Femto-LASIK – the operation

Topical anesthetic drops are applied to your eyes. The eyes and the adjacent areas are disinfected and covered in a sterile manner. Then the eye is being kept open inserting a lid speculum. Using a Femtosecond laser a fine flap is cut in the cornea with a 5-9 mm diameter and a thickness of 0.1 mm. The hinge is mostly located in the superior part of the cornea. The flap is lifted and folded back exposing the inner part of the cornea. The actual laser ablation is performed with an excimer laser. After the completion of ablation the flap is repositioned over the treatment area and the lid speculum finally removed.

Using the Schwind AMARIS laser significantly reduces the duration of the ablation (1.3 second for one diopter of correction). For example it can correct 5 diopter of myopia in just 6 seconds. During the operation a sophisticated eye tracking system registers your eye movements so that the laser beams will exactly follow your eye movements.

The wound healing of the cornea around the created flap usually takes one to two days. The final and strong adhesion of the flap to the cornea takes a few weeks or months.

Postoperative controls

One day, one week and one month after the operation our doctors will perform a routine eye exam to control the healing process and to adjust the eye drop treatment.

Advantages of a Femto-LASIK operation

- Correction of myopia, hyperopia and astigmatism.
- Better quality of life because of independence of glasses or contact lenses.
- Short ambulatory procedure in Bern.
- The most advanced and secure Laser technology with our AMARIS and Ziemer-LDV machines.

Pre and post operative examinations and the treatment itself are all performed on the same site by our doctors and laser specialists.

Advantages of the Femto-LASIK operations v.s superficial treatment: Less pain during and after the operation. Quick vision recovery

Disadvantages of all laser procedures

Structural integrity of the cornea is slightly weakened which should be considered in patients who practice marshal art.

Contraindications and Risks

Contraindications are conditions that serve as a reason not to perform a laser operation.

Thin cornea: the most important prerequisite to perform a Femo-LASIK operation is a sufficient thickness of the cornea. A thin cornea is a strong contraindication to the operation.

*Chronic eye disease*s: A Femto-LASIK operation should not be performed if the patient has a chronic eye disease like keratoconus since the cornea will become even weaker.

Further contraindications are Glaucoma with visual field defects and cataract.

General disorders: Like collagen, autoimmune or wound healing disorders

Rapid changes in refractive errors: If the refractive errors significantly differ in two subsequent exams in short time intervals a vision correction should not be performed

Age: The candidate should be at least 18 years of age.

Risks

With a Femto-LASIK operation, like with any other refractive vision correction, or even like with any surgery, there are certain risks. The type of the risks and their frequency can depend on the amount of the correction and on the pupil size. There is always a possibility of slight under or over correction.

Keratectasia is the abnormal bulging of the cornea. It usually occurs because of the structural weakening of the cornea after a laser ablation. The risk for developing a keratectasia increases with a decrease of the residual post-ablation corneal thickness. Residual corneal thickness is calculated by subtracting the amount of the flap thickness and the ablation depth from the original thickness of the cornea. As residual stromal thickness a minimal thickness of 0.25 mm is recommended. Furthermore genetic factors also seem to play a role.

In the first post-operative days a foreign body sensation is felt. In 15 to 20% of cases dry eye symptoms is reported in the first weeks or months after a laser correction. This is usually because the tear production and frequency of blinking are reduced. In general, artificial eye drops are prescribed for 1-3 months after a Laser correction.

The flap is usually very stable. Dislocation of the flap because of external influences is very rare. These are often reported after sport injuries (getting hit by a squash ball in the eye or car accident triggering the airbag.