An Introduction to Eye Laser Surgery

Since early times humanity has sought to correct visual problems. The ancient Chinese used to sleep with small bags of mercury on their eyes, flattening their corneas and improving their shortsightedness. Unfortunately, the effects only worked for a few minutes after waking! Spectacles were first used by the Arabs in the 11th century and were introduced into Europe about two hundred years later. This century has seen the development of contact lenses, initially the hard variety and later soft and disposable soft lenses.

Although these optical aids allow patients to see well while wearing them, they do not offer a permanent cure for the visual disorder. Also in many situations they are inappropriate, for example when swimming. Another problem is that in some instances dangerous situations can arise when they become dislodged, this can occur while they are being used by firefighters and police officers. Meticulous care is required to sterilize contact lenses to prevent corneal infections and permanent scarring and loss of vision.

Two decades ago surgical techniques were introduced to permanently correct shortsightedness and astigmatism. The radial keratotomy procedure used a diamond blade to make incisions into the cornea, the front surface or “window of the eye”.

These older techniques should not be confused with Excimer Laser treatment that has replaced the surgeon’s blade by a sophisticated, computer controlled laser that gently re-sculptures the shape of the cornea without cutting or weakening the eye.

We have been using Excimer Lasers since they were first introduced into South Africa in 1993. Since that time equipment and surgical techniques have made enormous advances. In our centre we now use an ultra-modern fifth generation scanning Excimer Laser, this is the LaserSight Astrascan XL custom laser. It is a small flying spot excimer laser with an active tracker that “locks” onto your eye and follows any movement of the eye, it even rotates to ensure the most accurate correction of astigmatism. In addition, with the new Astramax 3-D stereo topography unit we can generate corneal maps that with the Astrapro software allows us to individually treat corneas, this is known as custom ablation. This has been a major advance in laser surgery making the treatment even more accurate and safe; thus ensuring the best possible outcome. We offer this customized treatment at no extra charge.