Wydanie 2/2006

Postępy w chirurgii refrakcyjnej

Current Status of Refractive Surgery

Jerzy Szaflik1,2, Justyna Izdebska1,2, Iwona Liberek2,3

1 Klinika i Katedra Okulistyki II Wydziału Lekarskiego Akademi Medycznej w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
2 Centrum Mikrochirurgii Oka LASER w Warszawie
Kierownik: prof. dr hab. n. med. Jerzy Szaflik
3 Klinika Okulistyki Centrum Medycznego Kształcenia Podyplomowego w Warszawie
Po. kierownika: dr n. med. Iwona Liberek

Summary: Much has changed in the field of refractive surgery in the last decade. The previous techniques? radial keratotomy and PRK was replaced by newer techniques ? LASIK, LASEK and Epi-LASIK. Many developments in laser technology, improvments in laser algorithms and eyetracking systems, introduction of topography and wavefront guidance systems have greatly improved visual outcomes, enabled correction of higher refractive errors and resulted in less complications. Nowadays surgeons can choose from a range of techniques, microkeratomes, laser technologies (broad beam, scanning slit, flying spot). There is available a new fetomsecond laser for creation the most predictable corneal flap. The new wavefront and topography guided system have helped designed better individualised profile of ablation making possible to correct a higher optical aberrations. Surface ablation techniques-LASEK and Epi-LASIK attempt to minimise the pain and potential for haze of conventional PRK. Phakic IOLs and refractive lens exchange are methods of treatment of high myopia and hyperopia. There is no ideal method for correction of hyperopia. Photoablative procedures are only useful for lower amounts of hyperopia, thermal keratoplasty has low level of predictability and high level of regression and hyeropic eyes are often unsuitable for phakic IOLs. This paper is focused on the current status of available technologies for refractive errors correction.

Keywords: LASIK, LASEK, Epi-LASIK, phakic IOLs, topography guidance systems, wavefront guidance systems, fetomsecond laser, thermal keratoplasty.