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Çocuk Göz Hastalıkları

TREATMENTS

What is Excimer Laser?
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There are 3 methods for the correction of eye disorders such as myopia, hyperopia and astigmatism: Glasses, Contact Lenses and Excimer Laser. In the past years, sensitive knives were used to create scratches on the transparent part of the eye, called the cornea, to correct these disorders. The term "EYE DRAWING"  is used for this method. Today, eye number correction is done with excimer lasers and no scratches are created on the cornea. It is more correct to use the term "excimer laser" instead of "eye drawing" for the process to get rid of eye numbers.

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Excimer Lasers have been used in the treatment of eye disorders since 1988. It is the treatment method with the highest patient satisfaction. During the procedure, the refraction of the cornea is changed with micron precision. In myopia, the refraction is reduced, in hyperopia it is increased, in astigmatism, the refraction is equalized on the entire corneal surface. These processes are extremely fast (5-6 seconds).

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To Whom Can Excimer Laser Eye Surgery (eye drawing) be applied?
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People who want to have Excimer Laser must meet 3 conditions:

  • be 18 years or older,

  • Stability of the eye number, that is, the eye disorder does not increase more than 0.5 in a year,

  • Appropriate eye structure.

 

Apart from these conditions, Excimer Laser is not recommended for people with diabetes, connective tissue disease, rheumatism, pregnant or breastfeeding women. 

It should not be forgotten that one of the basic rules of medicine is the rule "There is no disease, there is a patient". Each patient is unique and should be evaluated individually. Therefore, it is not the right approach to say that everyone who meets these criteria will have a laser, or those who do not can definitely not have a laser.

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What are Excimer Laser Eye Surgery (Eye Drawing) Methods?
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There are 2 different Excimer Laser eye surgeries. These are PRK (Photorefractive Keratectomy) and Femto-LASIK (Laser in-situ Keratomileusis). A comparison is not made in such a way that one of these methods is superior to the other or that one method is better than the other.  Both methods have advantages and disadvantages. There is no difference between the results when the appropriate method is selected for the appropriate patient. There is no feeling of pain or pity during both procedures.

PRK

In this method, the superficial cell layer of the cornea is first removed with a surgical instrument or alcohol. Then the number is reduced by applying the excimer laser process. Then the contact lens is placed. The superficial cell layer is self-renewed in about 3 days and at the end of this period, the contact lens is taken back.  The laser procedure takes about 3 minutes for one eye. 3-5 days after laser treatment. Control examination is carried out between days.

Advantages of PRK:

  • It can be applied to thin corneas.

  • Dryness is lighter and lasts shorter.

  • In the future, corneal tapering is less likely to develop.

  • The cost is lower as a single laser system is used.

Disadvantages of PRK:

  • Sinking, watering and light sensitivity that can last for two days.

  • Complete recovery of vision takes longer time than LASIK.

  • The probability of staining on the cornea at high numbers.

Femto-LASIK

In this method, a layer (flap) of approximately 100 microns is first removed from the corneal surface. Tissue removal, which was done with a knife in the past , is now performed individually with a computer-controlled Femtolazer. Side effects associated with LASIK have been significantly reduced with the use of femtolaser. After the tissue is removed, the number is reduced by applying the Excimer Laser and the removed layer (flap) is placed in its place. The procedure takes about 7 minutes for one eye. A control examination is performed on the 1st day after the laser procedure.

Advantages of Femto-LASIK:

  • After the laser treatment, no discomfort is felt, except for burning, which can last for about 2 hours.

  • The next day, clear vision is achieved and the person returns to his daily life.

  • It can also be applied to high numbers as there is no possibility of staining on the cornea.

Disadvantages of Femto-LASIK:

  • The cornea must be of a certain thickness.

  • Dryness is more likely to develop.

  • The cost is higher as two laser systems are used.

 
How is the Preparation Process for Excimer Laser Eye Surgery?


The most important criterion of the Excimer Laser procedure is the determination of the appropriate patient and the appropriate method. For this reason, Excimer Laser should definitely be performed by physicians experienced in laser and cornea. Before the laser procedure, the patient should be discussed in detail and a detailed eye examination should be performed. Many subjects such as why the patient wants to have a laser, his expectations after the laser procedure, his profession, hobbies, sports activities, the diseases he has, and the drugs he uses should be discussed during the examination phase.

In the preliminary examination, numbers are determined, eye pressure is measured, strabismus examination and microscopic examination are performed. In the next step, it is checked whether the corneal structure is suitable for the laser with the topography film. If the corneal structure is suitable for laser treatment, drop measurement and retinal examination are performed. Drop measurement is mandatory for every patient who will have a laser.

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What are the conditions that the patient should pay attention to before the Excimer Laser Procedure?
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  • Discontinue the use of lenses at least 2 days before the laser examination and procedure.

  • Do not use perfume, deodorant, and do not make eye and face make-up on the day of laser operation.

  • Come to the laser procedure with your companion.

  • You cannot drive immediately after laser treatment. It would be right to come with a relative who will drive. 

  • There is no harm in eating before the laser procedure.

  • It would be good to have sunglasses with you.

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How is the process after Excimer Laser?
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After PRK, the patient has stinging, watering, and light sensitivity for about 2 days. Therefore, a rest period is required. The person can return to his daily life from the 3rd day. In addition, there will be slightly hazy vision that does not affect daily life for about 1 month after PRK, but is felt. The contact lens worn during the laser procedure is removed on the 5th day. The patient uses artificial tear drops for approximately 1.5 months. The control examination continues for a certain period of time.

After Femto-LASIK, the patient complains of burning for about 2 hours. The next day, the person can return to his daily life with clear vision. It is not recommended to enter the sea and pool for 4 weeks. The patient uses artificial tear drops for approximately 1.5 months. The control examination continues for a certain period of time.

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