25 years ago, the idea of treating the refractive errors by changing the declivity of the cornea, improved the “scratch” surgeries of Fyodorov. The procedure to treat myopia was relying on flattening the cornea by scratching it with diamond blades. Comparative satisfaction achieved with this technique forced scientists to search for better techniques. 20 years ago, researchers found out that excimer laser can create an ablation (destruction of the tissue by so to say vaporizing it) of 0,25 micron thickness. Thanks to improvements of the technique; excimer laser is now very consistent, controllable and reliable. For about 15 years refractive errors are being treated with excimer laser all over the world as well as in our country. Every single laser pulse embraces the ligaments between the corneal cells. The sensitivity of this procedure is up to 0,25 micron thickness. In excimer laser technology, the laser beam ablates (in desired thickness and width) the targeted tissue. Thus, refractivity of the eye changes as desired. This technique does not scratch the eye, therefore pressure alterations do not jeopardize the integrity of the eye. Since the laser only influences some specific areas of the cornea, it does not harm the optic center. Operations were used to be performed using a technique called PRK; however, today’s medical sciences prefer Lasik or Lasek depending on the condition of the eye and it is determined only by means of detailed examinations.

Thanks to this technique, pain after the surgery decreased a lot. The patients reach an adequate vision level the very next day. Even high refractive errors might be treated with lasik. No distinctive stain occurs in the corneaIt is very rare for the refractive error to redevelop after the lasik surgery. The stabilization is completed within a month. If the patient still needs glasses after a month, a second lasik surgery might be performed by simply folding the existent flap. In suitable eyes, lasik surgery shows satisfactory results with up to +6,00 hypermetropia and up to -12,00 myopia treatment. The purpose of refractive surgery is to minimize or to exterminate the refractive error if possible. If the patient can see without eyeglasses as good as he/she sees with them after the surgery, then it is considered a successful result. Excimer laser is a FDA approved technology in USA where very strict health-related rules are applicable, and millions of people were treated with it so far. Lasik is performed under drop anaesthesia. Eye lids are wide open with the aid of a tool, so that the patient does not blink. After marking the center of the cornea, a microkeratom that will create the flop is disposed into the eye. While preparing the flap, the sensation of light disappears for 3 to 4 seconds because of the pressure created by the keratom. After keratom is removed, the flap is opened and laser applied to the cornea bed. Laser process does not last more than a minute most of the time. The eye is carefully cleaned and the flop is folded back and the procedure ends with an antibiotic drop. For two days after the operation, the eye may burn, itch or feels like there is something in it. It is very important that no wrinkle occurs on the flap after the surgery. Therefore the eye should not be rubbed for a month, most importantly the first days. If wrinkle occurs, the flap should be folded back by the physician.

It is performed on patients with corneas not thick enough for the lasik. This procedure is also performed under drop anesthesia. The patient does not feel any pain during the laser procedure. In this method, the front layer of the cornea is lifted then the laser is performed. After the laser is performed, the layer of the cornea is folded back and a contact lens is disposed on the top of it. The contact lens stays on until this layer heals itself (4-5 days).During the first 1-2 days, the eye may burns, itches or feels like there is something in it. The vision starts improving the next day. However, complete improvement is slower and longer to recover (3 to 4 weeks) compared to the lasik.