Eye-Glasses and Contact

Lens-Free Lasik
dr.Ni Made Ayu Wulandari, Sp.M

Rumah Sakit Mata Bali Bali Mandara Rabu, 22 Maret 2024

Provinsi Bali
 Refractive Error

• Myopia
 The point of focus is in front of the retina 
to correct myopia, a concave (minus) lens is
used

• Hyperopia
 The point of focus is behind the retina  to
correct hyperopia, a convex (plus) lens is used

• Astigmatism
 The light rays of different orientations (eg,
vertical, oblique, horizontal) focus at different
points  to correct astigmatism, a cylindrical
Figure 1. Refractive Error lens is used
(A) Emmetropia; (B) myopia; (C) hyperopia; (D) astigmatism

Dhaliwal, D. K. (2024, February 21). Overview of Refractive Error. MSD Manual Professional Edition. https://www.msdmanuals.com/professional/eye-disorders/refractive-error/overview-of-refractive-error
 Management of Refractive Error

Refractive Errors | National Eye Institute. (2024, January 29). https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors#:~:text=Refractive%20errors%20can%20be%20caused,and%20helps%20the%20eye%20focus)

 LASIK
• The most common refractive surgery is LASIK
(Laser Assisted In Situ Keratomileusis)

• What is LASIK?
 LASIK eye surgery is a refractive eye
surgery that uses lasers to change the shape of
the cornea
 LASIK corrects refractive errors, which happen
when your eye can’t refract (bend) light as it
should.

Figure 5. LASIK surgery

What Is Refractive Surgery? (2023, June 7). American Academy of Ophthalmology. https://www.aao.org/eye-health/treatments/what-is-refractive-surgery
Professional, C. C. M. (n.d.). LASIK Eye Surgery. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21805-lasik-eye-surgery
 HISTORY OF LASIK

What Is Refractive Surgery? (2023, June 7). American Academy of Ophthalmology. https://www.aao.org/eye-health/treatments/what-is-refractive-surgery
Professional, C. C. M. (n.d.). LASIK Eye Surgery. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/21805-lasik-eye-surgery
 Overview LASIK
LASIK Candidate Risk of LASIK

• Dry eyes
• 18 years and older
• Glare, halos and double vision
• Normal thickness and morphology cornea
• Undercorrections
• Stable prescriptions
• Overcorrections
• Does not have eye condition such as eye
• Astigmatism
infection etc HZO
• Flap problems
• Not pregnant or nursing
• Corneal ectasia
• Does not have other health issues such as
• Regression
diabetes
• Vision loss or changes

Am I a Candidate for LASIK Eye Surgery? - The LASIK Vision Institute. (2024, January 30). The LASIK Vision Institute. https://www.lasikvisioninstitute.com/candidate-lasik/#:~:text=LASIK%20Candidates%20Should%20Have%20Overall,can%20slow%20or%20prevent%20healing.
LASIK Candidate. (n.d.). Harvard Medical School Department of Ophthalmology. https://eye.hms.harvard.edu/book/good-candidate-lasik
LASIK eye surgery - Mayo Clinic. (2023, August 2). https://www.mayoclinic.org/tests-procedures/lasik-eye-surgery/about/pac-20384774
 LASIK Preparation

Pre lasik Lasik Procedure

Early screening
Doctor consultation One day post lasik evaluation

Eyewiki.aao.org. (n.d.). Preoperative Evaluation for LASIK Surgery - EyeWiki. [online] Available at: https://eyewiki.aao.org/Preoperative_Evaluation_for_LASIK_Surgery#LASIK_Testing [Accessed 14 Mar. 2024].
 LASIK Preparation

Eyewiki.aao.org. (n.d.). Preoperative Evaluation for LASIK Surgery - EyeWiki. [online] Available at: https://eyewiki.aao.org/Preoperative_Evaluation_for_LASIK_Surgery#LASIK_Testing [Accessed 14 Mar. 2024].
 LASIK Procedure

1. Create a layer on the cornea (flap), this stage was

originally used the technique Mikrokeratom (Blade)

2. The laser irradiation at the inside of the cornea to reshape

the cornea after a flap is open

3. After irradiation is completed, the flap is returned to its

original position. In less than 3 minutes flap will cling by
itself without the need for stitches.
Figure 7. LASIK Procedure

Subudhi, P., & Agarwal, P. (n.d.). [Figure, Steps Of LASIK Eye Surgery Contributed by Ruby eye Hospital] - StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK580529/figure/article-142919.image.f4/
What is LASIK, all about LASIK - JEC Eye Hospitals & Clinics Best Eye Hospital in Indonesia LASIK Cataract Dry Eye Relex SMILE Glaucoma Low Vision Retina. (n.d.). JEC Eye Hospitals & Clinics Best Eye Hospital in Indonesia LASIK Cataract Dry Eye Relex SMILE Glaucoma Low Vision Retina.
https://jec.co.id/en/service/laser-vision-correction/lasik
 LASIK Technique
Photorefractive keratectomy (PRK)
• Photorefractive keratectomy (PRK) was the first type of refractive surgery to treat vision problems due to
refractive errors.
• It is used to treat myopia, hyperopia,and astigmatism
• The PRK method was first developed in 1948.

FemtoLASIK
• The FemtoLASIK procedure uses a Femtosecond Laser to change the shape of the eye's cornea to correct vision
problems.
• Femto laser was developed in the early 1990s.

Refractive Lenticule Extraction, Small Incision Lenticule Extraction (ReLEx SMILE)

• ReLEx SMILE or commonly called LASIK of the eye today is a LASIK method without the need to create a flap
which was common in the previous FEMTO LASIK method.
• The healing process is much faster and the procedure takes only a few seconds.

A. (2023, June 10). Perbedaan Relex Smile, Femto Lasik dan Lasek (PRK). National Eye Center. https://nationaleyecenter.id/perbedaan-relex-smile-lasik-prk/
D. (2024, January 22). Jenis Metode LASIK PRK FemtoLASIK ReLEx SMILE SMILE PRO. LASIK & Katarak Center Jakarta - Klinik Mata | Ciputra SMG Eye Clinic. https://ciputrasmgeyeclinic.com/4-jenis-metode-lasik-prk-femtolasik-relex-smile-smile-pro/
 LASIK Technique

A. (2023, June 10). Perbedaan Relex Smile, Femto Lasik dan Lasek (PRK). National Eye Center. https://nationaleyecenter.id/perbedaan-relex-smile-lasik-prk/
D. (2024, January 22). Jenis Metode LASIK PRK FemtoLASIK ReLEx SMILE SMILE PRO. LASIK & Katarak Center Jakarta - Klinik Mata | Ciputra SMG Eye Clinic. https://ciputrasmgeyeclinic.com/4-jenis-metode-lasik-prk-femtolasik-relex-smile-smile-pro/
 Photorefractive Keratectomy (PRK)

Advantages

• More feasible in patients with thinner corneas

• More affordable than other LASIK options

Disadvantages

• Postoperative discomfort
• Sensitive to light
• Requires wearing a contact lens bandage within a few Figure 8. PRK Procedure
days after PRK
• Post PRK vision recovery is longer than LASIK and
RelexSmile

A. (2023, June 10). Perbedaan Relex Smile, Femto Lasik dan Lasek (PRK). National Eye Center. https://nationaleyecenter.id/perbedaan-relex-smile-lasik-prk/
D. (2024, January 22). Jenis Metode LASIK PRK FemtoLASIK ReLEx SMILE SMILE PRO. LASIK & Katarak Center Jakarta - Klinik Mata | Ciputra SMG Eye Clinic. https://ciputrasmgeyeclinic.com/4-jenis-metode-lasik-prk-femtolasik-relex-smile-smile-pro/
Κολοσκόπης, & Κολοσκόπης. (2016, December 2). PRK Method Eye Surgery | EYE DAY CLINIC. EYE DAY CLINIC - Ophthalmic Surgery Day Clinic. https://www.eyedayclinic.gr/en/methodos-prk/
 Photorefractive Keratectomy (PRK)

https://www.youtube.com/watch?v=uw9foZagYtU
 FemtoLASIK

Advantages

• Postoperative comfort, no sensitive complaints like

PRK
• Postoperative vision recovery is faster and more
stable
• Does not require a contact lens bandage after LASIK
• Can be used for minus eyes above 10D

Disadvantages Figure 8. FemtoLASIK Procedure

• There is a risk of flap fold

• Sometimes there is still a slight dry eye complaint

A. (2023, June 10). Perbedaan Relex Smile, Femto Lasik dan Lasek (PRK). National Eye Center. https://nationaleyecenter.id/perbedaan-relex-smile-lasik-prk/
D. (2024, January 22). Jenis Metode LASIK PRK FemtoLASIK ReLEx SMILE SMILE PRO. LASIK & Katarak Center Jakarta - Klinik Mata | Ciputra SMG Eye Clinic. https://ciputrasmgeyeclinic.com/4-jenis-metode-lasik-prk-femtolasik-relex-smile-smile-pro/
Lasik / Femto Lasic procedure advantages and disadvantages & it’s More. (2021, June 5). Eye Care Clinic. https://eyecare.pk/service/lasik-femto-lasic/
 FemtoLASIK

https://www.youtube.com/watch?v=t80CNT5KK90
 ReLEx SMILE

Advantages

• Wound on the cornea is only 2 to 4 mm

• Not many nerves are cut
• Post ReLEX SMILE is free from discomfort like
PRK
• Post ReLEX SMILE is free from dry eye like Lasik
• No folded flap complications

Disadvantages

• Limited to eye minus up to 10D

Figure 8. ReLEx SMILE Procedure

A. (2023, June 10). Perbedaan Relex Smile, Femto Lasik dan Lasek (PRK). National Eye Center. https://nationaleyecenter.id/perbedaan-relex-smile-lasik-prk/
C. (2024, January 4). Epi-LASIK vs SMILE. Clearvision Eye Clinic & LASIK Centre Singapore. https://clearvision.com.sg/epi-lasik-vs-relex-smile/
D. (2024, January 22). Jenis Metode LASIK PRK FemtoLASIK ReLEx SMILE SMILE PRO. LASIK & Katarak Center Jakarta - Klinik Mata | Ciputra SMG Eye Clinic. https://ciputrasmgeyeclinic.com/4-jenis-metode-lasik-prk-femtolasik-relex-smile-smile-pro/
 ReLEx SMILE

https://www.youtube.com/watch?v=t80CNT5KK90
 Eyecare after LASIK

• Use the medication as advice

• Use protective eyewear for 1 week
• Do not rub or touch the eyes for at least 1 week after surgery
• No swimming for at least 2 weeks after surgery
• Avoid dirt an dust

LASIK Post-Op Care: Recovery Time & Aftercare Tips. (2023, December 15). NVISION Eye Centers. https://www.nvisioncenters.com/lasik/post-care/
 Terima Kasih
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