Surgery for defective vision / laser eye surgery

With near-sightedness (myopia), the eye is too long in relation to the refractive power of the optical system. The excessive refractive power produces a sharp image in front of the retina. Those affected have blurred vision in the distance.

With long-sightedness (hyperopia), the eye is too short in relation to the refractive power of the optical system. Due to the insufficient refractive power, a sharp image is only produced ‘behind the eye’. At long distances, those affected usually have sharp vision, but blurred vision at close range.

Most patients with near-sightedness or long-sightedness also have a certain degree of astigmatism in their cornea. Astigmatism means that the cornea is not round in its curvature (like a ball), but somewhat oval (in extreme cases like a rugby ball).

Starting with an astigmatism of around 0.5 dioptres, objects may be distorted or shifted. Dots are seen like a rod (hence astigmatism). Higher astigmatisms are often difficult to correct with eyeglasses.

Presbyopia is part of the normal ageing process, whereby the eye's natural lens loses its flexibility. When adjusting the eye to near objects (‘short distance accommodation’), the lens of the presbyopic person can no longer bend sufficiently. It is no longer possible to see clearly at close range. Presbyopia occurs in everyone between the ages of 40 and 50.

To date, presbyopia cannot be treated satisfactorily by surgery. A large number of surgical techniques are still at the experimental stage.

Higher-order refractive errors are irregularities that can arise, for example, due to a shift in the optical centres of lens systems connected in series (coma) or different refractive forces in the centre and in the outer areas of lenses (spherical aberration). However, different refractive powers of the lenses for light rays with different wavelengths (chromatic aberration) can also be a trigger.

All these refractive errors exist in the human eye. However, they are usually so small that they do not cause any major problems with vision. Due to their physical properties, they cannot be corrected with glasses or soft contact lenses.

The latest generation of diagnostic devices includes high-precision topography devices and so-called wavefront aberrometers, which can determine higher-order refractive errors individually for each eye with a high degree of accuracy. With the help of the latest generation of Excimer lasers, it is now possible for the first time to correct these higher-order refractive errors in a targeted manner.

• The visual defect must be stable, i.e. no change of more than 0.5 dioptres in the last two years.
• The patient should be at least 18 years old.
• The patient should not have any other eye diseases (e.g. glaucoma).
• The patient should not suffer from general illnesses (e.g. rheumatism, diabetes mellitus, wound healing disorders).
• The patient should not be taking any medication that could affect the healing of the cornea.
• Treatment during pregnancy and breastfeeding should be avoided.
• For patients suffering from allergies, the surgery should be scheduled during the allergy-free period.
• In order to be able to examine the eyes, it is necessary to remove soft contact lenses at least four days before the examination and hard contact lenses at least four weeks before the examination and to wear eyeglasses during this time. 

• LASEK (Laser-Assisted Subepithelial Keratectomy)

• With LASEK, no incision is made in the cornea, but only the superficial layer (the so-called epithelium) is carefully pushed aside and put back in place after the Excimer laser treatment. LASEK thus combines the advantages of PRK and LASIK.
  
  Our clinic has been using this surgical technique since 1998.

• Epi-LASIK (Epithelial Laser in situ Keratomileusis)

• Epi-LASIK is a further development of the LASEK surgery. In contrast to LASEK, in Epi-LASIK the epithelium is not removed manually with alcohol, but gently pushed aside using a special surgical instrument. After treatment with the Excimer laser, the epithelium is then put back in place and protected with a soft bandage contact lens for three days.

  We have had clinical experience with this surgical technique since 2003.

• PRK (Photorefractive Keratectomy)

• PRK using the Excimer laser currently has the longest experience in correcting visual defects. PRK is now used to treat short-sightedness, astigmatism and long-sightedness. The surgeon carefully removes the superficial corneal tissue (epithelium) under local anaesthetic using drops. Computer-controlled laser pulses are applied with the Excimer laser to the now exposed superficial parts of the cornea, thereby changing the refractive power of the cornea of the eye. The deep cell layers of the cornea remain untouched. The superficial corneal layer regenerates on its own within a few days.

  We have had extensive clinical experience in this surgical technique since 1989.

• LASIK (Laser in situ Keratomileusis)

• In the LASIK procedure, an incision is made in about 1/3 of the thickness of the cornea before the Excimer laser treatment.

  We have been using this surgical technique since 1993.

German Professional Association of Ophthalmologists (BVA)

German Society of Cataract and Refractive Surgery (DGII)

Refractive Surgery Commission (KRC)

European Society of Cataract and Refractive Surgeons (ESCRS)