What is Zeiss VisuMax® FemtoLasik?
9 April 2020
FemtoLaser in situ keratomileusis is a modern diopter correction method, indicated for: myopia, hyperopia, astigmatism. The technique requires two types of laser: Femto Laser and Excimer. The femtosecond laser cuts out a customized corneal flap, like a “lid”, with an accuracy of less than one micron. The dioptres are corrected by the Excimer laser. Thanks to the with vertical edges, which follow the corneal curvature, the lid can then be placed back easily.
What is FemtoLasik VisuMax® Zeiss?
The advantages of FemtoLasik VisuMax® Zeiss technique
- High accuracy of the correction, due to Zeiss Femtosecond Laser VisuMax®;
- Tailoring of a customized corneal flap (cover/lid), with an accuracy of under a micron, which follows the natural curvature of the eye and has vertical edges, which grants a high stability of the cornea, after the surgery;
- The surgery is painless;
- Fast recovery;
- Minimum postoperative discomfort;
- Reduced incidence of complications;
- Reduced risk of diopter regression.
What should I do before surgery?
The contact lenses wearers must discontinue wearing them for 7-10 days before undergoing the performance of the required investigations and of the surgery.
A treatment with antibiotic drops and vitamin C shall be administered 2 days before the surgery
Which are the required for this surgery and where can they be performed?
All starts with a clinical examination investigation and a set of ophthalmological tests, based on which your Doctor establishes if you are a proper/good candidate for laser surgery and decides which technique suits you the best.
The required investigations are:
- The visual acuity tested with the best optical correction;
- Kerato-refractometry test;
- The diameters of the pupil and the cornea;
- corneal pachymetry (thickness);
- corneal topography (map);
- Pentacam corneal examination;
- ocular biometry calculated with IOL Master 500;
- visual field testing;
- determination of intraocular pressure;
- Auto kerato-refractometry test after the instillation of cycloplegic drops. Caution! It is not recommended that the patients drive under the influence of drops!
- eye fundus examination.
How many diopters can be corrected through this technique?
The FemtoLASIK technique can correct:
- hyperopia up to +4 diopters;
- hyperopic astigmatism up to +4 diopters;
- hyperopia and hyperopic astigmatism up to +4 diopters spherical equivalent;
- myopia -7 diopters;
- myopic astigmatism up to -5 diopters;
- myopia and myopic astigmatism up to -7 diopters spherical equivalent.
Who CANNOT undergo the surgery?
- Patients with modifications of the diopters within 12 months;
- Any patient with an active, recurrent or residual eye disease or eye abnormality
- Patients with Keratoconus;
- Patients under general medication that affects wound healing, such as corticosteroids or antimetabolite agents;
- Patients with autoimmune diseases, unbalanced diabetes or HIV infection
- Previous ophthalmic surgery of any type performed on the eye to be treated;
- Patients with irregular astigmatism;
- Patients diagnosed with glaucoma or having an intraocular pressure above 21 mm Hg;
- Patients with a history of Herpes Simplex Virus or Varicella Zoster Virus keratitis
- Pregnant women or nursing mothers;
- Patients under 18 years old.
- This surgery is particularly intended for the persons who want to get rid of glasses!
What does the surgery consist of?
1. The first step consists of the creation of the flap by means of VisuMax femtosecond laser:
2. Then, the corneal layer to be treated by excimer laser is exposed:
3. The excimer laser polishes the surfaces of the cornea in order to correct diopters:
4. Following the correction of the diopter, the corneal flap closes perfectly, as a stopper:
The surgery does not cause any pain! The anesthesia is performed locally, with drops.
The surgery is performed ambulatory, without hospitalization.
The surgery lasts about 15 minutes and is performed at both eyes within the same session.
How am I going to feel after the surgery?
After the surgery you may need a person to accompany you and you will not be able to drive the car. The first day after the surgery you will feel a mild burning or a foreign body sensation. The first day the vision might/can be blurry and fluctuating or unstable. Generally, the vision is stabilized immediately and continues to improve every day.
There are rare cases in which the vision is recovered and stabilized within a longer period of time, of several weeks. The higher the corrected diopters, the longer the recovery.
The most important thing is to follow the instructions of your surgeon and to take the prescribed treatment. After the surgery, it is forbidden to rub the eyes, because of the risk of detachment /decentration of the corneal flap
If you think that the evolution is not normal or if you have certain issues, (as detalia: if the vision does not recover within the next few days or it worsens, if you have extreme pain if you have an abnormal discharge or if your eye/eyes are intense red) it is extremely important to inform the personnel of the clinic. The failure to follow the recommendations can lead to serious complications!
How do I manage pain?
Normally, this type of surgery does not cause pain. The first day after the surgery a burning or foreign body sensation can occur. The instillation of artificial tear drops will mitigate the discomfort.
How well shall/will I see after the surgery?
During the first day the vision can be blurred and fluctuating or unstable. Generally, the vision is stabilized immediately and continues to improve every day. There are rare cases in which the vision is recovered and stabilized within a longer period of time, of several weeks. The higher the corrected dioptric effect, the longer the recovery. The complete healing and stabilization of vision can take up to 3 months.
Dry eye sensation can be felt for 6-12 months. The healing process may vary from patient to patient!
WARNING, the visual acuity obtained following the surgery will not be better than the previous one with the best optical correction!
WARNING, the failure to follow the indications of your surgeon may have a negative impact on the result of the surgery!
What should I do the first week after the surgery?
- The most important is to follow the indications of the physician and to inform the personnel of the clinic if you consider that the evolution is not a normal one!
- You must wear high quality sunglasses;
- You must not rub the eyes;
- You must not do excessive physical effort;
- You can watch TV, work on your computer and read immediately after the surgery if the visual comfort allows it;
- During the first week after the surgery, you will need someone to help you wash your hair in order to avoid water to enter your eyes. After FemtoLasik ocular infections are extremely rare, but you need to have a strict hygiene and to carefully follow the medication treatment;
- The places with dust should be avoided.
Access postoperative instructions here
What should I do during the first month after the surgery?
- to take the treatment according to the doctor’s indications;
- to wear high quality sunglasses in case of sunlight exposure;
- to keep a rigorous eye hygiene;
- to inform immediately the medical personnel if the evolution is not favorable.
What are you NOT allowed to do during the first month after the surgery?
- to rub the eyes;
- to stay in dusty places;
- to swim in the swimming pool, lakes, sea;
- to go to the beach;
- to put on make up;
- to do excessive physical workout;
- to do sauna.
For how long does the postoperative treatment last?
Generally, the treatment lasts for 1-2 weeks, according to your doctor’s recommendation.
In case complications occur, the treatment can be modified.
Which are the complications that can occur?
Laser surgeries are quite safe!
If the surgeon is experienced and the equipment is of the highest quality, the incidence of complications is extremely rare.
In case of FemtoLasik VisuMax® Zeiss techniques, the complications which can occur are the following:
- vicious healing;
- amputation or fracturing of the corneal flap;
- corneal folds;
- corneal edema;
- corneal “haze” (fog), partial loss of the corneal transparency;
- difficult night vision, halos around the light sources;
- reduction of contrast sensitivity;
- increased sensitivity to lights and headlights;
- diopters recurrence/progression; the higher the dioptres, the higher the risk of regression;
- infections (extremely rare, with an incidence under 1:10000);
- cornea swelling;
- total loss of ocular transparency and the need of cornea transplant;
- diopters overcorrection or under correction: the goal of the intervention is to correct completely the diopters trough a single procedure and in more than 95% of the cases this goal is achieved. There are cases in which the reaction of the corneal tissue may lead to under correction or overcorrection. In case of residual diopters, a second intervention can be performed by an single Excimer laser, PRK technique, 6-12 months after the initial surgery;
- loss of vision.
WARNING, If any complications occur, it is important to notify immediately the medial personnel of the clinic. In this case, the compliance of the patient in taking the treatment and in following the doctor’s recommendation is extremely important!!!
Can I lose vision?
Basically, if the surgeon is experienced, he has available the best technology, and YOU follow his recommendations, the risk of losing vision does not exist.
When should I come back for investigations?
After the surgery, the mandatory investigations are performed 24 hours and 7 days after the surgery. Then, in certain cases, 1 month, 3 months, 6 or 12 months after the surgery.
The total recovery after laser surgery is variable and can lasts up to several months. On longer term, in majority of the cases, the postoperative evolution is favorable.
Therefore, the diopters reduction laser surgery has a very high success rate, can be easily endured by any patient, and is followed by a fast healing.
How stable are the diopters after FemtoLasik?
Normally, once the cornea is reshaped, diopters tend to remain stable, although the eye is part of a living organism. The patients over 40, at some point in time, will begin to wear near vision glasses.
The progression of the diopters after treatment occurs extremely rare, and the incidence increases with the amount of the corrected refractive defect. Most often, the regression can be treated by laser.
Our surgery room is equipped with the best quality equipment, provided by the most famous names of the specialized industry. In order to discover the range of state-of-the-art facilities within Ama Optimex Clinic, please visit the following page: Equipment