Laser eye surgery

Types of laser surgeries

Laser eye surgery consists in the treatment of the cornea in order to correct the eye error. The difference between the various methods is the way in which the cornea is uncovered in order to do the correction. On this basis, we distinguish superficial (conventional) methods (Lasek, No Touch - TE PRK) or in-depth methods (Z-Lasik, Lasik, Relex Smile 3D). Our eye clinics in Bratislava and Banská Bystrica provide the following procedures:

In-depth procedures

They are distinguished by the fact that the diopter adjustment occurs deep in the cornea. In this type of laser eye surgeries, there is no surface damage of the cornea and it is painless.

a) Relex Smile 3D  is suitable for patients with astigmatism and nearsightedness from -1 diopter prescription.

Using a special femtosecond laser, no part of the cornea needs to be lifted off. Instead, a lenticule is created inside. The cornea is then cut by laser with an about 3 mm incision, through which the surgeon removes the lenticule. The cut does not require stitches, so the eye defect is corrected, but the surface of the cornea remains intact.

Eye surgery using the Relex Smile 3D method is not suitable for patients with a thin cornea; on the contrary, good candidates are patients with -1 to-10 diopter power and with astigmatism up to 5 cylinders. In patients with hyperopia, we recommend the Z-Lasik method. The advantage of the Relex Smile 3D eye surgery is the maximum safety for the patient, maintaining physiological layers of the cornea, no complications known for other methods and minimum risk of dry eye.

b) Z-LASIK is a two-step method using a femtosecond and excimer laser. It is designed for the correction of myopia, hyperopia and astigmatism.

In the first phase, a lamella -flap is created using a femtosecond laser. In the second phase, it is lifted using an excimer laser. The surgeon then performs the correction of the cornea with the laser and puts the flap back in place after finishing. Within several hours after the surgery, the lamella adheres back to the cornea painlessly. In the evening you can read a book or watch TV without restriction. Incapacity for work after the surgery is more of an exception; you can go to work the next day. The advantage of Z-Lasik eye surgery is the fact that it minimally stresses the eye, it is comfortable and painless even with challenging findings on the cornea, and it has fast results.
 

Surface procedures

In the case of surgeries with the use of surface processes, the cornea is grinded on the surface with the laser. This step prevents transient corneal epithelium removal. According to the way in which this happens, we distinguish the following methods:

a)     PRK - corneal epithelium is removed mechanically without the use of an alcohol solution
b)     LASEK - epithelium is removed mechanically using a 20% alcohol solution
c)     No Touch = TE PRK - corneal epithelium is removed using an excimer laser in the first phase of the surgery

The removed corneal epithelium grows back in the post-operative period, therefore patients experience more pain than with in-depth methods. Laser eye surgery of this type is suitable for patients with a thin cornea, who suffer from myopia and astigmatism. Patients with plus diopters are inappropriate candidates for surgery.

Comparison of the individual laser surgery methods

Name	Relex Smile 3D	LASIK (iLasik/Neolasik HD/Z-Lasik)	LASEK/PRK/No Touch
the use of an excimer laser	no	yes	yes
the use of a femtosecond laser	yes	yes	no
the surface of the cornea is removed	no	no	yes
a flap is created on the cornea	no	yes	no
use of a cut on the cornea	no	yes	no
disruption of the corneal structures	no	yes	yes
disruption of corneal nerve fibers	no	yes	yes
pain after surgery	none	none	3 - 4 days
sick leave	none	none	3 - 4 days
stabilization of vision	within a couple of hours	within a couple of hours	within 1 month
the risk of dry eye syndrome and inflammation	none	low	yes
removes the diopters	-1 up to -10	+5 up to -10	+5 up to -10
removes astigmatism	yes	yes	yes

 

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