Clinique Roosevelt - 9 rue Jean Goujon - 75008 Paris - Phone : +33(0)1 42 25 02 59 - Fax : +33(0)1 42 56 51 33

Refractive surgery

laser-presentation

 

 

Laser Femtoseconde - Laser Excimer



For information, contact Miss Sauvage:
Tél: +33(0)1 42 25 02 59
Fax: +33(0)1 42 56 51 33 

 

 

Optical defects corrected by laser

Optical defects corrected by laser :femto-ldv

arrow1Myopia

arrow1Hyperopia

arrow1Astigmatism

arrow1Presbyopia



Operating room and lasers:

Combinations:

arrow1LDV Laser (Femtosecond ) + Allegretto Wavelight Laser (Excimer)

arrow1LDV Laser (Femtosecond) + Mel 80 Zeiss Laser (Excimer)

 

Femtosecond Laser - Excimer Laser

Femto-Lasik Surgery

 2 lasers, 1 Femtoseconde laser and 1 Excimer laser  laser2

Principle of LASIK:

create a corneal flap with a first laser (Femtosecond) and treatment of the refractive anomaly with an Excimer laser.

 

Contra- indications of Femto-Lasik Laser


arrow1Very high myopia
arrow1Evolutive ametropia: the refraction must be stable
arrow1Be over 18 years (except in special cases of anisometropia)
arrow1There is no age limit. After 40 years-old, a possible combination treatment of presbyopia should be discussed and the lens transparency should be checked.
arrow1Existence of a cataract
arrow1Corneal anomalies: too thin, opacity, herpetic keratitis.
arrow1Keratoconus (depending on the thickness, a treatment in combination with a cross-linking should be discussed).
arrow1Severe dry eyes syndromes (the laser modifies for several months the lacrimal reflex due to the alteration of corneal nerves and can increase a tear deficit)
arrow1Progressive diseases: glaucoma, retinopathy
arrow1Strong amblyopia
arrow1Autoimmune diseases that can affect the healing process
arrow1Pregnancy

 

Check-up

Before surgery, the patient undergoes a complete checkup that takes about 1 hour.

Soft contact lenses should be removed 3 days before the checkup and for hard contact lenses, 3 weeks before.

In case of corneal deformation due to contact lenses, a second measurement has to be made.

 

 

Examinations

 

arrow1Uncorrected/ best correctedvisual acuity

arrow1Auto-refractometry / electronic Tonometry

arrow1Contrast sensitivity test

test-contraste

arrow1Anterior segment examination with the slit lamp

arrow1Refraction with cycloplegia / Examination of the fundus

arrow1Digital photography of the fundus

arrow1Aberrometry / Corneal topography

arrow1Optical non-contact pachymetry

arrow1Orthoptic assessment / measurement of the axial length

arrow1Specular microscopy / tomography of the anterior segment

arrow1Schirmer test for assessing tear secretion

arrow1Measurement of the corneal hysteresis

arrow1Detection of keratoconus (Pentacam)

arrow1Densitometry of the lens.

 

If necessary :

arrow1Analysis of the visual field

arrow1Presbyopia correction simulation with contact lenses


Detailed information on the advantages and disadvantages of such a procedure is presented after the checkup results

Precautions

 

arrow1There are no dietary restrictions or medication before surgery.

arrow1You should only avoid coffee and alcohol.

arrow1Do not put makeup, perfume and cream on the day of surgery.

arrow1Your stay at the clinic will last approximately one hour.

arrow1Antibiotic eye drops should be instilled 24 hours before.

 

Preparation

 

laser3

arrow1You will be installed in a lounge; we will provide you with a disposable suit to replace your clothes.

arrow1A surface anesthesia using eye drops will be made a few minutes before the laser.

Using two lasers

1) Femtosecond Laser

2) Excimer Laser



arrow1The patient lies on a bed beneath the microscope of the laser.

arrow1The laser is programmed according to measurements taken during the checkup.

arrow1Eyelids and eyes are cleaned and a sterile drape is placed around the eye.

arrow1The patient is guided by the surgeon at each stage.

arrow1To avoid closing the eye, a small retractor is placed.

arrow1The surface of the eye is rinsed to remove any particles.

arrow1A suction ring is placed over the eye.

arrow1The corneal flap is performed with the Femtosecond laser (25 ")

arrow1The vision returns after a slight darkness phase, the flap is lifted up.

arrow1The patient has to fix a flashing green dot.

arrow1It is not necessary to look precisely at the dot as the laser will automatically follow your eye (tracking system by infrared).

arrow1The Excimer laser is then activated and it usually lasts less than twenty seconds.

arrow1An odor due to the vaporization of the corneal tissu can be smelled.

arrow1There is no pain. The laser is a cold ultraviolet laser without thermal effect, so there is no burning.

arrow1The corneal flap is repositioned after cleaning and after interface control.

arrow1The eyelid retractor is then removed.

arrow1After a re-calibration of the laser, the second eye can be operated.

arrow1The patient stays in the laser room about 10 minutes per eye.

 

 

  The patient lies on a bed beneath the microscope of the laser.
arrow1  The laser is programmed according to measurements taken during the checkup.
arrow1  Eyelids and eyes are cleaned and a sterile drape is placed around the eye.
arrow1  The patient is guided by the surgeon at each stage.
arrow1  To avoid closing the eye, a small retractor is placed.
arrow1  The surface of the eye is rinsed to remove any particles.
arrow1  A suction ring is placed over the eye.
arrow1  The corneal flap is performed with the Femtosecond laser (25 ")
arrow1  The vision returns after a slight darkness phase, the flap is lifted up.
arrow1  The patient has to fix a flashing green dot.
arrow1  It is not necessary to look precisely at the dot as the laser will automatically follow your eye (tracking system by infrared).
arrow1  The Excimer laser is then activated and it usually lasts less than twenty seconds.
arrow1  An odor due to the vaporization of the corneal tissu can be smelled.
arrow1  There is no pain. The laser is a cold ultraviolet laser without thermal effect, so there is no burning.
arrow1  The corneal flap is repositioned after cleaning and after interface control.
arrow1  The eyelid retractor is then removed.
arrow1  After a re-calibration of the laser, the second eye can be operated.
The patient stays in the laser room about
10 minutes per eye.

After the laser

arrow1You will rest a few moments and then can go out without bandage using sunglasses.

arrow1Eye drops will be prescribed

arrow1After treatment, there is no pain. There may be a discomfort that disappears with a few drops of anti-inflammatory eye drops.

 

Discomforts are:

arrow1Sensitivity to light, so you are advised to wear sunglasses for 24 hours.

arrow1Tearing

arrow1A foreign body sensation

arrow1Mild redness

arrow1Red spots on the conjunctiva may appear due to the suction ring. They regress quickly.

arrow1Do not rub your eyes.

 

 

Authorized activities


arrow1It is difficult to work the same day.

arrow1It is usually possible to drive the next day, but obviously the vision must be sufficient and without discomfort.

arrow1Most patients can work within 48 hours.

arrow1It is not advisable to swim for 1 week.

arrow1Eyes have to be protected under the shower; avoid getting water or shampoo in the eyes for 10 days.

arrow1It is best not to smoke because the smoke can irritate the eyes.

arrow1And avoid exposure to dust and wind.

 

Failure to follow these instructions may expose to infection or other complications that may compromise the quality of the final result.

The first day after surgery, the vision is clearer, and it improves the following days and for a few weeks.

The antibiotic eye drops should be continued for 7 days. Each patient heals at its own speed. Reaching the final result may take more time for certain patients.

For patients over 40 years, the vision may require glasses. Glare and halos at night may occur for a few weeks and regress more or less quickly, sometimes without disappearing for certain myopic patients.

 

 

Medications

arrow1Antibiotic eye drops to put four times per day for 7 days.

arrow1A few eye drops of anti-inflammatory.

arrow1Artificial tears to compensate the reduced lacrimation.

 

Control:

arrow1It can be done the same day

arrow1Then a week after

arrow1Then a month later.



When LASIK is not possible:

PRK (photo refractive keratectomy) may be possible: the same laser Excimer procedure, but on the surface, after removing the epithelium.

 

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