What is laser diopter removal (refractive eye surgery)?
Laser removal of diopters is a procedure in which a high precision laser remodels the cornea and thereby removes the refractive error. The procedure is safe because today’s lasers are very accurate and do not produce any thermal effect on underlying tissue.
Am I a candidate for refractive eye surgery?
In short, candidates are all adult persons who meet the criteria for the procedure. Some of the basic criteria are: stable refractive error, sufficient corneal thickness, proper curvature of the cornea, good tear film quality and absence of diseases that impede tissue healing. It is important to note that only a detailed preoperative examination can determine whether you are a good candidate for the procedure and whether the surgery is recommended.
Fill out a short questionnaire and find out with over 95% chance that you are a candidate for laser correction.
What is the age limit for refractive surgery?
The prerequisite for the procedure is that you are older than 19, although in practice, we rarely perform the procedure on people under the age of 21 because the eye can still grow and change and the amount of the refractive error may change. Exceptions are professional indications, such as enrollment at the military and police academies where the refractive error is the reason for non-fulfillment of qualification criteria. In these cases, we can perform the procedure in people younger than 21. The upper age limit is virtual and largely depends on a number of factors, primarily about the amount of the refractive error, the structure of the eye, the state of the eye lens, habits and the profession.
Shortsightedness and laser refractive surgery
Myopia or minus diopter is ideal for laser correction. Here the laser acts on the central part of the cornea and the remodels it in a permanent and wanted fashion. Most of the people are very pleased with the outcome of the procedure, which is long-lasting and usually does not change significantly. Minus diopters can be removed up to -10, of course if the corneal parameters allow it. Sometimes it is possible to remove over-10 diopters, and in some patients it is not possible to correct even -2 D (e.g. in thin corneas). The examination clearly defines all the necessary details and the patient gets clear information on the amount of the refractive error that can be removed in his or her case.
Far-sightedness and laser refractive surgery
Certain amount of plus diopter may also be routinely removed by laser. Here the results are good, but in the long run they are not like minus diopters because of the fact that plus diopters usually have their own “hidden” component that may “reappear” after some time. These values are accurately determined on the preoperative examination after the pupils are dilated. It is possible to correct up to +5 diopters.
Is it painful?
The procedure itself is completely painless. In our polyclinic, we use a laser made by renowned German company, Wavelight, which removes one diopter in just two seconds. Thus, the procedure is very fast and lasts approximately ten minutes and is completely painless for the patient.
What kind of anesthesia is used for laser eye correction?
The procedure is performed in local topical (eyedrops) anesthesia. After the eyedrops application the eye is fully anesthetized, which makes the surgery completely painless.
What laser correction methods do you have?
There are two main methods of laser eye correction: LASIK and PRK. In LASIK methods, a special laser (femtosecond laser) or a mechanical blade (microkeratome) creates a flap on the front third of the cornea. Prior to the laser correction this flap is raised, the excimer laser removes the diopter and the flap is positioned to the place where it was before. After a couple of days, the flap heals.
In the Knezović Polyclinic we use modern femtosecond laser – IntraLase 150 Hz.
In the PRK method, the procedure is performed on the corneal surface, without the creation of a flap. The outer part or corneal epithelium is previously removed and the excimer laser ablates the cornea below the epithelium. Therapeutic contact lens is placed on the eye. Epithelium regrows on the corneal surface which takes approximately 2 days. The advantage of the PRK method is the thicker cornea, better biomechanics, better tear film, less higher order aberations while its disadvantages are postoperative discomfort and sometimes the pain which can last up to 2 days postoperatively.
DIFFERENCES BETWEEN PRK AND LASIK AND NO CUT METHODS
The NO CUT method is the advanced surface procedure. The advantages are that the cornea epidermis is removed by special microsurgical brush instead of alcohol. In this way, the chemical effect of alcohol on the underlying tissue is avoided and the procedure is faster and more precise which has been confirmed by our research and experience. Furthermore, during the procedure the ocular pressure is constant and unchanged, while with PRK and especially with LASIK ocular pressure increases even 4 times the normal (15 mmHg). Although rarely, short-term elevation of the eye pressure can cause unwanted complications such as retinal ablation.
An additional advantage is that the edges of the epithelium are more regular and the healing is more regular and faster and there is less postoperative discomfort. According to the most recent research we conducted in our polyclinic, where we worked on a single eye using a PRK method and the second NO CUT method, we came to the conclusion that the appearance of haze in the cornea is 50% less with the NO CUT method. Please note that Polyclinic Knezovic is the only medical institution in the Republic of Croatia that owns the Pallikaris microsurgical brush to perform the NO CUT method.
Laser Refractive surgery – Patient Experience – Jelena Glišić (TV Presenter)
“After having been dependent on glasses and lenses for years, I decided because of the nature of my job, at the recommendation of my friend to visit Dr. Knezovic and to consult about the laser refractive surgery. This has really changed my life. Now I can see perfectly and I would advise anyone who is considering refractive surgery to first consult with a doctor and then do a No Cut method because my vision is now perfect and I would recommend it to everyone! ”
How do I know which method to choose?
The best method in your case will be advised after a detailed preoperative examination. Some patients are suitable for several methods, while some are not because they have a thinner cornea, tear film problems, etc.
ADVANCED DIAGNOSIS AND TREATMENT IN KNEZOVIĆ clinic
Examination for laser eye correction and why is it more expensive than a general specialist exam?
The laser vision correction is far more complex than the general specialist examination. The eye is scanned on a range of diagnostic devices and all eye parameters are precisely defined so that the operation is safe for the patient. You can do this type of examination only in laser eye surgery facilities, while general examination can be performed at any eye clinic.
What do I need to know before examining laser correction?
It is important to know that if you wear contact lenses it is necessary to pause wearing them before the examination. For soft lenses, 4 days is enough, while for rigid gas permeable lenses this period should be longer, depending on how long you wear your lenses (usually 7-10 days). Also, after the exam, your vision will be worse for 2-3 hours because the pupils are dilated, which is important to know if you are a driver and if you arrive for examination by your car.
What does the exam comprise?
The exam consists of a series of diagnostic procedures and is one of the most comprehensive – the exact description of the laser ophthalmic scan can be found HERE.
How long does the ophthalmic examination for the laser eye correction last?
The exam takes about an hour, sometimes a little longer, depending on how fast the pupils dilate.
Can I get prescription glasses or contact lenses with specialist examination findings?
After the exam – you will get a prescription for glasses or soft contact lenses and you can easily order them in the optic shop.
What does the refractive surgery looks like?
Preoperative Preparation – How Much Should I Be Without Lenses Before Laser Correction?
After a specialist examination, the Polyclinic staff will tell you how much you need to be without contact lenses if you are wearing them. Once again – the check up exam is done prior to the surgery.
The procedure itself is not unpleasent for the patient. During the preparation, the patient gets a premedication and enters the laser room. The eyes are draped and anesthetic drops and a sterile eyelid holder is applied to keep the eye opened throughout the procedure. It takes about ten minutes for both eyes.
After the surgery, the patient goes to examination room where visual acuity is checked and eye examination is performed on the biomicroscope. Vision is immediately significantly better and it is the “most exciting” part because people are usually very happy with the newly gained eyesight. After all the necessary documentation and instructions patients leave the clinic.
How long does it take to recover?
Right after the surgery
Immediately after surgery the sight is significantly better and usually is about 90%.
One day after the surgery
The day after the surgery with the PRK method, the visual acuity may be worse than immediately after the surgery because of the epithelialization and the increased dryness of the eye in the first 2 days. All this is harmless and transient, but some patients may feel discomfort.
One week after surgery
A week after the surgery the sight is good and the patients are able to perform usual activities.
Month after surgery
Excellent visual acuity, eyedrops are no longer needed.
What are the guarantees and is the laser dioptre removal safe?
Refractive laser surgery is among the safest procedures in medicine. The need for repeating the procedure is extremely rare, especially if the procedure is done by the NO CUT method.
Eventual occurrences of the minimum diopter during epithelial healing occur within the first 6 months after the procedure is performed. Please note that the best guarantee is the quality of the operation because no further action is needed. In such a case, such procedure is free of charge.
What are the possible complications of laser removal of the diopter?
Complications largely depend on the type of surgery. If the LASIK method is used, potential complications are most commonly flap-related, such as microstriae, macrostrae, flap dislocation, DLK and reduction in the tear film quality. PRK methods have less possible complications and the most common one is haze.
The NO CUT method has the least complications because it is generally safer, there is no chemical effect of alcohol, there is no cut as well as elevated eye pressure during the procedure.
Astigmatism (cylinders) and laser eye correction
Astigmatism is a condition when the cornea is unevenly curved. Lenses that correct astigmatism are cylindrical, so people often mix astigmatism and cylinder concepts. Laser can remove up to 5 cylinder diopters, if the corneal parameters allow it.
Is there a possibility of night vision problems after laser vision correction?
At a newer laser platform, night vision problems do not happen. The reason is that the optical zone laser adjusts to the width of the pupil. In the Knezovic polyclinic we have the most precise devices that measure pupil diameter at different levels of illumination so that we did not have any patients who had problems with night vision or flashes in the last five years after the laser surgery.
Does the diopter return to the laser eye correction or is the laser correction of vision permanent?
The laser correction is permanent and lifelong. It cannot return if the operation is properly performed. There is a possibility of developing a new diopter, but this is very rare. The reason for this may be a change in the density of the lens and the appearance of a cataract.
Can my vision worsen after laser correction?
Vision after surgery is much better than before. Visual impairment is theoretically possible if severe infection or eye inflammation occurs, but the likelihood of this is more than minimal.
Can I have dry eyes after laser eye correction and need artificial tears?
Laser correction temporarily worsens the tear film. This is more commonly occurring with the LASIK method, somewhat less pronounced in the PRK method and at least in the NO CUT method. In the case of tear film impairment, artifical tears regimen might be needed for a certain period.
LASER DISCHARGE OF DIOPTER IN KNEZOVIĆ CLINIC
The Clinic Knezović is an institution where every patient is valued, respected and loved. The approach is strictly individualized and here you are not just a number.
We are equipped with top diagnostic devices such as pupilometers, topographs, tomographs, OCTs, optical biometers etc. The laser platform is made by respectable and verified German manufacturer of Wavelight, leading in the field of laser eye surgery.
Particular attention is paid to the quality of tear film, as this is a precondition for good results after laser eye correction. Only in this part of Europe we use a special device to improve the quality of the tear film – E-eye – that acts on the cause of the problem.
NO CUT – a unique method in the Knezović Polyclinic (this is why patients visit us from all over the world)
Also, we introduced the NO CUT laser correction method that is most eye tissue preserving and after which we have had no complications on thousands of patients operated. The imperative of patient satisfaction is of the paramount importance for us.This is attributed to very careful patient selection undergoing surgery, as well as the methods we use in our Polyclinic.
IGOR KNEZOVIĆ – Eye Surgeon
Dr. Knezović has performed thousands of successful surgical procedures for laser eye correction and ultrasonic cataract surgery. He has been educated on 4 continents, in several world centers of excellence, and has educated many colleagues on laser procedures and methods.
He introduced the NO CUT method of laser eye correction, which he personally improved and brought to a high level in terms of long-term patient safety.
He also introduced Karate Chop’s surgery technique from India, where he was personally trained by one of the largest expert authorities in the world of ophthalmology – Dr. Agarwal.
Both of these methods fall into the very top of the front eye segment surgery because they leave the surrounding eye structures intact. In addition to the professional part, our doctor is a good human being and humanist, and each patient is approached primarily as a person with the problem they are trying to solve in the best possible way.
Come and meet our doctor.
See the laser eye correction chart. All the current actions you can accomplish at the Knezović clinic
Strictly Necessary Cookies
Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.