LASER REFRACTIVE SURGERY:
LASER EYE SURGERY:
such as Photorefractive keratectomy (PRK), Laser In Situ Keratomileusis (LASIK), and the most recent SMILE surgery is among most common ophthalmic procedures in the world. Reasons for its popularity lie in its safety, efficacy, quick visual recovery, and minimal patient discomfort.
Patient satisfaction is almost 99% with this type of surgery.
Photorefractive keratectomy (PRK):
PRK is performing the refractive surgery without making the corneal flap. There are no flap complications with the PRK surgery, however visual rehabilitation is longer, and in the first few days after surgery, it is more painful than LASIK.
Involve forming a corneal flap with femtosecond laser, it is less painful than the PRK and the visual rehabilitation is faster, however patient could suffer from flap complications (incomplete, dislodged, eccentric, button hole).
IS LASIK SAFE?
LASIK is a very safe and successful procedure, with 97% of patients achieving 20/40 vision (driving performance). Only 0.3% of patients might lose 2 or more lines of vision due to LASIK complications. LASIK surgery involves creating a corneal flap, and most of the LASIK complications are related to the flap, and it is almost 0.1%
Ectasia (bulging of the cornea) is one of the most serious side effects of LASIK, however the incidence of this complication is very low (almost 1/10000) especially with current advanced diagnostic instruments.
HOW OLD DO YOU HAVE TO BE TO GET LASIK?
LASIK is recommended for patients age 21 year-old and above
WHAT IS SMILE?
SMILE is the newest technology in correcting myopia and astigmatism, by removing a thin layer from the corneal stroma through a small 2-3 mm incision, using femtosecond laser.
SMILE procedure provide quick and painless visual improvement, and the risk of developing dry eyes is negligible, due to the small incision made on the surface of cornea, in comparison to the large incision made in LASIK surgery.
Please read more about SMILE laser eye surgery and what results to expect here:
IS SMILE EYE SURGERY SAFE?
Every procedure is associated with potential complications and SMILE is not an exception. However since this is a flap-less procedure, it indicates that all complications associated with the corneal flap, as in the case of LASIK, would be excluded from SMILE.
The most encountered complication with SMILE is the lenticule misdissection, which could lead to the procedure being aborted. With newer techniques emerging in lenticule dissection, however, this complication is becoming less frequent.
Difficult lenticule extraction could be encountered during the surgery in 9%. This could be related to the laser energy setting. It usually leads to an extended time of surgery and delayed visual recovery of up to one month due to corneal oedema. With continuing improvement of energy setting, this complication is becoming less encountered
Cap tears could be encountered in 1%. The cap is the anterior part of the cornea overlying the lenticule. Difficulty with delivering the lenticule could result in cap tears. If this complication happened, a bandage contact lens will be used to faster the healing process. The visual recovery might be delayed for up to one month, however, the final visual outcome is no less than uneventful surgery
Retained lenticule is also related to difficult lenticule dissection and could be encountered in 3%. If the visual outcome was suboptimal, further refractive surgery, such as LASIK, could apply three months later with a very good outcome.
The recurrence of short-sightedness could be encountered in 2.2% to 2.9% after the SMILE procedure and this is comparable, or slightly lower, than those reported for LASIK
Enhancement could be achieved with further refractive surgery like LASIK or PRK.
Most of the SMILE complications are related to difficult lenticule extraction, however, these complications would be less with further improvement of the laser setting.
Even if a complication happens, the visual outcome is still excellent, albeit with delayed recovery.
HOW LONG IS THE RECOVERY TIME AFTER SMILE?
On the first day following SMILE procedure, 55% of the patient will achieve 20/20 vision. This percentage would increase to 80% at one week, 93% at one month, and 96% at three months.
Patients may notice reduced quality of vision on the first day like glare and haloes, which is due to the postoperative corneal swelling. As the corneal swelling settles down, the quality of vision will get better and over the following three months there might be further improvement in the visual acuity.
HOW OLD DO YOU HAVE TO BE TO GET SMILE?
Like other laser refractive surgery patient should be 21 year-old and abov
Presbyond laser surgery:
Presbyond is the latest corneal refractive solution for Presbyopia (inability to see near objects that usually comes with age or following cataract surgery). Presbyond is performed using special laser platform that is incorporated with the Zeiss Laser machine.
ICL (Implantable Collagen Lens) or IMPLANTABLE CONTACT LENS:
ICL is a lens that could be implanted inside the eye without having to remove the normal lens. The advantage is that the patient can keep his normal lens, which means the patient will still be able to accommodate (to be able to see for distance and near) until the patient reaches the age of 40, at which time the normal lens would start to lose the ability to accommodate.
ICL is a good option for patients who have refractive errors (short-sightedness, long-sightedness, ASTIGMATISM), who are not a good candidate for laser refractive surgery.
It could treat a wide range of refractive errors (between +6 to -18 dioptres) and astigmatism up to 6 dioptres.
IS ICL SAFE?
The main risk is the development of cataract formation over 10 years after the surgery, in almost 10% of the patients, for which patients might need to have cataract surgery to improve the vision. Eye pressure may increase in 5% of the patient, however, the surgery is reversible and the lens could be removed if needed.
AM I ELEGIBLE FOR ICL?
ICL could be used for patient 21 year-old and above.