Types of refractive surgery
La refractive surgery It is an increasingly common option among users of glasses or contact lenses to eliminate their dependence.
Therefore, we will explain in this article the types of refractive surgery and the different techniques that exist today.
Types of refractive surgery
La refractive surgery It is an increasingly common option among users of glasses or contact lenses to eliminate their dependence.
Therefore, we will explain in this article the types of refractive surgery and the different techniques that exist today.
Surface techniques
The techniques of refractive surgery that we describe in this section are without cutting and are ordered from less to greater surgical complexity.
PRK (Photo Refractive Keratectomy)
The technique of laser refractive surgery PRK is a conventional treatment of surface, indicated in ametropias with low graduation or in the cases of fine cornea (<500 microns).
Handle (Advance Surface Ablation)
ASA (Advance Surface Ablation): It is similar to the PRK, but the technique uses a more sophisticated de-epithelialization system, the Mitomycin C for avoid scarring disorders (haze) and a re-epithelialization accelerator (drops of Cacicol) is applied.
It is ideal for special corneal remodeling treatments en anomalous corneas or especially in athletes, to improve visual quality.
FABRIC (Trans Epithelial Laser Assisted) PRK-TELA and ASA-TELA
Consists in remove the epithelium directly with the laser.
The main advantage is that the surface of the corneal stroma on which we will perform the refractive ablation, is much smoother and allows us to obtain better optical quality results than in PRK or ASA, without laser de-epithelialization.
LASEK (Laser assited epithelial keratomileusis)
Is preserve the corneal epithelium. The epithelium is removed after applying alcohol for a few seconds on the cornea, laser ablation is performed and then the epithelium is replaced, as if it were a lens.
It is more laborious but for presents advantages like the lower incidence of healing problems (Haze)
It supposes a superior level of surface refractive treatment.
EPI-LASIK (Epithelial LASIK)
Is the more sophisticated way of performing surface refractive surgery.
It consists of using a microkeratome special that in an automated way, lift the corneal epithelium, without applying alcohol or abrasive systems such as Amoils brush.
El epithelium is better preserved and the corneal stroma bed where we will do the laser ablation is smoother and more uniform, which allows get better results in optical quality.
Techniques of refractive surgery with cutting
Lasik (Laser Assisted In situ Keratomileusis)
The technique LASIK It is the classic cutting procedure in refractive surgery and the most widely used worldwide.
It consists of creating a circular flap of the anterior lamellae of the cornea, generally 140 microns. A mechanical microkeratome like blade.
After the cut, the flap rises, the refractive laser ablation and replace the fla againp, no need to give points.
Ultrathin-LASIK
It is a technique similar to LASIK but the flap is thinner, usually 90 microns, for which a mechanical microkeratome with a special head is needed to achieve the fine flap.
It has the advantage that not as aggressive with the nerves of the cornea and decreases the incidence of dry eye after refractive surgery
FemtoLasik
The technique FemtoLASIK consists of the technique of LASIK assisted with the femotsecond laser, to create the flap.
Is most sophisticated method that exists today and is especially indicated in corneas with parameters of curvature in which the use of the mechanical microkeratome could cause complications. Another advantage is that the flap is better attached and the risk of folds or displacements that can be an important complication is reduced.
It is known as argues that it is the 100% laser refractive surgery, as a synonym for efficiency and safety.
Refractive surgery with intraocular lenses
Epicapsular lenses (ICL and others)
Conclusion lenses that are implanted inside the eye. Through a small incision they are implanted between the lens and the iris (back camera).
Se indicate in patients who corneal refractive surgery cannot be performed, when are they high rankings or in very thin corneas.
Fixing lenses in iris
Conclusion lenses that are implanted inside the eye and fixed using a clamp system which incorporates the lens.
They have the advantage that they have a less contact with the lens (less cataracts) and allow to correct higher graduations, Especially astigmatism.
