Eye health and diseases specialist Op.Dr. Sinan Göker will give information about what is curious about laser treatment applied in problems such as myopia, hyperopia and astigmatism in the eye.
Laser surgeries are popularly known as “eye scratching operation”. Is the eye really scratched in laser surgery? And is the number in the eye completely reset and does the need to use the eye for near or far disappear?
"Now, the most commonly used methods are excimer laser and lasik. In other words, after removing a flap on the cornea, which we call a flap, we make a laser and close it. This method is called “lasik”. The laser removes tissue from the cornea. It vaporizes the tissue, but this is a cold laser. Therefore, it gives a new shape to the cornea by removing tissue. And when you close the lid, a tiny lens is formed in the intermediate layer of the cornea. So there is no drawing process in the eye. There is only a new shaping process by taking a tissue. Since this shape is permanent, the number does not come back again."
WHO CAN UNDERGO LEUKIC EYE SURGERY?
Up to what degree of myopia, hyperopia and astigmatism can this method be applied today?
"There are different methods, but the one I use is the Lasik method. Lasik is one of the most widely applied and accepted methods in the world. With the excimer laser and lasik method, we can make myopes up to number 10. I started to apply laser in Turkey 33 years ago. Therefore, in the past, I could correct myopes up to number 20 with the old techniques. But with the new technology, I prefer to correct myopes up to 10. We apply another technique for those above number 10. Astigmatism can be as high as number 7 in a human eye. And the most difficult of these are the types we call hypermetropic astigmatism and mixed astigmatism. Thanks to a special laser, we can make these up to 7 with 95 percent success. As for hyperopia. The latest hypermetropic and hypermetropic astigmatisms have already started to be made. We have been able to do them with 95 percent success for about 15 years.
FROM WHICH COUNTRIES DO PATIENTS COME TO TURKEY FOR LASER EYE SURGERY?
Patients from various countries of Europe and the world come to Turkey for laser eye surgery. Which countries do more patients come from?
"Mostly from Germany, France and Northern European countries such as Denmark and Norway. We also get a lot of patients from the Netherlands.
WHAT ARE THE REASONS WHY TURKEY IS PREFERRED FOR LASER EYE SURGERIES?
So, why do patients abroad prefer Turkey? Of course, there are physicians like you in Turkey who are very experienced and knowledgeable in the treatment of eye diseases. Turkey is also in a very good place in terms of health technologies. Could you give some information about this? Also, is treatment in Turkey more affordable in the private health sector compared to western countries? Is the geographical location of Turkey an attractive factor?"
"Now it is like this, those who want to have this treatment do not usually come to travel. They directly get this treatment and come back. There are very few people who want to travel while they are here. Therefore, the first reason is the fee. The price is really different. We also use high technology. Since we have been practicing this method for a very long time, we have 33 years of experience. Therefore, the first factor is of course the affordability of the fee. The second factor is experience. Because when I first started 33 years ago, there were a few doctors doing this in Europe. At that time, many patients started to come from Europe. These patients started to tell their relatives about it and over time, word of mouth has increased exponentially."
YOU CAN RETURN TO YOUR COUNTRY 2 DAYS AFTER LASER EYE SURGERY!
You have just said that most of the patients coming from abroad and especially from Europe return after laser surgery. How long does laser surgery take? Do people need to stay in the hospital? How is anesthesia? Are the patients put to sleep with anesthesia? In other words, if we take into account a patient who is thinking of coming to Turkey from Greece, how many days should he spend to get rid of his glasses with laser?
"Now this laser is actually a very ideal treatment for health tourism. Because it is a very fast treatment. Recovery is very fast. The person came to us from abroad. We do the examination on the same day and the laser in the afternoon. That day he goes home or to a hotel and rests. When he wakes up the next day, he opens his eye and starts to see clearly. He starts to see one hundred percent and without glasses. The next day he comes to us for control. After the control, he returns to his normal life. He can go out, travel, shower, work with the computer, do sports, everything is free. Only no sea or pool for a week. If he came to Turkey for a vacation, it is enough for him to spend one or two days with us on his way back after he finishes his vacation. In other words, one day and one night is enough time for treatment. Therefore, when those coming from abroad spare two days, they can easily return with this treatment."
CAN EVERYONE WHO HAS HAD LEUKEMIA SURGERY SEE WITHOUT GLASSES?
So, is the number in the eye reset in every case? In other words, does the need for glasses completely disappear for near and far?
"Yes, now it is like this. Not for near. Because with this laser treatment, we only correct distant numbers. No laser is applied to the near. Therefore, since the problem of nearsightedness starts after the age of 40, we prefer to perform this laser for people up to the age of 40. Because if it starts near, we correct it with another type of intraocular surgery that we call “smart lens” for those over the age of 40. Therefore, the success rate is very high. The rate of dropping to numbers close to zero is 97 percent to 98 percent. In other words, with a very, very high probability, the numbers fall to very close to zero, such as 0.25, 0.15. There is no need for glasses and lenses. It stays there for life. It is a permanent treatment. After it falls, it does not rise again. This is the most important feature. In fact, another important feature is that it is a safe and reliable method. So there is no risk of losing the eye. That is why it has actually become so popular. To date, 60 million people in the world have gotten rid of glasses and contact lenses with this laser treatment."
CAN LASER SURGERY BE PERFORMED ON EVERY MYOPIA AND HYPEROPIA?
If we consider a patient coming here from Greece, a detailed eye examination is performed first. Is it possible to perform laser surgery on every patient or do you encounter a group of patients who should not be operated on? Who are they?
"Yes, rarely. I mean, let me put it this way, 95 percent of patients can be lasered. It cannot be done for 5 percent. Since the laser is applied to the cornea, the thickness of the cornea must be sufficient. In other words, a good corneal thickness is required. Secondly, it cannot be performed on very severely dry eyes. But if there is a moderate degree of dryness, we can somehow relieve the patient and treat them again. So on the same visit. Apart from that, there are a few corneal disorders and some corneal diseases. These are rare diseases. We cannot do this group. Of course, the number is also important. Laser surgery can be performed for myopia up to number 10, hyperopia up to number 7 and astigmatism."
So, can diseases such as rheumatoid arthritis also be an obstacle to laser treatment?
"Very rare. It is also not performed in rheumatism, which we call systemic tissue diseases.
IF YOUR EYE IS NOT SUITABLE FOR LASER SURGERY!
Do those who do not undergo laser surgery go back home or is there another treatment option that saves them from glasses?
"Now, if it is a high number, for example numbers 6 and above 6, it is an intraocular lens, but it is not a smart lens. The person's own lens is inside the eye. Think of it as somehow putting the contact lens into the eye. In other words, it can be thought of as wearing a contact lens in front of that lens. Intraocular lens is not inserted from outside. It stays there, it is a 10-minute surgery, but it is very easy and very successful. With this surgery, we can now correct myopia and astigmatism from number 4, number 5 up to number 20 with the intraocular lens."
IS THERE AN AGE LIMIT FOR LENS SURGERY?
So, is there a lower age limit for laser surgery?
"Yes. 18 years old, 17 years old. In other words, the eye must have completed its development."
I wondered about the age of the patients. What are the age groups of the patients coming from abroad especially for laser eye surgery?
"Now the age groups for laser are as follows. Since the laser is applied to the problem of far-sightedness, the age of the patients is usually under 40. So let me put it this way, people between 20 and 40 come more."
SMART LENSES FOR AGE-RELATED NEARSIGHTEDNESS
Well, I would like to talk to you a little bit about smart lenses. Smart lenses are used in age-related nearsightedness and cataract surgery. While we are on the subject of age-related nearsightedness, could you please give us some brief information on this subject?
"Sure. As I said, we can only correct distant numbers with laser, we cannot do near vision. Age-related nearsightedness problem starts after the age of 40. There is only one method we apply to save people over 40 from near glasses. This method is multifocal intraocular lenses, which we call smart lenses. This surgery is a kind of cataract surgery. This surgery is performed on people with cataracts and after cataract surgery, the person sees near and far without glasses. However, in recent years, we have started to apply smart lens surgeries to people who do not have cataracts and want to get rid of near glasses. Lens technology has advanced a lot, patient safety has increased a lot, and we can routinely perform smart lens surgery to get rid of near glasses even without cataracts."
CONTACT LENSES SHOULD BE REMOVED ONE WEEK BEFORE LASER
Let's think again about the patients from the other side of the Aegean, from Greece, our neighbor, our friendly country Greece, who want to have laser surgery in Turkey. What would you like to say? For example, before they come to Turkey, do you want them to have any examinations, their glasses numbers? Now they will contact you through us. What kind of message would you like to give them?
"Of course, first of all, their eyeglass numbers. Because we do not want a number that we cannot do to come here. If they wear contact lenses, we ask them to take them out a week before. If they have had an eye examination and corneal topography there, that can also be useful, but we already do that here."