Treatment of Refractive Errors with Excimer Laser

Excimer Laser: Modern Solution for Refractive Errors

Excimer Laser, known as eye laser surgery, is actually the reshaping of the corneal layer with computer-controlled laser beams. Excimer Laser is widely used in the treatment of myopia, hyperopia, and astigmatism, known as refractive errors of the eye. Excimer Laser is a short procedure. It ends dependence on glasses or contact lenses.

The answers to all the most frequently asked questions about Excimer Laser operations, which are painless and have a high success rate, such as "Who is Excimer Laser suitable for?", "How is the recovery process?" and "What are the risks?", can be found in this article.

At Daviva Health Group Eye Health Department, we stand by your side on the path to clear vision with our laser technologies and expert surgeon staff.

What Is Excimer Laser?

Excimer Laser is popularly known as eye laser surgery or laser eye surgery. In fact, the eye is not cut in the Excimer Laser procedure. The reason it is referred to this way comes from the treatment previously applied by making small scratches on the cornea with diamond blades. However, this method has been completely abandoned today. Instead, with Excimer Laser, the front layer of the eye, namely the cornea, is reshaped.

Used to permanently correct refractive errors such as myopia, hyperopia, and astigmatism, Excimer Laser is a cold laser technology that uses ultraviolet light under computer control.

Which Vision Problems Are Treated With Excimer Laser?

Myopia Treatment

Myopia is the most common refractive error of the eye worldwide. As a problem of not seeing distant objects clearly, it significantly limits quality of life in daily activities. Excimer Laser offers a revolutionary success in the treatment of myopia. In Excimer Laser application for myopia treatment, the central part of the cornea is precisely flattened with computer-controlled laser beams. Thus, light is focused on the correct point on the retina. With Excimer Laser treatment, the problem of seeing far away, that is, myopia, can be permanently eliminated. Especially for those who experience a loss of comfort due to using glasses and contact lenses, Excimer Laser is a reliable treatment with a high success rate.

Hyperopia Treatment

Hyperopia is popularly known as difficulty seeing near objects. Because light focuses behind the retina, it can cause both near and sometimes distance vision to become blurred. Scientific studies show that Excimer Laser treatment provides highly reliable results in the treatment of hyperopia. With Excimer Laser application in hyperopia treatment, laser beams precisely reshape the peripheral tissue of the cornea. In this way, the central area is given a steeper curvature. This ensures that incoming light focuses exactly on the retina. After Excimer Laser treatment, it is possible to get rid of dependence on glasses while reading a book or using a computer.

Astigmatism Treatment

Astigmatism is a refractive error that causes blurred, shadowed, or stretched vision both at far and near distances. It occurs because the cornea loses its normal circular shape and takes on an egg-like form. Scientific studies show that Excimer Laser treatment achieves a success rate of over 90% in correcting astigmatic errors. Computer-controlled Excimer Laser equalizes the asymmetric curves in the cornea with millimetric precision. It ensures that light focuses on a single point on the retina. In this way, patients can be relieved of vision problems, especially while driving at night and in jobs that require detailed focus.

Excimer Laser is primarily used in the permanent treatment of myopia, hyperopia, and astigmatism. In addition, it can also provide a solution for removing spots on the corneal surface and eliminating certain medical corneal conditions.

Advantages of Excimer Laser Treatment

The cold laser technology used in Excimer Laser application performs the procedure without causing thermal damage to the corneal tissue. In this way, surrounding tissues are protected and the recovery process is accelerated.
Computer-controlled systems reshape the cornea with the precision of a sculptor. During the operation, each laser pulse removes only between 0.25 and 0.6 microns (one-thousandth of a millimeter) of tissue, minimizing the margin of error.
The total operation time for both eyes is usually as short as 10-15 minutes. A large majority of patients achieve clear vision very shortly after the procedure.
It puts an end to the hassle of searching for glasses when doing sports, swimming, or waking up in the morning. By eliminating the infection risks caused by contact lenses, it provides complete freedom.
Scientific data have proven that Excimer Laser operations provide a permanent success rate of over 90% in correcting refractive errors. A procedure done once offers lifelong visual quality.
Thanks to anesthetic drops applied before the procedure, the operation is completely painless. This method, which does not require surgical incisions or stitches, keeps patient comfort at the highest level.

Risks and Points to Consider in Excimer Laser Treatment

Temporary Dry Eye: Affecting the nerve endings in the cornea during the laser procedure may cause a temporary decrease in tear production. This condition is usually controlled with drop treatment within the first few months after the operation.
Night Vision Changes: In the first weeks after the procedure, halos around lights or light reflections may be experienced, especially in dark environments.
Immune System and Systemic Disease Factor: In the past, this surgery was considered risky for individuals with immune system-related diseases such as rheumatoid arthritis, lupus, or multiple sclerosis. However, current studies show that the operation can be safely performed in people whose disease has been under control for at least 6 months. Still, the recovery process in these patients should be monitored more closely.
Corneal Ectasia and Structural Limitations: If the corneal layer is thinner than it should be or if there are structural abnormalities, this may pose an obstacle to laser treatment. This risk should be identified through a detailed pre-examination.
Undercorrection or Overcorrection: The response of eye tissue to laser energy may vary from person to person. In rare cases, the target prescription may not be fully achieved and a very low prescription may remain.
Possibility of Regression: In eyes with very high prescriptions, a slight regression of the prescription may occur over time. If the eye structure is suitable, this can be addressed with a secondary correction procedure.

It is important for patient comfort and safety that the excimer laser procedure be performed by specialist doctors in fully equipped centers.

How Is Excimer Laser Performed?

Excimer Laser surgery is a short and effective procedure that takes about 10-15 minutes, combining advanced computer technology with the surgeon's experience.
The operation process is carried out with the following technical steps:
Before the procedure begins, the eyes are numbed with special anesthetic drops, without the need for general anesthesia. This way, the patient feels no pain during the procedure.
After the area around the eye is sterilized, a light device is placed to prevent blinking throughout the operation.
To allow the laser beams to reach the deeper layers of the cornea (stroma), the surface is prepared according to the chosen method. If the LASIK method is to be used, a micron-thin flap called a "flap" is lifted from the uppermost layer of the cornea. If the PRK / No-Touch method is to be used, the epithelium layer on the very surface of the cornea is removed with a laser or special techniques.
After this stage, the laser reshaping phase begins. This is the heart of the operation. Laser beams with a wavelength of 193 nm are applied to the corneal surface.
Excimer laser is called a "cold laser." It reshapes the cornea with micron precision by separating tissue molecules from one another without causing thermal damage to surrounding tissues.
The laser device vaporizes tissue layer by layer according to a preprogrammed algorithm to correct the refractive error in the eye
The patient's eye moving during the procedure does not pose a risk. Modern devices have Eye Tracking System technology capable of scanning up to 1000 times per second. This system detects even the smallest movements of the eye within milliseconds and redirects the laser shots accordingly or, if necessary, stops the procedure instantly.
After the reshaping is complete, the lifted flap is placed back into its original position. The lifted flap adheres naturally without stitches due to a natural vacuum. The eyes are moisturized with protective drops, and the procedure is successfully completed.

Who Can Undergo Excimer Laser?

Excimer Laser treatment is a globally accepted method for both the permanent correction of refractive errors and the treatment of certain corneal diseases.

In general, individuals who meet the following criteria are suitable candidates for this operation:

Those with refractive errors of the eye such as Myopia, Hyperopia, and Astigmatism
Those who are 18 years of age or older. The minimum age is 18 so that eye development is complete and prescription changes have stopped.
Those in whom no significant change in eyeglass prescription has been observed in the last year.
In cases where the tissue on the corneal surface is frequently damaged and causes pain
In removing superficial corneal opacities that occur after injury, infection, or alkali burns.
In removing layers formed as a result of calcium accumulation in the cornea and impair vision.
In smoothing the corneal surface after removal of tissue popularly known as "eye flesh."
In individuals with diseases such as rheumatoid arthritis, lupus, or multiple sclerosis who have not experienced a flare-up for at least 6 months and whose disease is stable, it can be performed under specialist supervision if the corneal structure is healthy.

Who Is Not Suitable for Excimer Laser?

Those diagnosed with Keratoconus (corneal steepening) in the eye structure.
Those with advanced uncontrolled eye pressure (Glaucoma) or cataracts.
Women who are pregnant or breastfeeding are not suitable for excimer laser due to the risk of hormonal changes affecting the eye prescription.

FREQUENTLY ASKED QUESTIONS ABOUT EXCIMER LASER

Will my prescription increase again after eye laser (Excimer laser) surgery?

Although excimer laser eye surgery provides a permanent change in the shape of the cornea, there is a possibility that your refractive error may return over time. This usually occurs in high prescriptions.

Will I feel pain during the operation?

Before excimer laser treatment, the eyes are numbed using anesthetic drops. No pain or discomfort is felt during the procedure. You may only feel a slight pressure on your eye.

How long after surgery can I return to work?

Although it varies depending on the method (LASIK or PRK), most of our patients can return to their daily routines and work life 24 to 48 hours after the operation.

Is dry eye after laser permanent?

Dry eye is usually a temporary side effect. Due to the effect of the laser on the corneal nerves, feeling dryness in the first months is normal. This process is comfortably managed with artificial tear drops recommended by your doctor.

Will laser surgery prevent me from having cataract surgery in the future?

No, absolutely not. Excimer Laser is a procedure applied to the cornea. Cataract surgery, on the other hand, involves the lens inside the eye. A person who has had laser treatment can safely undergo any eye surgery when needed, including cataract and glaucoma surgery, etc.