In the early days of refractive surgery, the correction of the eye was performed completely manually. This was often called “scratches”. The eye was corrected by means of a very sharp knife, used by the surgeon to make little incisions to the front side of the eye. Luckily, these days are far behind us now. Even the most experienced surgeon does not have the required precision to perfectly correct an eye. The human hand is not precise enough for this kind of procedure.
From manual to laser
Instead of the unreliable human hands as an instrument to perform delicate surgical interventions, nowadays, modern laser eye clinics use the Excimer laser. The latter was developed by the famous optician company Zeiss Meditec and allows for the execution of a stable intervention with extremely high precision.
The results of the very strict FDA tests with the most recent model of Carl Zeiss Meditec, the Zeiss MEL 80 Excimer laser, show that this is the most precise LASIK laser in the world. This eradicates the problem of a human error during the procedure, which as the most common cause of complications.
In the early days of laser eye surgery, the excimer laser was still used in combination with the “knife”, which was used to cut the flap in the cornea. Although this was not performed manually anymore, but driven by an engine or microkeratome, it was still a mechanical intervention.
The evolution towards 100% laser technology
Laser eye surgery, performed completely without the use of a knife was created in 1999 with the introduction of the femtosecond laser – a high energy laser allowing for a fully automated laser eye surgery, without any manual or mechanical intervention.
This technology was applied for the first time in the United States and was further developed in the form of an extremely precise femtosecond laser, which is used today in many clinics .
And there is more: besides these innovations in the field of laser eye surgery, other security systems have been introduced, which contribute to the optimisation and control of the laser eye surgery.
One of the developments which ensures that the result is not affected by the movement of your eyes, is called eye-tracking technology. This technology prevents the greatest fear of patients from becoming reality: that the eye would not be lasered at the right spot.
What happens when I move?
With eye-tracking technology, the eye is photographed five hundred to one thousand times per second. Every image is analysed to determine if the position of the eye is still at the exact same position for the laser treatment. If not, the laser is adjusted immediately.
With eye-tracking, you can, so to speak, move the eye during the laser eye treatment, without risks. Nobody can move an eye faster than the laser is capable of following. So, every move is detected and every laser pulse is corrected before it is released by the laser. The patient doesn’t have to be afraid to look in the wrong direction during the treatment. Thanks to eye-tracking, it is now possible to determine the exact location where the laser pulse needs to arrive with the precision of a thousandth of a millimetre.
An important factor in the precision of a laser eye surgery treatment is the dot size of the laser. The spot where the laser touches the eye needs to be as small as possible. You could compare it with the point of a pencil that you would use for precision work, while you would use a paintbrush for thicker lines. The more precise the location, the more focused the laser, which means that the laser will only remove the part of tissue that really needs to be removed. Not all lasers have the same dot size. The exact dot size of a laser can vary among institutions. The Zeiss MEL 80 Excimer laser has a very small dot size. This laser is capable of moving over the eye very rapidly and has a very quick response time, resulting in very precise laser eye surgery.
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