Ametropia LASIK, femto or smile procedure in comparison

More than half of Germans need a visual aid to see clearly. In addition to conventional aids such as glasses and contact lenses, today more and more people are opting for an operative correction of their refractive error. About 125,000 surgical procedures are performed by eye surgeons each year in Germany. But the market is confusing for many. Good clinics and practices can still be recognized by the seal of quality "LASIK-TÜV", which is awarded by TÜV Süd after intensive examination of the results of operations. But there are also different procedures: the LASIK, the femto-LASIK and the smile procedure. Dr. Robert Löblich, medical director refractive surgery and TÜV-certified surgeon of the Artemis Eye Clinic Frankfurt, explains which procedure is suitable.

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LASIK - method with the most experience
The refractive error correction with the laser is considered very safe today. The method is scientifically recognized and corrects myopia to minus ten, farsightedness to three and astigmatism to about minus five diopters. In conventional LASIK, a very thin layer of the cornea is first cut with a microfine knife. "This layer, also known as flap, is flipped aside and the freed inner surface of the cornea treated with an excimer cold-light laser," Dr. Robert Loblich. And so long until the refractive power optimally changed in the eye and thus the refractive error is resolved. Then folded back, the flap sucks by itself and acts as the body's own patch. "LASIK has been approved in Germany since 1990, and thus the procedure with the most experience," says Dr. med. laudable.

Femto-LASIK - today's method of choice
Since 2005, a further development, the so-called Femto-LASIK, has been approved in Germany. In this LASIK form, the necessary corneal lid is not created with a mechanical cut, but with the femto laser. On the one hand, the incision is very precise, on the other hand, physicians thereby produce very uniform and thin flaps. For patients, this means increased safety and protection of the tissue. Thus, this LASIK is also possible with severe myopia and thin cornea. This new development has made the already safe procedure even safer in recent years. "Femto-LASIK is today the method of choice for the correction of defective vision," adds Dr. med. Commendable. "With a LASIK device of the latest generation we achieve very reliable results and in 95 percent of all treatments a target accuracy of +/- 0.5 dioptres."

Smile method - method of the future?
For about three years, a new method has spread, the so-called Smile method. Here, the excimer laser is completely dispensed with and a thin slice is modeled with the femto laser by means of two cuts inside the cornea. This is then removed by a cut, with the opening in the cornea being lower than in the LASIK flap. The comparison to the new smile method, however, Femto-LASIK does not need to shy away. Although in the smile process the sometimes occurring glare effects are lower at dusk, the previous process would be more precise and better matured. "In our estimation, Femto-LASIK has a technical advantage over the new procedure for some years to come" Löblich's conclusion. "The predictability of the results in the smile procedure correspond approximately to the precision, as with the LASIK ten years ago." Even long-term results are still missing. (Pm)