What is the difference between lasik and lasek. Lasik or Femtolasik: comparison of correction methods and which is better. Stages of the operation

Femto Lasik is a modernized excimer laser procedure designed to correct visual acuity. The advantage of femtolasik is the absence of mechanical impact on the surface of the cornea, which allows minimizing exacerbations of ophthalmic disease.

Advantages of the femtolasik technique

The method allows you to use modern technologies to the maximum, reduces the risk of complications, eliminates instrumental impact on the eye, and provides comfortable and quick correction. All these advantages lead to the high cost of the procedure.

Benefits of the procedure:

1. High performance. The procedure involves cutting the boundaries of the upper layer of the cornea with extreme caution and precision. This allows you to preserve the natural sensitivity of the eye. The flap is created using a femtosecond laser (a special ophthalmic device). It makes it possible to have a beneficial effect on vision in the long term. The patient retains the ability to distinguish objects under any conditions.
2. Safety. Femtolasic is the safest procedure possible. The doctor pre-models the parameters of the flap individually for each patient. By determining the thickness, radius and structure of the flap, it is possible to minimize damage to the natural structure of the cornea.
3. Efficiency. The procedure is carried out extremely quickly. A corneal patch is created in 5-6 seconds, correction takes approximately 30 seconds.
4. Fast rehabilitation. After femtolasik, the patient needs little time to fully recover. This is due to the absence of mechanical resection of the cornea during the procedure.
5. Reduce complications. After the procedure, the risk of developing astigmatism and other complications is reduced tenfold (compared to).
6. No pain. During the procedure, the patient is free from discomfort.
7. Extensive application possibilities. Indicated for people with visual acuity impairments that cannot be corrected with medications and the Lasik technique. This occurs when the cornea is thin and there are defects in its structure (for example, severe myopia).
8. Lack of fear. The patient at almost all stages of the procedure has the opportunity to monitor the process, which deprives him of discomfort and fear.

In Russian clinics, the procedure costs over 50 thousand rubles. An additional fee for a consultation with an ophthalmologist (5-7 thousand rubles). If difficulties arise with the retina (problems with strength, etc.), additional therapy will require 10-12 thousand rubles. The procedure in clinics abroad will cost the patient $1,500-2,500.

Indications and contraindications

Like any other procedure, Femto Lasik has a number of indications and contraindications. It is worth noting that, unlike other laser vision correction technologies, the list of contraindications is quite small.

Indications:

1. Myopia. Recommended for myopia up to 10 diopters. At least in practice, doctors are limited to these values. In theory, a correction of -15 diopters is acceptable. The appropriateness of the procedure will depend on the individual characteristics of the individual patient.
2. Farsightedness. The operation is permissible in values ​​up to +4 diopters.
3. Astigmatism. Correction of pathology using the femtolasik method is possible with a threshold of 5 diopters.

Contraindications:

1. Age up to 18 years. In children and adolescents, the eyeball is still developing. Any manipulation to correct visual acuity can cause unstable side effects.
2. Age from 45 years. In older people, age-related transformations of the lens begin, and many age-related disorders occur. The procedure will not harm the patient’s health, but there will either be no effect or it will be temporary. Ophthalmologists recommend alternative methods for correcting visual acuity for older people.
3. Pregnancy and lactation. At this stage, a woman’s thyroid gland is extremely unstable, and her hormonal levels are constantly changing. Due to errors in hormonal status, it is impossible to accurately assess the consistency of the effect of the procedure. The operation will be useful, but there is no guarantee of permanent success.
4. Constant changes in vision throughout the year. If there are regular changes in myopia or farsightedness, the procedure is not recommended.

1. Active progress of cataracts, accompanied by severe deterioration of vision.
2. History of diseases that negatively affect the body’s protective functions, as well as infectious diseases. These are AIDS, multiple sclerosis, lupus erythematosus, rheumatoid arthritis and so on. These conditions directly interfere with the body's ability to maintain treatment.
3. The patient regularly takes medications that depress visual function.
4. Only one eye remained functional.
5. The patient is susceptible to conditions that thin the surface of the cornea. Femto Lasik can cause severe vision loss in the future, which will only increase the need for major surgery.
6. Excessive addiction to alcohol and drugs.
7. Inflammation of the visual system develops. Before the procedure, the infection must be eliminated.

Femtolasic can worsen dry eye syndrome.

Preparing for surgery

Preparation for surgery should include avoiding contact lenses a couple of weeks before the procedure. Contact lenses promote the growth of blood vessels into the corneal material, which complicates femtolasik surgery.

Two weeks before the operation, the attending physician consults with the patient, questions him about chronic and infectious diseases, performs an ophthalmological examination, and assesses the condition of the operated area. If factors and errors are discovered that can adversely affect the course of the operation, you need to postpone the procedure and completely eliminate them. Naturally, provided that this is feasible, otherwise the operation is canceled and an alternative method of vision correction is chosen.

On the day of surgery, you should not use cosmetics (even decorative ones), drink alcohol or smoke, or use medications, especially those that thin the blood.

When preparing for surgery, you should not use perfumes or aftershave lotions. It is recommended to wash your hair thoroughly before surgery, since after surgery this is prohibited for 3-5 days due to the risk of injury to the eyes. On the day of the operation, you can eat regular food, but before arriving at the clinic it is better to limit yourself to a light meal.

You should not drive for diagnosis and correction of ophthalmological disorders. It is better to use a taxi or ask your loved ones. Laser correction is carried out only if the patient has a reliable accompanying person. This is because specific vision changes may occur for some time after surgery.

Femto Lasik action and procedure steps

The femtosecond laser produces a beam of infrared light. This ensures accurate and precise separation of the horny tissue at a certain depth. This process is called photofracture.

The laser sends a short pulse into the outer layer of the cornea, causing microbubbles to form. They arise in the neighborhood, gradually merge and form a stratification. After working with a femtosecond laser, the doctor bends the formed valve and corrects the underlying layers using an excimer laser. This makes it possible to give the cornea the correct shape, change the refractive power of light and improve visual acuity.

The femtosecond laser makes it possible to make the surface of the corneal dissection border perfectly smooth, while avoiding mechanical effects on the corneal tissue. The valve is formed according to individual parameters specified in advance. They are determined in the process of studying the pathology of the visual system.

Capabilities of non-contact valve forming technology:

• improved contrast characteristics;
• improving vision clarity;
• restoration of visual function with a thinned cornea;
• reduction of the recovery period after surgery;
• minimizing side effects, complications and relapses.

Stages of the procedure

1. Painkillers are instilled into the eyes. This way the eye loses sensitivity, and the patient is relieved of pain and discomfort during the procedure.
2. The patient is placed on a table near the equipment. A small flashing light will be located exactly above the area being operated on. It is needed to hold the patient's gaze during the procedure. A slight aversion of the eyes will not affect the result, but a significant aversion of the eyes will disrupt the procedure. Professional equipment corrects movements and tracks the desired area with a slight deviation.
3. A vacuum instrument, which has the shape of a cylinder, is placed on the eye. Under the influence of a laser, it is attached to the eye.
4. The laser activity causes a flap to be removed from the outer layer of the cornea. Its parameters are determined by the doctor long before the procedure. The duration of separation is 5-6 seconds.
5. The flap is removed, allowing the laser to reach the deeper layers of the cornea.
6. Small and short bursts of energy allow you to transform the cornea. Changes are needed to adequately focus light rays.
7. After exposure to the cornea, the flap is returned. No stitching is required as the layers of the cornea fuse instantly.

The operator is guided by a patient card with predetermined operation parameters. This allows the procedure to be performed accurately.

What happens immediately after surgery

• the patient is left in the clinic for 1-1.5 hours for a follow-up eye examination;
• the doctor must ensure the successful outcome of the procedure, check the adherence of the upper layers of the cornea;
• sometimes patients experience excessive lacrimation, burning, mild discomfort and increased sensitivity to light;
• You shouldn’t panic when your vision changes; they usually go away the next day;
• The patient may leave the clinic only with the doctor’s permission;
• For the patient’s comfort, he will be given dark glasses to protect his eyes from light;
• patients are also given special drops that will help protect against infection and reduce discomfort;
• You can only return home if accompanied.

For the most part, after femtolasik, patients begin to see the same as with glasses or contacts, or much better. Some experience an improvement in visual acuity of up to 120-150%. Having assessed all the advantages of the procedure, we can say that femtolasik is a highly effective and safe method of vision correction. The high cost of the operation pays off significantly during a comfortable life without glasses and contact lenses.

Features of rehabilitation

After the operation, you are allowed to shower and wash yourself easily. From the third day you are allowed to wash your hair, but only by tilting it back. It is necessary to control the process and prevent water, especially soapy water, from getting into your eyes.

Cosmetics should not be used for three days after surgery. In the first days, bright light will irritate your eyes, so you should wear dark glasses. It is recommended to sleep on your side; during the first couple of months you should not sleep on your stomach, as you can damage your eyes with the pillow. However, bending and moderate physical activity are not prohibited.

There are no restrictions on pregnancy after laser eye surgery. According to statistics, the percentage of complications after surgery is minimal.

Possible complications and side effects:

1. Negative reaction to brightness. It becomes difficult for the patient to distinguish luminous objects. This effect is usually temporary and can be successfully treated with eye drops.
2. Surrounded by rainbow halos of bright objects. This phenomenon is also temporary and disappears quite quickly.
3. Stinging and dryness in the eyes. To eliminate this complication, doctors prescribe moisturizing drops for 15 days after surgery (along with anti-inflammatory drugs).

What not to do after surgery:

• visit the pool, sauna and steam room 1-2 months after exposure to the eyes;
• Taking a bath should be replaced with a short shower, also for up to 2 months;
• you should not visit the beach or solarium for 1.5 months after surgery;
• Do not sunbathe or swim in salty sea water, this will slow down the healing process;
• You should not organize picnics or similar events for a month after the procedure (you can injure your eyes).

For the first two weeks after surgery, you should avoid alcohol, cosmetics, prolonged use of the computer, and driving.

What are the differences between lasik and femtolasik technologies?

In addition, during the Femto Lasik procedure, the corneal flap is individualized depending on the parameters of the visual system of each patient. This method makes it possible to significantly improve visual function, increase sensitivity, and ensure good perception of objects in low light.

The most well-known methods of laser vision correction are two types: PRK (photorefractive keratectomy) and Lasik. In the first case, the cornea is affected from the outside. With the second - on its inner part.

The two correction methods do not compete with each other, but complement each other. Methods such as PRK are used to perform operations for myopia and astigmatism. In other cases, Lasik is used, which has a more modern version called Super Lasik. In order to compare these techniques, let's first look at them in more detail.

Lasik is a hybrid technology that is performed using laser and microsurgical techniques. With this approach, a section of the surface layer of the cornea is performed using a microkeratome. Laser exposure occurs deep in the stroma. This allows you to improve vision, while wearing bandages during treatment is not necessary, and pain after surgery is minimized. Correction can be done even with the highest degrees of ametropia.

Advantages of the method:

• fast recovery;
• the epithelium is preserved;
• avoiding pain after surgery;
• the possibility of vision correction with high degrees of ametropia;
• fast operation.

Flaws:

• cannot be used if the cornea is thin and in the process it becomes thinner;
• errors during valve formation;
• contrast decreases.

Super lasik: advantages and disadvantages

This technique is currently the most accurate and high-quality. It allows people to be relieved of ametropia, as well as aberration, i.e. distortions of large orders. SuperLasik allows you to take into account all the patient’s vision characteristics in order to perform the operation with maximum accuracy. In this case, the surface of the cornea is polished using a laser beam.

Advantages:

• high quality of vision;
• fast rehabilitation period;
• high contrast;
• vision improves at night.

The disadvantage is the depth of evaporation of the cornea.

Comparison of techniques

The difference between the two technologies is that super lasik allows you to take into account all the patient’s vision characteristics and perform the operation with better accuracy.

LASEK and LASIK are some of the most popular laser surgeries to restore vision. They are similar in many ways, but also have distinctive features. Let's find out what they are and choose which one you should make.

What is LASIK?

LASIK, or laser assisted keratomileusis, is a surgical procedure to correct nearsightedness, farsightedness and astigmatism. During this procedure, the surgeon makes an incision on the cornea, thus obtaining a flap from its surface layer. The doctor moves it to the side and uses a laser to evaporate the deep stroma, that is, changes the shape of the cornea, correcting the refractive error. After this, the flap is returned to its original place.

The operation is completely painless. Visual functions are restored within a few hours. The likelihood of complications is very low. It is important to follow all doctor’s recommendations during the rehabilitation period. However, complications are still possible. They appear as:

• deformation of the flap due to trauma, touch;
• clouding of the cornea;
• inflammation;
• protrusion of the cornea, keratoconus.

The LASIK method has a number of limitations. It is impossible with a thin cornea. It cannot correct severe myopia. LASEK can eliminate these shortcomings.

What is the LASEK method?

The difference between the two methods lies in the procedure itself. If during LASIK an incision is made, then LASEK involves creating a flap from the superficial layer of the cornea in a different way. Its essence is as follows: an application of alcohol is applied to the surface for 20-30 seconds, due to which the connection between the epithelium and the lower layers of the cornea is weakened (that is, chemical treatment is carried out). Next, the flap is folded and moved to the side, the laser beam corrects the visual pathology, and the flap is returned to its place. A special one is applied over the operated area. The surgeon removes it after 2-3 days.

The postoperative period is much shorter. The risk of complications is even lower than after LASIK. This correction method is safer and less traumatic, since there is no need to cut the cornea. In this regard, its thinning is not considered a contraindication to LASEK. LASEK is prescribed not only for myopia and hypermetropia. It is suitable for patients who need correction of higher order aberrations.

Another difference between the two types of surgeries is the price. The cost of LASEK is significantly lower. However, prices in clinics do not vary much, so the choice of method is usually not related to its cost. Both methods guarantee 100% correction of the refractive error. The type of procedure is determined by the doctor after a thorough examination of the patient. If necessary, other operations may be prescribed (EPI-LASIK, SUPER-LASIK, REIC).

There are several types of laser vision correction, and they all have certain differences. Also, in different sources you can find different spellings of the name of the technique itself - Lasik, Lasik. This name comes from the English abbreviation LASIK - Laser-Assisted in Situ Keratomileusis, which means “laser intrastromal keratomileusis”.

LASIK

Laser vision correction involves two stages: the creation of a corneal flap (flap) and the correction itself, carried out by exposing the tissue to an excimer laser. The flap, consisting of epithelium, Bowman's membrane, and stroma layer, is created using a microkeratome. The procedure involves forming a section of part of the cornea, while the flap is not completely removed, remaining on a pedicle.

The second stage is excimer laser treatment of the inner part of the stroma. A new surface is formed, after which the corneal flap is returned to its place. With this intervention, the layer-by-layer structure of the cornea is preserved (unlike), so the recovery period is much shorter, pain is less, and goes away faster. The next day, patients can already lead their normal lives. Vision may change over the course of several months, but this does not in any way affect the quality of life.

Super LASIK

The difference between the standard technique lies in the second stage: when the cornea is exposed to an excimer laser, the computer algorithm by which the equipment operates makes it possible to individualize the characteristics of the patient’s eye due to a larger number of parameters. Everything else is carried out in the same way as with standard LASIK (formation of the flap, laser exposure, returning the flap to its place). This option is also called personalized LASIK. In some situations this method is preferable. Each clinical case is considered separately by an ophthalmic surgeon, and the optimal technique is selected based on the characteristics of a particular patient.

Video about the difference between SuperLASIK technology and LASIK

Femto LASIK

The technique, or Intra LASIK, which is currently the latest modification of the method, has a fundamental difference: the corneal flap is created not using a mechanical microkeratome, but using a femtosecond laser. That is why there are names of the method such as knifeless, all-laser LASIK. The equipment for carrying out these interventions is still very expensive, so the technique has not yet become widespread. The femtosecond laser has been developed for various ophthalmic interventions, and its use in laser correction is only one of the areas.

The main advantage of a flap created with a femtosecond laser is its thickness. At the time the technology appeared, this parameter was significantly less than that of knife microkeratomes. However, microkeratomes have now been developed that are capable of creating a flip, the thickness of which is comparable to that created using a femtolaser.

Some experts consider the Femto LASIK method to be the best, while others prefer the use of proven mechanical microkeratomes. Femto LASIK can also be performed using a personalized ablation program, and this method is currently the most expensive, while the need for such a combination is questionable. Many ophthalmic surgeons believe that some time must pass before the technique takes root.

Standard LASIK is the least expensive method. Experts unanimously believe that the use of Super LASIK is always justified. There is still controversy about the Femto LASIK method.

PRK (photorefractive keratectomy) is a type of refractive surgery to correct myopia (nearsightedness), hypermetropia (farsightedness) and astigmatism. PRK and LASIK are two fairly common methods of vision correction, but differences between PRK and LASIK quite significant.

Like LASIK and other types of laser eye surgery, PRK corrects the refractive power of the eye by altering the surface of the cornea using an excimer laser, allowing light entering the eye to be properly focused on the retina for clear vision.
The main difference between PRK and LASIK is the first stage of the operation.

In LASIK, a thin flap is created on the cornea using a microkeratome. This flap is raised to expose the underlying corneal tissue and placed back after the cornea is reshaped using an excimer laser.

Difference between PRK and LASIK in which the thin outer layer of the cornea (epithelium) is removed before the underlying corneal tissue is reshaped using an excimer laser. Then, just like in LASIK, the main part of the cornea is removed with a laser. After the procedure, the epithelium itself will grow over the surface of the cornea within a few days after the operation and its traces will not be visible at all. It's as if you didn't have laser correction at all. This is good for military personnel, pilots, firefighters, machinists and people in other professions who have their eyes thoroughly checked during a physical examination.

Another type of PRK is LASEK (not to be confused with LASIK), which is also available in the arsenal of refractive surgeons. Instead of removing the outer epithelial layer of the cornea, as in PRK, LASEK involves lifting the epithelial layer (using a surgical instrument called a trephine), preserving it during surgery. The cornea is reprofiled with an excimer laser, and this epithelium is then laid back onto the surface of the eye at the end of the procedure.

But when only the epithelium is lifted, it often turns out to be non-viable at the end of the operation. Therefore, vision recovery is slower compared to PRK, since it takes longer to replace a poorly functioning epithelial layer with a new one with LASEK than to grow a new epithelial layer on a smooth surface formed by a laser with PRK.

Differences between PRK before LASIK procedure

PRK and LASIK. Comparison of results after surgery.

The final surgical results for PRK are the same as for LASIK. 100% vision is achieved with both procedures. Vision recovery after PRK is slower because it takes several days for new epithelial cells to regenerate and cover the surface of the eye. But then there will be no signs of any operation on the eye. Whereas with LASIK, these signs remain and the specialist can find out about the previous correction operation on the cornea (a pimple formed during the LASIK operation is visible in the thickness of the cornea).
Within 1-2 days after LASIK, patients usually have less discomfort than after PRK and their vision stabilizes more quickly (within the same 1-2 days), while vision improvement with PRK is gradual, and the final result appears after a few days.

PRK has some advantages over LASIK in other aspects, since PRK does not require the creation of a corneal flap (the cap that contains both the epithelial and deeper tissues of the cornea), the entire thickness of the underlying layer of the cornea is used for vision correction.

This is especially helpful if your cornea is too thin for LASIK or if you have had LASIK surgery before and therefore have thinner residual corneal thickness. Also, if a valve is not created, then there are no complications associated with its formation, just as there are no postoperative complications associated with it.

There is a new, modified version of PRK - trans-FRK. During surgery using this method, neither the surgeon nor the laser touches the patient. The operation is completely contactless. This circumstance reduces discomfort during surgery and reduces the overall time of the operation.

Let's summarize the advantages and disadvantages of PRK and LASIK in one table.