Life Without Glasses Part 2 – Refractive Laser Treatments

Refractive Laser Treatments

These procedures are used to correct refractive errors such as nearsightedness, farsightedness, and astigmatism:

Femto-LASIK (Femtosecond Laser-Assisted In Situ Keratomileusis)

Procedure:

• A femtosecond laser creates a corneal flap (thin lamella).
• An excimer laser reshapes the underlying cornea to correct the refractive error.
• The flap is repositioned.

Advantages:

• Fast healing, sharp vision often the next day.
• Suitable for many refractive errors.

Restrictions:

• Not suitable for very thin corneas.

PRK / LASEK (Photorefractive Keratectomy)

Procedure:

• The outermost corneal layer (epithelium) is removed.
• An excimer laser reshapes the cornea to correct the refractive error.
• After treatment, a bandage contact lens protects the eye until the epithelium regrows.

Advantages:

• Suitable for thinner corneas.
• Alternative when LASIK is not an option.

Restrictions:

• Longer healing time.
• Temporary discomfort such as pain or light sensitivity.

CLEAR (Corneal Lenticule Extraction for Advanced Refractive Correction)

Procedure:

• A femtosecond laser creates a thin tissue segment (lenticule) in the cornea.
• The lenticule is removed through a small incision, giving the cornea its new shape.

Advantages:

• Minimally invasive, no flap creation necessary.
• Shorter dry eye phase after surgery.

Restrictions:

• Mainly suitable for myopia and mild astigmatism.

Therapeutic Laser Treatments

These procedures are used to treat corneal diseases:

PTK (Phototherapeutic Keratectomy)

Procedure:

• The excimer laser removes diseased corneal tissue.
• Frequently used for:
  • Corneal scars
  • Recurrent corneal erosion
  • Superficial corneal dystrophies

Advantages:

• Improves visual quality in structural corneal damage.

CXL (Crosslinking with Laser Support)

Procedure:

• Used to treat keratoconus.
• Combination of riboflavin eye drops and UV light to stabilize the corneal structure.
• Laser can be used to precisely remove the epithelium (epithelium-off procedure).

Advantages:

• Slows or stops the progression of keratoconus.
• Can be used after refractive laser treatment to further stabilize the corneal structure.

Restrictions:

• Not suitable for advanced stages.

Hybrid Procedures
Sometimes refractive and therapeutic approaches are combined:

Topography-guided PRK or LASIK:

• Specially adapted to irregular corneal shapes (e.g., in early-stage keratoconus).

Advantages:

• Improves corneal structure and visual quality.

Laser-Assisted Transplantations

In certain corneal diseases, such as scarring or late-stage keratoconus, the laser can also be used in corneal transplants:

Femtosecond laser-assisted transplantation (DALK, PKP):

• The laser prepares the cornea precisely for transplantation.

Advantages:

• Faster healing and more precise results.

What is Femto-LASIK?

Femto-LASIK is a modern and precise method for correcting refractive errors (nearsightedness, farsightedness, and astigmatism) using laser technology. The term "Femto" refers to the femtosecond laser, which is used in this procedure instead of a mechanical microkeratome to create a corneal flap (a thin lamella). This flap is folded back, and the underlying cornea is shaped with an excimer laser to correct the refractive error.

Surgical Procedure