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refractive laser treatment

The eye is a very impressive and intricate system. A colourful and sharp image of our environment falls on the retina due to the perfectly synchronized cooperation of the cornea, iris and lens. Light reflected from objects in our environment enters the eye, moving through the cornea and then through the aperture created by the iris, which widens or contracts depending on the amount of light passing through. The light travels through the lens, responsible for fine adjustments to sharpen the image onto the retina. The retina consists of a variable-resolution sensor with 3 colour channels as well as an ultrasensitive black and white channel. This is where optical stimuli are transformed into electric signals which pass through the optic nerve to the brain for analysis.

Laser procedures

  • 1.

    LASIK is a surgical procedure that uses a laser to correct nearsightedness, farsightedness, and/or astigmatism. In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser. The surgeon folds back the flap, then removes some corneal tissue underneath using an excimer laser and repositions the flap back into its original position on the cornea.

  • 2.

    Photo-refractive keratectomy (Trans-PRK) is a new laser technique where the laser cuts through the epithelium and performs the laser treatment simultaneously. Although recovery time is slower, final results for LASIK and surface treatments are similar. With this normal PRK the outermost corneal tissue (epithelium) is removed with a special brush or with diluted ethanol before the laser is used to reshape the cornea. This procedure is most often used for specific occupational or recreational reasons and for patients with thinner corneas. Bandage contact lenses to wear immediately after the procedure for two to four days are necessary.
    Read more about our Schwind Amaris Laser and the difference between LASIK & PRK

  • 3.
    RLE (Refractive Lens Exchange)

    Myopia / Hyperopia at any level can be treated with RLE. This is based on the principle that the natural lens is replaced with an intra-ocular lens (IOL) delivered through a self-sealing micro incision, which does not affect eye wall strength. Specialized toric IOLs can be used in tandem with RLE to reduce astigmatism and multifocal IOLs can be implanted within the capsule of the natural lens. The natural lens becomes misty with age, and patients over 60 years old are often more suited to RLE than laser refractive surgery.

  • 4.
    Monovision Correction

    This procedure usually involves treating only one eye with LASIK surgery. Most often it is offered to patients who are presbyopic and unwilling to wear spectacles. One eye is usually treated to focus on objects at near proximity and the other eye is left untreated or treated to focus at a distance. It is essential that the patient understands that it does take a few weeks for the brain to adjust to this vision but once that has occurred, the vision is good. A patient can try wearing contact lenses before having the procedure done to simulate monovision and to assess whether adjustment is possible.

  • 5.
    Small Incision Lenticule Extraction (SMILE)

    The first minimally invasive, flapless SMILE solution
    Small incision lenticule extraction (SMILE) is a relatively new refractive procedure designed to treat a multitude of refractive errors such as myopia, hyperopia, presbyopia, and astigmatism. The procedure involves using a femtosecond laser to create a corneal lenticule which is extracted whole through a small incision without the use of an excrimer laser. It is reported to achieve effects similar to laser-assisted in situ keratomileusis (LASIK) with excellent post-operative outcomes.
    ReLEx® SMILE from ZEISS is the first and, until now, the only solution for performing SMILE. ZEISS is the only company to provide a way for treating patients with this minimally invasive, flapless procedure. Now it is time: Move up to the 3rd generation of laser vision correction – with ZEISS ReLEx SMILE.

  • 6.

    PRESBYOND® Laser Blended Vision from ZEISS (video link below) is an advanced method for treating patients with age-related loss of accommodation, also known as presbyopia. This procedure offers the opportunity for good functional vision without spectacles. There are limitations to which patients are good candidates, and therefore an optometrist will do an assessment to determine whether this procedure will benefit you, before you have a consultation with Dr. De Beer.



Am I a candidate?

Healthy eyes are the biggest prerequisite.
Your refractive error, leisure activities, age and personal expectations all help to determine whether you are a good candidate for LASIK surgery. The earliest age at which this procedure is considered is 20.
You must have realistic expectations and understand that vision correction procedures are not always perfect.
Stable vision for at least 2 years is very important to decrease the chances of your eyes regressing

Bring a record of your spectacle prescriptions over the last 2 years. Refractive surgery is normally postponed until the spectacle prescription is stable. Small variations in your spectacle prescription are normal, but if there is a change of more than 0.5D over the last 2 years, we normally wait 12 months before proceeding with surgery to ensure that there is no progressive change.

Sometimes an additional enhancement is necessary for desired results. For most patients, refractive surgery offers the opportunity to function normally without spectacles or contact lenses. While it is impossible to guarantee 20/20 vision with every vision correction procedure, many patients do achieve 20/20 vision and say that they see better than ever.

In some cases it may be necessary to wear a pair of glasses with thin lenses at times, such as when driving at night.

As refractive surgery does not alter the natural aging process of the eyes it may be necessary to wear reading spectacles, unless you are successful at monovision.