Lasik eye surgery, also commonly referred to as “laser eye surgery”, is a type of refractive surgery that corrects common vision problems such as hyperopia (nearsightedness), myopia (farsightedness) and/or astigmatism, with the aim to reduce or eliminate the dependency on glasses and contact lenses.
In Lasik eye surgery, each type of eye problem is treated differently:
Myopia: Myopia (nearsightedness) is a refractive error that causes distant objects to be out of focus, while close objects appear sharp. It occurs when the cornea (the protective outer layer of the eye) is too curved or the eyeball is longer than normal. As a result, the light that enters into the eye isn't focused accurately, and objects at a distance look blurry. To cure myopia and improve vision, the cornea needs to be slightly flattened. This can be achieved by decreasing the angle at which light is bent (refracted) in the eye through the cornea.
Hyperopia: Hyperopia (farsightedness) is another eye condition that causes close objects to be out of focus, while distant objects appear sharp. It occurs when the eyes are too short compared to the curvature of the cornea. As a result, the eyes cannot bend light properly. In the treatment of hyperopia, the curvature of the cornea needs to be increased (steepened).
Astigmatism: Astigmatism, is another type of refractive error in which the shape of the eyes are not perfectly round but rather irregular. It causes distorted or blurry vision at any distance. To correct astigmatism, the surface of the eye needs to be made spherical, by smoothening the cornea.
The Lasik technique is based on the principle of creating a thin protective flap on the outer layer of the cornea (the epithelium layer) using either a microkeratome (blade) or a femtosecond laser, and then lifting the corneal flap to smoothly reshape the underlying corneal tissue using an excimer laser.
Once the reshaping process of the cornea is finalized, the doctor will carefully reposition the thin protective flap back to its original position. The negative suction will instantly bind the tissue to the surface of the eye.
Standard LASIK uses a microkeratome blade for creating the thin protective corneal flap, whereas in IntraLase LASIK the corneal flap is created with a femtosecond laser. Once the flap is created, both Standard LASIK and IntraLase Lasik will use the excimer laser to reshape the underlying corneal tissue. So the main difference is how the flap is created. IntrLase LASIK was developed to provide greater mechanical stability of the corneal flap with the objective to reduce flap-related complications and also to enable individuals experiencing additional challenges such as thin cornea or large pupils to undergo the procedure.
With the help of the computer-guided femtosecond laser, the surgeon is able to create the corneal flap at a precise depth and diameter, making it possible for a majority of individuals who were normally not suitable for LASIK, to undergo the procedure.
Both LASIK and LASEK reshape the stroma, the mid-layer of the cornea with an excimer laser to help treat nearsightedness, farsightedness and astigmatism. However, unlike LASIK, where a corneal flap is created and replaced, LASEK does not involve the creation of a corneal flap. The top layer of the cornea called the epithelium is loosened with the help of a dilute alcohol solution, which is then gently folded back to create access to the excimer laser to reshape the layer of the cornea called the stroma. Once the cornea has been reshaped, the surgeon will then replace the epithelium and put a special contact lens to protect the eyes while it heals. The contact lenses will remain on the eyes for a duration of 3-4 days. LASEK is generally recommended for patients who have very thin corneas, which is a condition that makes it difficult for the surgeon to create a thin protective flap on the outer layer of the eye's surface and for patients who have significant myopia (nearsightedness).
‘How much you can see’ depends on optical defects associated with common refractive errors such as myopia, hyperopia, and astigmatism, which can be treated with the standard lasik eye surgery. On the other hand, ‘how well you can see’ in terms of sensitivity and fine details, depends on the presence of, and type and the number of higher-order aberrations, also known as vision disorders. Other than common refractive errors such as myopia, these vision disorders may also include corneal irregularities in the structure of the eye that affect the quality of the vision creating problems such as decreased contrast sensitivity or difficulty with night vision. Wavefront technology measures how light waves travel through the eyes, scanning all layers from the front to the back, with a special laser to create a detailed 3D map also called ‘optical fingerprint’ of the eyes and address any refractive errors and/or corneal irregularities. The information obtained is then electronically transferred to program the laser to create a customized laser treatment for your specific visual needs.
PRK (photorefractive keratectomy) is another type of refractive surgery that corrects common vision problems such as hyperopia (nearsightedness), myopia (farsightedness) and/or astigmatism. It was the first type of laser eye treatment for correcting refractive errors and is considered the precursor of the popular LASIK eye surgery. Both LASIK and PRK reshape the stroma, the mid-layer of the cornea with an excimer laser to help treat nearsightedness, farsightedness and astigmatism. However, unlike LASIK, where a corneal flap is created and replaced, PRK does not involve the creation of a corneal flap. In PRK, the thin outer layer of the cornea called the epithelium is removed with an alcohol solution, a "buffing" device or a blunt surgical instrument and discarded prior to sculpting the outermost layer of the corneal tissue using an excimer laser.
Within a few days following the procedure, the epithelium will be repairing itself as it grows back over the corneal surface. The final outcome of PRK surgery is comparable with the results achieved with LASIK surgery, but initial PRK recovery is slower because it takes around 7 to 10 days for the corneal epithelium to regenerate. As PRK surgery does not involve the process of creating a corneal flap, the entire thickness of the underlying stroma will be available for treatment. This particularly provides a benefit for individuals with thin corneas who may not be suitable candidates for undergoing LASIK surgery.
Presbyopia is a vision condition caused by aging, commonly seen at around 40 years of age, where the natural lens of the eye starts to lose its flexibility, leading to a gradual decrease for the capability of an individual’s eye to focus on close objects, thus causing blurry vision and difficulty in reading small texts. Individuals will generally start to experience the symptoms, once they start to notice that they need to hold books and other written materials at a distance in order to have the ability to focus their eyes to read.Reading glasses, bifocals and progressive lenses are some of the most commonly known options for correcting presbyopia (nearsightedness). However, there are also 2 alternatives that many people are less familiar with; the correction method of "Monovision” and the more advanced method; “Supracor Lasik”.
In Monovision, your dominant eye-the eye you’d prefer to see with if you had to choose between the right or left eye-is corrected for distance vision, while the other eye is corrected to enhance near vision. This, in turn, will provide clear vision for both near vision and distant vision. While many people find they adapt well to this technique, some individuals may not be comfortable through this technique, as it may cause problems like loss of depth perception.
Who is a suitable candidate for Monovision?
● In their 40s or older
● Who are looking for the convenience and freedom of living “spectacle-free”
● Who are not active in high sports such as football, motorcycle riding, tennis
● Who have tried monovision contact lenses before and liked it
● Who don’t want to use reading glasses and only need one eye corrected
● Who are fine with the idea of using distance glasses to adjust distance vision for night driving or for sports activities
Fortunately, today there is another option for patients with presbyopia; Supracor Lasik. Supracor Lasik is considered to be one of the latest advancements in multifocal laser technology. It is a safe, effective and novel method that aims to create multifocality on the cornea.
The process starts by creating a thin cornea flap using a femtosecond laser or a microkeratome.The flap is then lifted and the cornea is gently re-shaped with an Excimer laser, correcting both distance and near acuities without impairing the far sight. After the cornea has been sculpted to provide good vision at all distances, the flap is then replaced back, allowing the eye to naturally heal.
Who is a suitable candidate for Supracor Lasik?
● In their early 40s and 50s having difficulty in reading (near vision), with no eye diseases such as keratoconus/retinal issues
● Who have a stable eyesight prescription of moderate degree for distance; myopia or hyperopia and a minimum degree of +1.75 minimum for near
● Who are happy with binocular vision (the ability to look at the same object with both eyes at the same time, which gives us perception of depth) after the procedure
● Who having no major systemic illness
Implantable lenses are an alternative to LASIK and PRK eye surgery for correcting moderate to severe to moderate nearsightedness (myopia), however unlike traditional contact lenses, Implantable lenses are surgically placed either between the cornea and the iris (the colored part of the eye) or just behind the iris, without removing your natural lens. There are two types of implantable lenses; IOL (intraocular lenses) and ICL (implantable collamer lenses).
IOL (Phakic Intraocular lenses) is made of acrylic or silicone, and is attached in front of the iris. It is designed for people aged 21 years or older who have nearsightedness ranging from -5 diopters to -20 diopters.
ICL (implantable collamer lenses) is made from Collamer, which is a combination of collagen and polymer; a biocompatible material that works in harmony with your eye and is implanted behind the iris (the colored part of the eye) in front of the natural lens of the eye. It is designed for people aged 21 to 45 years who have;
- A myopia (nearsightedness) correction from -3 diopters (D) to -16 D
- A myopia reduction from -16 D to -20 D
Both lenses require patients to have an astigmatism degree of 2.50 D or less.
Implantable lenses may be ideal for patients who are not candidates for LASIK or PRK, due to high levels of nearsightedness, chronic dry eye symptoms, thin corneas, or large pupils.
Over the last century, as with many fields of specialty practices in medicine, modern cataract surgery has also benefited from the advances in medical technologies through the implementation of innovative techniques and the high-tech instruments used.
90% of the patients we treated at our ophthalmology clinic, had multifocal intraocular lenses implanted as a solution to correct their cataracts. We owe this success to our skills and expertise, our professional team of qualified ophthalmologists and the utilization of new technology, advanced lens implants.
A Substantial Novelty in Cataract Surgery: Drop-free Cataract Surgery
The lens, located just behind the colored part of the eye, provides a clear and sharp vision by focusing the lights received by the cornea onto the retina. This lens should be clear in order to focus this light onto the retina.
Cataract implies a condition, in which the clear lens is blurred due to different causes. Overproduction of oxidants, certain diseases such as diabetes, long term use of medication or steroids, radiation therapy and smoking are some of the common causes of cataract. Cataract is no longer just a problem related to the aging process, as it was before. Today, it is also seen in about half of the people aged between 50 and 59. Our Ophthalmology Clinic uses an innovation in cataract surgeries which is gradually becoming more comfortable to implement as technology advances. Owing to this method, patients no longer require frequent use of eye drops for their recovery, which has to be continued for a month during the postoperative period of cataract surgery.
Dropless Cataract Surgery
When a trans-zonular intravitreal injection (a mixture of long-acting antibiotics and cortisone) is used to treat the eyes, patients are able to see more comfortably the following day of the surgery, without needing to use eye drops. With this method, the risk of infection and the occurrence of retinal edema is very low. It remarkably simplifies the postoperative period and also decreases any likely side effects of eye drops.
Keratoplasty is a surgical procedure that involves replacing a damaged corneal tissue with a healthy corneal tissue obtained from a donor. Keratoplasty can bring back clarity of vision, reduce pain and improve the appearance of corneas that have taken an opaque or whitish hue due to scarring. We have observed the positive effects of Keratoplasty on over 2500 patients who underwent corneal transplantation at our ophthalmology clinic. We take pride in their successful results and continue to perform these procedures, with more expertise.