Refractive surgery is the set of surgical techniques applied to millions of people to correct refractive errors such as myopia, η hyperopia και ο astigmatism. These procedures are regulating the focus of the eye, by altering the surface of the eye, and particularly that of the cornea, so that the patient can see clearly without needing glasses or contact lenses.
There are numerous and different techniques, and each patient undergoes a preoperative check, in order to select the one that will offer the best result. Thanks to technological advancements, and the continuously increased experience of refractive surgeons, these techniques are perfectly safe, and can meet all of the patient’s needs.
The basic techniques used in Refractive Surgery are:
With the Lasik method, refractive errors are corrected not on the surface, but inside the cornea. Initially, a thin flap of the corneal tissue is formed on the surface, that is not completely detached but remains connected to the cornea on one side. Then, this flap is lifted revealing the inner layers of the cornea and Excimer Laser is applied, that achieves the sublimation of the corneal tissue, in order to change the corneal curvature and thus correct the refractive error. Finally, the surgeon reattaches the flap.
The way the flap is formed in recent years has evolved into a procedure of high precision. Up until recently the incision was carried out only through the use of a mechanical microcornea blade, to cut the cornea.
Today refractive surgeons enjoy the outstanding benefits of the Femtosecond Laser. Femtosecond Laser uses light pulses that penetrate the surface of the cornea and form small cavities (bubbles) at a predetermined depth, and within the corneal layer. The result of the application of Femtosecond Laser is the creation of a uniform layer of bubbles on the cornea. By using a special spatula, final separation of the flap from the rest of the cornea is achieved. Then, the surgeon may apply the Excimer Laser treatment.
Compared to the mechanical microcornea blade, the flap creation using femtosecond technology is a more predictable, and more controllable procedure. The thickness, the diameter, the angle of the flap’s limits, the position in which it remains joined to the cornea M and the angle of the stem are all defined by the surgeon, prior to the application of the Femtosecond Laser.
Continuous technological advances have helped with the impressive improvement of the technical characteristics of Excimer Lasers. The new machines have the ability to use a very narrow laser beam, that “flies” to various parts of the cornea (flying-spot laser). Therefore, it allows a more detailed surgery. The speed of these machines has also increased, so as to minimize length of treatment.
Finally, individualized treatments can be implemented according to the needs of each eye separately (wavefront-optimized & wavefront-guided treatments). These treatments are used in conjunction with corresponding diagnostic machines, that have introduced refractive surgery in the exciting world of Wavefront-guided / optimized & Topography guided customized ablation.
Surgery is now customized for each eye, and is not the same for all patients with the same eyeglass prescription.
At “Diathlasis” Femtosecond Laser VisuMax by ZEISS is used exclusively, a system that in conjunction with Excimer Laser Wavelight Concerto 500Hz, the only one in Northern Greece, offers outstanding clinical results, and greater comfort for patients during the eye surgery.
In the Xtra Lasik technique, the surgeon combines the Lasik Cross-Linking technique to avoid any postoperative corneal ectasia, in marginal cases for the application of the classical LASIK method (high myopia - thin cornea).
PRK method is very effective in correcting small degrees of myopia, with or without astigmatism, and higher degrees, where the cornea is relatively thin. A very thin laser beam is applied to the surface of the cornea.
In this technique no corneal flap is created, but the surface membrane of the cornea (epithelium) is removed using a special tool, and then Excimer Laser treatment is applied.
At the end of the surgery, a contact lens is applied to help the epithelium heal within the next three to four days.
The surgery takes just a few minutes, and is performed using local anesthetic eye drops.
n this method all customized treatments may be applied.
SMILE Small-Incision Femtosecond Lenticule Extraction
Last generation method in Laser Refractive Surgery.
Now for the first time in Greece, exclusively available at the Ophthalmological Institute ‘Diathlasis’.
Refractive surgery using the new SMILE method changes entirely the field of refractive surgery. The innovative SMILE technique, in conjunction with Femtosecond technology, achieves high precision corneal tissue removal, depending on the degrees we wish to correct, resulting in greatest safety and less time in surgery.
The Laser creates a lenticular meniscus on the corneal tissue (< 4mm), that is removed through a small incision, and no flap is created.
Correction is carried out exclusively and using only one last generation Femtosecond Laser (Carl Zeiss Visumax).
- It is less invasive than LASIK, because no flap is created, avoiding the possible complications that can occur, while offering more advantages :
- Preservation of the cornea’s natural stability.
- Less proven postoperative dryness, due to the fact that the cornea nerve plexus is less affected.
- Less imported optical aberrations.
- Excellent long-term stability and predictability of results, regardless of the degrees of correction.
- The procedure is carried out with a single Laser, offering a minimum procedure time, and greater patient comfort.
- It allows for a wider ranger of myopia corrections.
PHAKIC LENSES (Visian ICL)
Patients unable for some reason to undergo Laser treatment for the correction of a refractive error (myopia> 10D - thin cornea - hyperopia> 5D), may be submitted, in certain cases, to surgical positioning of a very thin lens (like a contact lens), in front of the crystalline lens of the eye, enjoying very good quality of vision postoperatively.
Ideal candidate for the procedure
- You have to be at least 18 years of age.
- You must not have a chronic cornea, or retinal disease.
- Your vision must be stable over the last year.
- Refractive surgery is not recommended during pregnancy, during lactation, or in the case of expected pregnancy, during the next two months.
Preoperative check is carried out by qualified ophthalmologists in our fully equipped space, and it ensures a proper assessment of each patient's problem, securing the most appropriate treatment approach.
- Vision stability
- Cornea status
- General health of the eye
The examination is completed with a fundoscopic image and the complete assessment of eye metrics.
- You should avoid the use of soft contact lenses for at least 1 week. If the patient wears hard contact lenses, it is advisable to avoid using them for at least 4 weeks prior to the preoperative check.
- If older eyeglasses are available, it is best if the patient carries them with him for comparison reasons (with the new refractive correction).
Pre- and postoperative instructions
- Contact lenses must be removed before surgery (2 weeks for soft contacts, and 2 months for semi-soft).
- You must avoid any eye makeup for at least 2 days prior to the surgery.
- Use of eye cream, perfumes, and hair spray/gel is forbidden.
- We advise that you are accompanied, so that you avoid driving after surgery.
- It is necessary to have a pair of sunglasses with you (blurred vision, photosensitivity).
- The total time that you will remain at the clinic on the day of the surgery will be approximately 2 hours.
- After the surgery you will feel drowsy and it is advisable to rest.
- The first hours after the surgery your vision will be blurred, and that is normal.
- Returning to work is possible for most patients even on the very next day.
- Washing your hair: For 7 days you will be careful whilst washing your hair.
- Driving: As soon as you feel comfortable to do so.
- Heavy physical activity: One to two weeks after the surgery, and after consulting with your doctor.
- Swimming: After 2 weeks.
- Avoid using cosmetics around the eyes for at least 10 days after the surgery.
- Sweat may cause stinging, but it is not harmful.
- Avoid substances that may cause irritation (smoke, dust etc.) for a few days.
- Do not rub your eyes.
- It is likely to experience redness, photosensitivity, dryness, and possibly tiredness after reading for a significant amount of time. All of the above usually disappear after 48 hours.
After the procedure, detailed instructions are given for both the use, and dosage of eye drops, and for all necessary constraints for an excellent and quick recovery.
The patient must visit the clinic for a postoperative examination on the day of the surgery, on the first week, the first month, after six months, and on the completion of exactly one year after the surgery.