WHAT is refractive surgery/ spectacle removal surgery?

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Refractive surgery, is a surgical procedure aimed at correcting or improving common vision problems, primarily refractive errors, such as nearsightedness (myopia), farsightedness (hyperopia), and astigmatism. The goal of refractive surgery is to reduce dependence on prescription eyeglasses or contact lenses, allowing individuals to see more clearly without the use of visual aids.

 

What are the types of refractive surgeries?

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• PRK
   

 (Photorefractive Keratectomy) is a type of refractive surgery that aims to correct vision problems caused by refractive errors. Similar to LASIK, PRK is used to treat conditions such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism.

As opposed to LASIK, in PRK, the surgeon does not create a flap on the cornea. Instead, the surgeon removes the outer protective layer of the cornea, called the epithelium, using a chemical solution and a blade or similar instrument to scrape it off. After the epithelium is removed, an excimer laser is used to reshape the cornea by removing a precise amount of corneal tissue. The cornea is then allowed to heal naturally.

 

• SmartSurface
   

Our centre proudly employs the groundbreaking SmartSurface technology, setting a new standard in personalised vision correction using transepithelial-PRK . With its sophisticated topography-guided (customized aberration correcting) treatment, SmartSurface ensures a customised approach that accounts for the unique corneal irregularities of each patient, leading to exceptional visual outcomes and heightened patient satisfaction. It is performed with dynamic cyclotorsion compensation, a feature that allows exact cylindrical power correction, unmatched by any other technology. It is single shot, TOUCHLESS and PAINLESS procedure where no blades or chemical solution are used over the corneal epithelium. There are no flap related complications in this surgery, unlike Lasik. Compared to conventional PRK, Epi-LASIK, Epi-Contoura, Streamlight and other similar procedures , SmartSurfACE stands out with its SmartPulse Technology . This technology makes the treated corneal surface supremely smooth, reducing the healing time to 1/3rd compared to the other procedures. 

 

• LASIK
   

LASIK (Laser-Assisted In Situ Keratomileusis) is one of the most common types of refractive surgery. During a LASIK procedure, a surgeon uses a laser to reshape the cornea, which is the transparent front part of the eye, to alter its focusing power. The procedure involves creating a thin, hinged flap on the cornea, which is flipped open to allow the surgeon to access the underlying corneal tissue. Using an excimer laser, the surgeon removes precise amount of corneal tissue to reshape the cornea, correcting the refractive error. The flap is then laid back into place, where it adheres without the need for stitches. The cornea begins to heal immediately after the procedure, and visual recovery is typically rapid, with many patients experiencing improved vision within a day or two. 
 

• CUSTOMISED LASIK- 
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Customized LASIK, also known as topography-guided or wavefront-guided LASIK, is an advanced form of laser vision correction that utilizes sophisticated technology to create a personalized treatment plan tailored to the unique characteristics of an individual's eyes. Unlike traditional LASIK, which corrects refractive errors based solely on the patient's eyeglass prescription, customized LASIK incorporates a detailed analysis of the eye's entire optical system, including the cornea and the lens.

Customized LASIK aims to provide patients with the potential for improved visual outcomes, including sharper vision and reduced occurrence of visual disturbances such as glare and halos, especially in low-light conditions. By tailoring the laser treatment to the individual characteristics of the eye, customized LASIK has the potential to enhance visual quality and provide patients with a more precise and personalized vision correction experience.

 

TYPES OF CUSTOMISED LASIK
 

• CONTOURA VISION Contoura Vision is an advanced topography-guided LASIK treatment that utilizes precise corneal topography mapping to create a personalized treatment plan for each patient. By mapping 22,000 points of the cornea , it captures the unique irregularities and imperfections of the cornea. In order to achieve better results contoura vision performs  visual axis centred treatment. It aims to achieve better that normal quality of vision by incorporating these two important features. 
   

• However, certain limitations with this technology are the lack of dynamic cyclotorsion compensation, need for manual calculations & modifications of treatment profile as per the prescribed criteria and treatment tracking limited only to 2 dimensions. These limitations make the applicability of this technology limited. 

 

• SMARTLASIK-
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SmartLASIK is currently the most advanced customized LASIK technology available in the world. Launched in 2022, SmartLASIK allows high-resolution topography-guided treatment with 7 dimensional tracking. 
 

Sirius High Resolution Corneal Imaging : The SmartLASIK procedure is powered a combined topography and tomography device that analyses >1,00,000 data points on the cornea to map all the surface irregularities and aberrations. Added to this, a high resolution infrared iris imaging helps achieve a perfect tracking in all eyes. 
 

Eye-tracking Technology: SmartLASIK utilizes advanced eye-tracking technology to monitor and adjust for any small eye movements during the laser procedure. By continuously tracking the eye's position in all the dimensions of space, the laser can maintain precise accuracy by compensating for all the movements of head and eye during the process. Using Artificial-Intelligence, it performs motion analysis and predicts the precise point of delivery of laser spots on the corneal surface during a time lag.  This ensures perfect correction of higher order aberrations and high cylinder powers. 
 

SmartLASIK scores over its predecessors by providing a seamless and fully automated process of customized LASIK with precise aberration correction alongwith 7 dimensional tracking. This provides patients with best possible vision correction , alongwith negligible side-effects.

 

 

 

• LENTICULE EXTRACTION SURGERY
   

Lenticule extraction refractive surgeries, such as SMILE, CLEAR, SILK, and SmartSight represent advanced minimally invasive procedures for vision correction. These techniques offer an alternative to traditional laser vision correction procedures like LASIK and PRK, providing patients with a safer approach to address refractive errors.

 

• SMILE (Small Incision Lenticule Extraction): SMILE is a minimally invasive refractive surgery that involves the use of a femtosecond laser to create a lenticule within the cornea. The lenticule, containing the refractive error, is then removed through a small incision, altering the shape of the cornea and correcting myopia and astigmatism. SMILE aims to offer patients a quick recovery and reduced risk of dry eyes, providing a comfortable and efficient visual correction experience. The disadvantage is that it doesn’t correct cylindrical power efficiently and uses high energy laser spots delivered with tissue gaps.
   

• CLEAR (Corneal Lenticule Extraction in Advanced Refractive Surgery): Launched in 2019, CLEAR is the next generation lenticule extraction surgery designed to correct myopia and astigmatism(cylindrical power) by extracting a lenticule from the cornea. This procedure aims to provide precise and predictable outcomes, with a focus on maintaining the cornea's biomechanical stability and preserving its natural shape to promote long-term visual stability and clarity. 
   

• CLEAR is a pioneering technique which utilizes ultra low energy femtosecond laser with overlapping spots delivered without any tissue gaps . It provides visual axis centration and cyclotorsion correction, thus allowing for precise and accurate correction of all refractive errors, especially astigmatism . CLEAR boasts of customized energy delivery pattern and unparalleled smooth interface, thus allowing quick and comfortable visual recovery . 
   

• SILK (Smooth Incision Lenticule Keratomileusis): SILK procedure is similar to CLEAR and follows the same principles of low energy femtosecond laser spots delivered without tissue gaps. It is thus regarded as one of the next generation lenticule extraction surgeries. SILK procedure also allows for precise visual axis centration and cyclotorsion correction, same as CLEAR. However,as opposed to CLEAR, SILK procedure does not have a customized energy delivery pattern. The disadvantage of this procedure is the lack of “wow” effect after surgery, owing to slower visual recovery. Being a new platform, the long-term results of this procedure are not known. 
   

Experience the future of vision correction at AcuraVision Clinics, where your visual well-being is our utmost priority. Discover the transformative benefits of CLEAR lenticule surgery and take the first step towards a clearer and brighter future today.
 

ICL/IPCL
 

ICL (Implantable Collamer Lens) and IPCL (Implantable Phakic Contact Lens) are types of refractive surgery procedures also known as Phakic Lens implants. They are used to correct vision in patients who have high refractive errors, generally beyond -8D of myopia, +5D of hyperopia or high astigmatism . These procedures are designed for individuals who are not good candidates for other refractive surgeries like LASIK or PRK (Photorefractive Keratectomy) due to factors such as corneal thickness, corneal shape, or, the severity of their refractive error.

It's essential to consult with a qualified ophthalmologist or refractive surgeon to determine if ICL or IPCL is a suitable option for your specific needs and circumstances. These procedures are not one-size-fits-all, and the decision should be based on a thorough evaluation of your eye health, refractive error, and lifestyle considerations.