As with any operation, it must first be clarified whether surgery is possible or advisable.
Moreover, refractive surgery is usually performed on a healthy eye. The patient's medical history, individual level of suffering and motivation are therefore of particular importance.
In addition to the normal ophthalmological functional and organic examinations, special diagnostics are required for refractive surgery.
These include:
- Measurements that we need to calculate the laser treatment, such as the refraction of the eye, the aberrations (imaging errors) of the cornea and the entire eye, etc.
- Measurements to determine limiting conditions, such as the size of the pupils during the day and at night, the determination of the cell count of the corneal endothelium and thus the quality of the tissue
- A morphological exclusion diagnosis to limit the indication for surgery - This applies to all parts of the eye, from the tear film to the lens to the retina.
Imaging diagnostics
to expand, refine and document manual-optical examinations
Optomap
- Digital, non-invasive images of the inside of the eye, i.e. the retina right into the periphery, even with a narrow pupil
- AF imaging (recording and display of autofluorescence) visualizes metabolic changes in the retina.
- This enables risk predictions to be made about any expected retinal diseases, which can also lead to the identification of contraindications.
OCT (optical coherence tomography)
- for fine tissue examination and documentation of the macula, but also of the optic nerve or cornea
Endothelial biomicroscopy
- to be able to draw conclusions about the imaging quality and the “load capacity” of the cornea from the visualization of the cells of the corneal back surface
- This helps both in the prognosis before laser treatment of the cornea and in the IOL selection before lens exchange or can also serve as an exclusion criterion.
Optomap
- Digital, non-invasive images of the inside of the eye, i.e. the retina right into the periphery, even with a narrow pupil
- AF imaging (recording and display of autofluorescence) visualizes metabolic changes in the retina.
- This enables risk predictions to be made about any expected retinal diseases, which can also lead to the identification of contraindications.
OCT (optical coherence tomography)
- for fine tissue examination and documentation of the macula, but also of the optic nerve or cornea
Endothelial biomicroscopy
- to be able to draw conclusions about the imaging quality and the “load capacity” of the cornea from the visualization of the cells of the corneal back surface
- This helps both in the prognosis before laser treatment of the cornea and in the IOL selection before lens exchange or can also serve as an exclusion criterion.
Advanced functional diagnostics
ERG (Electro Retinography)
- to differentiate between any central visual disorders (optional)
MAIA - Microperimetry
- to detect any paracentral defects in the visual field (optional)
Tear film analysis
- Examination of the quality of the tear film (LipiView and IDRA) and the quantity of tears (Schirmer test)
Examination of twilight vision
- Mesotest
ERG (Electro Retinography)
- to differentiate between any central visual disorders (optional)
MAIA - Microperimetry
- to detect any paracentral defects in the visual field (optional)
Determining the dominant eye
- Important for planning monovision, optional depending on age
Laser measurement of the eyes
for the (computer-controlled) determination of treatment data
Aberrometry
- for measuring aberrations of the eye
- All aberrometers are matched to a special excimer laser system. They deliver different results due to the different measuring methods. In addition, every person has fluctuations in their aberrations like their spectacle values - even if these are often only very slight.
Autorefractometry
- to determine the total refractive power of the eye, if necessary additionally after administration of eye drops that relax the lens (cycloplegia)
Corneal topography
- Parallel measurement with 2 devices: MS 39 and Pentacam
- to determine corneal thickness, shape of anterior and posterior surface, diameter and other data (for lens surgery additionally cassinitopography)
IOL-Master
- to determine data for IOL calculation and selection, also in the case of planned LASIK or PRK as a basis for possible subsequent lens surgery
Pupillometry
- to determine the pupil diameter under twilight conditions (with MS 39)
- Important for estimating possible glare in the dark (e.g. additionally with Plusoptix)
Corneal topography
- Parallel measurement with 2 devices: MS 39 and Pentacam
- to determine corneal thickness, shape of anterior and posterior surface, diameter and other data (for lens surgery additionally cassinitopography)
Aberrometry
- for measuring aberrations of the eye
- All aberrometers are matched to a special excimer laser system. They deliver different results due to the different measuring methods. In addition, every person has fluctuations in their aberrations like their spectacle values - even if these are often only very slight.
The diagnostics program we have established goes far beyond the internationally prescribed and standard. Parallel examinations with different devices, but with the same measurement objective, serve to rule out measurement errors.
Tear film diagnostics, which is not normally used, is intended to provide more certainty in the indication and indications for possible postoperative problems.
The patient also receives a glaucoma exclusion diagnosis.