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EyeSTAR Lasik Treatments: Lasik

Before LASIK

Before your EyeSTAR LASIK eye treatment you will have a detailed eye exam. If you wear contact lenses it is important to remove them in advance. Soft contact lenses should be removed at least 1 week before the exam and laser treatment. For hard and gas permeable contact lenses, this period is at least 3 weeks.

 

On the day of laser treatment, please do not wear any make-up (eye and face), cream, moisturizer, perfume or aftershave. Do not drink too many caffeinated drinks. Since the laser suite is kept at a cool temperature please be sure to wear warm, comfortable clothes. If you are going to have your laser treatment during the day, bring non-prescription sunglasses.
 
Before your EyeSTAR LASIK treatment you will be thoroughly informed about the procedure and told how it will feel during each step. After the mental preparation and paperwork are done, the medical preparation will start.
 
Here at EyeSTAR LASIK Institute we give great importance to the preparation of the eye laser treatment because we believe that the success rate of treatments is very dependent on preparation. Your preparation at EyeSTAR will entail becoming fully informed about the procedure and knowing what to expect. If we feel that you are comfortable and informed enough, we will proceed with your EyeSTAR LASIK treatment.
 
Meanwhile, our surgeons will be answering your questions and working on the technical aspects of your laser treatment, such as entering your eye values into the laser. Our nurses and laser technicians will be preparing the laser suite and calibrating the laser and other equipment, as well as turning on your desired music and preparing the DVD recorder to record your treatment. EyeSTAR LASIK treatment success is dependent on many factors, including the latest technology, most experienced surgeons, and VIP-service trained staff, as well as commitment to patient preparation and comfort.
 
 
What makes EyeSTAR LASIK the most popular eye laser treatment method?
 
EyeSTAR LASIK is: 
 
Quick. Laser ablation time is about 10 seconds, and total treatment time only about 3 to 4 minutes per eye.
Painless. Patients feel virtually no pain and discomfort during or after treatment.
Bloodless. No needless, patches, mess.
Safe. There is absolutely no risk of vision loss. EyeSTAR's fully sterile conditions and daily limit of 10 patients assure no risk of infections and optimal vision results.
Permanent. There is no regression in most patients' vision, with only about .05% of patients requiring enhancement treatments.
Fast in recovery. EyeSTAR patients go sightseeing in Istanbul the day after their treatment.
 
What is so special about EyeSTAR LASIK?
a fully sterile treatment environment: features in the laser suite include Hepa filters, a UV air sterilization system, a multiple air-conditioning system, and a real-time air quality monitoring system
one-of-a-kind loop system to optimize patient comfort and facilitate sterile conditions
a massage prior to treatment
a transparent operating room and laser floor plasma panel giving your friends and relatives the option to watch the treatment
private post-treatment relaxation room
listening to your preferred music during treatment
"Ready when you feel ready" approach: more questions? do you want to be treated last? or the next day? Just let us know and we'll be ready when you are.
Certified treatment service by strict German TUV-SUD ISO 9001 quality standards.
 
 
The EyeSTAR LASIK Experience
 
Step 1: Pre-Treatment Examination
 
A comprehensive eye exam will be performed by one of our surgeons. This is not a ‘routine’ eye exam, but a comprehensive, two-hour exam that will investigate the overall health of your eyes and determine whether you are a good candidate for EyeSTAR LASIK treatment, and which kind of treatment would be best for your situation.
 
Your eye exam will include measurements of corneal thickness, corneal topography, corneal tomography, eye mapping, current prescription evaluation, visual acuity, pupil size in low light and presence of cataracts, glaucoma or other disease.
 
 
During the eye exam, we instill drops into your eyes to widen the pupils in order to see the back part of your eyes better. Also for obtaining a reliable value of your refractive error we put drops that temporarily stop your accommodation. This may cause a blurry near vision and sensitivity to light for a few hours.
 
Upon successful completion of your pre-treatment exam, we will assist you in scheduling and preparing for your procedure. You will be provided both pre- and post-treatment instructions.
 
 
Step 2: EyeSTAR LASIK Treatment
 
Before your treatment we will explain each step of the procedure. We will ask your music preference or play music directly from your CD/MP3/DVD/ipod in the laser suite. After we have answered all of your questions and are certain that you are comfortable we will start your treatment with a massage.
 
 
· Eyes will be wiped clean and anaesthetic drops will be applied.
 
· You will be offered medication to calm you, which you may decline.
 
· An eyelid holder will be used to prevent blinking.
 
· You will be asked to focus on a green light throughout the procedure.
 
 
 
Step 3: Sleep!
 
After your treatment we will ask you to lay down and relax in a private resting room. Following a quick check of your eyes, we will give you an appointment time for your post-treatment exam the next day and walk you to your hotel.
 
You can expect a few hours of discomfort after your lasik treatment, such as a foreign body sensation in the eyes, burning and tearing. The best thing to do after the procedure is to sleep, and this is why EyeSTAR LASIK treatments are scheduled for late afternoon or evening.
 
The next day you can go on with your day as usual. Visual recovery is extremely fast; in low to medium prescriptions more than 80% of the aimed vision is achieved even in the first day.
 
After your treatment we will ask you to lay down and relax in a private resting room. Following a quick check of your eyes, we will give you an appointment time for your post-treatment exam the next day and walk you to your hotel.
 
The first night following your EyeSTAR LASIK treatment, you will be asked to wear a patch over your eyes at bedtime to prevent you from inadvertently rubbing your eyes while sleeping. You will be asked to use your eye drops and artificial tears for several days, and to avoid rubbing your eyes.
 
Most of our patients experience no pain or discomfort after the procedure. Some patients have a little watering of the eyes and a mild burning sensation. Others may have a mild to moderate foreign body sensation for a few hours following surgery, but the eye normally feels comfortable after about 3-4 hours. Most people feel fine if they take a nap soon after the treatment.
 
The day following their EyeSTAR LASIK treatment, most of our patients have good enough vision and are comfortable enough to go sightseeing in Istanbul, return to work and even drive the next day.
 
Women are instructed not to wear eye make-up for at least two days, ideally one week. LASIK patients should avoid water sports for two weeks and contact sports for one month following the LASIK treatment to permit healing. We will provide you with detailed instructions prior to your EyeSTAR LASIK treatment.
 
 
LASIK Results
Numerous studies have been published about LASIK results. Even the most pessimistic studies state that at least 90% of all the LASIK patients achieve a vision equal or better than driving license requirements. All of our existing LASIK patients (without any preexisting eye diseases such as lazy eye, retinal diseases etc.) see far better than these requirements. Although no results can be guaranteed, our goal is to correct your vision to be between 20/10 (more than 20/20) and 20/40 (legal driving vision) without glasses or contacts.
 
At EyeSTAR LASIK Institute Istanbul, we are meticulous in tracking our outcomes and analyzing them statistically. This attention to detail allows us to create reproducible, excellent outcomes. Our patients are very happy. Because people heal differently, outcomes can vary. So it is important that your expectations are reasonable, and this will be discussed with you during your consultation. If you are over 40 years old, you may need to wear reading glasses afterwards. As presbyopia naturally occurs in this age group or you may choose to have monovision.
 
Your corrected vision following LASIK depends on the strength of your prescription as well as other individual factors. As with any surgical procedure the results are not guaranteed. However, all of our patients without any preexisting eye disease such as lazy eye, retinal diseases etc., see 20/40 or better (enough to pass a driver's exam). 99% of our patients achieve 20/20 or 20/25 vision. Although the vast majority of our patients will achieve excellent vision without glasses or contacts, a few will have a small residual refractive error, leaving them still slightly nearsighted or farsighted or with astigmatism. Most of these patients can see fine for most of their daily activities, and use a thin pair of glasses for such tasks as nighttime driving. If you would like this residual refractive error corrected, an enhancement laser procedure can be performed after six months. The enhancement rate in our practice at EyeSTAR LASIK Institute Istanbul is 0.5%. Our doctors will weigh the probable benefits, patient expectations, and potential risks when determining whether an enhancement is appropriate. Typically, patients considered for an enhancement procedure should have at least 1.00 diopter of residual hyperopia, myopia or astigmatism or unaided vision of 20/40 or worse. Enhancement procedures should only be performed once adequate corneal healing and stability is achieved.
 
The goal of refractive surgery is to reduce your dependence on glasses and/or contact lenses, and very few LASIK patients may benefit from reading glasses or distance glasses when they desire perfect near or distance vision.
 
People often ask how long the benefits of their procedure will last. The first nearsighted patient's eye ever treated with laser vision correction was in the United States in 1987. That patient achieved 20/20 vision following treatment and is still 20/20, almost two decades later. Today, most experts around the world are confident that they will discover no long-term problems with laser vision correction. Based on the excellent results seen to date, laser vision correction has become the most commonly performed refractive procedure in the world.
 
LASIK Risks
Every surgical intervention besides its benefits may carry some risks. Even though LASIK is one of the most developed operations ever invented by mankind, although very rarely, it is possible that it may cause some undesired results. All the risks associated with LASIK operation are very rare and just a few of them have a long course. First of all, LASIK doesn't cause blindness according to all the prestigious scientific literature. We heard some rumors about some patients from India, Turkey, Europe, Canada and the US, but we couldn't verify the facts. If you know anybody suffering from a LASIK related vision loss, please advise him/her to contact us. We will provide a free service and assistance for them. We are confident that all of the possible LASIK complications can be handled by good cooperation without any significant vision quality loss.
 
What do we do to lower the LASIK risks:
 
We have created a summary of safe and high-quality LASIK practice, called Good LASIK Practice Guidelines (GLPG). GLPG is a result of years of experience and academic research. If GLPG is strictly applied, LASIK complication risks fall below 1% (which is around 2 to 6% in general [refraction deviation not included]) and also this ensures overall medical quality and evident visual outcome.
 
We always use the eye-tracker. This ensures a well-centered homogenous treatment. Many centers in Turkey and in the world don't activate eyetracking since it is time consuming.
 
We always use new original disposable blades for each patient. At each use of the microkeratome, the cornea may scratch the blade. Used dull blades may cause imperfect cuts. Aiming for the perfect results, this malpractise is unacceptable for us.
Be aware: some eye hospitals in Turkey and around the world do not change the blades from patient to patient: an open invitation for contagious diseases such as hepatitis and AIDS.
 
Even though all of the microkeratome systems we use have an alarm for inadequate vacuum levels, our refractive surgeon always checks the pressure manually and reconfirms the status by cooperating with the patient.
 
Our refractive surgeons always inspect and check the microkeratome themselves.
We always simulate the operation before performing it on our patients. This enables us to foresee possible laser related problems and it also gives us the chance to correct errors before our patients experience a problem.
Since our surgeons are refractive (corneal) surgery specialists, we are not commited to LASIK option. If your eyes need special treatments like LASEK, PTK, AK etc… we can help you with the solution that suits your special need.
 
We devote the time necessary for each patient. More time devotion means better results, less error and more content patients. One of the most well-known centers in Istanbul, Turkey has a re-operation (second laser treatment for residual myopia, hyperopia or astigmatism) rate of 21%, and ours is only 0.5%.
 
All of the pre-op examinations (before LASIK), LASIK operations and post-op examinations (after LASIK) are conducted by the same refractive surgeon. We believe that direct information is always better than indirect information.
 
Our complication rate for the flaps is around 0.2%. We encountered a few cases of SOS (Sands of Sahara) last year. We worked on it and since then, we haven't had any SOS cases. In summary, our total complication rate is under 1%. None of our patients have a vision less than the driving license requirements except the ones with severe amblyopia (lazy eye).
 
LASIK risks in general
 
A few weeks after LASIK surgery, haloes around bright light sources may be seen. In general this effect fades away with time.
Sometimes desired correction may be less or more than planned and some astigmatism may be induced. This problem can be solved by a touch-up laser treatment. Re-treatment is usually necessary for higher and more complex prescriptions.
If the vacuum of microkeratome is less than normal, an irregular/incomplete flap may be created on the cornea. Sometimes this might be due to patients' excessive squeezing or microkeratome malfunction. In this case, the LASIK procedure may be postponed or different Laser modalities may be considered.
 
Very rarely, epithelial cells may migrate under the flap. This may cause blurry vision. To solve this problem, the surgeon irrigates and washes these cells away. Sometimes if the problem is persistent, these cells can be killed with topical application of alcohol.
Another rare case is when a reaction (colonies of white blood cells) may be seen under the flap. This condition, which causes cloudy vision, is called DLK (Diffuse Lamellar Keratitis) or SOS (Sands Of Sahara). Grease and debris of microkeratome motor, patients' own secretions have been accused for this condition. Flap interface wash and drops with steroids may be used to end the reaction.
 
In the early days after treatment, although occurring in very rare instances, the patient may involuntarily displace the flap (such as during sleep, play or fight) causing wrinkles, folds or striae on the flap. In this case, the flap is repositioned and swollen, if needed.
 
Very rarely, the flap may be free without a hinge (free cap or free flap). Then, laser treatment is performed and the flap is repositioned (In the past, this was the routine).
Infection is another rare risk. It can be handled with antibiotic drops. General statistics show an infection rate of 1:20 for LASIK versus contact lens use.
After LASIK, due to the decrease of corneal tear reflex and manipulation of the tear glands (which is located under the eyelids), the eyes may be dry. This is especially obvious for elderly people, who have a natural tendency for the condition. Artificial tears and lubricant gels might be helpful. Normally after a few months, the complaints related to dry eyes disappear. Very rarely, a punctum plug to keep the tears in the eye might be needed.
International Studies About LASIK complications
 
Frequency of the complications seen during and after LASIK Surgery
One of the most well-known studies about LASIK complications is the CRS-USA study. Published in April 1998, the study was an evaluation of 1800 eyes that had undergone LASIK surgery.
 
CRS-USA STUDY: COMPLICATIONS DURING LASIK SURGERY
(Intra-operative complications, TOTAL %1.2)
 
Type of Complication Frequency
Irregular flaps 0.03%
Epithelial damage 0.47%
Thin flaps         0.38%
Too small flaps 0.38%
 
Please note that, this kind of microkeratome-related complications decreases with the advance of microkeratome technology. More recent large-scale studies such as, Tham & Maloney (n=3998), published in 2000, found this type of complications only 0.7%, in total.
Patients should realize that the incidence of such complications is generally very low. Nevertheless, in the event that one should occur, most surgeons will not proceed with the laser ablation at the time. Irregular flap cuts rarely lead to significant visual loss, and usually the surgeon will simply end the procedure that day and re-schedule the surgery a few months later. After 3 months of follow-up, it is found that there is no significant vision difference between patients who experienced complications during LASIK surgery and the ones who did not (CRS_USA study).
The CRS_USA study also summarized the complications seen after the LASIK surgery. The details of post-op complications are as follows:
CRS-USA STUDY COMPLICATIONS AFTER LASIK
(TOTAL %5.8)
 
TYPE OF COMPLICATION        FREQUENCY
Corneal Edema (Swelling of the cornea) 0.6%
Persistent Epithelial Defect                 0.5%
Corneal scarring                                 0.1%
Significant glare                                         0.2%
Persistent Discomfort                         0.5%
Epithelial in growth                         0.6%
Flap (cap) thinning                         0.1%
Interface debris                                 3.2%
 
It is worth noting that interface debris - retained metallic particles, lint, etc. under the LASIK flap - almost always causes no harm to the health or vision of the eye. Since interface debris is accepted as a non-relevant complication for vision, it has been removed from many studies published thereforeafter. From this point of view, the total LASIK complication rate may be revised as 2.6% for the CRS-USA study. None of these complications resulted in a loss of two or more lines of BCVA (Best Corrected Visual Acuity), and there was no occurrence of infection amongst the study population.
According to the Emory study (1999, n=1062 eyes), intra-operative (during surgery) complication rate has been found to be 1.8%. During this study laser treatments of 17 patients have been postponed due to microkeratome related flap problems.
Another study, Lin & Maloney (1999, n=1019 eyes) has reported a 2.2% total intra-operative complication rate.

 

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