Customized Femtosecond LASIK, Customized LASEK or PRK, SMILE, Phakic IOL
Today, after 30 years of laser surgery methods for correcting refractive errors of the eye, there are three main methods for correcting refractive errors:
1) Correction by PRK, LASIK or Trans PRK
2) Correction by Femtolasik (FSLASIK)
3) Correction by SMILE and the latest method of Smart Smile (Customized SMILE)
In three methods, the operation can be performed using smart technology and identifying the patient’s iris, in which case the results of the operation will be more accurate and reliable, especially in patients with astigmatism, hyperopia or myopia or combined astigmatism.
1) Laser corneal surface method including LASEK, PRK and TransPRK (Customized LASEK)
Today, these methods are considered safe, safe and effective and can be performed in patients with low to moderate myopia, myopia and astigmatism with low numbers and hyperopia up to number 2.
Patients who have thin corneal thickness or are highly exposed to severe trauma or have risk signs in pre-operative examinations in corneal topography are the most suitable cases for this surgical method.
Points to consider in these methods:
• Accurate and complete preoperative evaluation and iris recognition for better results, intelligent surgery, evaluation of the condition of the ocular surface and tear film, and treatment of associated problems if needed before surgery
• Avoid wearing contact lenses for one week before surgery in soft lenses and for 2 to 3 weeks in hard lenses
• Choosing the appropriate surgical method along with sufficient surgeon experience and careful postoperative control, especially in the first days after surgery until the corneal epithelium is completely repaired and the dressing lens is removed, usually on the third to fifth day, is very important.
• The treatment period in this method is long and return to activity will be one week after the operation. On the first and second day after the operation, pain, watering, fear of light and the feeling of a foreign body in the eye are disturbing.
• The use of eye drops for three months and the use of sunglasses with the property of absorbing ultraviolet rays at a wavelength of 400 in the first six months are very decisive in the success of the operation.
2) Customized Femtosecond LASIK
In this method, which is one of the most advanced laser correction methods, a 110-micron-deep layer of the cornea is first created with the help of a femtosecond laser, and then a laser ablation is performed using an excimer laser in a smart way. This procedure is performed in 5 minutes and using anesthetic drops.
The advantages of this method include rapid return of vision, rapid return to daily activities, and rapid and painless recovery.
This method can be more effective than the corneal surface laser method in people with high myopia, high astigmatism, hyperopia, and hyperopia with astigmatism.
Suitable individuals for femtolasic surgery include those with a corneal thickness of 500 microns or more and who have no problems with corneal topography.
Since this method uses two laser systems, the cost of the procedure is approximately twice that of corneal surface laser procedures.
If preoperative evaluations are performed with sufficient accuracy and completeness and the best techniques are used during surgery, there are no worrying and vision-threatening complications. Complications include residual refractive error, nighttime light scattering, and dry eye sensation, which usually resolve within 3 to 6 months (in rare cases).
Reoperation to correct refractive errors can be performed 3 to 6 months after the first operation, if there are no other problems.
3) SMILE and Customized SMILE
It is considered the newest and most advanced method of refractive error surgery. This method has been presented in the last ten years and is performed with a femtosecond laser device and is very effective in patients with myopia, hyperopia and astigmatism. This method is safe with reliable results and its advantage is that it causes less dry eyes and heals faster and is possible in a smart and customized way with new femtosecond devices. It is the best choice for people who are exposed to trauma since a very small incision is made in the cornea. It is currently considered one of the safest and most stable methods of correcting refractive errors in the cornea. The femtosmile device, owned by the German company Schwind, is installed in the Iranian ophthalmology clinic.
4) Intraocular lenses for the correction of myopia, hyperopia and astigmatism (Phakic IOL)
Intraocular lenses, especially the new ICL, Toric ICL, are safe, effective and predictable methods in patients who are not suitable candidates for laser correction. If there are no restrictions in the preoperative examinations and the surgeon has sufficient experience in these operations, this method is also very effective. In patients with thin corneas or mild keratoconus whose refractive error number has been proven, it is considered one of the best correction methods
Dr. Seyed Javad Hashemian
Iranian Ophthalmology Subspecialty Clinic