Eye surgery

Eye surgery

There are two eye laser surgeries to correct ocular issues : the Femtosecond laser procedure and the Classic Lasik laser surgery.

The femtosecond laser procedure : High-level security and precision

The femtosecond laser, or femto-LASIK intervention we offer is an eye surgery that uses the latest technology. It consists of an infrared laser treatment of the eye tissue that creates less heat than other laser treatments, while remaining ultra precise.
A femtosecond-LASIK intervention, doesn’t require the surgeon’s preparation of any mechanical blade. This new eye laser surgery technique consists of the successive use of two types of lasers (femtosecond laser and excimer laser).
The femto-LASIK intervention offers the same advantages as the more conventional LASIK treatment of myopia, with reduced surgical risks (e.g. shutter cutting). It guarantees greater accuracy, leaves more residual cornea and offers better correction of astigmatism than a classic LASIK myopia surgery. Moreover, it is also suitable for thin-cornea eyes.

The "FEMTOSECOND LASER" technique

The femto second laser relies on the use of ultra-rapid light pulses requiring only a billionth of a second to create a spot as small as 1/100 mm.
Before the start of the myopia laser intervention, anesthetic eye drops are applied on the eyes of the patient to avoid any discomfort during the procedure. The doctor may also give medication to the patient to helm him/her relax.
The eye will be positioned under the laser, and an instrument called a lid speculum will be used to maintain the eyelids open.
The surgeon will use an ink marker to mark the cornea before creating the flap. A suction ring will be placed on top of the eye to prevent movement or loss of contact that could affect flap quality.
Once the corneal flap is created, the surgeon uses a computer to adjust the excimer laser to the particular prescription. Painless laser light pulses will reshape the cornea. Patients may feel a slight pressure on the eye and hear a steady “click” while the laser is running.
The myopia laser operation is performed on each eye separately, each procedure lasting about five minutes only, for a total of 10 minutes.
The femtosecond myopia laser surgery usually results in a vision of 20/20 for patients, without glasses or contact lenses.
Recovery time: a few days to several weeks are needed for the vision to stabilize.

Potential complications following a myopia laser surgery

The computer-assisted femtosecond laser surgery was developed to provide the best predictability of refractive results and improvement rates using a micro-keratome.
However, some side effects of the femtosecond myopia laser intervention have been reported, such as the development of a transient-light sensitivity syndrome.

Pre-intervention examination

Patients should be aware that some individuals may not be suitable candidates for this intervention due to a variety of factors.
Although surgical complications following myopia laser surgery are very rare, they must be carefully considered. Hence the importance of a cautious post-operative examination.
The ophthalmologist will perform a thorough analysis to verify that the eyes are healthy enough to undergo myopia laser surgery.
This review will assess:

  • The shape and thickness of the cornea.
  • The pupil size, potential refractive errors (nearsightedness, farsightedness and astigmatism), as well as other eye abnormalities.
  • Eye humidity - precautionary treatment may be recommended to reduce the risk of developing eye dryness following the myopia laser surgery.
  • Usually, an automated instrument called a “corneal topograph” is used to measure the curvature of the frontal surface of the eye and to create a "map" of the cornea.
  • The ophthalmologist will also go through the overal health and medication history of the patient to determine his suitability for the myopia laser intervention.
  • The patient should stop wearing contact lenses for a period of time advised by the doctor (usually about two weeks) before the eye examination and myopia laser intervention, as contacts may alter the natural shape of the cornea.

Best candidates for the myopia laser intervention

Patients with: mild or moderate myopia; hyperopia and / or astigmatism; adequate corneal thickness.

Recommendations following a myopia laser intervention

Following a laser myopia operation, the surgeon recommends taking some rest.
Patient should expect to have a blurred vision immediately after the myopia laser operation. Clarity should however be recovered the following morning.
After the intervention, the patient may experience a temporary burning or itching sensation.
In most cases, patients’ view should stabilize and continue to improve within the few days following the intervention. In very rare cases, full recovery may take several weeks or more.
Following a brief postoperative examination, the patient should be accompanied back to his/her hotel. Patients will not be allowed to drive following the intervention and should await the surgeon or ophthalmologist’s approval during another postoperative examination before driving.
The patient may be able to resume work the day after the myopia laser operation, but many doctors recommend taking a few days of rest.
Moreover, it is generally recommended to abstain from any intense physical exercise for at least a week following the intervention as this could cause a trauma in the eye and affect healing.
Patients must generally visit the ophthalmologist or LASIK surgeon the day following the intervention. This visit is intended to test the vision of the patient to make sure it is legal for him/her to drive without glasses or contact lenses.
As for any other surgery, Cosmetica Travel insists on following the doctor's instructions and taking the prescribed medication.
Patients should avoid rubbing their eyes before they are completely recovered and the underlying cornea are solidly attached as there is a small chance this could dislodge the flap.

Long-term results of myopia laser surgery

After a myopia laser surgery, most patients achieve a 20/20 vision or more. Results however vary.
Some may achieve a vision of only 20/40 or less. In such cases, patients will have to continue wearing glasses or contact lenses.
Complications of myopia laser surgery can occur and include infection or night reflections (bursts or halos that will be most apparent when the patient will encounter strong lights while driving at night).
A small percentage of patients will need an improvement laser myopia surgery, or a "touch-up" procedure, a few months after primary LASIK surgery to achieve the sought visual acuity.
Even after undergoing a myopia laser procedure, a patient may still need reading glasses, especially after reaching the age of 40, due to a normal age-related loss of near-vision known as “presbyopia”.
Cosmetica Travel will assist you to achieve the highest success rate of myopia laser surgery possible, but it is important to go through all aspects of the procedure with your surgeon before consenting to undergoing the intervention.

The CLASSIC LASIK EYE LASER SURGERY : Technique & necessary precautions

The eye laser operation is indicated for the correction of low, moderate and high myopia, with or without astigmatism.
The eye laser operation is also indicated for presbyopia.
The eye laser operation allows for the simultaneous treatment of both eyes.
The eye laser operation thus guarantees a rapid visual recovery.
Touch-ups of the eye laser operation are easy.
The eye laser surgery induces no risk of corneal opacity.
Moreover, the eye laser operation allows for an advanced correction of the associated astigmatism.

Eye laser surgery technique

The medical team prepares the necessary tools for the "LASIK classic" laser surgery: a suction ring, a corneal lamella, and a micro keratome (a high-precision surgical instrument with an oscillating blade).
The laser operation is done in two stages:

  • The first step of the eye laser intervention is to incise the flap using a microkeratome;
  • The second step of the eye laser intervention is to remove the cornea with the excimer laser.

Before starting the intervention, the surgeon must ensure the appropriate treatment data is entered into the laser computer.
An eyelid speculum is placed in the eye, which has been anesthetized with drops, while the other eye is covered.
The cornea is marked to facilitate postoperative flap alignment. A suction ring is placed on the eye to ensure fixation. The microkeratome is used to create an articulated corneal flap. Once the flap has been created, it is far from the cutting surface.
Tracking and recording technology is used on the eye and iris to verify the vision is well-focused.

Required evaluation prior to the eye laser surgery

Cosmetica Travel, along with its excellent surgeons will assist patients in deciding whether the eye laser surgery is indicated or not, based on a complete preoperative examination as well as an assessment of objectives and potential alternatives (glasses, contact lenses and implantation of phakic intraocular lenses).

  • Assessment prior to eye laser surgery should include a complete eye examination, and a complete assessment of the patient’s medical and ophthalmological history.
  • Rigid contact lenses should be removed several weeks prior to the intervention and soft lenses several days or weeks prior to it.
  • Abnormal ocular refractions (myopia, astigmatism and farsightedness) must have been stable for at least one year prior to eye laser surgery.
  • A thin cornea may also be an indication of subtle keratoconus and will require particular caution during the tissue removal during the eye laser surgery.
  • Other tests that must be performed before laser eye surgery include movement and size measurement of the eye and pupil.

On the day of the intervention

  • On the day of the eye laser intervention, the patient can eat and drink normally, but must refrain from smoking.
  • For hygienic purposes, it is important for the patient to wash his / her face, remove any make-up, and avoid wearing perfume prior to the intervention.
  • On the day of the eye laser intervention, the patient should wear comfortable clothing.
  • This surgery is done on an outpatient basis. Anesthetic eye drops are generally used. The intervention does not require bandaging, but it is recommended to wear sunglasses after the eye laser surgery.
  • The total duration of the surgery is of approximately 25 minutes for both eyes.
  • Right after the intervention, the patient will not be allowed to drive.

Contraindications for this intervention

Fuchs endothelial corneal dystrophy; corneal epithelial dystrophy basement membrane; peripheral retinal tears, especially in very myopic eyes; systemic autoimmune disease; pregnancy; breastfeeding; severe eye dryness; and major blepharitis requiring treatment before eye laser operation.

Potential complications of the eye laser surgery

As is the case for any surgical procedure, a LASIK-laser eye intervention can lead to complications. Serious complications leading to significant or permanent visual loss are however very rare. The eye laser may also provoke other less serious side effects such as eye dryness, night time bursts, and / or reduced contrast sensitivity.

Postoperative care

  • Patients may experience mild postoperative discomfort 4 to 6 hours after the eye laser surgery, during which they should keep their eyes closed and rest or nap.
  • Patients should avoid rubbing their eyes after the laser surgery.
  • Steroids and antibiotics drops should be applied 4 to 10 days following the intervention.
  • Drops that do not contain preservatives could be used for weeks or months after the eye laser intervention depending on the appearance of eye dryness symptoms or of corneal stains.
  • Vision stabilization can take up to 3 months depending on the postoperative treatment course.

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