Refractive surgery

Refractive surgery is the set of surgical techniques aimed at correct refractive vision defects such as myopia, farsightedness, astigmatism and / or the presbyopia.

The surgical options for performing refractive surgery are the laser (FemtoLASIKLASIK y PRKor the implantation of a intraocular lens and ICL.

Refractive surgery is aimed at all those who want definitively eliminate the use of glasses or contact lenses.

Refractive surgery

Refractive surgery is the set of surgical techniques aimed at correct refractive vision defects such as myopia, farsightedness, astigmatism and / or the presbyopia.

The surgical options for performing refractive surgery are the laser (FemtoLASIKLASIK y PRK) or the implementation of a intraocular lens and ICL.

Refractive surgery is aimed at all those who want definitively eliminate the use of glasses or contact lenses.

What is refractive surgery?

La refractive surgery is the set of surgical options to correct refractive defects such as myopia, hyperopia, astigmatism and presbyopia and It is intended for all those people who want to eliminate the use of glasses or contact lenses.

Usually, we perform refractive surgery using the excimer laser. Among the techniques that use this technology we find the FemtoLasik, the LASIK and the PRK.

It is important to know that refractive surgery is not always performed with a laser, sometimes it will be necessary to use other alternatives, such as ICL intraocular lens implant. We recommend this surgical option when the patient has a high graduation or when the cornea is not thick enough to apply the laser.

La refractive surgery with laser or intraocular lenses It is one of the surgeries with the largest number of cases performed in the world, it is painless and very safe but it is not without certain risks, therefore it is very important that it be performed by an expert ophthalmologist and with the best technology to treat specific needs. of each patient.

The result after refractive surgery is a clear vision and free of glasses or contact lenses.

What do you want to delete?

Thanks to refractive surgery we can eliminate graduation of the following refractive errors. Refractive surgery also allows us to definitively treat cases of myopia and astigmatism simultaneously in the same surgical act.

Myopia

Myopia is a refractive defect that occurs when a person sees distant objects blurry but can see the nearby ones correctly.

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Farsightedness

Hyperopia is manifested when a person cannot clearly see objects that are close but those that are at a distance.

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Astigmatism

Astigmatism occurs when the surface of the cornea is irregular. Similar to the wavy mirrors of the amusement parks.

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The best treatments

LASIK

Laser surgery
710/eye
  • Security: Safe.
  • Recovery time: Fast.
  • Technology: Use of a laser (excimer) and a blade (microkeratome).
  • Technique: With cut in the corneal tissue.

PRK

Laser surgery
915/eye
  • Security: Safe.
  • Recovery time: Moderate.
  • Technology: Use of a laser (excimer) and instruments for de-epithelialization.
  • Technique: No cut in the corneal tissue.

ICL

Intraocular lens
2740/eye
  • Security: Very safe.
  • Recovery time: Fast.
  • Technology: Specific instruments for intraocular lens implantation.
  • Technique: Intraocular lens implant.

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Result of refractive surgery

Refractive surgery is a type of eye surgery that serves to correct refractive vision defects like myopia, hyperopia, the astigmatism I presbyopia by using laser or implanting an intraocular lens.

The result of refractive surgery is that the person enjoys a life free of glasses or contact lenses.

This correction is achieved through the use of excimer laser, thanks to which we “sculpt” a lens on the cornea in the same way that a lathe molds a lens for glasses. In patients with high myopia or very thin corneas, where we do not recommend applying laser surgery, we implant a intraocular lens to correct vision and, in this way, we avoid weakening the cornea.

Your best option with laser

Laser cut surgery

Eye laser surgery is aimed at all those people who want to eliminate the use of glasses or contact lenses and the three cutting laser refractive surgery techniques that we perform are: FemtoLasik, LASIK and the technique SMILE.

Among them stands out the FemtoLasik as It is the most modern and the only one that is made entirely with laser. In Área Oftalmológica Avanzada We have this technology and it is the option we use the most in our ophthalmology center.

In order to carry out laser eye surgery, the center must have some professional to master each of these techniques as well as technology necessary to be able to carry out each one of them, since they are different.

FemtoLasik

The technique of refractive surgery FemtoLasik It is the most modern and safest that exists today. It consists of combining two lasers, on the one hand the Femtosecond laser to perform the cutting of the cornea and on the other the excimer laser to shape the cornea.

The difference with LASIK is that the cut or flap of the cornea no It is performed mechanically with a microkeratome, but by Femtosecond laser.

LASIK

El LASIK (Laser Assited Intraestromal Keratectomy or Laser-assisted intrastromal keratectomy), is the most commonly used technique for myopia operation.

Consists in lift a corneal lamella (corneal flap) of approximately 100 microns and expose the corneal stroma for the laser to work sculpting a lens that will correct the patient's refractive defect, diopters.

After ablation, the corneal flap is repositioned and the intervention ends, without sutures and without waiting for the epithelium to regenerate.

The results are very good, predictable and pain and haze are almost completely eliminated.

The appearance of this technique has meant an important advance in the speed of functional recovery of vision as well as in the accuracy of the results.

However, tampOCO is exempt from complications, rare, but of a certain severity when they appear

Complications are usually related to failures in the cut of the corneal lamella or excessive weakening of the cornea, appearing a picture that we know as corneal ectasia, difficult to control. Therefore, the use of new techniques such as FemtoLasik, which performs laser cutting, are increasingly used in specialized centers such as ours.

SMILE

The SMILE technique in laser refractive surgery is a modern technique where trauma is minimal.

The carving of a lens inside the cornea is carried out and the excess tissue is removed through a small hole, so the recovery is almost immediate and the complications inherent to the flap in the LASIK technique are eliminated.

It is a new technique and you still don't have the experience and results that LASIK offers, tampOCO allows treating farsightedness and astigmatism.

More time is needed to verify its effectiveness and safety.

No-cut laser surgery

The two surface eye laser surgery treatments is the PRK and LASEK. These treatments are especially indicated for patients with thin corneas or people who practice impact sports high level.

PRK

The refractive surgery technique PRK It was the first technique used.

In it, the laser acts directly on the cornea After removing the corneal epithelium, epithelium that regenerates again after 3 at 5 days.

This regenerative process could cause problems, greater pain in the postoperative period and inflammatory reactions that could induce scars that did not allow vision to be fully recovered. To eliminate this problem, the technique was modified and LASIK emerged.

LASEK

As a way to avoid the problems caused by the PRK and LASIK, a new variant has been proposed that consists in taking the positive from the previous two.

It is called LASEK, and consists of dissecting and lifting only the corneal epithelium and retaining it to reposition it at the end of the surgery. By preventing the cutting of the corneal stroma, corneal biomechanics are much less weakened, preventing the dreaded ectasias.

The main problem is to separate the epithelium from its natural bed, a maneuver that is performed by applying a dilution of isopropyl alcohol, which can induce toxic effects when not used correctly.

To eliminate this problem, a mechanical system with special blades is known as EPILASIK.

In both cases, some patients who presented the option known as haze have been described, less than in the cases of PRK. To avoid this complication, it has been proposed to use a drug known as Mitomycin C, which has the peculiarity of inhibit abnormal healing, demonstrating high efficiency and very high safety.

Perhaps the most current in this type of surgery is what is being called personalized aberrometry treatments, based on the technology applied to optical systems such as telescopes.

Today, aberrometers have been incorporated into ophthalmological practice.

At first, it was thought that, in the same way that the quality of the images provided by the telescopes could be improved, the optical structure of the eye could be improved. It was about analyzing the small imperfections of the optical media of the eye and suppressing them.

For example, when treating a myopia patient, in addition to eliminating diopters, these small imperfections known as high-order aberrations could also be corrected to the point of get the eye to have superior imaging quality to what we currently consider 100% vision, the unit; that is to say: to be able to read even smaller letters to those that put us in the last row of the visual acuity tests (optotypes).

This is true in some cases, and these aberrations can be detected and attempted to be corrected.

We currently know that this type of treatment is not indicated in all patients, only in cases where aberrations are high, especially the type known as "coma."

Postoperative

Laser refractive surgery It is performed in both eyes simultaneously, it is very fast, only 3 minutes per eye and it hardly hurts, anesthetic drops are applied and sedation is not necessary as in other surgeries.

After completion, the patient can see with some difficulty and no need to cover your eyes.

The first day you must stay at home and after 24 hours you can go out, walk and watch television, the computer or read, although we recommend that it be done gradually, in 2 or 3 days.

Intraocular lenses

There are different types of intraocular lenses, which we implant inside the eye, and whose choice depends on the needs and ocular morphology of each person.

In cases of high myopias and astigmatism, we combine the implantation of an intraocular lens to correct the spherical defect (myopia or hyperopia) and the laser to correct astigmatism.

The main advantage offered by the intraocular lens implant is that with this intervention the tissues are not modified, the eye is not “weakened”, and, in addition, this allows correcting high graduations obtaining a excellent visual quality; since the geometry of these lenses and the position they occupy in the optical system of the eye allows it.

Phakic lenses for high prescription

In cases of refractive disorders that laser surgery cannot be performed, the best option is to implant an intraocular lens inside the eye (phallic lens), preserving the lens, the natural lens of the eye.

The visual quality they offer phakic lenses it is very good and are designed to correct very high graduations, myopias even above 20 dioptres.

In our Center we are pioneers in what is called Bioptic, which consists of the combination of a phakic lens and laser treatment on the cornea. With this we are able to correct complex refractive disorders, such as very high astigmatisms in patients with Keratoconus or graduations after a cornea transplant.

There are two basic types of phakic lenses, those that are placed in front of the iris, in the anterior chamber and those that go behind the iris, back camera. Currently, those in the posterior chamber are preferred.

Anterior camera lens

The anterior camera lenses were the first to appear and, although the initial experience was not all the good that could be expected, they have been perfected until reaching a very high degree of reliability, provided that the inclusion-exclusion criteria are respected and the surgery is performed correctly.

The most commonly used lenses in this group are Alcon's Cachet Lens (angular fixation) and the new Artisan and Artiflex lens models (iris fixation).

Rear camera lens

Regarding the rear camera lenses, something similar to the previous ones happens.

The first experiences were not very good because, being close to the lens, they induced opacification. The first designs were replaced by the current ones that have improved the materials and the implantation technique, which has enabled the results obtained to be very good, both in efficiency and safety.

The most used lenses in this group are the ICL (Star) and the PRL (Zeiss).

Pseudophakic lenses for myopia and presbyopia

If the patient wants eliminate myopia and presbyopia the best solution is the implantation of a pseudophakic intraocular lens.

In these cases the intervention is similar to that of the Cataracts in which we implanted a lens that corrects the defect from far and near, that is, the objective is that this person does not have to use glasses.

Experts in refractive surgery

It is necessary to think that the vision is not based exclusively on the optics of the eye. It is a dynamic neurosensory process, with several stages in the processing of information that comes from the retina.

We currently know that a certain degree of aberration is necessary to constitute what is known as the "first visual outline".

This is essential to quickly capture the scene that appears in front of us, especially when accompanied by movement, as in the case of driving, when a vehicle approaches in the opposite direction and we must make an overtaking.

The analysis of this process leads us to conclude that, before attempting to eliminate aberrations, we must know better which are necessary for a correct vision, to be sure that it is preferable to eliminate them.

Along with laser treatments, there are other surgical alternatives (intraocular lenses), born as a result of the limits they have, basically those imposed by the anatomy of the eye.

The laser sculpts the surface of the cornea by removing (ablating) tissue, modifying the corneal structure.

In this operation it is essential that the residual tissue, the corneal bed that we retain, has characteristics, basically a minimum thickness, that guarantee its normal operation throughout life.

This anatomical limitation forces the number of diopters that we can eliminate to be less than 10 in myopia, 5 or 6 in farsightedness and only 5 in astigmatisms.

In cases where the number of diopters is higher, it is advisable to resort to other techniques or to the combination of several.

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Refractive surgery
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Refractive surgery
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We are specialists in refractive surgery to eliminate myopia, hyperopia, astigmatism and / or presbyopia. We use the most advanced technology.
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Área Oftalmológica Avanzada
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