Laser Surgery

When is the Excimer Laser used?

The Excimer laser is used exclusively for reshaping the cornea during refractive surgery. A very thin layer of the cornea is removed with the Excimer Laser.  This changes the shape of the cornea resulting in improved vision.

The Excimer Laser is used to correct vision in cases of mild to severe shortsightedness (Myopia), astigmatism and farsightedness (Hyperopia).  Myopia of up to -10 diopters, hyperopia of up to +5 diopters and astigmatism of as much as – 6.0 diopters can be corrected.

Where is the Excimer Laser used?

At Ocumed the Excimer laser is used in a sterile specially equipped eye operating theatre.  Laser microsurgery is performed on an outpatient basis under local anaesthesia in the theater.  The procedure is performed under a high-powered microscope using the modern Schwind Amaris Excimer Laser.

Planning for laser surgery

If you wear contact lenses please note that hard contact lenses should be discontinued for two weeks before the consultation and again for one week before the operation.  In the case of soft contact lenses, they should be discontinued one week before the consultation and the operation respectively.  If you wear make-up, please note that: NO make-up may be used on the day of the operation and not for two days thereafter.

What happens on the day of surgery?

You will be informed about the arrival time at Ocumed during your preceding consultation with your ophthalmologist.  We suggest comfortable, loose-fitting clothing; no jewelry or valuables, please.  At Ocumed you will be required to fill out certain documentation. Please ensure that you take your Medical Aid membership card and the ID document of the member/person responsible for the account along.  Before surgery, drops will be administered to anaesthetise the eye. You will also receive a sedative so that, even though you will not be sleeping through the operation, you will be quite relaxed during surgery.

If you are one of the many people who have heard that the eye is removed from the socket during surgery, you can relax as you will be a witness to the fact that this is a mere fable!  The patient lies on his/her back and looks into the laser.  The eye is held open with the aid of an instrument, the other eye is covered with a light cloth and laser is administered.

The actual procedure for 2 eyes takes less than 20 minutes.  A plastic transparent eye cover will be placed on your eye following surgery.  About 30 minutes after laser treatment you will be allowed to go home.  You can expect to be at the clinic for no more than three hours.

Please arrange to have a driver for your return home and as a result of the sedation, plan on relaxing at home for the remainder of the day.  Please do not touch your eyeball with your finger during the first two days after the operation.

Are all Excimer Laser operations the same?

Types of Excimer Laser treatments that are in regular use:

• Lasik

In lasik treatment a thin flap of superficial corneal tissue is cut with a handheld blade called a microkeratome, leaving a 60 degree hinge which still connects this flap to the cornea. This flap is then elevated similar to lifting a page in a book. The Excimer laser is then applied to the corneal tissue, stroma, beneath the flap. Then the flap is gently replaced in its original position. This concludes the surgery. The eye is covered with a protective shield until the next morning.

• Femto Lasik

With Femto Lasik the flap of superficial cormeal tissue is cut with a Femto laser instead of a handheld blade. With the Femtosecond laser, the flap can be cut thinner and more accurately, and thus greatly increasing the safety factor. Excimer Laser is then administered to the cornea.

• Transepithelial Photorefractive Keratectomy (Trans PRK)

Trans PRK is a sophisticated procedure to carry out a no touch, all laser surgery. During this procedure the epithelium will be ablated by the laser. The epithelium is removed by the laser in a very precise, uniform and easy manner without  any touch or alcohol-assisted debridement. In contrast to Lasik and Femto-Lasik, Trans PRK does not require any suction of the eye and no corneal flap has to be prepared, thus there is no weakening of the cornea. After treatment the eye is also covered with an eye shield until the next day.

• PresbyMAX Femtosecond Laser

With the PresbyMax module, corrective laser treatment can be done on presbiopic patients. After PresbyMax Femtosecond Laser, patients older than 45 years will be able to see well far and near.

What happens after the operation?

You will be given a prescription for eye drops on leaving the clinic.  After Lasik you will experience very little discomfort. After Trans PRK some people experience severe pain while others may only report tearing and itching.  You will have an appointment with your Ophthalmologist the day after your operation.  During this visit your eye will be opened for the first time after the operation and drops will be administered.  Please note that the best way of administering drops to the eye is by lying on a bed and ensuring that the container does not touch the eye.  Good vision should be experienced between 24 hours for Lasik and 1 week for Trans PRK after the operation.  In some cases it takes longer but those are really exceptional.

How will the operation influence my lifestyle?

Most people are apprehensive about the possible implications of the operation on their lifestyle.  Please rest assured, two days after Lasik you may bend to pick something up, do the washing, play golf, do gardening or undertake any other normal activity.

Specific instructions will be given to each patient according to their lifestyle.  The only immediate limitation is contact sport. Lasik patients may only participate in contact sport 6 weeks after the operation. Trans PRK patients take about 1 week to resume normal activities.

For patients who may need to wear contact lenses for any particular reason, the good news is that this is definitely possible after the operation.

Are there any risks?

Those who undergo eye surgery today need no longer face the fear, inconvenience and discomfort which accompanied eye surgery years ago.  Of course, all surgical procedures involve some risk. However, the skilled use of effective microsurgical technology and local anaesthesia make for the safest and most convenient surgery possible.

What results may be expected?

After one operation approximately 95 percent of eyes will have 95 percent [20/25 or 6/7.5] or better vision.  No further treatment will be required and neither will glasses be needed.  Most people find that 90 percent [20/30 or 6/9] vision is ample to live a normal life without glasses.  In South Africa  a person with 6/9 [90 percent] vision may for instance obtain a valid driver’s licence without glasses.