient. This can cause a less distinct vision of contrasts. The myopic or astigmatic eye is already characterized by a difficult visual perception in low light conditions (e.g at night). PRK and LASIK may increase the perception of halos, in case of reduced diameter treatments (narrow optical zones). The Vision of light and halos around the lights occur when the healing process is not yet completed. Accurate preoperative measurement along with the use of femtolasik , the latest generation of laser make this phenomenon of the almost disappeared.
What causes dry eye after refractive surgery?
Both LASIK femtosecond that the DPRK make eyes dry, because the surgery blocks the superficial nerve endings of the cornea, which regulate the production of tears by the lacrimal glands. Restoring the pre-operative condition may take some time, even months.
In high myopia, for which laser is not recommended, what can I do?
For the correction of defects that can’t be treated with laser it is possible to take action by establishing a lens inside the eye (phakic lens). This perfectly bio-compatible lens may be inserted behind the iris (the lens from the posterior chamber) or in front of the same (from the anterior chamber lens). The type of lens is chosen by the ophthalmologist, after a thorough medical examination and execution of specific instrumental tests.
What are "refraction defects"?
The defects of view, also called refractive errors or defects are myopia, hyperopia, astigmatism and presbyopia.
These are all those refractive conditions in which images from the outside world are perceived as sharp rather than blurred.
The type of blur depends on the type of defect (myopia, astigmatism and so on.) while the strength of the blur depends on the extent of the refractive defect.
Itcan usually can be corrected with glasses or contact lenses.
In adulthood the visual defect correction can be performed with surgical techniques such as the excimer laser and the femtosecond laser.
Normal eye (emmetropia)
The light rays are focused on the retina.
Normal eye (emmetropic eye) images through the cornea and the lens, 2 real natural lenses and are focused perfectly on the retina. The cornea functions as a lens and is a bit equivalent to autofocus digital cameras.
Between the two lenses is located the iris, a muscular ring, which determines the color of the eye and delimits the pupil. This narrows and widens in automatically, depending on the light conditions, similar to the diaphragm of the cameras.
What is Myopia?
Myopia is the condition in which the individual can clearly see up close, but the vision is blurred for a distance.
Myopia is the most common defect of view.
There can be several causes for this - excessive curvature of the cornea, marked curvature of the lens or excessive length of the eyeball.
The light rays are focused in front of the retina.
Glasses and contact lenses correct the defect by dropping back into focus images on the retina.
Myopia is corrected with negative, divergent lenses that allow you to drop the images on the retina and see fire
The interventions with the excimer laser "reshape" the corneal profile, reducing the curvature of the cornea power, moving the images on the retina and not in front of it.
What is farsightedness?
The vision is hard to see up close and often even for a distance.
There can be several causes - reduced curvature of the cornea, decreased curvature of the lens or reduced length of the eyeball.
At a young age, the distance vision is clear, but objects placed near the eye tend to be blurred, and only with some effort, become sharp.
This happens because the person is below 45 years and strains your eye muscles to focus on objects.
The accommodation has an automatic mechanism (a kind of autofocus unconscious) that acts instantaneously by changing the shape of the lens, depending on the distance of the image that you are observing.
In general the hyperopic eye is a more "short" eye of the normal and for this reason the images are to be focused behind the retina appear blurry.
All children are born with physiological hypermetropia which is reduced with the growth of the bulb up to the age of puberty.
The symptoms mainly consists of eye fatigue (asthenopia), that showcases red eye, tearing, soreness bulbar, listlessness in school activities as symptoms.
It can be accompanied by headaches after prolonged reading.
When the accommodation mechanism starts to be not so effective, patients experience progressive visual reduction for both distance and for near.
Hyperopia is corrected with plus lenses, that allow dropping the images on the retina and to see a fire.
For several years, it can also be corrected by refractive surgery. The excimer laser reshapes the corneal profile by increasing the power of the cornea curvature, and then allowing the images to focus on the retina and not behind it.
What is Astigmatism?
The vision is blurred and doubled from near and far
The defect is congenital. It is identified in the first years of life and remains almost unchanged over the years. Astigmatism can however also occur secondary to surgical procedures such as cataract, corneal transplantation, retinal detachment, or after ocular trauma, or even for the upper eyelid pressure on the bulb as happens in the case of palpebral type growths chalazion.
Astigmatism is a rather common visual defect that does not allow a good view either closely or from afar.
In an astigmatic eye, the curvature of the cornea is comparable to a rugby ball with a meridian curvature at most (the one crushed) and one with a lower curvature, perpendicular to it.
In general, an astigmatic eye bright spot from the outside is seen as two lines orthogonal to each other placed on two different planes, so the ima
ges appear blurry and distorted.
Given that a distinct retinal image can not be formed, in an attempt to improve image quality, there are continuous changes of accommodation that can easily give rise to astenopeici disorders or visual fatigue.
Astigmatism can be myopic, hyperopic and mixed.
Myopic astigmatism both focal lines fall to the front of the retina, the hyperopic both focal lines are located on the back of the retina.
Mixed astigmatism a focal line is at the front of the retina while the second falls behind the retina itself.
Minimal astigmatism, 0.5 or 1 diopter, it is considered physiological and generally does not require correction.
Glasses or contact lenses have the function of "return" the images on the retina.
Astigmatism is corrected with contact lenses or glasses that allow you to drop the images on the retina and to see a fire.
For several years, it can be corrected with refractive surgery.
The excimer laser reshapes the corneal profile by increasing the power of an axis of curvature of the cornea or reducing the perpendicular axis thereby allowing the images to go to focus correctly on the retina.
At the same time it is also possible to treat nearsightedness or farsightedness may be associated.
The images appear blurry / split vertically
The images appear blurry / split horizontally
What is Presbyopia?
Presbyopia is the difficulty in focusing on close images for people in their 40s and worsens steadily until 60 years when you can focus well only the distant figures. To close will serve an additional lens, one for each distance that you want to focus on, or you will have to take a multifocal lens or progressive. This condition, absolutely natural, is called presbyopia and being physiological, occurs in all people.
Presbyopia is caused by the gradual hardening of the lens. For this reason, the ciliary muscle, responsible for the accommodation, no longer able to change its shape. Remains fixed the power to focus from a distance. This condition is not reached suddenly but gradually.
Presbyopia is corrected with converging lenses, which allow a distinct vision for near compensating for the accommodative function.
In the event of defects in existing view several things happen:
Who is shortsighted starts seeing better up close after removing his glasses, while far the situation does not change.
Who is hyperopic, however, exhibits the first of presbyopia, because the two defects are added.
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