LASER VISION CORRECTION
What is laser vision correction?
Laser vision correction is an operation in which a high-precision laser gently remodels the cornea and thus removes the appropriate diopter. The procedure is safe because today's lasers are accurate to one-twentieth of a diopter and do not have any thermal effect on the underlying tissue.
Am I a candidate for laser vision correction?
Roughly, the candidates are all adults who meet the criteria for performing the operation. Some of the basic criteria are: stable diopter, sufficient corneal thickness, appropriate corneal curvature, quality tear film and the absence of diseases that impede tissue healing.
What is the age limit for laser vision correction?
The prerequisite for the procedure is that you are an adult, although in practice we rarely remove diopters from people under the age of 21, because the eye can still grow and therefore the diopter can change. Exceptions are professional indications, such as enrollment in military and police academies where diopters are a problem due to non-compliance with qualification criteria. In these cases, the diopter is also removed in people younger than 21 years of age. The upper limit is virtual and largely depends on a number of factors, primarily on diopter, eye structure, presence of cataracts, habits and profession. Roughly, we routinely remove diopters by the age of 45, although we sometimes work with significantly older patients if we estimate that they will be satisfied with the result.
Myopia and laser vision correction
Myopia or minus diopter is ideal for laser correction. Here, the laser acts on the central part of the cornea and the change it causes is permanent in most patients. People are very satisfied with the result of the procedure, which is permanent and does not oscillate significantly. Minus diopters can be taken down to -10, of course if the corneal parameters are adequate. Sometimes it is possible to remove over -10 diopters, and in some patients it is not even possible to remove -2 diopters (in thin corneas for instance). The examination clearly defines all the necessary details and the patient receives clear information on how many diopters can be removed in his or her case.
Farsightedness and laser vision correction
Farsightedness or plus diopters are also routinely removed with a laser. Here the results are good, but in the long run they are not like minus diopters because plus diopters usually have their own "hidden" component that the eye only compensates for and which after the procedure in some people can "float". These values are accurately determined on preoperative examination after pupil dilation. The laser lowers up to plus 5 diopters.
Does laser vision correction hurt?
The procedure is completely painless and comfortable for the patient. In our polyclinic we use a laser from the renowned German company Wavelight, which removes one diopter in just two seconds. So, the procedure is very fast and lasts only ten minutes and is completely painless for the patient.
What kind of anesthesia is needed for laser vision correction?
The procedure is performed under local anesthesia with eye drops. After instillation, the eye is completely anesthetized, the operation is painless and the patient does not need to blink.
What are the methods of laser vision correction?
There are two main methods of laser vision correction: LASIK and PRK. In the LASIK method, a special laser (femtosecond laser) or a mechanical knife (microkeratom) creates a flap on the front third of the cornea. Before laser correction, this cover is lifted, the excimer laser removes the diopter and the cover is returned to where it was before. After a few days the flap heals. At the Knezović Polyclinic, we use the most modern femtosecond laser - IntraLase 150 Hz.
In the PRK method, the procedure is performed on the surface of the cornea, without creating flaps. The outer part or epithelium of the cornea is previously removed and the excimer laser removes the diopter below the epithelium. A therapeutic contact lens is placed on the eye. The epithelium grows again and covers the cornea in 2 days. The advantage of the PRK method is a thicker cornea, better biomechanics, better tear film, fewer higher-order aberrations, and the lack of postoperative discomfort and sometimes pain lasting 2 days.
How do I know which method to choose?
The optimal method for you will be advised by your doctor after a detailed preoperative examination. Some patients are suitable for several methods, while some are not because they have a thinner cornea, weaker tear film and the like.
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THE NO CUT METHOD
We also introduced the NO CUT method of laser correction, which is the safest procedure for the human eye and after which we did not have complications on thousands of operated patients. The imperative of patient satisfaction is the durability of the results, as soon as we can also boast because our percentage of correction is significantly lower than world statistics. We attribute this to the extremely careful selection and selection of patients undergoing the procedure, as well as the sparing methods of laser vision correction that we use in Knezovic Eye Institute.
The advantages are that the corneal epithelium is removed with special microsurgical brushes instead of alcohol. In this way, the chemical effect of alcohol on the underlying tissue is avoided and, in our experience, the procedure is about 20% more accurate than other methods. Furthermore, during the procedure, the intraocular pressure remained unchanged, while in the LASIK and PRK methods the intraocular pressure increased up to 4 times higher than normal (15 mmHg). Although rare, this short-term increase in intraocular pressure can cause unwanted complications such as retinal detachment.
An additional advantage is that the edges of the epithelium are smoother, so healing is more regular and faster, and postoperative discomfort is less and shorter. According to the latest research conducted in our clinic, where we worked one eye with the PRK method and the other with the NO CUT method, we came to the conclusion that the incidence of haze or corneal opacity is as much as 50% lower with the NO CUT method. We note that the Knezović Eye Institute is the only medical institution in the Republic of Croatia that has a Pallikaris microsurgical brush for performing the NO CUT method.
We are proud to represent laser we use for the NO CUT method, the WaveLight Allegretto Eye-Q Laser which is an excimer laser of the latest generation. When creating an individual profile for corneal laser ablation, it takes into account the computer-derived data of topographic measurements of the cornea and eye aberrometry, which enables perfectly precise and customized dioptre reduction in each individual patient.
ADVANCED DIAGNOSTICS AND TREATMENT AT THE KNEZOVIC EYE INSTITUTE
Examination for laser vision correction and why is it more expensive than a general special examination?
The examination for laser vision correction is far more complex than the general specialist examination. The eye is scanned on a number of diagnostic devices and all eye parameters are precisely defined to make the procedure safe for the patient. You can perform this type of examination only in institutions that deal with laser eye surgery, while you can perform a general examination in any eye surgery.
What do I need to know before a laser correction examination?
It is important to know that if you wear contact lenses, it is necessary to take a break from wearing them before the examination. For soft lenses, 24-48 hours is enough, while for semi-hard lenses, this period should be longer, depending on how long you wear the lenses (usually 4-10 days). Also, after the examination, your vision is worse for 2-3 hours because the pupils are dilated, which is important to know if you are a driver and you come with your car.
What do I need to know before a laser correction examination?
It is important to know that if you wear contact lenses, it is necessary to take a break from wearing them before the examination. For soft lenses, 24-48 hours is enough, while for semi-hard lenses, this period should be longer, depending on how long you wear the lenses (usually 4-10 days). Also, after the examination, your vision is worse for 2-3 hours because the pupils are dilated, which is important to know if you are a driver and you come with your car.
How long does an ophthalmological examination for laser vision correction take?
The examination takes about an hour, sometimes a little longer, depending on how fast the pupils dilate.
Can I get instructions for buying prescription glasses or lenses with the results of a specialist examination?
After the examination, you get a prescription and diopter for glasses or soft contact lenses and you can easily order them at the optician.
What after laser correction examination
After the examination, the patient can go home, but due to the dilation of the pupils 1-2 hours after the examination, he will not be able to drive because his eyes will be more sensitive to light.
WHAT DOES LASER VISION CORRECTION SURGERY LOOK LIKE?
Preoperative preparation
After the specialist examination, the staff of the polyclinic instructs you on how long you have to be without contact lenses before the operation if you wear them, most often you should pause depending on which lenses you wear and how long you wear them. If you wear;
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Soft 7-10 days
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Soft toric 10-14 days
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Semi-hard 1-3 weeks (usually the lenses should be paused for as many days as you wear them)
Preparation for the operation is an examination, and after the examination we move on to the operation.
The course of the operation
The operation is very pleasant for the patient. In preparation, the patient receives a disposable hair cap and shoe socks and enters the laser room. It is placed comfortably on the operating table, the eyes are dripped with anesthetic drops and a sterile holder is placed on the eyelid to keep the eyes open throughout the procedure. The patient has no need to blink because the eyes are anesthetized. The procedure is short, only ten minutes for both eyes.
Postoperative
After the operation, the patient goes to the outpatient clinic where visual acuity is checked and the eye is examined on a biomicroscope. Vision is immediately significantly better and these are the "happiest" parts of our socializing because people are very happy with the new view. After all the necessary documentation, instructions on how to behave after the procedure and therapy are given, people are happy to leave the our clinic.
How long does it take to recover from laser diopter removal?
Immediately after the procedure
Immediately after the procedure, vision is significantly better and usually amounts to about 90%.
Day after
The day after surgery with the PRK method, visual acuity may be slightly lower than immediately after the procedure due to the fact that the first 2 days there is epithelialisation and increased tearing of the eye. All of this is harmless and transient, but it can cause some patients mild discomfort.
One week after
One week after the procedure, the vision is good and daily tasks can be performed without any problems.
One month after
Excellent visual acuity, drop therapy is no longer needed.
What are the guarantees and is laser diopter removal a safe procedure?
Laser vision correction is one of the safest procedures in medicine for extreme precision. Corrections are performed extremely rarely, especially if the procedure was performed with NO CUT method.
The possible occurrence of minimal diopters in epithelial healing occurs within the first 6 months after the procedure. Please note that the biggest guarantee is a quality operation because there is no need for additional procedures after it. In this case, such diopters are corrected free of charge.
What are the possible complications of laser diopter removal?
Complications largely depend on the type of procedure. If the LASIK method is used, potential complications are most often flap-related, such as: microstria, macrostria, flap dislocation, DLK, etc., and a decrease in the quality of the tear film. PRK methods have fewer complications than the most common haze or temporary corneal opacity.
Astigmatism (cylinders) and laser vision correction
Astigmatism is a condition where the cornea is unevenly curved in the vertical meridians. Spectacle lenses that correct astigmatism are cylindrical, so people often confuse the terms astigmatism and cylinder. Up to 5 diopters of the cylinder can be removed with a laser, if the parameters of the cornea allow it.
Is there a possibility of night vision problems after laser correction?
Newer laser platforms do not cause night vision problems. The reason for this is that the optical zone of the laser adjusts to the width of the pupil. At the Knezovic Eye Institute, we have the most modern pupil width meters in different levels of illumination, so we have not had a single patient who has had problems with night vision after laser surgery or flashes in the last 10 years.
Can my eyesight get worse after laser correction?
Vision after surgery is much better than before. Deterioration of vision is theoretically possible if a severe infection or inflammation of the eye occurs, but the likelihood of this happening is more than minimal.
Can I have dry eyes after laser vision correction and is it necessary to drip artificial tears?
Laser correction temporarily worsens the tear film. This happens more often with the Lasik method, slightly less with the PRK method and least with the NO CUT method. In case of disturbed tear film, tears may drip for a certain period. At the Knezovic Eye Institute, we also have a treatment for the treatment of the tear film Dry Eye Protocol, and you are completely safe in our hands.
LASER VISION CORRECTION AT THE KNEZOVIC EYE INSTITUTE
Knezovic Eye Institute is an institution where every patient is valued, respected and loved. The approach is strictly individualised and here you are not just a number but a man who is approached with a lot of warmth and a desire to be helped.
We are equipped with the best diagnostic devices such as computerised tear film meters, pupilometers, topographs, tomographs, OCTs, optical biometers, etc. The laser platform is from the renowned and proven German manufacturer Wavelight, a leader in laser eye surgery.
We pay special attention to the quality of the tear film because this is a prerequisite for a good result after laser vision correction. We are the only ones in this part of Europe to use a special device to improve the quality of the Dry Eye tear film, which acts on the cause of the problem.
IGOR KNEZOVIC, MD, Ph.D.
Dr. Knezovic performed several thousand successful surgical procedures of laser vision correction and cataract ultrasound. He has been educated on 4 continents, in several world centers of excellence and has educated many colleagues about laser procedures and methods.
He introduced the NO CUT method of laser vision correction, which he personally improved and brought to a high level in terms of long-term patient safety.
Both of these methods belong to the very top of anterior eye segment surgery because they are gentle on the human eye and leave the surrounding eye structures intact. In addition to the professional part, our doctor is a good man and humanist, and he approaches each patient primarily as a person with a problem that together they try to solve in the best possible way.