Quick guide: Laser Eye Surgery technologylaser eye surgery equipment

Aside from the brain — the most complex structure in the known universe — the human eye is by far the most complex and fascinating organ in the body.

Evolved over millions of years from basic photosensitive cells, these precious globular organs allow us to process light and see the world in all its magnificent glory. You could even say they are one of our most sophisticated pieces of technology.

And as such, it’s only right that they require the very best in technology to scan, analyse, and treat them.

Their complexity goes way beyond generic measurements such as your lens prescription and wavefront aberrations. As a pair, they’re completely unique to you, and individually, they contain incredibly minute differences that mean no two are ever the same.

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It’s worrying then that some Laser Eye Surgery clinics still work with such bog-standard measurements, choosing not to update their systems and technology in the name of increasing their profit margins. And as time passes by, their testing equipment for measuring, scanning, and evaluating your suitability for Laser Eye Surgery gets old, their safety systems and protocols become outdated, and their laser technology for conducting treatments gathers dust.

This means anyone looking to have Laser Eye Surgery needs to have a basic understanding of its technology. With this, they can choose a clinic which uses the safest and most advanced equipment and avoid those that use second-rate and less efficient tech.

In this brief guide, we’re first going to look at the latest and most comprehensive scanner and laser systems in the industry, before diving into the drawbacks and safety issues of using old technology. Lastly, we’ll bring it all together so you feel 100 percent safe in the knowledge you can pick the right clinic for your treatment.

The technology used in the assessment and screening process

Artemis™ Ultrasound Scanner

In the short video above, Mr. Glenn Carp explains what the Artemis is and what makes it unique.

A vital part of the diagnostic stage of Laser Eye Surgery is pachymetry: measuring the thickness of the cornea. For a long time this was best done with the Orbscan or hand-held ultrasound machines, but today we have the ultra-precise Artemis Ultrasound Scanner.

In simple terms, the more accurate the scanner the safer and more effective the treatment will be, and the Artemis is the most accurate corneal scanner in the world. It’s unique in that it can measure the individual layers of the cornea, produce a 3D image, detect the thinnest point of the cornea, and display a profile of its exact depth. Since it’s introduction, it has significantly increased patient safety and refractive outcomes.

The Artemis is only used in a handful of select clinics around the world and is only available in the UK at the London Vision Clinic.

Carl Zeiss Atlas, the Pentacam, and the Bausch & Lomb Orbscan II

As Pachymetry measures the thickness of the cornea, topography measures its curvature. This is performed to spot abnormalities in its shape and help diagnose conditions like keratoconus or irregular astigmatism.

There are many instruments you can use to do this but the Carl Zeiss Atlas, the Pentacam, and the Bausch & Lomb Orbscan II are the most advanced of their kind. Using them surgeons can create a 3D map of both the front and back surfaces of the cornea and determine its exact shape and curvature.

Carl Zeiss Meditec WASCA High-resolution Wavefront Aberrometer

An aberrometer is a diagnostic tool used to measure higher-order aberrations — the tiny errors in the eye that affect the finer qualities of vision. Some clinics only offer wavefront analysis at an extra cost but we believe it should come as standard.

Aberrometers work by mapping the surface of the cornea and building a detailed picture of its unique irregularities. The effectiveness of an aberrometer is gauged by how many spots it projects onto the surface. The Zeiss WASCA High-resolution Wavefront Aberrometer is special in that it has one of the highest spot density of any other aberrometer, and can, therefore, create a much more accurate profile.

Procyon Pupillometer

As pupils change size in response to light, they need to be measured in a range of lighting conditions. This makes pupilometry an essential part of the assessment process and drawing up your personal treatment plan.

The Procyon pupillometer measures your pupil size in a range of light conditions and is used to determine your habitual pupil size. This ensures the treatment works seamlessly throughout the day and night, and that you avoid any side effects due to improper measurement of pupil dilation.

Technology used in the Laser Eye Surgery procedure

Carl Zeiss Meditec VisuMax Femtosecond laser

The femtosecond laser took Laser Eye Surgery from being a procedure you need two instruments for, to a one-instrument only procedure, SMILE surgery. And the VisuMax is the most precise and energy-efficient femtosecond laser for the job.

Other advantages of the VisuMax include: it doesn’t increase the pressure excessively inside the eye (so you feel nothing), it reduces chances of complications like sub-conjunctival haemorrhages (the little red marks in the whites of the eyes), and it offers a higher level patient comfort (as you don’t have to move during treatment).

Carl Zeiss Meditec MEL90 Excimer laser

Excimer lasers were the technology that revolutionised Laser Eye Surgery and first allowed surgeons to safely remove tiny amounts of corneal tissue and rid patients of refractive errors.

Today, according to the rigorous US FDA trials, the Zeiss MEL90 is the most accurate of these lasers in the world. It was developed by a team of experts, including Professor Dan Reinstein, and was designed to offer auto-stabilised laser energy delivery and have the faster response time on the market.

At 0.7mm, it also has the finest beam of any other Excimer laser. This is important as the finer the beam, the more focused the laser and the better able it is to remove only the material it needs to.

Technology and the real cost of cheap Laser Eye Surgery

When you head down the high street or online to buy a new phone, it’s easy to know which are the older models and which are built on the latest technology. If you can’t tell by their names and position in a sequence of models, you know just by looking at their prices.

It’s not as easy to go into a Laser Eye Surgery clinic and look under the machines for their model numbers, but there’s no reason a clinic shouldn’t be upfront about which technology they use. If you have your doubts, special offers that seem too good to be true usually are. Just like in the mobile market, a low price is usually a strong indication of outdated technology.

But with a huge range of prices spanning from as a little as £600 per eye to £6000+, how do you know a good deal from something to stay well away from? Well, let’s draw some more parallels with something nearly everyone has experience with, the smartphone market.

At the higher end is where you find the iPhones, Sony Xperias and Samsung’s latest offering. You buy these phones for their cutting edge features, quality, user experience, and long-standing reputations. Toward the lower end is where you find the older and entry-level models like the Nokia 2310 and names like Dummy which people have never heard of. You buy them not for their amazing features or dazzling good looks, but for their value and simple tech, knowing they won’t be as fast or powerful as other phones.

It’s similar in the Laser Eye Surgery market. Clinics with prices at the lower end, such as national chains and high street providers, keep their costs low by using old technology, not updating their medical safety systems, and skimping on the patient experience.

Their business model is based on selling a lot and selling cheap.

As we know from older forms of LASIK like PRK and LASEK, this can mean a greater risk of complications, some discomfort during the procedure, and a longer time spent in recovery.

On the other end of the scale are independent and private clinics. Their prices are higher so they can afford to offer the best diagnostic and examination equipment, invest in the most effective and safe laser technology, and employ a large qualified staff to care for patients.

Their business model is based on selling less and at a fair price.

However, the quality of a clinic’s treatments doesn’t all hang on what technology they use. The quality of their surgeons is equally if not more important.

In the short video below, Mr Glenn Carp explains the benefits finding a clinic that both uses the latest technology and employs highly skilled surgeons — two of the best markers of a good clinic.

As a modern surgical treatment, Laser Eye Surgery depends heavily on sophisticated technology. But that doesn’t mean you need to go around comparing the specifications of every piece of a clinic’s equipment.

The best place to start is, of course, asking them what technology they use — but this shouldn’t be your only method. Consider the clinic’s business model by reviewing their prices: do they sound too good to be true? Is there just one transparent price that covers everything? By answering these questions, you can get a good idea of the company’s priorities and whether or not they’re fully committed to patients and positioned to invest back into their equipment and technology.

Have a question about Laser Eye Surgery technology? Ask us in the comments below! Or, if you’d like to book a consultation, contact one of our Patient Care Coordinators. 

References:

New technology makes the process quicker and more effective
Where can I learn more about the screening and assessment technologies used for Laser Eye Surgery
Does Laser Eye Surgery technology correlate with Laser Eye Surgery costs?
Low price can mean older technology
What is more important the surgeon or the technology?

 

Quick guide: Laser Eye Surgery technology

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