http___metro-portal.hr_lasersko-skidanje-dioptrije-odgovori-na-cesto-postavljena-pitanja_60965_1.xml
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FAQ I have a cylinder in both eyes. Can the cylinder be removed by laser? Laser can correct astigmatism to 5 diopters cylinder (either plus or minus diopters). Considering the nature of astigmatism and irregular cornea curvature, procedure success rate is slightly lower than with ordinary myopia (minus Diopter) and it is approximately 90%. I have poor vision in my right eye, I have a -4 diopter cylinder and a visual acuity of 50%. Can laser improve my vision in that eye? Laser vision correction allows that the vision after surgery is like it was with contact lenses or glasses, but now without them. Laser can not fix poor vision because the problem is not in the diopter of the eye, but in the underdevelopment of the brain centers for vision. Can I drive immediately after laser vision correction? Immediately after the procedure you are not capable to drive because in the first few hours after the operation the vision is blurred, and eyes are often sensitive to light. After obtaining a clear vision which is usually the second or the third day after surgery you can drive, though it is recommended avoiding driving long distances in the firt week. How long does the laser vision correction last? Laser vision correction procedure takes about 5 minutes per eye, but the laser pulse application itself does not last more than 10 seconds. Total time spent in the clinic is two hours and includes a diopter checking and preparation for the procedure, and also the time of about 30 minutes that you spend in the hospital after the procedure to make sure that everything is all right. I spend more than eight hours a day on the computer because of my job. How many days after the laser vision correction I cant't work on the computer? Longer work on the computer with all people leads to increased dryness of the eye. This is due to less frequency of blinking which is very important for the quality of the tear film that covers our corneas. Since the tear film is damaged after the procedure it would be wise to avoid long, several hours working on the computer in the first seven days. If not, we recommend making short breaks of work at the computer every 30 to 45 minutes and instillation of artificial tears frequently. After how long the full effect of the laser vision correction is acomplished? Most patients notice significantly improved vision the first morning after removing the diopter and that causes the greatest enthusiasm. This is so called WOW effect. This is the case with almost all patients from 2 to 3 days after the procedure. In the first few weeks (or months in some patients) the small transient oscillations in vision are common, as a result of poor tear film. After full recovery and stabilization of the tear film the oscillations are lost and the vision is crystal clear all the time. Is the laser vision correction painfull? Will I be awake during the procedure? The LASIK method of the laser vision correction is completely painless. Anesthesia is local, that is achieved with instilling the drops in the eye, without any injections. You are all the time awake and aware during the treatment. You're looking at the light above. At one point you will lose the light in the eye where the diopter is removing for a period of ten seconds, after which it will return. After how long I can workout at the gym again? After laser vision correction hard physical effort and strain are prohibited in the first four weeks. Easy aerobic activities such as cycling, slowly jogging etc, may be practiced after 2 to 3 weeks. I have worn soft contact lenses for many years. But because of the pronounced dry eye I'm not able to wear them anymore. Can I undergo the laser vision correction? One of the prerequisites for laser vision correction is a good tear film. Since the procedure itself damages the tear film, it is not wise to remove the diopter until tear film gets better. If the bad tear film and dry eye are diagnosed at the preoperative examination, you will get drops for your eyes and if it is necessary also a gel used for repairing and stabilizing the tear film. This usually takes about two to three weeks and then, after the healing of dry eye, you can go to laser vision correction. I have 65 years. Can I undergo the laser vision correction? There are no age limits for laser vision correction, except that the patient must be of legal age. However, we should have two things in mind. The first is that laser vision correction does not correct the diopter for reading in patients your age (so-called presbyopia) but provides good distance vision. The other thing is the question of the cataract. Cataract is the lens opacification and if it happens, whic is common for patients your age, it would be necessary the cataract surgery, which resolves the question of distance vision correction by itself. How important is it that my diopter is stable? It is essential that your diopter is stable at least a year for the simple reason: it makes no sense to remove the diopter if there is a high posibility that it will grow so that would lead to wearing glasses or contact lenses for several months after the intervention. If the diopter is stable laser removal is a highly effective procedure with a success percentage of 95%. I have a correction of -3 in the right eye and -3.75 on the left. What is the success of laser vision correction in my case? Im nearsighted or minus diopters without astigmatism success rate of laser vision correction is 95%, ie 95% of patients will see perfectly without wearing glasses or contact lenses. In 5% it can remain small diopters, which are never even close to the original level. If it the cornea allow, theycan be removed completely with a re-laser procedure. Is there a minimum diopter value when the laser vision correction is advised? Is the procedure is advised or not, does not depend on the amount of the diopter but on it's effect on the vision. In practice this means that if patient has a small diopter of -1 but he sees without glasses or contact lenses 50% and with correction sees 100%, you will get the sight of 100% after he procedure, but without wearing glasses or contact lenses, and here will be a native visual acuity improvement of 50 percent.
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Lasersko skidanje dioptrije - odgovori na često postavljena pitanja Ako su vam dosadile naočale ili leće i željeli biste se baviti sportom, svojim hobijima ili poslom bez naočala - ima odličnih rješenja! Poznato je da naočale, pogotovo pri većoj dioptriji, sužavaju vidno polje, a dugotrajno nošenje kontaktnih leća kod nekih osoba može izazvati iritaciju, alergije te upale ili nemogućnost prilagođavanja oka kontaktnoj leći. U posljednjih je desetak godina upravo oftalmologija toliko napredovala da su laserske korekcije vidne oštrine postale gotovo rutinske i predstavljaju jednostavno rješenje skoro za svakoga. Ako se još uvijek niste odlučili na taj značajan korak u vašem životu, jer vas je strah operativnog zahvata, ishoda operacije, ili pak imate cijelu listu pitanja na koja ne možete pronaći odgovore, dr. sc. Nadežda Bilić iz Poliklinike Bilić Vision u Zagrebu, specijalist oftalmolog s osmogodišnjom praksom u laserskoj korekciji vida i prva žena refraktivni kirurg u Hrvatskoj, odgovara na neka od najčešće postavljanih pitanja u vezi s laserskom korekcijom vida. Najčešće procedure laserskog skidanja dioptrije su LASIK (laser-assisted in situ keratomileusis i PRK (Photorefractive keratectomy). Lasik je metoda kod koje se mikrokeratomom (oscilirajući nožić pokretan elektromotorom) ili laserski, formira poklopčić u sloju rožnice, nakon čega se isti podiže da bi se uz pomoć laserskih zraka modelirala rožnica i odstranila dioptrija. Oporavak je brz, a povratak na radno mjesto moguć je praktički unutar 24 sata. Kod metode PRK nema formiranja poklopčića rožnice što smanjuje mogućnost komplikacija vezanih uz poklopčić. Kod ove metode se mehanički ili laserom odstranjuje površni epitel rožnice, a nakon toga excimer laserom modelira rožnica i odstranjuje dioptrija. Metoda je sigurnija od Lasika, no oporavak vida do normale traje i do 3-4 tjedna, a može se primjeniti samo kod kratkovidnosti do -6,0 dioptrija i manjeg astigmatizma do 1,0 dioptriju. Uglavnom se preporuča kada je rožnica tanka (ispod 550 mikrometara). Prednost joj je i u tome što je pojava suhog oka izražena u znatno manjem postotku u odnosu na Lasik. Ipak, najčešće pitanje refraktivnom kirurgu nije koju proceduru izabrati već: Je li postupak bolan? Lasersko skidanje dioptrije je bezbolno. Manju neugodu može izazvati pritisak na oko koji se javlja kod formiranja poklopca, ali traje svega 10-15 sekundi. Nekoliko sati poslije operacije može postojati lagani osjećaj stranog tijela, suzenje i sl. Takvi simptomi vrlo brzo se gube korištenje propisanih protuupalnih lijekova i umjetnih suza. Možete li mi garantirati 100% vidnu oštrinu poslije operacije? Bilić izvodi lasersku operaciju oka Nije moguće dati takvu garanciju. Ipak iz mog osmogodišnjeg iskustva bavljenja laserskom kirurgijom možemo predvidjeti da će oko 95% pacijenata postići normalan vid, tj. onakav kakav su imali prije operacije uz nošenje naočala ili kontaktnih leća. Takav dobar rezultat postići će uglavnom oni s manjom i srednjom kratkovidnošću i dalekovidnošću te oni s umjerenim astigmatizmom. Ukoliko je dioptrija visoka (od-8,0 do -10,0 Dptr.) postoji veća mogućnost povratka manjeg dijela dioptrije. Tu je dioptriju moguće odstraniti nakon 3-6 mjeseci od operacije ukoliko je ostalo dovoljno tkiva rožnice nakon prvog zahvata. Ukoliko ponovna operacija nije moguća, takvi pacijenti ostatak dioptrije korigiraju kontaktnim lećama ili naočalama, a u najvećem broju slučajeva takva potreba se javlja samo u određenim situacijama (npr. vožnja). Kad se mogu vratiti na posao? Poslije Lasika u pravilu nakon 24 sata, dok je poslije PRK oporavak vidne oštrine duži i traje oko 2 tjedna. Kada mogu voziti? U pravilu već sljedeći dan nakon Lasika, no moj je stav da pacijent treba pričekati s vožnjom nekoliko dana, pogotovo ako je imao visoku dioptriju, radi prilagodbe na novonastalo stanje. To znači da za volan treba sjesti onda kada osjeti da je sposoban za vožnju i da dobro vidi bez oscilacija u vidu. Mogu li se oba oka operirati isti dan i kod Lasika i kod PRK? U pravilu mogu, no kod PRK zbog sporijeg oporavka vidne oštrine odlučuje se na individualnoj bazi. Mogu li se po potrebi nositi kontaktne leće nakon laserskog skidanja dioptrije? Neznatan broj pacijenata imat će potrebu za nošenjem kontaktnih leća nakon Lasika ili PRKa, no oni koji će željeti eventualnu preostalu dioptriju korigirati kontaktnim lećama moći će to bez problema učiniti ukoliko je zakrivljenost rožnice unutar normalnih granica. Mogu li od laserske operacije oslijepiti? Zbog lasera ne možete oslijepiti. Nigdje u literaturi nije zabilježen slučaj sljepoće kao posljedice laserskog skidanja dioptrije. Može li laser oštetiti neki dio moga oka? To nije moguće, jer zbog valne duljine excimer lasera, laserske zrake prodiru samo do najviše polovine debljine rožnice, tako da su dublje strukture oka, očna leća, vidni živac ili žuta pjega sigurni prilikom ovih procedura. Može li nešto poći krivo ako trepnem, kihnem, zakašljem se i sl. To nije problem. Iskusan operater te moderna tehnologija lasera omogućuju preciznost i sigurnost postupka. Koliko dugo traje suhoća oka nakon Lasika? Može potrajati i do šest mjeseci, pa je potrebno oko ovlaživati umjetnim suzama u količini koju preporuči liječnik. Bez obzira na još uvijek prisutne strahove i donekle rezerviranost pacijenata prema laserskom skidanju dioptrije, treba ipak naglasiti da je metoda sigurna u preko 99% slučajeva, a da su preostalih 1% ipak više nuspojave nego komplikacije koje ostaju trajno. To se prvenstveno odnosi na suho oko, moguću infekciju, uraštanje epitelnih stanica pod poklopčić, osjetljivost na svjetlo, razlijevanje slike pri vožnji noću i. sl., jer većina takvih simptoma spontano nestaje nakon nekoliko tjedana ili mjeseci. dr. sc. Nadežda Bilić, specijalist oftalmolog Poliklinika Bilić Vision, Ksaverska cesta 45, Zagreb www.bilicvision.hr