The word “refractive” means it is to do with the ability of the eye to
create a clear, unblurred picture. There are many refractive problems,
but the most common ones are short sight, long sight, astigmatism and
presbyopia. Short sight, long sight and astigmatism are the result of
the imperfect shape and length of the eye.
At least one in five of us has a significant refractive problem. In a
normal eye the cornea (the clear front of the eye) focuses light rays to
a single point on the retina (the light sensitive area at the back of
the eye). The lens (the flexible part of the eye) only does the fine
adjustment of the image. The result is sharp, precise sight.
How does Microsurgery
compare with Laser Eye Surgery?
Healthy people over 20y with stable refraction, no significant eye
disease or keratoconus. Myopia below –7D with or without astigmatism (up
to 7 dioptres) can be treated.
Diamond Microsurgery takes only a few minutes. Topical anaesthetic
(eye drops) is used which ensures that the procedure is painless. A
circular treatment pattern is imprinted on the cornea using a marker to
guide the surgeon. Patients usually notice an immediate improvement in
their vision after surgery but the vision may fluctuate at first. This
is perfectly normal after–care. Myopia Surgery Center provides
follow-ups at 2 weeks to 1 month after
surgery, as well as in-between and after if required. If treatment to
the second eye is planned it will usually be scheduled about 4 weeks
after the first when the patient is comfortable. When surgery is
completed it is recommended that patients have an annual eye test (as
recommended to all patients with high refractive errors) carried out by
Restrictions after Microsurgery
As with any type of vision procedure certain precautions should be
taken after the operation. Restrictions for the 2 weeks following
surgery generally include strenuous exercise and avoiding contamination
through water, e.g. swimming. Patients can generally return to work 48
hrs after surgery.
These are very rare. Please discuss specific incidences and our safety
record with your surgeon.
Complications may include:
Similar to general refractive procedures, such as central scarring,
ulceration and eye infection. There has been no significant incidence of
these reported in connection with Microsurgery at Myopia Surgery Center.
Regression, balance problems, overcorrection or astigmatism which may
require further corrective surgery.
£1250 per eye including any secondary refractive surgery up to 1 year
after the last visit. We accept most major credit cards, cash
or cheques and there is an option to spread payment over several months.
Please ask us if you are interested in financing options.
We offer a number of procedures and our staff are happy to discuss them
with you. You can also find detailed information on our web site, which
also includes our safety record, research and other useful information.
Parolini B. Marcon G. Panozzo GA.
Teclo Refractive Surgery Center, Verona, Italy.
Central necrotic lamellar inflammation after laser in situ
Journal of Refractive Surgery. 17(2):110-2, 2001 Mar-Apr.
To report four cases of corneal interface complications that occurred
Laser in situ keratomileusis (LASIK).
Four eyes of three patients underwent technically uneventful LASIK.
One day after LASIK, patients presented with severe pain, blurred
conjunctival infection, and diffuse opacity at the interface. Two days
after LASIK, significant
Features were central opacity, striae in the flap, loss of uncorrected
and best spectacle-
Corrected visual acuity, and corneal sensitivity. The findings did not
improve by using drugs or
by lifting the flap and irrigating the bed. The central opacity
partially resolved over 8 to 12
Months, leaving a hyperopic shift (one patient), striae (one patient),
and loss of two or more
Lines of best spectacle-corrected visual acuity (three patients).
This severe central inflammation after LASIK could be an extreme
Manifestation of diffuse lamellar keratitis.
DRIVING ABILITY FOLLOWING REFRACTIVE SURGERY
M.C. Knorz, B. Wiesinger, A. Liermann, P. Hugger, V. Seiberth, H.
Excimer laser treatment becomes more and more the treatment of choice in
refractive surgery. Usually
excimer laser treatment does not interfere with driving ability, but a
few patients complain about loss of
night vision and glare. Patients and method; We evaluated 41 patients,
who underwent PRK and 50
patients who underwent LASIK for the correction of myopia. Patients were
included in this prospective
clinical study if their best corrected visual acuity was 20/40 or
better. Pre- and 12-14 months
postoperatively we tested uncorrected and best corrected visual acuity,
contrast acuity (Regan low
contrast acuity charts) and night vision (Nyktometer, Fa. Rodenstock).
Results; One year after treatment, visual acuity of all patients
was still within the legal limits for
driving (visual acuity of 0.4/ 0.2, respectively). 4 eyes (10%) aRer PRK
and 3 eyes (7%) aAer LASIK
had lost 2 or more lines of contrast acuity at 25% contrast. At 1 l%
contrast, 6 eyes (14%) after PRK
and 10 eyes (22%) after LASIK had lost 2 or more lines. Tested with the
brightness acuity tester at
25% contrast, 22% (7%) of the eyes alter PRK (LASIK) had lost 2 or more
lines. At 11% contrast, 27%
(13%) of the eyes after PRK (LASIK) had lost 2 or more lines. Even
preoperatively, 22% of the PRKgroup
and 72 % of the eyes of the LASIK-group did not reach the recommended
limits (1:5 night vision contrast level) for driving a car at night. 12
months postoperatively, 21% (28%) of the eyes after PRK (LASIK) had lost
2 lines of night vision.
Conclusion: All patients have to be informed preoperatively that
an excimer laser treatment might
impair their driving ability at night.
University Eye Hospital, Klinikum Mannheim, 68135 Mannheim,