Who invented femto photography?
Interview with Dr. Breyer on the subject of 'seeing without glasses'
Editing (RE): "Dr. Detlev R.H. Breyer, Focus top physician since 2013, is an ophthalmologist and lead surgeon at Breyer, Kaymak & Klabe eye surgery at the Schadow Arkaden in Düsseldorf. He specializes in operations for “seeing without glasses” from laser correction of myopia, hyperopia and astigmatism to treatments for presbyopia and cataracts.
In the interview, he draws on 20 years of ophthalmological experience and over 40,000 operations: Dr. Breyer, which eye diseases can be treated with laser eye surgery? "
Dr. Detlev Breyer (DB): “The most common laser correction is used for nearsightedness, i.e. myopia, up to minus ten dioptres and astigmatism, i.e. astigmatism, down to minus four dioptres. Far-sightedness, the so-called hyperopia, is lasered in significantly lower numbers. Correction of presbyopia with the laser is currently the fastest growing laser method, also known as laser blended vision or 'Presbyond', a procedure that was developed in cooperation with Carl Zeiss Meditec. "
(RE): “How does the Lasik operation work? Can you explain this to laypeople? "
(DB): “In principle, there are roughly three generations of laser methods to be distinguished from one another, with one method based on the knowledge of the other. The first generation is the oldest and most painful: the photorefractive keratectomy PRK or Trans-PRK, in which the top layer of the cornea is lasered. Since this method was only tolerated by a few patients due to the pain and the long visual recovery time of 4-6 weeks, the second generation of laser eye surgery, LASIK, was invented. Here, the top layer of the cornea is cut open with a knife or a femtosecond laser over about 20 millimeters in a circular manner and, apart from a small remainder, is opened, lasered and then closed again. The older method with the knife is more painful and carries a higher risk of complications, the femtosecond laser works more precisely, the risk of complications is significantly lower. The disadvantage of LASIK is a dry eye for 3-6 months and that the corneal flap never grows back as tight as it did before. With the latest, painless method, the third generation, the 3D ReLEx smile from Zeiss, the femtosecond laser only makes a minimal incision of two to three millimeters through which a corneal disc is removed. This variant has the lowest risk of complications, is completely painless and also suitable for athletes. "
(RE): "How quickly can you work normally again after the operation?"
(DB): “That depends on the type of work and the laser method or the level of ametropia. The fastest and easiest way to get back into the job is using the latest ReLEx-SMILE method. Patients are allowed to rub their eyes, shower and exercise on the same day. In theory and often in practice, patients can drive and work again on the first day after the operation. With the LASIK methods, you must not rub your eyes under any circumstances for two weeks and you have to wear two eye patches at night until the corneal lid grows back on its edges and the eye is stable. After the older photorefractive keratectomy, the return to work is often only possible after 2-4 weeks due to the severe postoperative pain and the long visual recovery. "
(RE): "Can the ametropia always be corrected or do some patients also need glasses afterwards?"
(DB): “If the patient has been examined in detail according to the latest scientific findings and treated by an experienced surgeon with the latest lasers, a complete correction can be assumed in almost all cases. The patient then no longer needs glasses. But the same applies to the surgeon: Practice and experience make perfect. So pay particular attention to whether your laser center uses all methods and can choose the best one for you, or whether there are restrictions from the outset. Because lasers are not always the best choice. Sometimes, for example, implanting contact lenses in the eye is safer and better. "
(RE): "How much does an operation cost on average?"
(DB): “The older the method, the cheaper. The PRK and Femto-LASIK start at around 1000 euros. The ReLEx smile costs from 2450 euros and refractive lens replacement can cost up to 4500 euros, depending on the lens model. But if you calculate the cost of glasses or contact lenses over the years, you even save money in the medium to long term. "
(RE): "Do you see any dangers in the booming fixed-price offers for Lasik operations abroad?"
(DB): “Let's be honest: When was the last time you got excellent quality at a low price? What about legal security if something doesn't go as planned? For example, we look after some patients who were not satisfied with the operation abroad and then have to pay for everything privately with us. Personally, I would rather save a little longer than have my eyes lasered outside Germany at a bargain price. As the saying goes: The sweetness of the low price is quickly forgotten, but the bitter aftertaste of poor (visual) quality remains. "
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