WHAT IS THE REFRACTIVE SURGERY?
Refractive eye surgery is any eye surgery used to improve the refractive state of the eye and decrease or eliminate dependency on glasses or contact lenses. These procedures are designed to correct refractive errors such as myopia, hyperopia, astigmatism and presbyopia.
SURGICAL TECHNIQUE
LASER VISION CORRECTION TECHNIQUES
We have been performing Excimer laser surgery since 1988, and LASIK surgery since February 1995. We upgrade continuously our equipment’s so that we can offer our patients the last available technology to obtain the best optical and functional results.
LASIK technique starts by cutting a thin layer of cornea or “flap”. The flap can be created with a high precision microkeratome, which uses a specially designed metal blade, or with a Femtosecond laser. The flap is folded back exposing the deep stroma of the cornea and the Excimer treatment is applied remodeling the cornea to achieve the refractive correction.
Depending on the functional characteristics of the eye, the procedure can be optimized with wavefront-guided and aspheric Personalized Treatments, in a way we correct not only the refractive error, but also the optical aberrations and irregularities, hence improving visual quality of the patient. At the end of the procedure the flap is carefully repositioned over the treatment area.
The latest evolution is the so-called Presbylasik-Supracor technique to treat presbyopia, reducing glasses dependency both for distance and near vision. In this procedure we use a LASIK technique with a new type of software that applies two sequential treatments in the sema eye -one for distance and the second for near vision correction- to obtain a bifocal effect.
INTRAOCULAR TECHNIQUES
Phakic intraocular lens implantation. In young patients with high myopia or hyperopia, with reduced visual acuities or thin corneas, Laser Vision Correction could not be the best option. In these patients we recommend to implant a flexible intraocular lens called ICL (Implantable Collamer Lens) which can correct higher degrees of refractive errors than LASIK and at the same time improve vision quality significantly.
In older patients or in cases where ICL cannot be implanted, we perform a Reflactive Lens Exchange, extracting the crystalline lens and substituting it with a Premium Intraocular Lens aspheric, toric or multifocal.
PREOPERATIVE EVALUATION
It is necessary to perform some diagnostic tests prior to establishing the suitability of the patient and to select the proper type of treatment to provide full efficacy and safety for optimal results to be achieved. A wide range of therapeutic solutions for each age range or diopter is to be rigorously studied in order to apply a particular technology in each case. The Castanera Institute of Ophtalmology has all the means to analyze and evaluate visual function and to establish the most appropriate surgical indication.
Corneal topography serves to evaluate and quantify the shape, curvature, and thickness and corneal power. Corneal pathologies can be detected even at very early stages of its evolution, and treatment planning allows us to evaluate patients who are candidates for laser refractive surgery techniques or intraocular techniques.
The Aberrometry is the study of optical irregularities of the eye which directly affect the quality of vision.
Biometrics by laser interferometry determines the ocular length allowing calculation of the power of the intraocular lens implanted.
Endothelial microscopy allows to analyze the morphology and density of the corneal endothelial cell.
The optical and ultrasonic Pachymetry measures the thickness of corneal tissue.
With optical coherence tomography of the anterior segment, the cornea, the iris, the anterior chamber and the central are of thelens are analysed by menas of high-resolution transverse images.
Patients contact lens wearers should discontinue their use prior to the preoperative examination and surgery for 7 days.
Instituto de Oftalmologia Castanera
Via Augusta 20-22, 2
08006 Barcelona.
Tel. 932 173 704
Fax 934 155 125
info@institutocastanera.com