See clearly without glasses

Femtolasik

In recent years millions of patients have undergone a laser treatment or eye surgery. The results are impressive.

The Goes Eye Centre applies the most modern techniques. During the preliminary examination the technique recommended for your particular case is discussed. Advantages and disadvantages are openly and honestly discussed in order to make an informed decision. The various techniques are summarized below.

Abnormalities that can be treated by laser surgery are myopia, hyperopia and astigmatism. The laser can flatten the cornea which is needed for nearsightedness, or steepen it which is needed for farsightedness.

Did you know that 39% of all ophthalmologists and who perform laser surgery have had laser treatment themselves? 36% have treated their spouse, 19% have treated their children. This is a much higher percentage than the rest of the population.

Femtolasik Visumax

€1750 / eye

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History

The history of laser surgery started with the very popular radial keratotomy. This consisted of flattening the cornea by making several incisions with a small diamond knife.

Afterwards came the PRK method with the ‘excimer laser’. The cornea was still being flattened with this method, however, since tissue of the cornea was being vaporized, it was done without incisions. Although the treatment itself was good and precise, the healing process was very slow and sometimes involved some level of discomfort.

With ‘LASIK’ surgery a flap was first made manually and the treatment with the excimer laser happened afterwards, underneath this flap. This treatment was equally precise and resulted in a practically instant healing process. Nevertheless, it has since also become outdated.

Ever since the arrival of the femtosecond laser there is no need for creating a flap with a knife anymore, instead this is done with a computer-controlled and extremely precise laser. This method is called ‘FEMTOLASIK’. Again, the quality improved and the safety increased.

Since the introduction of the SMILE-technique we mostly only use the precise femtosecond laser to perform the entire treatment. SMILE eye surgery is the cream of the crop and the latest innovation in the ever evolving world of laser surgery.

Lasik

During a ‘Lasik’ treatment we use the same technique as during a ‘Femtolasik’ treatment, except that the flap is created with a surgical scalpel instead of the laser. After the flap is created, the curvature of the cornea is modified by an ‘excimer’ laser.

There is slightly more discomfort after a ‘lasik’ treatment than after a ‘femtolasik’ treatment. The depth of the flap is slightly less accurate. It is generally accepted that this technique is likely to be replaced by the more modern ‘Femtolasik’ treatment.

Lasek

During a lasek treatment, unlike Femtolasik and lasik, no flap is made in the cornea. A superficial layer of cells is manually pushed aside, and an excimer laser (computer controlled) is precisely programmed to perform the laser treatment of the corneal surface.

Afterwards, the cells are pulled back over the cornea, and a contact lens is placed over the eye. The major advantage of this technique is the limited distressing nature of the treatment, as there is no flap to be made. The disadvantage is a longer recovery time. In practice, this technique is particularly suitable for patients where Femtolasik-treatment is not possible. The results of the different techniques in the long run, however, are all very comparable.

Femtolasik with the Zeiss Visumax laser

The ‘femtolasik’ treatment is the successor of the gradually outdated ‘lasik’ treatment. A ‘Lasik’ treatment creates a flap with a surgical scalpel and subsequently treats the cornea with an excimer laser.

During a ‘Femto-Lasik’ treatment however, the flap is created with a ‘femtosecond laser’, instead of a scalpel. This is why it is often referred to as an ‘All-Laser-Lasik’: only a laser is used, and there is no longer need for a surgical scalpel. Once the flap has been made, it is lifted and the surface of the cornea is modified using a laser beam. Then the corneal flap is put back in its natural position where it will spontaneously re-attach. After the laser treatment, the new corneal surface will project a sharper image on the retina.

For this femtolasik procedure we have the privilege of using the Carl Zeiss Visumax laser. This company is known worldwide and has over 160 years of experience in the development of optical devices.
The continued high quality and experience of Carl Zeiss is an added advantage to make the perfect corneal flap.

A femtosecond laser works with extremely short infrared laser pulses. One pulse is 1 femtosecond or 0.000000000000001 second. Each laser pulse produces a microscopic gas bubble that separates the corneal tissue.
Thousands of microscopically controlled gas bubbles come together in order to make an extremely precise corneal flap.
Additional features of the Zeiss Carl Zeiss Visumax laser are the extremely fast laser speed (500 kHz) and the low energy needed to make the flap.
Increased safety: The Visumax Femtosecond laser uses extremely little energy especially in comparison to other femtosecond lasers. And the less energy we use the more accurate the depth of the flap can be determined while the neighbouring areas remain untouched. Using the Carl Zeiss femtosecond laser is the safest way to accurately perform laser surgery.

Increased indications: Laser Surgery for patients with thin corneas or high myopia used to be questionable. The VisuMax Zeiss laser provides more opportunities due to the accuracy of the laser;therefore it is more predictable. The laser creates an extremely accurate flap and this at a depth that can be determinedmuch more precisely than with a scalpel.

Increased comfort: The curvature of the contact surface of this laser is bent in the same way as our own cornea. That way there is no (temporary) loss of vision during the treatment as, opposed to the classical lasik treatment or other femtolasers where vision is lost completely during treatment and the patient may feel a very uncomfortable sensation. With a femtolasik treatment there is generally very little discomfort both during and after the treatment. The recovery is also extremely rapid. Much faster than after having a conventional lasik treatment

The premliminary examination

This examination has two main goals: to exclude eye disorders and to determine the risk of side effects after treatment. If the preliminary examination is normal and no disadvantages are found, we decide on the most appropriate treatment procedure for you.

At the Goes Eye Centre, tens of thousands of treatments have already been carried out. Safety is always the priority when it comes to laser surgery or eye surgery. After all, your vision is your most precious possession! Goes Eye Centre therefore makes use of the most modern equipment and techniques to make your surgery as safe as possible.

The entire eye is completely examined during this first visit:
• objective and subjective refraction
• pressure measurement
• retinal examination
• visual examination
• counting the number of endothelial cells
• determination of the length of the eye
• three-dimensional topography of the front and back of the cornea
• measurement of pupil size
• wavefront measurement
• biomicroscopic examination
• determination of the spherical aberrations of the eye

If any negative factors are discovered, they will be openly discussed, and in many cases treatment may not be recommended after all. This to avoid rare complications.

Laser treatment may greatly reduce the dependency on glasses or contact lenses. The possibility exists, however, that in rare circumstances, the need for glasses or contact lenses remains. Particularly when you are over 45 years of age, in which case you may need reading glasses. If after the treatment an over-or under-correction is found, retreatment may be considered.

Sometimes after the treatment, patients may perceive some glare or experience halos around lights, especially in darkness. Other patients may exhibit dry eyes after laser treatment, which is usually treatable by administrating artificial tears.This problem resolves itself spontaneously in the weeks or months after laser treatment. In rare cases, the symptoms of dry eyes may, take a more serious form, especially in patients who already exhibited dry eye problems before the laser treatment. In severe cases, the use of punctum plugs in the lacrimal pathways will be considered in order to reduce the symptoms of dry eyes.
Very rarely does anyone experience a decrease of vision in the eye. This means that the best visual acuity you may achieve after the laser treatment with contact lenses or glasses may be slightly less than the best visual acuity you had before the laser treatment with contact lenses or glasses.

An infection of the cornea very rarely causes problems after laser treatment. This complication is usually treated with antibiotic drops and/or medication.

Laser surgery has a relatively high level of satisfaction amongst patients.

Frequently asked questions

What is a personalized laser treatment?

A “personalized” treatment is a treatment that is custom made. This treatment is unique to your eye. Another eye could never undergo exactly the same treatment. It is so unique to your eye as your fingerprint is to your finger. If it appears that you would benefit from a personalized treatment then it shall be performed. The treatment is no more expensive than a ‘standard’ treatment. As a patient and client, you have the right to the best treatment possible. In other words, we do not give you the option for a low quality treatment.

Who is the ideal candidate?

To qualify for laser treatment, you must have a stable refraction over the past few years. You need to be 18 years or older. You may not exhibit significant eye disease. And of course you should also know the potential risks and side effects involved.

Is the treatment painful?

Our procedures are painless. A lasek-surgery can sometimes cause some irritation, but this disappears within a few days.

Is the treatment stable?

When long-term adverse effects emerge from the literature these are most likely due to an incorrect assessment during the preliminary examination. Therefore, the importance of a thorough preliminary examination, using modern equipment, must not be underestimated. The effect of the treatment is stable over the years. Near vision may be reduced after the age of 45, just as it would decrease in patients who never received laser treatment.

When can I resume work?

With most techniques you may resume work the next day. After a lasek treatment it may take longer. After lasek also try to avoid UV lights if possible, the use of sunglasses is strongly recommended.

What are the risks of treatment?

This has already been discussed. The procedure is obviously very safe, otherwise there would not be more than one million laser procedures a year. Even so it always remains a surgical procedure, 100% guarantee cannot be offered in medicine. But an accurate preliminary examination, proper indications and careful surgery bring possible complications to a minimum.

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