Barraquer Eye Hospital (Barcelona, Spain) is a world reference in laser surgery to correct myopia, hyperopia and astigmatism.
Refractive surgery is a quick and painless procedure with very high success rates.
Professor Rafael Barraquer (myopia specialist) has been appointed in 2017 President of EVER (European Association for Vision and Eye Research).
Currently, laser eye surgey can correct myopia to a maximum of -10D and hyperopia up to +6D.
In patients with high myopia, the best solution would be an ICL surgery (Negative Implant Surgery) with posterior chamber phakic lens implant (PCPIOL). This is done as outpatient surgery and under local anaesthetic.
Barraquer Eye Hospital (Barcelona, Spain) : your best option for refractive surgery (laser eye surgery).
FAQ ABOUT LASER EYE SURGERY (REFRACTIVE SURGERY) AT BARRAQUER HOSPITAL (BARCELONA, SPAIN).
What techniques are currently being used to correct myopia, hyperopia and astigmatism?
Laser eye surgery (refractive surgery): the definitive solution for myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism.
For many years, technological advances have offered patients with myopia, hyperopia, and astigmatism an alternative to glasses or contact lenses: laser refractive surgery. LASIK and PRK are the most used techniques for operations of mild to moderate cases of myopia, hyperopia, and astigmatism, because of their proven safety and effectiveness.
The amount of patients with myopia, hyperopia, and astigmatism that have benefitted from these operations all over the world numbers into the millions with a high level of satisfaction. Barraquer Eye Hospital in Barcelona (Spain) has a wide experience in laser eye surgery.
Which patients can be operated on with laser refractive surgery?
Currently, Barraquer Eye Hospital (Barcelona, Spain) carries out laser interventions on patients to correct myopia to a maximum of -10D and hyperopia up to +6D and without limit for astigmatism.
Before undergoing laser refractive surgery (LASIK or PRK) it is necessary to determine the state of the cornea of the patient and also its thickness. In cases where short-sightedness is high, the cornea is thin and the patient is not young, cataract surgery with refractive correction purposes is suggested.
Age is an important factor when deciding if a patient can undergo laser surgery for myopia or hyperopia. The minimum age is 18 and the maximum is about 50 years old.
Oftentimes, younger patients will not have completed the development of myopia or hyperopia. Over a certain age (45 to 50 years old) it is possible to develop cataracts in the following years. For that reason, for these patients it may be preferable to use other techniques such as exchanging the crystalline lens for an IOL (intraocular lens).
In the case of patients with high myopia, Lasik laser surgery is contraindicated. If the patient is young and has high myopia, they should also avoid cataract surgery, to conserve their crystalline lens, which is still young.
In patients who are under 50 years old with myopia (between -10 and -20 dioptres) or high hyperopia, or who have thin corneas, it may be better to perform a surgery to place a flexible lens inside the eye to correct the existing defect. This is a posterior chamber phakic lens implant (PCPIOL). This lens is inserted into the eye through a microincision that doesn’t need stitches, and is placed behind the pupil, in the space between the iris and the crystalline lens. The crystalline lens of the patient remains intact. This is done as outpatient surgery and under local anaesthetic.
What benefits and risks are involved in laser refractive surgery?
Laser refractive surgery is highly effective and safe for the correction of low to moderately high cases of myopia, hyperopia and astigmatism.
The procedures of corneal refractive surgery with laser are highly safe, above all because they are external to the eyeball, automated and computerized.
Barraquer Eye Hospital (Barcelona, Spain) is equipped with the most advanced technology which minimizes the risks that could occur during the surgery.
However, we should not forget that the surgeon performs on living human tissue (and not on inert materials), which is subject to reacting unpredictably. For that reason when we talk about high effectiveness it doesn’t mean that it will be 100% in all cases, nor that, despite its proven safety, it won’t entail some risk or possible complication.
What positive aspects of laser refractive surgery can be highlighted?
- Laser surgery greatly reduces, often completely, the dependence on glasses or contact lenses that a patient with myopia (short-sightedness), hyperopia (long-sightedness) or astigmatism has.
- LASIK is a low-risk intervention and complications are rare.
- It is a quick and painless outpatient surgery, with almost immediate visual recovery. The definitive and stable optical result is usually obtained between a few days and a few weeks after the intervention.
- The post-operative treatment and visits to our Barraquer Ophthalmology Centre are straightforward and allow the patient to very quickly restart their work and daily activities.
- When necessary, the result can, in general, be adjusted relatively easily.
- LASIK laser surgery can be performed on one or both eyes in the same session.
What negative aspects about laser refractive surgery is it necessary to keep in mind?
- No current surgical procedure cures myopia (short-sightedness) or hyperopia (long-sightedness).
- The eye of the patient with myopia (short-sightedness) or hyperopia (long-sightedness) will continue to be at higher risk from damage from such things as cataracts or glaucoma.
- The surgery does not stop the possible progression of myopia (short-sightedness) or hyperopia (long-sightedness), which would be more probable the higher it is and the younger the patient is.
- It is not possible to guarantee that all patients will get total freedom from their use of glasses or contact lenses. Some patients may need them some of the time or for certain activities (for example, driving at night).
- There are some cases of patients who are operated on for myopia (short-sightedness) that need reoperations to get the desired result.
What is the procedure used for laser refractive surgery at Barraquer Eye Hospital?
Preparation for the surgery
Once the date has been set for the intervention, you should go the day before it to the facilities of Barraquer Eye Hospital (Barcelona, Spain) to carry out a series of preoperative tests. This will help decide the exact method of treatment for patients with myopia or hyperopia.
It is important to stop using contact lenses at least three or four weeks before as these can falsify the results obtained from the tests. To prevent the growth of bacteria around the eyes, you should avoid wearing make-up for a few days.
It is not necessary to come fasting, and you can take medication if you normally do so, although you should tell the nurse about it. It is recommendable to avoid wearing perfume or other products that contain alcohol, as these can mitigate the effect of the laser. The anaesthetic is topical, by means of eye drops. Once you start applying them, it is advisable to keep your eyes closed as much as possible before the intervention to avoid possible drying of the eyes. Depending on the need, a mild tranquilizer may be administered.
How long does the laser surgery to correct myopia, hyperopia and astigmatism last?
The surgery lasts only a few minutes (from 10 to 15 minutes per eye). It is important to remain calm and relaxed. The application of the laser lasts only a few seconds and during this time it is especially advisable to try and keep your eyes fixed on the fixation light. The only thing you will notice of the laser is the sound, as it is invisible and doesn’t cause a heating effect.
Is laser surgery painful?
The surgical procedure is brief and painless. It is outpatient surgery, without the need of a stay in the hospital, which allows the patient to return home after the operation.
The immediate postoperative period
During the first 6 hours it would be recommendable to keep both eyes closed as much as possible. Although it is possible to open them momentarily, keeping them closed during this period reduces the discomfort and helps the patient’s recovery. Before leaving Barraquer Hospital, specialists will give you the necessary instructions and medication.
It is advisable to protect the eyes with glasses even when at home, to avoid rubbing them, to avoid exposing them to smoky or irritating environments, to avoid straining them and to protect them from situations where there is the risk of knocks.
After the surgery, you may note a burning or itching sensation, or the feeling that there is something in your eye. This sensation doesn’t last more than 6 hours in the majority of cases.
The doctor may prescribe medication for mild pain and a sedative.
Vision is generally blurred or cloudy the same day of the operation, but this blurriness will improve the next day.
The first weeks
Although visual recovery is quick, it is recommended to have a few days of rest or of limited activity in work. During the following days various follow-up visits will be carried out.
International patients should anticipate a stay of 10 days in Barcelona (Spain) for the postoperative tests. These visits and tests are completely free.
Which technique should be chosen? Lasik or PRK?
Lasik surgery and surgery with Surface Procedures (PRK/Lasek) share objectives, as both interventions try to solve refractive problems (myopia, hyperopia and astigmatism).
In both cases lasers are used. However, the surgical procedures are done in different ways.
In Lasik refractive surgery the surgeon uses a scalpel (microkeratome) to separate the corneal epithelium and to create a corneal flap. This is folded back leaving the internal part of the cornea exposed and ready to receive the laser treatment.
During the eye surgery with Surface Procedures (PRK/Lasek), the surgeon removes the thin external layer of the cornea (epithelium) to be able to get access to it.
The choice of one or the other procedures depends on the results of the tests that are carried out during the first preoperative consultation in the Barraquer Ophthalmology Centre of Barcelona (Spain). It should be the specialist in refractive surgery who personally evaluates your case and who will help you to determine which type of intervention is most adequate for you.
Advocates of LASIK
These days, almost all of the specialized ophthalmologists in refractive surgery are advocates of LASIK for two basic reasons:
- It causes less discomfort for the patient
- Recovery is faster
But sometimes it is necessary to turn to the PRK technique.
Advantages and disadvantages of the PRK/Lasek technique:
The procedure with the PRK/Lasek technique has the advantage that it permits surgery for some patients who, for certain personal circumstances are not candidates for Lasik surgery. There are certain disorders or circumstances when it is not advisable to use Lasik surgery: corneal scarring or because of having had an eye infection or eye injury in the last year.
However, it is considered that recovery after PRK surgery is slower. Furthermore, after the intervention, it is necessary to use therapeutic contact lenses to encourage the epithelium to heal. Another disadvantage is that the postoperative period is more painful and more uncomfortable as it is quite frequent that the first days after the operation the patient has a little pain in the eyes as the epithelium heals and covers the treated zone.
How much does laser refractive surgery cost?
Laser refractive surgery cost depends on many factors. We would be delighted to answer your query. Please, fill in this form. If you have any medical reports or examination results from other centres, we would appreciate it if you could send these tests to us by email so we can offer you the solution that best suits your needs.
You can be sure that this information will always be treated with the maximum confidentiality.
I am a foreign patient. Will the medical personnel at Barraquer speak my language?
Qualified personnel are placed at your disposal and they will advise you in your language and accompany you during all the hospital process. In case the doctor does not speak your language, a personal interpreter can accompany you throughout all your visits.
What prescriptions can be treated with laser refractive surgery?
Currently the limits are approximately 10-12 dioptres for patients with myopia (short-sightedness) and 6 for patients with hyperopia (long-sightedness) and without limit for patients with astigmatism. However, these limits can vary depending on the particulars of each patient.
Is laser refractive surgery painful?
Absolutely not. For laser refractive surgery anaesthetic drops are used which stop the patient feeling anything.
Are there any risks involved in laser refractive surgery?
All surgeries carry a certain level of risk as small as they may be. For this reason the preoperative consultation is important as it allows the ophthalmologist to avoid any unnecessary risks.
How long does the laser refractive surgery intervention last?
The intervention is very fast, it only lasts a few minutes. After 30 minutes, including a brief rest and the first postoperative examination, the patient can leave the clinic.
Is the postoperative period very complicated?
The procedures require very little postoperative medication: some eye drops and artificial tears that have to be used for a brief time.
How long will it take me to resume my normal activity?
After an intervention with laser, the patient’s visual recovery is very fast, practically a matter of hours and, in the majority of cases, normal activities can be resumed the day after the operation. The final result is usually achieved after a week, although, on specific occasions, it could take up to a month to reach this objective.
If I am not a candidate for laser refractive surgery, what alternative is there to remove my vision problem?
If after having carefully studied the case, specialists at Barraquer decide that a patient cannot be treated with laser refractive surgery because of their high myopia (short-sightedness) or the characteristics of their eye, the alternative could be the implantation of an intraocular lens.
Can I be operated on if as well as myopia or hyperopia, I have astigmatism?
Yes, the LASIK technique can correct myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism in the same operation.
Is laser refractive surgery a definitive operation?
In the majority of cases the refractive problem doesn’t usually reappear. A very small percentage of people might need additional small adjustments.
What happens if I move my eye during the intervention?
It is necessary to understand that, as it is a microsurgical operation, the patient must not move their head or body. However, during the application phase of the laser, the system has a device which can correct small eye movements.
What happens if I have any postoperative problems?
Emergency department at Barraquer Eye Hospital is open 24 hours a day 365 days a year.
I am pregnant; can I be operated on with laser?
No. It is necessary to wait until after childbirth and the breastfeeding period. During the pregnancy there could be slight changes in eye strength and during the breastfeeding period there is a risk that the postoperative medication could get into the breast milk.
Best refractive surgery specialists at Barraquer Eye Hospital (Barcelona, Spain)
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