Excimer Laser

People with refractive disorders such as Myopia, Hyperopia and Astigmatism can get rid of their glasses and lenses with Excimer Laser eye surgery. Laser eye surgery can only be applied to patients who have the necessary conditions for the operation.

Safe, effective and predictable results can be obtained in the treatment of refractive disorders such as myopia, hyperopia and astigmatism with Excimer laser technology, which enables revolutionary developments in laser eye surgery.

Excimer Lasers can reshape the cornea layer, which is at the very front of the eye, without damaging the surrounding tissues and with a very high precision. There is more than one excimer laser device approved by the FDA, and although each laser device has different features, the results of refractive surgery are largely similar. After eye surgery with the excimer laser, which precisely shapes the surface of the cornea in line with the refractive disorders of the patients, the rays coming to the cornea can be properly focused on the retina.

In eye surgeries with excimer laser, myopia can be treated by flattening the cornea, and hyperopia by straightening the corneal surface, or astigmatism by removing asymmetries in the corneal structure.

Excimer lasers are controlled by computers programmed to eliminate refractive disorders in the patient. Therefore, surgeons have a critical importance at this point. Because in order to reshape the corneas of the patients, the necessary sensitive settings must be programmed by the surgeons. The amount or shape of tissue to be reshaped is different for each patient.

Modern excimer lasers monitor patients’ eye movements during surgery and can keep the laser beam where it should be. For this reason, the success rates of eye surgery performed with excimer laser are undeniably high.

What is Excimer Laser Therapy?

The development of medical technologies makes it possible to experience radical changes in order to increase the life comfort of patients. With excimer laser treatment, refractive disorders of the eye can be effectively treated.

Today, excimer laser therapy is the most widely used method worldwide in the treatment of visual defects such as Myopia, Hyperopia and Astigmatism. Excimer laser treatment provides safe results when applied to suitable patients, while eliminating the need for glasses or contact lenses. With the Excimer laser treatment, which can be completed in just a few minutes, it is aimed to reshape the corneal layer and increase the focusing and clear vision of the eye.

Although excimer laser treatment has been used for a long time and its success has now been accepted worldwide, it should not be ignored that the surgeon’s experience and detailed examination processes are very effective in the success of the treatment. Excimer laser treatment should definitely not be applied without accurately calculating the degree of refractive disorders in the eyes of the patients, without examining the corneal structures of the patients in detail, without obtaining precise information about the corneal thickness and without questioning the other eye diseases of the patients.

Excimer laser treatment is applied to the layer called “stroma”, which is located under the uppermost epithelial layer of the cornea, which makes up 90% of the corneal thickness. Before shaping the stroma layer with the excimer laser, as I have just mentioned, it is necessary to reach under the epithelial layer of the cornea. How the cornea is reached under the epithelial layer causes different methods to emerge in Excimer laser treatment.

What are Excimer Laser Application Methods?

In Excimer laser application, the different techniques preferred to reach the stroma layer to be shaped in the cornea diversify the Excimer laser application methods. In excimer laser treatment, laser can be applied both under the flap created in the cornea (Lasik and ilasik) and laser can be applied by simply scraping the upper epithelium (PRK) or vaporizing (No-Touch laser) without any incision in the cornea.

LASIK

Lasik is the most preferred method in the treatment of refractive disorders of the eye. It means “Laser-Assisted in Situ Keratomileusis”. In the standard Lasik operation, a flap is opened from the epithelial layer of the cornea with a special blade called “microkeratome” and then an excimer laser is applied to the exposed underlying layer to reshape the cornea.

In order to perform LASIK (eye drawing) surgery, the patient must be older than 18 years, the corneal thickness must be sufficient for Excimer laser application, the patient does not have conditions such as cataracts or keratoconus, the degree of refractive disorders has not changed more than 0.25 D. in the last 1 year, and the eye Conditions are sought, such as the number of numbers being in ideal ranges. You can find more detailed information about LASIK in my article titled “Methods to Get Rid of Glasses”.

iLASIK

iLasik stands out as a safer method compared to the Standard LASIK application. In both LASIK and ILASIK methods, a flap is opened in the cornea before the excimer laser is applied. The main difference between the two methods is the technology used to open the flap. In the standard LASIK method, a knife called a “microkeratome” is used to create the flap, while in the iLASIK method, the flap is created safely and untouched by a Femtosecond laser. Since femtosecond laser technology enables the depth, diameter and shape of the flap created in the cornea to be determined very precisely by computer, patients can have a more comfortable surgery. While the ILASIK treatment ensures that the eye surgery is carried out completely individually, the examinations performed to determine the suitability for this technique are important for achieving high success in all stages of the operation. It is known that after laser eye surgery performed with the iLASIK method, 97 out of every 100 patients can completely get rid of their glasses or lenses. It should not be forgotten that the correct evaluation of the patients, the technology used and the experience of the surgeon have a decisive effect on the success rates of ILASIK.

PRK – “Photorefractive Keratectomy” procedure is another method used in the treatment of refractive disorders such as LASIK. The main difference between PRK and LASIK or ILASIK methods is that no flap is opened in the cornea before shaping the cornea with Excimer laser. During standard LASIK and ILASIK, the flap is opened in the cornea, Excimer laser is applied to the corneal tissue under the flap, and then the flap is closed. In the PRK method, the epithelial tissue in the outer part of the cornea is stripped and an excimer laser is applied directly to the area. After the procedure, patients should wear non-numbered contact lenses until the epithelial tissue of the cornea regenerates and heals. PRK can help patients whose corneal thickness is not sufficient for LASIK to get rid of glasses and is a very safe method.

LASEK (Laser Assisted Epithelial Keratomileusis) application can be considered as another version of PRK application. During PRK, the epithelial layer is peeled off by the surgeon with the help of a spatula, while during LASEK, the epithelial tissue is loosened with alcohol and lifted. Then the cornea is shaped with the Excimer laser and the lifted epithelial tissue is placed in place. In order to accelerate epithelial healing in the post-operative period, patients are fitted with unnumbered contact lenses.

No-Touch Laser

In the treatment of Myopia, Hypermetropia and Astigmatism defects, the procedure performed using only the Excimer laser device without any contact with the eye is called “No-Touch Laser”. As a result of detailed examinations, patients whose eye tissue is suitable for No-Touch laser can get rid of their contact lenses and glasses after the operation. It is especially preferred in people with thin corneal tissue (corneal thickness below 500 microns), who do not want to be contacted during eye surgery, and who have keratoconus disease whose progression has stopped.

During eye surgery with No-Touch Laser, the epithelial tissue in the cornea is not loosened with alcohol as in PRK or LASEK techniques. It is vaporized directly with the Excimer laser and then pre-programmed shaping is performed in order to eliminate refractive disorders in the cornea. After eye surgery with No Touch Laser, which is completed in approximately 2 minutes for each eye, high oxygen-containing contact lenses are worn for epithelial healing. When the epithelial healing is complete, the contact lens is removed.

No-Touch Laser surgery, also called Trans-PRK, can be performed on both eyes at the same time and there is no need to bandage the eyes after the treatment.

SMILE

Relex Smile, which I can describe as the 3rd generation laser eye surgery, is a method that provides very successful results in the treatment of refractive disorders. Unlike PRK, LASEK, LASIK and FemtoLASIK techniques, RELEX SMILE uses only FemtoSecond Laser, not Excimer Laser, during eye surgery.

During the Relex Smile surgery, which is performed without opening the corneal flap or removing the corneal epithelium, a micron-level thin piece called the lenticule is removed from the stroma layer of the cornea in order to eliminate refractive disorders.

In the treatment of myopia and astigmatism, myopia up to 10 degrees and astigmatism up to 5 can be treated with the Smile Laser. RELEX Smile, which ensures the protection of corneal biomechanics, is completed in one step. First, a tissue called a disc-shaped lenticule is created in the cornea, and then this lenticle is removed through a 2 mm opening created in the cornea. The thickness and shape of the created lenticule is planned individually to eliminate the visual impairment of the person. Relex Smile, in which corneal stability is largely preserved, can be completed in a short period of time such as 30 seconds for one eye.

Who is Excimer Laser Treatment Applied to?

Having to wear glasses or contact lenses due to refractive disorders such as astigmatism, myopia and hyperopia has a negative impact on the life comfort of many people. Patients who want to have a healthy and clear vision, as well as to get rid of glasses and lenses that restrict freedom, can apply for eye surgery with Excimer laser.

In all methods in which refractive disorders are eliminated with laser, corneal shaping is done by Excimer laser. Although the techniques applied to open the cornea flap or remove the epithelial tissue before shaping the cornea differ, the process of reshaping the cornea with laser is called eye surgery or eye scratching with Excimer Laser as a general definition.

In order for patients to get rid of their glasses or lenses and have a clear vision after eye surgery with excimer laser, all examinations and evaluations must be done in detail in the pre-operative period.

have completed the age of 18,

Those whose eyeglasses have remained stable in the last 1 year or have advanced at most 0.25 diopters,

Myopia up to 10 diopters, astigmatism up to 5-6 diopters or hyperopia refractive disorder,

As a result of the examinations, it can be applied to people who do not mind having eye surgery with excimer laser.

Who Cannot Have Eye Surgery with Excimer Laser?

Congenital corneal problem

Continuing progress in glasses degrees,

Cataract, uveitis, glaucoma and retinal disease,

with uncontrolled systemic diseases,

During pregnancy or lactation,

who are under the age of 18 or over the age of 60,

Not having realistic expectations about operations,

It is not applied to patients whose eye numbers are too high for excimer laser application.

Examinations to be Done Before Eye Surgery with Excimer Laser

The tests performed before eye surgery with the excimer laser provide important information about whether the patients are suitable for surgery with the excimer laser and which of the excimer laser methods will provide the most correct response to the patient’s needs.

Before excimer laser surgery, the general health status of the patients should be evaluated, detailed eye examinations should be performed and eye numbers should be determined precisely. In addition to all these, evaluation of the shape of the cornea by corneal topography and accurate determination of corneal thickness by pachymetry measurement are the most important steps before Excimer laser surgery.

As I have just said, these data both enable the evaluation of patients’ suitability for laser eye surgery and provide information on which of the excimer laser treatment methods should be applied.

FAQ About Excimer Lazer

Is Eye Surgery Safe With Excimer Laser?

Excimer laser is a technology that has been used safely for many years in the treatment of refractive disorders. Eye surgery with excimer laser applied to SUITABLE patients with visual defects such as Myopia, Hyperopia and Astigmatism is one of the most frequently performed surgeries all over the world with its high success rates. The treatment of refractive disorders with laser technology eliminates the necessity of using glasses or contact lenses and ensures clarity of vision. For this reason, laser eye surgery is also known as “glasses-free surgery”.

Are There Risks of Excimer Laser Treatment?

Excimer laser treatment, which provides reshaping of the cornea with laser, may bring certain risks like all surgical operations. However, these risks can be minimized by the correct evaluation of the comprehensive examinations performed before the operation and the surgeons having a lot of operational experience. Today, laser technologies have advanced significantly and the comfort of patients after laser eye surgery has been increased. The diversification of excimer laser treatment methods also provides the opportunity to apply the right treatment method to the right patient.

Does Refractive Disorder Recur After Excimer Laser Treatment?

The main purpose of excimer laser treatment is to permanently eliminate the refractive disorders of the patients. The rate of getting rid of glasses after laser eye surgery performed with the right technique for the right patient is around 97%. However, although rare, some patients may experience an increase in eye numbers and in this case, laser application may be required again.

Is Blurred Vision Problem Possible After Laser Eye Surgery?

Those who have eye surgery with laser may experience blurred vision for a short period of time, usually 1 week. However, this situation improves over time and patients can have a clear vision.

Can Those Who Have Excimer Laser Treatment Have Cataract Surgery In The Future?

For many people who want to have eye surgery with excimer laser, it is an important question mark whether they can have cataract surgery in the future. Cataract, which commonly occurs with aging; It is an eye disease characterized by the deterioration of the transparent and elastic tissue of the natural lens of the eye. Having eye surgery with Excimer laser in the past does not necessarily mean that one cannot have cataract surgery in the future. Since there is no intervention in the eye lens or inside the eye during excimer laser treatment, it does not pose any obstacle to cataract surgery.

Is There Any Pain or Bleeding During Excimer Laser Treatment?

Before the eye surgery with the excimer laser, eye drops with a numbing effect are applied to the eyes of the patients. Therefore, the patient does not feel pain during the procedure. Due to the nature of laser technology, bleeding does not occur during excimer laser treatment.

What Should Be Considered After Excimer Laser?

Patients undergoing eye surgery with excimer laser must strictly follow the recommendations and directives of the surgeons. These recommendations may vary depending on the techniques used.Those who have excimer laser surgery should regularly use eye drops at the specified dose and frequency. Medications or drops recommended by surgeons prevent pain, tenderness, infection or temporary dry eye complaints after excimer laser treatment.After eye surgery with excimer laser, patients should protect their eyes from impacts and avoid rubbing their eyes harshly. The main reason for this is cutting the flap from the cornea in LASIK and ILASIK operations and repositioning the felp after the operation. Blows to the eye before the flap has fully healed may cause the valves to dislodge. In order to prevent a possible complication, heavy or impact sports are not recommended for those who have laser eye surgery for 3 months.
After excimer laser surgery, patients should not wash their eyes for about 2-5 days.

In case of problems other than the possible complaints of the surgeons after the surgery to get rid of glasses with laser, specialists should be consulted without wasting time.

Check-ups after laser eye surgery may vary depending on the type of surgery performed. Controls are usually scheduled the day after the surgery, 1 week after the surgery, and 1 and 3 months after the surgery.