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Advanced technology offers the cure

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Dr. Mahipal S Sachdev
No matter how ready you are for a life without spectacles or contact lenses, the decision to undergo Laser Vision Correction is a big one. Your eyes are most important, and you want to make sure that the procedure you undergo offers you the maximum safety, precision and comfort.
For all those who are fed up with the tedious rituals of the severely near-sighted – wearing contact lenses, treating dry eyes and blind fumbling for glasses at night, latest technology brings reasons to smile by introducing a much safer procedure which is flap less. ReLEx Smile or Refractive Lenticule Extraction is one of a quick and ablation free technique that is boon especially for those who have thin or irregular cornea.
Thousands of people who cannot get Lasik due to button hole irregular corneal curvature can now have a laser vision correction procedure which is not only 100% blade free, but also allows the luxury of no corneal flap creation, and which offers a pain free treatment in a few minutes. 15% of all patients who go seeking laser eye surgery are found to have corneas that are too thin or too dry. ReLEx can help patients even with thinner corneas and very high prescriptions of up to -14 in some cases.
Unlike LASIK, which uses two lasers and vaporises the corneal tissue to correct vision, ReLEx uses only one laser for the entire procedure. Instead of vaporising the unwanted tissue, the new generation laser used in ReLEx simply cuts out a lens-shaped piece of corneal tissue to correct the myopia. The tissue is extracted through a keyhole incision. This means more accurate vision correction and less discomfort during and after surgery. ReLEx is a step superior to the No Blade approach of Femto-LASIK. In Femto-LASIK, a laser is used to create the corneal flap, which is then folded back by the surgeon to perform the LASIK procedure. While Femto-LASIK or No Blade LASIK is superior to the more traditional method of microkeratome blade LASIK, it still means that a corneal flap needs to be created in eye.
This procedure has a 100 per cent success rate. It is also more accurate than LASIK, which is especially beneficial for those with higher degrees of myopia, between 500 and 1,000 degrees. “This is currently the most advanced procedure available. And it only takes 30 seconds to perform the correction as this laser is extremely fast and uses very low energy, so there is less discomfort for patients”.
ReLEx also feels more comfortable for the patient because the suction on the eye during the treatment is gentler. “Patients are also able to see the ‘aiming beam’ better because of the gentle suction, so there is almost no occurrence of what doctors call ‘light blackout’ during the treatment as compared to LASIK,” \ The patients may experience some foreign body sensation or pain for a couple of hours, but they can resume all normal activities almost immediately after the procedure. There is no flap in the eye, so there is no need to be terribly careful, he reiterates.
“There are several additional benefits due to the small incision that ReLEx offers. Since there is no flap, flap displacements & flap complications cannot occur. The small incision heals relatively quickly, leading to less patient discomfort after the procedure. There is no risk of the flap getting displaced, and this could be a benefit for all patients who are at risk for flap shearing or displacement for example, those patients who play contact sports. There could be other advantages-the small side cut incision means that there is lesser likelihood of cutting corneal nerves, perhaps leading to less problems of dry eye after the procedure, as opposed to Femto-LASIK.
Currently, ReLEx is available to treat myopic errors upto -10 Diopters spherical equivalent, with or without astigmatism of upto -5 Diopters. Patient selection criteria are similar to LASIK. The use of femtosecond laser has greatly enhanced the efficacy and safety of laser vision correction.
Advantages of the ReLEx SMILE
The ReLEx SMILE method gives the surgeon many advantages over the conventional LASIK treatment. These include:
•No Flap to Displace: Since there is no flap, there is no risk of flap displacements and flap related complications to occur.
•Less Dry Eye: Because of the tiny incision, there is less cutting of corneal nerves, leading to less dry eye and improved corneal sensitivity after the procedure.
•Better Corneal Biomechanics: Since the lenticule is removed from a small incision, the corneal biomechanical strength is less reduced after ReLEx SMILE than with other techniques.
•Much More Precision and Stability: ReLEx SMILE does not involve using an excimer laser at all, only a femtosecond laser. The total energy introduced by the laser into the eye is upto 10 times less than an excimer laser. So inflammation is less, and there is more stability of the result. While an excimer laser is dependent on atmospheric humidity and other conditions, the femtosecond laser is much more robust. The result is a much more precise treatment. This ensures that the patient has a more comfortable and better visual quality after the ReLEx SMILE method.
(The author is Chairman and Managing Director – Centre for Sight group of Hospitals)

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