vision correction procedures

What is the difference between femtosecond LASIK  and LASIK?

Both Femtosecond LASIK and LASIK are out-patient laser vision correction procedures available at Finland Eye Center used to treat myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism. With either method, the aim is to reduce or eliminate the need for glasses or  distance vision you will probably still need reading glasses by around age 45, at which time you can opt for other procedures aimed for presbyopic patients such as multifocal IOLs (available at FEC).

With LASIK (laser in-situ keratomileusis), your ophthalmic surgeon uses a small blade (microkeratome) to create a flap in the cornea followed by reshaping the exposed surface by excimer laser to improve the way the eye focuses light rays onto the retina.

Femtosecond lASIK  is the advanced method of LASIK in which femtosecond laser application is used to create the flap (instead of a blade), followed by reshaping the exposed surface. Femtosecond LASIK is considered to be more efficient, more reliable, more precise, and safer than regular LASIK with quicker healing time and lower complication rate. 
 

Which procedure is better for me?

Which procedure is better for you depends on several factors, including your refractive errors, corneal thickness and other corneal characteristics as well as your individual circumstances such as your priorities, needs and financial situation. Unless there is a specific reason why one option is unsuitable (such as too thin cornea for traditional LASIK), you may be given the option to choose either. 

Am I a good candidate for Femtosecond LASIK  or LASIK?

Femtosecond LASIK and LASIK are suitable for most patients wishing to become glass independent but your ophthalmologist will advise you about certain conditions that may prevent you from being a good candidate for these procedures. Patients for either procedure should be over 18 years of age with a stable glass prescription for at least one year. If you are not a suitable candidate for these procedures, your surgeon will discuss other options with you.

Prior to surgery, your surgeon may prescribe you eye drops or suggest treatment of any underlying eye disease in preparation for your surgery. Soft contact lenses should not be used for one week and hard contact lenses should not be used for 3-4 weeks prior to the operation. Patients should not use eye make-up on the day of the surgery. Also, please inform about using any topical or oral medications, any previous or present eye/systemic diseases, previous eye surgeries, and current pregnancy or lactation.
 

How is the surgery done?

For both femtosecond LASIK and LASIK, you will be fully awake throughout the procedure, which takes only a few minutes per eye. Your face and eye lids are cleaned with disinfectant solution. Topical anesthetic eye drops are used to avoid discomfort, which may sting briefly when administered. An eyelid holder (called a lid speculum) is placed between the eyelids to keep your eye open and prevent you from blinking. While one eye is being operated, the other is covered. When ready, the flap is created either using a suction ring and microkeratome blade (LASIK) or femtosecond laser. During the flap-making process, you will hear sounds and you may feel some pressure. It is normal for your vision to appear dim or black during this time. Then, the hinged flap is opened and moved aside to reveal the surface to be lasered. A special laser with pre-programmed settings customized for your eyes is then centered above your eye. You will be instructed to keep staring straight towards a green blinking light. You will again hear sounds and you may notice a burning smell - both of which are normal. When the reshaping is complete, the flap is closed and positioned back into its original place. 

What happens after surgery?

You will be escorted to a recovery room to rest for a while after which your eyes are checked to ensure the flap is in its original position. If the flap is not as expected, your surgeon will immediately take you back to the surgical suite to readjust the flap. You will need someone to take you home after the operation and dark glasses are provided for your way home as bright lights may feel uncomfortable. These protective glasses should be used for one week (at night) to avoid accidental scratching or rubbing. Foreign body sensation is normal for a few hours after the operation. If the sensation does not alleviate or is unbearable, please contact your surgeon. You will be instructed to use eye drops to avoid infections, speed the healing process and moisten the cornea. Please do not leave the clinic before your eyes have been examined and the post-operative appointment has been given. You will notice a difference in your vision even as soon as you get up from the operating bed. Your post-operative visual outcome will be checked the next day.

What are the risks, complications and side effects?

With an experienced doctor and careful patient selection, complications (listed below) are rare and treatable. 
•    Over or under-correction
•    Astigmatism
•    Dry eyes
•    Risks associated with making the flap (reduced risk with Femtosecond LASIK)
•    Temporary red eye
•    Risks associated with the laser machine (settings/program, decentration)
•    Discomfort
•    Risks associated with the flap replacement (lines, misplacement/moving)
•    Epithelial growth under the flap
•    Foreign objects under the flap
•    Glare and halos (especially at night time)
•    Keratectasia (progressive corneal thinning)
•    Diffuse lamellar keratitis (DLK, non-infectious corneal inflammation)
•    Pressure-induced stromal keratitis (PISK)
•    Central toxic keratitis (CTK)
•    Bacterial infections

Some of these complications may require extra medications or further procedures (lacrimal plugs, glasses, contact lenses, corneal cross-linking, re-operation, corneal graft). 
 

 

When can I go back to my usual life and activities?

Most routine activities can be preformed the next day. Swimming and heavy exercise should be avoided for two weeks and eye make-up should not be used for one week after the operation. Avoid rubbing your eyes heavily. Please speak with your surgeon if you have any concerns.

How many follow-up visits are required?

Follow-up visits are recommended on the day after your operation, during the second week after the operation and in 3 months. These are all included in your package at FEC. Sometimes more visits are advised depending on individual circumstances.

 

Which type of laser is best?

There are several types of laser refractive procedures available around the world. Techniques, machines and names can be different, but the end goal is the same; to help you get rid of your glasses as much as possible. At Finland Eye Center, our most advanced procedure is referred to as ‘Femtosecond  LASIK  , which is a combination of a femtosecond laser and an extremely precise eye tracking system with which we deliver the laser treatment. This combination offers high precision, high success rate and a high safety level. Your doctor will discuss the best option for your eyes at your consultation.

What are Femtosecond  LASIK  Xtra and LASIK Xtra?

Femtosecond  LASIK  Xtra (or X) and LASIK Xtra (or X) are combinations of Femtosecond  LASIK  or LASIK and accelerated corneal cross-linking (CXL). 

What are Femtosecond  LASIK  and LASIK?

Both Femtosecond  LASIK  and LASIK are out-patient laser vision correction procedures available at Finland Eye Center used to treat myopia (near-sightedness), hyperopia (far-sightedness) and astigmatism. With either method, the aim is to reduce or eliminate the need for glasses or contact lenses. Please see ‘Femtosecond  LASIK  and LASIK’ leaflet for more information.

What is CXL?

CXL is an out-patient procedure to strengthen and stabilize a weak, unstable cornea by creating new collagen bonds using a combination of ultraviolet light (UVA) and Vitamin B2 (riboflavin). CXL is most commonly used to treat keratoconus patients or corneal ectasia occurring after refractive surgery. Please see ‘CXL’ leaflet for more information..

Why should I undergo Femtosecond  LASIK  X or LASIK X?

Although both Femtosecond  LASIK  and LASIK are by themselves safe procedures, at times the ‘X’ will be advised to strengthen the cornea if your surgeon suspects an underlying unstable/progressive corneal condition (especially early keratoconus). Femtosecond  LASIK  X or LASIK X are also safer and more reliable procedures for patients with certain conditions affecting the cornea such as thin corneas or irregular corneal curvature. Your doctor will explain to you why they decide Femtosecond LASIK  X or LASIK X is the best option for your eyes. 

How are Femtosecond  LASIK  X and LASIK X done?

After applying the excimer laser to shape the cornea during the Femtosecond LASIK or LASIK operation, riboflavin (vitamin B2) drops are administered to the exposed cornea. UVA light is then applied. After this, antibiotic eye drops are given and a soft bandage contact lens may be placed to help the healing and the re-growth of the epithelium. Sunglasses or other protective eyeglasses are recommended during the healing process. Please be assured that the UVA will not harm your eyes when applied properly.

Which type of laser is best?

There are several types of laser refractive procedures available around the world. Techniques, machines and names can be different, but the end goal is the same; to help you get rid of your glasses as much as possible. At Finland Eye Center, our most advanced procedure is referred to as ‘9D Z  LASIK’ , which is a combination of a femtosecond laser and an extremely precise eye tracking system with which we deliver the laser treatment. This combination offers high precision, high success rate and a high safety level. Your doctor will discuss the best option for your eyes at your consultation.

What is PRK?

Photorefractive keratectomy (PRK) is an out-patient surgical procedure used to correct refractive errors (myopia, hyperopia, astigmatism) and to reduce dependency on glasses or contact lenses. PRK uses a laser to reshape the cornea and to improve the way the eye focuses light onto the retina.
PRK used to be the most common refractive procedure and it is still indicated for certain patients.

Am I a good candidate for PRK?

PRK is suitable for most patients but your ophthalmologist will advise you about certain conditions that may prevent you from being a good candidate for this procedure. Therefore, any medical conditions you may have (for example progressive eye diseases or systemic diseases causing dry eyes) are vital information for your ophthalmologist.

Patients for PRK should be over 18 years of age with a stable glass prescription for at least one year. Depending on the power of your glasses, corneal thickness and other characteristics of your cornea, you may be advised to have PRK rather than other types of vision corrective surgery to get rid of your glasses. A thin cornea is one such instance.

Your surgeon may prescribe you eye drops or suggest treatment of any underlying eye disease in preparation for your surgery. Soft contact lenses should not be used for one week and hard contact lenses should not be used for 3-4 weeks prior to the operation. Patients should not use eye make-up on the day of the surgery.

How is PRK performed?

PRK is preformed with the patient in a lying position in an outpatient surgical suite. Before entering the suite, the eye area is cleaned and a surgical cap is placed to cover the patient's hair. You get the first eye drops before entering the suite with more drops throughout the procedure including anesthetic drops to avoid discomfort. These drops may sting briefly. An eyelid holder is placed between the eyelids to keep them open and prevent you from blinking. While one is being operated, the other is covered.

The epithelium (superficial layer of the cornea) is gently removed to reveal the surface to be laser-treated. A special laser for sculpting the area, pre-programmed with measurements customized for your eyes, is centered above the eye. A pupil tracker is used to keep the laser centered on your pupil during surgery. You will be instructed to stare at a green blinking light while the laser sculpts the exposed corneal tissue. You will hear the buzzing of the laser and you may notice a burning smell. Both are a normal part of the procedure. After the laser has completed reshaping the cornea, the surgeon places a bandage contact lens for 3-5 days to help the healing process and to facilitate the re-growth of the epithelium. You will be fully conscious throughout the procedure, which lasts approximately 5-7 minutes per eye.

What happens after surgery?

You will be escorted to a recovery room to rest for a while after which your eyes will be checked. After the check you may go home but you will need someone to take you as you will not be able to drive. It is advised to use dark glasses on your way home as bright lights may feel uncomfortable. These glasses should be used for one week (at night) to avoid accidental scratching or rubbing. You will be instructed to use eye drops to avoid infections, speed the healing process and moisten the cornea. Please do not leave the clinic before your eyes have been examined and the post-operative appointment has been given.

What are the risks, complications and side effects?

With an experienced doctor and careful patient selection, complications (listed below) are rare and can usually be treated without any loss of vision. Some of these complications may require extra medications or further procedures (lacrimal plugs, glasses, contact lenses, corneal cross-linking, re-operation, corneal graft).

  • dry eyes
  • long healing period/delayed recovery
  • glare or halos
  • over or under-correction
  • corneal haze or scarring
  • increased sensitivity
  • infections
  • ectasia

 

When can I go back to my usual life and activities?

You will be given sick leave for 3-5 days due to discomfort/foreign body sensation, which can be quite unpleasant. Swimming and heavy exercise should be avoided for two weeks and eye make-up should not be used for one week after the operation. Please speak with your surgeon if you have any concerns.

How many follow-up visits are required?

Follow-up visits are recommended 3-5 days later to remove the bandage contact lens, during the second week after the operation and in 3 months. Sometimes more visits are advised depending on individual circumstances.

What is PRK X?

PRK Xtra (or X) is an outpatient procedure combining PRK surgery and corneal cross-linking (CXL).

What is PRK?

Photorefractive keratectomy (PRK) is an out-patient surgical procedure used to correct refractive errors (myopia, hyperopia, astigmatism) and to reduce dependency on glasses or contact lenses. PRK uses a laser to reshape the cornea and to improve the way the eye focuses light onto the retina. Please see 'PRK' leaflet for more information.

What is corneal cross-linking?

Corneal cross linking, or CXL, is an outpatient procedure to strengthen and stabilize a weak, unstable cornea by creating new collagen bonds using a combination of ultraviolet light (UVA) and Vitamin B12 (riboflavin). CXL is most commonly used to treat keratoconus patients or corneal ectasia occurring after refractive surgery. Please see 'CXL' leaflet for more information.

Why should I undergo PRK X?

Although PRK in itself is a safe procedure, at times the 'X' will be advised to strengthen the cornea if your surgeon suspects an underlying unstable/progressive corneal condition (especially early keratoconus). PRK X is also a safer and more reliable procedure for patients with certain conditions affecting the cornea such as thin corneas or irregular corneal curvature. Your doctor will explain to you why they feel PRK X is the best option for your eyes.

How is PRK X done?

After applying the laser to shape the cornea during the PRK operation, riboflavin (vitamin B2) drops are administered to the exposed cornea. UVA light is then applied. After this, antibiotic eye drops are given and a soft bandage contact lens is placed to help the healing and the re-growth of the epithelium. Sunglasses or other protective eyeglasses are recommended during the healing process. Please be assured that the UVA will not harm your eyes when applied properly.