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Refractive Surgery

Overview of Prodcedures

Eye and Vision

Refractive Surgery
What is Refractive Surgery?
Overview of Prodcedures
Who is a Candidate?
Course of Treatment
Risks, Complications

Laser Eye Surgery
Refractive Lens Surgery
Other Procedures

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Classification of refractive-surgical procedures
Corneal procedures correct the refractive error by changing the refractive power of the cornea
Eye Laser	= ablation of cornal tissue
	Femto-LASIK The modern, bladeless femtosecond laser technology offers an alternative to the microkeratome (see LASIK) in creating the corneal flap and therefore eliminating all mechanical instruments from the procedure.
	LASIK During LASIK surgery, a microkeratome is used to cut a corneal flap. After the inner corneal tissue is exposed by lifting the flap, the excimer laser ablates (burns off) the cornea by removing small amounts of tissue.
	LASEK, Epi-LASIK, PRK PRK is an early laser technique which ablates corneal tissue at the surface (without cutting a flap), after removing the epithelium. In the 90ies, LASEK and Epi-LASIK succeded the PRK.
Implantate	= The implant changes the curvature of the cornea
	ICRS, INTACTS INTACTS are clear, thin inserts placed in the periphery of the cornea (under the surface) reshaping the curvature of the cornea and enhancing the natural shape of the eye to correct mild nearsightedness.
Inzisionen	= Incisions change the curvature of the cornea
	Astigmatic Keratotomy AK is a procedure for reducing the degree of astigmatism by reshaping the cornea from an oval shape into a more spherical shape.
Intraocular (lens) procedures Due to the implantation of an additional lens (phakic lens) or an lens exchange, higher refractive vision orders can be treated.
Phakic lenses	= Implantation of an additional lens
	Posterior chamber lens (e.g. ICL) The additional lens is positioned between iris and natural lens.
	Anterior chamber lens (e.g. Artiflex, Verisyse, Veriflex) The additional lens is positioned right in front of the iris. Most lenses are even iris-fixed. .
Lens exchange	= Removal of the natural lens and implantation of an artificial lens
	Refractive lense exchange For patients of 40 years of age or older, or those with a beginning cataract, the natural lens can be removed and replaced with an artificial lens.
Combination of a laser and lens procedure An extreme refractive error can be treated combining of both techniques and therefore changing the refactive power of the cornea and the lens.
Bioptics Extreme nearsightedness (above -20 dpt.) in comibation with astigmatism, can be treated with the combination of a lens implant and (4-6 weeks after) a LASIK.

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