Femtosecond LASIK and LASIK

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.