Smart Lens and Refractive Surgery (Laser)
What is Smart Lens Therapy?
Smart lenses are a type of treatment that finds solutions to the vision problems of multiple focal points at close, medium and far distances, not at a single focal point, which we call trifocal lenses. Smart Lens Therapy, which is an option for patients who want to get rid of their glasses but are not suitable for laser treatment, is a treatment method that eliminates refractive errors such as myopia, hyperopia, astigmatism and presbyopia, as well as diseases such as cataracts. The eye numbers of the patients to whom this treatment is applied do not progress again and the formation of cataracts is prevented in the following years.
The natural number of lenses in our eyes begin to lose their ability to focus near and far after the age of 40-45. These lenses in the eye are transparent and elastic in nature. Lenses that allow focusing by changing shape thanks to their elastic structure during far and near vision, allow obtaining clear images both far and near. Over time, lenses may lose their flexibility due to both age and genetic reasons. It cannot change shape and focus when looking at close range, or it may lose its transparency with age and cause cataract formation. In both cases, the person’s visual quality decreases, paving the way for an uncomfortable social life. Our lens, which has lost this focusing ability, is cleaned with the phaco method and replaced with trifocal lenses, so we can provide clear vision at far, near and even intermediate distances.
Our patient groups not suitable for smart lenses
-People with yellow spot disease
– Vascular damage to the retina due to diabetic or other causes
-Uncontrollable glaucoma patients
The operation takes approximately 10-15 minutes. The operation of both eyes is not performed on the same day, if it is not the patient’s preference. We can perform trifocal lens operation of both eyes with an interval of about one day. Since the operation is performed with local anesthesia, the patient can come and have the operation and be discharged without making any changes in his daily activities.
Eye drops are prescribed to prevent post-operative infection and reduce pressure. You will be given instructions on how to use it after the operation and you will be invited for control examinations. If you follow the given instructions without any problems and come to your check-ups regularly. You will quickly complete your healing process.
We can divide the lenses used in cataract surgeries into three groups.
– With the monofocal intraocular lens in the first group, the patient sees far, but he has to wear close glasses in order to see up close, for example, to read a book or newspaper.
-Intraocular lenses in the second group are bifocal lenses, including near and far; The patient sees both near and far without glasses, but the distance between 40 cm and 2 meters, which we call the middle distance, cannot be seen.
Trifocal intraocular lenses, which we call Smart Lenses, are trifocal and are the lenses that solve this problem. When this lens is worn, the patient can see far, near and intermediate distance (distance between 40 cm and 2 meters) well without glasses.
What is astigmatism?
Astigmatism, like myopia and hyperopia, is a refractive error that causes blurriness in both distance and near vision. Everyone has some degree of astigmatism. When the amount of astigmatism is small, it does not bother the person. When astigmatism rises above 1 diopter (number), people’s complaints increase, and astigmatism needs to be corrected with glasses, contact lenses or lasers.
What is an astigmatic (Toric) intraocular lens?
Along with new technological developments, it is aimed to correct astigmatism during cataract surgery. Toric intraocular lenses are lenses placed inside the eye produced with high technology for the purpose of correcting astigmatism. If the patient’s astigmatism is connected to the corneal layer and has a regular structure, toric intraocular lenses are applied during cataract surgery. With these lenses, very successful results are obtained in the treatment of high astigmatism, and astigmatism up to number 6 can be corrected. . These lenses are also available in types that correct both astigmatism and distance, medium and close range. Such lenses (trifocal toric) are preferred in patients who want to see every distance without glasses. If the patient has diabetes, glaucoma or macular degeneration, a monofocal toric lens that corrects astigmatism should be preferred instead of a trifocal (multifocal) toric lens. Therefore, it is very important for patients to be evaluated by an ophthalmologist before surgery.
What are the points to be considered for success in surgery?
-Choosing the astigmatism lens that provides accurate and full correction to the patient,
-Correct determination of which angle to place the lens,
For these reasons, it is extremely important that toric intraocular lens surgery is performed by experienced surgeons.
Eye laser surgery is performed to eliminate myopia, hyperopia, astigmatism and keratoconus problems in appropriate conditions. These treatments are also called eye drawing. Excimer Laser is a high-tech device that reshapes the cornea with 193 nm ultraviolet light and corrects refractive errors such as myopia, hyperopia and astigmatism.
Laser;
It can be done for people over the age of 18. Because the development has not been completed until this age, there is a possibility of increasing the number of glasses. Therefore, people under the age of 18 are not suitable for the operation.
Those who use glasses or lenses, colored lenses,
Those whose eye grades have stopped progressing,
– Those with myopia up to 14 diopters, – Those with astigmatism up to 6 diopters, and those with hyperopia up to +6 diopters can have corneal refractive surgery,
Those with sufficient corneal tissue thickness,
Those who do not have systematic diseases such as diabetes, rheumatism, lupus,
Those who do not have any other disease (keratoconus, eye pressure, herpes virus infection, cataact, etc.) in their eyes.
How can I tell if my eye is suitable for laser?
– In the examination, eye numbers are measured, visual acuity is evaluated, eye pressure is measured, anterior and posterior segments of the eye are examined in detail with a device called biomicroscopic. If there is no obstacle to the surgery as a result of the examination, a topographic map of the eye is drawn and a pachymetry measurement, which determines the corneal thickness, is performed. Corneal thickness is as important a parameter as the eye number in choosing the surgical method to be applied.
-Laser surgery is completed in about 5-10 minutes.
-The time you return to daily life after the operation may vary depending on the type of laser applied. Pain, stinging and watering may occur up to 6 hours after Intralase-LASIK and LASIK, and for 48 hours after PRK. These times may vary from patient to patient. Sunglasses may be needed for a few days after the surgery.
– During the first 24 hours, the treated eye should not be played with and should not be bathed.
-If your numbers and eye structure are suitable, you can have excimer laser surgery over the age of 40.
Can Laser Surgery Be Performed for the Second Time?
The aim of laser treatment is to bring the eye degrees to the level of + / – 0.50. If it is determined that there is a trick in your eye at least 6 months after the first operation, all examinations and tests are repeated.
Whether the corneal thickness and the number to be applied are suitable for a second laser operation is evaluated with Pakimeter, Orbscan and Topolazer. If appropriate; In the light of the first operation information, the second laser operation can be performed by removing the old flap without cutting it again. There is no harm in repeating the treatment in this way.
EYE LASER TYPES
1-Femto lacquer
2-Lasik
3-No touch
4-Prk
1.PRK: The epithelial tissue, which is the top layer of the cornea and is the layer that can renew itself, is peeled by the physician with a special tool. After peeling, laser is applied. The patient may feel pain and watering in his eyes for a day or two.
2.NO TOUCH LASER: It is known as a laser without touching the eye among patients. In this procedure, the physician does not touch the patient’s eyes, only the patient looks at a constant green light between 30 seconds and 60 seconds and the procedure ends. On the first day, the patient should keep his eyes closed. On the first day, there is pain and watering in the eyes.
3. LASIK: After a thin flap is removed from the corneal layer with a femtosecond laser, the laser is performed. The patient only rests at home with his eyes closed on the day of the procedure. There is little or no pain on the first day. Eye grades improve one day after the procedure.
The patient’s eye is kept open all the time by attaching a device called a bleforosto. Excimer laser devices also have an eye tracking system and adapt to small movements. However, if the patient makes large eye movements, the device stops making lasers. In such a case, the patient is warned and the procedure is continued.
4.FEMTO LASIK
One of the most important steps in the elimination of eye defects is the creation of a corneal flap in the transparent part of the eye, in other words, lid lifting is performed with an intralase femtosecond laser. It is created completely under computer control without using a knife. With the femtosecond laser technology, which allows the creation of completely personalized and desired lids, surgery is up to 3 times faster. provides the opportunity. Femtolasik treatment detects the slightest rotational movements of the eye and allows the treatment to be concluded in an error-free and unplanned manner.
Difference between FEMTO LASIK and LASIK methods
In the LASIK method, it is formed by an automatic knife called a microkeratome. In the LASIK method, the anatomy of the eye becomes effective when creating the lid. The Intralase LASIK method, performed with the Intralase iFS femtosecond laser, allows the tissue to be approached with maximum smoothness and micron-level security. In this way, the treatment takes place completely in accordance with the eye structure of the person and the patient’s visual comfort increases. Lid removal, which is performed in 30 seconds in the LASIK method, is reduced to 10 seconds in Intralase LASIK.
Prof. Dr. Muhammed Talha SADIK
