The patient must know
“Ask yourself a logical question – to cut or not to cut?
And the answer will be obvious – certainly NOT!”
one of developers of laser “Profile-500”.
Under the laws of the Russian Federation before carrying out any medical procedure the patient has to give a so called informed consent. It means that the patient realizes the following things:
- What he/she is actually undergoing and what result he/she is expecting.
- He/she wishes to reach this result.
- What method is used for the effect.
- He/she knows about alternative ways of reaching a desirable result.
- He/she knows about the risks connected with this intervention.
The legislation does not specify a way in which the informed consent is given, so it can be even an oral one. Nevertheless, the medical institution is obliged to give the patient all information on the listed above items in a form available to the patient.
This section of a website submits general information for the people who want to correct their eyesight with the help of laser refractive surgery.
So...
The patient has the right to know that today there are two main ways of vision laser correction:
- LASIK (and methods based on it)
- PRK (and its modifications)
So what is the main difference of the methods and why “Ost-Optik К Co., Ltd.” does not perform and will never perform operations carried out with the help of LASIK?
Methods of vision laser correction:
i.e. technologies at which corneal knee is formed on the eye surface at the beginning of operation. Differences in modifications of technology are found in a way of flap formation and also in a way of its turning at the time of laser influence.
The surgery procedure:
A patient will be instilled with drops which anesthetize eyes. When anesthesia has worked, eyelids are opened with an eyelid retractor. It prevents blinking. The patient is asked to look at a beam of light on the device to center an eye position. Markers are put on cornea.
Eye is fixed with a vacuum ring. With the help of microkeratome blade (special instrument) the upper layer of cornea is separated. It is lifted and turned. Then laser influence begins. A new surface of cornea is formed with the help of excimer laser. The development of laser correction is supervised by an ophthalmic surgeon. When laser influence is complete, the cornea is washed with special liquid. The upper layer falls to its place and serves as “a natural bandage”. Thanks to the features of this nonvascular layer of tissue, it sticks well (but doesn't accrete!) already in a few minutes, therefore sutures are not required. The patient is instilled with anti-inflammatory drops and antibiotics. The bandage is put on the eye, it protects the eye from external influence.
Advantages of the method:
- Rather fast restoration of vision acuity (within the first two days)
- Possibility of correction of any kind of astigmatism (simple, compound, mixed) and farsightedness (not to confuse with age presbyopia)
As the video shows there are a lot of sources of complication emerging: locking ring, cornea cut, formation of a valve, its correct laying into place...For last decade operations the following complications after LASIK have been found out:
- Hypercorrection and undercorrection (the probability of correcting and "completing" is very small)
- induced astigmatism (i.e. appeared because of the operation)
- twilight and night sight disorders – gratings and circles appear when edges of an expanded pupil pass borders of a zone of laser influence on a cornea
- uneven cut of flap or its total cut (it depends on experience of the surgeon)
- turning (shivelling) of flaps
- infections, penetrating of dust and dirt particles under the flap
- epithelium growing under the flap
- detachment and ruptures of a retina and macular rupture - consequence of installation of a lock ring when intraocular pressure increases sharply
- bleeding, damage of an optic nerve
- diffuse lamellar keratitis (so called “sands of Sahara”)
- epithelial disorders and epithelium growing
- syndrome of a dry eye
- involution - returning of an ocular refraction to an initial presurgical condition
and it is far not the full list...
2. PRK (photorefractive keratectomy)
This technology is carried out without a preliminary formation of a corneal flap. The epithelium from cornea surface is removed mechanically.
The surgery procedure:
A patient will be instilled with drops which anesthetize eyes. When anesthesia has worked, eyelids are opened with an eyelid retractor. It prevents blinking. The patient is asked to look at a beam of light on the device to center an eye position. If it is needed the eye is fixed with a vacuum ring. The marking is put on cornea. Epithelium is removed with a surgical instrument (spatula) from the area exposed to laser.
A new surface of cornea is formed with the help of excimer laser. The development of laser correction is supervised by an ophthalmic surgeon. When laser influence is complete, the cornea is washed with special liquid. The patient is instilled with anti-inflammatory drops and antibiotics. The bandage is put on the eye, it protects the eye from external influence.
Advantages of method:
- Lasting refractive effect when working with small and medium degrees of myopia;
- High quality of eyesight;
- A surgery in which no blades are used;
- Keeping initial stability of an eye to traumatic influences after an operation;
- Low probability and severity of possible complications;
- Possibility of performing an operation in case of a thin cornea, insignificant dystrophic diseases of retina;
- Keeping of mechanical properties of cornea;
- Some discomfort and unpleasant feelings are observed within the first days after an operation;
- Long (up to 3 - 4 days) sight recovery;
- Long (up to 1,5 - 2 months) period of taking care of eyes.
Complications of PRK:
- Undercorrection or overcorrection (on an average from 0.25 to 0.82 dioptres);
- Haze (unstable easy haze on the surface of cornea which completely disappears within 8 - 12 months after operation);
- Regress of refractive effect (frequency of regress ranges from 2.5 to 10% depending on the degree of ametropia, an average size area is from 0.5 to 3 dioptres).
3. And a special attention is given to the technology "TRANS-PRK" ("Транс-ФРК®"), which is applied in “Ost-Optik К Co., Ltd.” by using the laser installation “Profile-500”. The technology is developed and patented in Moscow “Eye Microsurgery” Center n.a. S.N. Fyodorov.
Procedure of operation:
A patient will be instilled with drops which anesthetize eyes. When anesthesia has worked, eyelids are opened with an eyelid retractor. It prevents blinking. The patient is asked to look at a beam of light on the device to center an eye position.
After that, the new surface of cornea is formed with the help of the excimer laser “Profile-500”. The laser works on an epithelium. There is not any mechanical contact with an eye. Each impulse of laser removes the thinnest lens. The wide beam of laser covers the whole area for operation at once; therefore there is no need of installation of a ring to exclude eye movements during operation.
The development of laser correction is supervised by an ophthalmic surgeon. The patient is instilled with anti-inflammatory drops and antibiotics.
A real operation performed in “Ost-Optik К Co., Ltd.” has been filmed for this video.
Main advantages of this Russian technology, which has been successfully used in different variants in Russia since 1988, are the following:
- There are no postsurgical complications. Colour, night and twilight vision remain on the presurgical level.
- During the time of operations the eye is touched by NOTHING. There are absolutely no scars after the operation, mechanical stability of an eye does not change at all. Therefore, no additional physical limitations are imposed on a patient.
- Operations can be performed in several stages and after other operations on cornea, including keratotomy.
- We correct shortsightedness from –0.5 to –28 (!!!) diopters and complicated myopic astigmatism.
- Optic corneal profile that is acquired ensures a depth of focus (photographers are acquainted with this term) and it is of great importance for patients who are more than 40 – 45 years old.
- A cooperative work of a doctor and an engineer in real time keeps from happening of absolutely any emergency situations.
These are the characteristic features of “Profile” that should be specially stated. They are not disadvantages, but restrictions on application (after all nobody tells that the disadvantage of a car is that it is impossible to plow!):
- There are some restrictions on astigmatism correction. With the help of this installation it is possible to correct only complicated myopic astigmatism with a certain degree of sphere and cylinder.
- Farsightedness (Hipermetropia) is not corrected.
- Some corneal haze can appear on the surface of cornea after an operation.There are two possible reasons for that: wrong operating mode of laser and peculiarities of an organism. The constant analysis of patient’s data allowed us to adapt the technology placed with installation during the first year and get rid of a fibroplasia (hazes) connected with an operating mode of laser. Peculiarities of an organism of such kind are rather rare and not specifically connected with the work on “Profile”, i.e. they can arise after any technology. They are cured with treatment (drops). Or they can be corrected again on “Profile” by treating the upper layer one more time; in other words it is a process of a so called cornea “polishing”. There is no such opportunity after the usage of other laser systems!
Even the first impression of the seen videos VISUALLY testifies the safety of a technology “Progressive Super-PRK technologies” (Trans-PRK ®) applied in “Ost-Optik К Co., Ltd.”
We wish you great eyesight and please remember that the decision on laser correction of eyesight is made once in a lifetime. Think about this decision with your full responsibility!
