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Laser techniques in correction of refractive errors previously and today

Refractive errors have been corrected with laser techniques worldwide for decades. I myself started performing laser treatments 20 years ago and to this day, I have performed about 20 000 different laser procedures. Despite the great advancements in laser techniques during the last decades, my very first patients still have perfect vision and are happy with the outcome from their procedures. Even with the newer techniques, laser surgery is still based on the same principle: a reshaping of the cornea with laser impulses.

The very first laser technique was topical laser or PRK (photorefractic keratectomy). This method was however discarded due to painful healing and to clouding of scar tissue. In the next LASIK (laser-assisted in situ keratomileusis) technique, a small lid in the cornea was created, and the corrective laser surgery was performed underneath the lid. The procedure´s advantage was a fast healing, but later it was noticed that some patients experienced complications due to the shape that the cornea took after the procedure. Nowadays, the disposition to this kind of complication can be screened beforehand and hence, this complication is no longer a contraindication for the procedure. Furthermore, a technique called FEMTOLASIC also involves the creation of a lid in the cornea. These methods vary in being better or worse than the mechanical methods in creating the corneal lid, which renders them equal in quality. For the patients, the procedure and the healing is similar regardless of method; the eye sight is good already the day after the procedure, but artificial tears will be needed for the first few months.

The newest laser technique is called SMILE (small insicion lenticular extraction). Developed by Zeiss, this new laser technique is characterized by a laser procedure carried out inside the cornea, without any incisions or flaps made to the corneal surface. The advantages include higher mechanical strength, non-existent risk of corneal ectasia, a more permanent outcome and no complications with regards to dry eyes. A few years back I operated my 18 year old daughter with SMILE laser technology and today, many years after the surgery, her vision has remained flawless and she is very pleased with the outcome.

Today the results from laser eye surgery are the best they´ve ever been, and the prevalence of risks and complications is at the lowest it´s ever been. One can safely say that laser surgery has reached a level where anyone can undergo a procedure provided that no contraindications have been identified in the pre-examination. I recommend booking an appointment to an ophthalmologist who can perform any of the aforementioned procedures, and who has a long and extensive experience from all mentioned techniques. The patient should be in a situation where he or she is free to choose from many alternatives instead of choosing from a limited range of available alternatives. I would not consider the procedure´s price to be of crucial importance: after all it is your eye sight and most important sense that is at stake.

July 11, 2017 Laser
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