LASIK Laser eye surgery

What is LASIK?

LASIK was the most well-known eye laser surgery performed to correct vision problems. Laser-Assisted In Situ Keratomileusis (LASIK) is a very effective alternative to glasses or contact lenses.

In eyes with normal vision, the cornea bends—or refracts—light precisely onto the fovea which is the most sensitive part of retina. But in cases of nearsightedness, farsightedness, or astigmatism, light is refracted incorrectly. This improper refraction causes blurry vision.

During the LASIK surgery, a special type of cutting laser is used to change the shape of the cornea. The cornea is the dome-shaped, transparent tissue at the front of the eye.

Glasses or contact lenses can correct vision, but reshaping the cornea through laser refractive surgery provides the necessary refraction to correct vision.

Why is LASIK surgery performed?

LASIK surgery can be an option to correct these vision problems:

• Nearsightedness, also known as myopia: With nearsightedness, your eyeball is slightly longer than usual, or the cornea curves too sharply. This causes light rays to focus in front of the retina, making distant vision blurry. Objects up close can be seen quite clearly, but objects in the distance will be blurry.
• Farsightedness, also known as hyperopia: With farsightedness, you have a shorter-than-average eyeball or a cornea that is too flat. When this process is disrupted, light focuses behind the retina instead of directly on it. This results in blurry vision for objects up close and sometimes even for those at a distance.
• Astigmatism: With astigmatism, the cornea curves or flattens unevenly, affecting the focus of both near and distant vision.
• Presbyopia: There are several different eye laser methods, such as PRESBYOND, to correct age-related farsightedness as well.

How is LASIK surgery performed?

First, your LASIK surgeon will use a small surgical instrument called a microkeratome or an advanced and very precise femtosecond laser to create a very thin, superficial flap in your cornea.

The surgeon then folds back the hinged flap to access the underlying cornea (called the stroma) and removes some corneal tissue with an excimer laser.

Excimer lasers produce a cool ultraviolet light beam to remove (ablate) microscopic amounts of tissue from the cornea, reshaping it so that light entering the eye is more accurately focused onto the retina for improved vision.

After the laser ablation reshapes the cornea, the flap is laid back in place, covering the area where the corneal tissue was removed. The flap seals to the underlying cornea during the healing period after surgery.

For LASIK, only topical anesthetic drops are required, and no bandages or stitches are needed.

Types of LASIK Surgery

Types of LASIK surgery that only relate to the creation of the corneal flap during the procedure.

Traditional / Classic LASIK

The LASIK is performed with a blade:

A microkeratome, which is a specialized surgical instrument equipped with an oscillating thin blade, is specifically designed to create a corneal flap during the LASIK procedure.

In traditional LASIK, the surgeon utilizes this mechanical device, known as a microkeratome, to carefully and precisely create the necessary corneal flap.

This creation of the corneal flap is a crucial step in the LASIK process, as it allows for the subsequent reshaping of the cornea with the excimer laser to correct refractive vision errors.

FemtoLASIK

All-laser LASIK, also known as bladeless LASIK, is a vision correction procedure that enhances the safety and precision of traditional LASIK.

FemtoLASIK uses the femtosecond laser, a highly precise and accurate type of laser, to create CO2 bubbles and separate corneal tissue without making cuts or incisions. Thanks to the femtosecond laser, a corneal flap is created more safely.

Once the flap is created, the Femto LASIK process is the same as with LASIK, i.e., the excimer laser is used to correct the refractive error. After the action of the excimer laser is completed and the refractive error is corrected, the flap is placed back onto the cornea. One of the main advantages of this operation is that the femtosecond laser minimizes the chances of complications during and after the surgery.

Differences between Femto LASIK and LASIK

The main differences between LASIK and Femto LASIK are in the use of the femtosecond laser for creating the corneal flap:

• In the LASIK procedure, the microkeratome makes a cut in the corneal tissue, while in FemtoLASIK, the femtosecond laser separates the layers of tissue without making an incision. The absence of cuts in Femto LASIK allows for better and fairer recovery after the procedure.
• The femtosecond laser works very accurately, precisely, and controlled. Blade cuts depend on the surgeon’s maneuver, and there is a risk that the cut will not be precise.
• The femtosecond laser used in FemtoLASIK offers a lower risk of corneal ectasia compared to the LASIK procedure.
• Thanks to the precision of the femtosecond laser, thinner corneas can be operated on with Femto LASIK.
• Patients operated on with FemtoLASIK have a lower risk of needing a touch-up in the future.
• The likelihood of dry eye after the surgery is lower with Femto LASIK than with the LASIK technique.
• The results and visual recovery are better in patients operated on with Femto LASIK compared to traditional LASIK.

During the Procedure

A LASIK surgery is typically completed in less than 20 minutes. During the procedure, you will lie on your back in an adjustable chair. You may receive medication to help you relax. After numbing drops are put in your eye, your doctor will use an instrument to hold your eyelids open.

A suction ring will be placed on your eye just before the corneal flap is cut. This may cause a feeling of pressure, and your vision might dim a little.

Your eye surgeon will use a small blade or a cutting laser to cut a small hinged flap away from the front of your eye. Folding back the flap allows your doctor to access the part of your cornea that needs reshaping.

Using a programmed excimer laser, your eye surgeon reshapes parts of your cornea. With each pulse of the laser beam, a tiny amount of corneal tissue is removed. Once the cornea has been reshaped, the surgeon repositions the flap back into place. The flap heals without stitches.

During the surgery, you will be asked to focus on a light point.  Focusing on this light helps keep your eye steady while the laser reshapes your cornea. You might notice a distinct smell as the laser removes corneal tissue. Some people describe the smell as similar to burnt hair.

If you need LASIK surgery on both eyes, doctors generally perform the procedure on the same day.

After the Procedure

Immediately after the surgery, your eye may itch, feel gritty, burn, and be watery. Your vision will likely be blurry. Generally, you will experience little pain, and your vision will mostly recover quickly.

You may receive pain medication or eye drops to ensure comfort for several hours following the procedure.  Your eye doctor will also ask you to wear a protective shield over your eye at night until your eye heals.

After the surgery, you will be able to see, but your vision is not expected to be clear immediately. Although vision typically becomes good within a few days after LASIK, it may take up to 2 to 3 months for your eye to fully heal and your vision to stabilize. Your chances of improved vision partly depend on how good your vision was before the surgery.

You will have a follow-up appointment with your eye doctor 1 to 2 days after the surgery. This is to see how your eye is healing and to check for any complications.

It may take several weeks before you can use cosmetics around your eyes again. You may need to wait a few weeks before resuming strenuous activities such as contact sports, swimming, or using hot tubs.

Follow your doctor’s recommendations on how soon you can return to your usual activities.

LASIK Results

If you’re tired of wearing glasses or contact lenses, you might be considering whether LASIK surgery is a suitable option for you.

LASIK is a type of laser refractive eye surgery.

Typically, the majority of people who undergo laser-assisted in situ keratomileusis (LASIK) eye surgery achieve 20/20 vision or better, which is adequate for most daily activities. However, many people still eventually need glasses for driving at night or reading as they age.

The LASIK surgery has a good track record.

Complications are uncommon, and the majority of patients are pleased with the outcomes. Certain side effects, particularly dry eyes and temporary visual disturbances (such as glare), are quite common. These usually disappear after a few weeks or months, although some people consider them a long-term problem.

Your results will depend on your specific refractive error and other individual factors. People with a low degree of nearsightedness tend to have the most success with refractive surgery. People with a high degree of myopia or hyperopia, along with astigmatism, tend to have less predictable outcomes.

In some cases, the surgery may result in undercorrection. If this happens, you may need another surgery to achieve the correct correction.

Researchers from the U.S. and Germany recently conducted a literature review of 97 peer-reviewed clinical studies on LASIK vision correction, published between 2008 and 2015.

Nearly 68,000 LASIK-treated eyes and 30 different laser systems were examined in these studies.

Results of this analysis showed:

• A vision of 20/20 or better was attained in 90.8 percent of the 56,000 eyes that reported visual acuity data.
• Additionally, 99.5 percent of patients were able to achieve 20/40 vision or better without the need for corrective lenses after LASIK.
• Overall, 90.9 percent of patients were within 0.5 diopters (D) of the intended vision correction, and 98 percent were within 1.0 D.
• Less than 1 percent of patients lost 2 lines of best-corrected visual acuity on a standardized eye chart (out of 58,653 procedures reporting this data).
• Also, studies that provided patient satisfaction data found only 1.2 percent of patients dissatisfied with their LASIK outcome.

It’s better to keep in mind that as eye laser technology and methods continue to advance, the complication and side effect rates of laser eye surgery keep decreasing.

MORE information about laser eye surgery results

LASIK Risks

Complications that lead to a loss of vision are very rare. However, certain side effects of LASIK are common. These include dry eyes and temporary visual disturbances such as glare. These symptoms usually disappear after a few weeks or months.

Risks of LASIK surgery include:

• Dry Eyes: LASIK surgery causes a temporary decrease in tear production. For the first six months or so following your surgery, your eyes might feel unusually dry as they recover. This dryness can diminish the quality of your vision.
• Glare, Halos, and Double Vision: You may have difficulty seeing at night after surgery, which usually lasts a few days to a few weeks. You may experience increased sensitivity to light, glare, halos around bright lights, or double vision.
• Undercorrections: If the laser removes too little tissue from your eye, you won’t get the clearer vision you hoped for. Undercorrections, where insufficient tissue is removed, are more frequent in people who are nearsighted. You may need another LASIK surgery within a year to remove more tissue.
• Overcorrections: It is also possible that the laser removes too much tissue from your eye. Overcorrections are often more difficult to fix than undercorrections.
• Astigmatism: Astigmatism can be caused by uneven tissue removal. It may require another surgery, glasses, or contact lenses.
• Flap Problems: Folding back or removing the flap from the front of your eye during surgery can cause complications, including infections and excess tears. During the healing process, the outermost layer of corneal tissue may grow abnormally beneath the flap.
• Corneal Ectasia: Corneal ectasia, a condition where the cornea becomes too thin and weak, is one of the more serious complications. The abnormal corneal tissue is unable to hold its shape, leading to corneal bulging and deteriorated vision.
• Regression: Regression means that your vision gradually changes back toward your original prescription. This is a less common complication.
• Vision Loss or Changes: Although rare, surgical complications can occasionally result in a loss of vision.

MORE information about laser eye surgery side effects and complication

Some surgeons believe that creating a flap during LASIK carries a slightly higher risk compared to procedures that do not involve a flap. Depending on your circumstances and preferences, you might consider:

• FemtoLASIK: The main difference from traditional LASIK is that FemtoLASIK uses a femtosecond laser instead of a mechanical microkeratome (surgical tool) to create a thin layer of the cornea (flap). This method allows for extremely precise execution and reduces the risk of complications during the flap creation.
• Photorefractive Keratectomy (PRK): Instead of creating a flap, PRK involves removing the top layer of the cornea, the epithelium. This corneal abrasion heals in 3 to 4 days, causing mild to moderate pain and temporary blurred vision. Visual recovery takes longer with PRK than with LASIK. This disadvantage was thought to be offset by the theoretical advantage that PRK is safer for individuals likely to be hit in the eye—for example, those involved in contact sports, law enforcement, or the military. But even with standard LASIK, the risk of corneal flap displacement is still very low, so there may not be a significant advantage with PRK. PRK could be a better procedure for individuals with thin corneas. However, with the SMILE laser eye surgery, this statement is also invalid, as SMILE is very suitable and stable for thin corneas.
• Small-Incision Lenticule Extraction (SMILE Pro / Relex SMILE): This newer type of refractive surgery changes the shape of the cornea by using a laser to create a lens-shaped piece of tissue, called a lenticule, beneath the surface of the cornea. Once the lenticule is created, it is removed through a small incision, changing the shape of the cornea. This new technique eliminates all the flap-related complications, which are the most serious and permanent complications of LASIK.

LASIK Costs in Germany

The LASIK procedure (Laser-assisted in situ keratomileusis) is a method of eye laser surgery used to correct vision problems such as myopia, hyperopia, and astigmatism.

Average Costs

The costs for a LASIK treatment in Germany can vary significantly and depend on various factors. On average, the prices for a LASIK treatment per eye range between 1,000 and 2,000 euros. It is important to note that these costs are incurred individually for each eye, which means that treating both eyes will double the cost. Due to the relatively higher likelihood of problematic complications, traditional LASIK is not performed at the Lasikwelt Eye Laser Center.

Factors Influencing the Costs

• Technology: The type of laser technology used can have a significant impact on the costs. Newer and more advanced technologies such as femtosecond laser technology can be more expensive than traditional methods.
• Surgeon’s Experience: The experience and skill of the surgeon performing the procedure can also influence the costs. Doctors with extensive experience and a good reputation may charge higher fees.
• Location of the Clinic: The geographical location of the clinic often affects the prices. Clinics in larger cities or areas with higher living costs tend to charge higher prices.
• Extent of Pre- and Post-Operative Care: Comprehensive care before and after the surgery can increase the overall cost of the treatment but also ensures better care and potentially better outcomes.

What is Included in the Costs?

The stated costs for a LASIK treatment should ideally cover all necessary steps of the procedure, including pre-examinations, the actual laser treatment, and post-operative check-ups. Some clinics offer packages that include additional services such as guarantees for follow-up corrections. It is advisable to find out in advance which services are included in the price.

Financing and Health Insurance

In Germany, LASIK treatment is usually not covered by statutory health insurance as it is considered a cosmetic procedure. However, some private health insurance plans may offer coverage or partial coverage. Additionally, many clinics offer financing plans or installment payments to ease the financial burden for patients.

Final Thoughts

Deciding on LASIK treatment is not just a matter of cost but should also consider the potential improvement in quality of life through better vision. It is important to thoroughly research and choose a clinic with a good reputation for safety, successful treatments, and patient satisfaction. A thorough preliminary examination and consultation with the treating doctor can help make the best decision for your individual needs.

In the modern world of eye laser treatments, traditional LASIK has become less popular due to complications associated with the flap. As mentioned earlier, the primary serious problems with traditional LASIK are related to the use of blades in flap creation. To prevent these complications, the femtosecond laser has been widely used in the ophthalmic world for over 20 years. At Lasikwelt, we are committed to using the best technology and methods available worldwide. Therefore, we do not perform the old-fashioned and problematic traditional LASIK (blade LASIK). Instead of traditional LASIK, we offer our patients the safer and more modern Femto-LASIK method for 1250 euros per eye. The option of financing at 24 euros per eye/per month is also a very attractive offer from Lasikwelt Eye Laser Center Cologne.

Lasikwelt Eye Laser Center Approach

Comprehensive Care

Individuals treated at the Lasikwelt Eye Laser Center experience continuous, comprehensive care by Lasikwelt ophthalmologists from evaluation to post-operative follow-ups, rather than transferring post-operative care to another eye care provider.

Advanced Technology & Best Methods

The Lasikwelt Eye Laser Center is committed to the best available technology in the world for laser refractive eye corrections and continually updates its equipment to the most advanced technology. The eye surgeons at Lasikwelt are experts in all types of eye laser surgeries. Your eye specialist will discuss with you the technique that best suits your situation.

Thorough Examination and Latest Treatments

Lasikwelt places a high value on a thorough evaluation to ensure you are a good candidate for this type of surgery. This careful examination, combined with the use of the latest eye laser technology and techniques such as Smile PRO, Presbyond, and FemtoLASIK, helps ensure quality results for laser vision correction.

Experience

The experienced ophthalmologists at Lasikwelt are specially trained in eye laser surgeries. The eye surgeons at Lasikwelt have been performing laser-assisted in situ keratomileusis (LASIK) and a variant called photorefractive keratectomy since 1995, and each surgeon performs more than 2,000 state-of-the-art eye laser surgeries annually.

Costs and Insurance

Lasikwelt always offers very reasonable and affordable prices for laser eye surgery methods. There are also very attractive financing options.

Please contact your insurance company to verify medical coverage and obtain necessary authorization before your visit. The customer service phone number of your insurance company is often printed on the back of your insurance card.

Make an appointment for a non-binding and free quick test now to free yourself from your visual aids. If you need additional information, please request our free information package by filling out the form.