Refractive Surgery
LASIK

Clínica Oftalmológica Iradier - C/ Doménico Scarlatti, 3 - 28003 Madrid - +(34) 91.550.24.48

Refractive Surgery corrects refractive errors, reduces or decreases the dioptric power of the eye.

The most common refractive errors or problems with focusing are nearsightedness (Myopia) and farsightedness (Hyperopia), which occur when light rays refracted by the cornea and the lens do not focus on the retina. Myopia is caused due to an increase of the refractive or dioptric power of the eye, while Hyperopia is a decrease of the dioptric power. The result is blurred vision. Astigmatism is another common refractive error in which the eye is not uniformly shaped, resulting in distorted images.

Myopia.The image appears before the retina.

The cornea is responsible for 80% of the refractive power of the eye. By modifying the curvature of the cornea refractive errors can be corrected. This is the basis of current refractive techniques such as LASIK (Laser in situ Keratomileusis). In LASIK, the surface of the cornea is reshaped using the Excimer beam. The laser is applied in the inner cornea after pulling back a thin flap of corneal tissue, which is replaced to its initial position when the laser application is finished. Stitches are not necessary because the layers of the cornea are naturally "sticky" and will adhere to one another once the flap has been put back.

LASIK. Laser in situ Keratomileusis

Normally the surgical procedure is completed in a few minutes. There is no pain and only minimum discomfort. Anesthetic eyedrops are administered to numb the eyes. No postoperative eye patching is needed. Visual recovery begins immediately after the operation.

LASIK appears to be currently the most accurate and safest surgical procedure to correct Refractive errors, and Dr. Iradier is applying it using <a href="./cintralase.htm">IntraLase</a>.

For further information about LASIK surgery click here

Refractive Surgery
Intraocular lenses

Clínica Oftalmológica Iradier - C/ Doménico Scarlatti, 3 - 28003 Madrid - +(34) 91.550.24.48

Sometimes in order to solve the refractive error other surgical techniques are used, such as intraocular phakic lenses (without removing the crystalline) or intraocular pseudophakic lenses (replacing the crystalline).

To correct high myopias (more than 12 diopters), high hyperopias (more than 5 diopters) and some high astigmatisms, when LASIK is not indicated, intraocular lenses are the best option.

Fig.1A: Angle-fixated anterior chamber lens.	Fig.1B: Angle-fixated anterior chamber lens 24 hours after surgery.
Fig.1C: Angle-fixated lens - GBR.	Fig.1D: Angle-fixated lens - ICARE.
Figure 1E: Iridian-fixated lens - VERIFLEX	Figure 2: Intraocular contact lens "ICL"

Intraocular phakic lenses can be implanted in the anterior chamber, as angle-fixated lenses (Fig. 1A, 1B, 1C and 1D) or iris-fixated (Fig. 1E), in the posterior chamber as intraocular contact lenses (ICL) (fig.2).

When implanting intraocular pseudophakic lenses, the natural lens is removed usig phacoemulsification and the new one is inserted in its place (Fig. 3).

Fig.3: Implanting a lens in the capsular bag.

Sometimes in order to completely correct patientŽs refractive error it would be necessary to combine LASIK.

Choosing one lens or another will depend on surgeonŽs criteria and patientŽs eye condition.

Currently, due to technology and wide experience of ophthalmologists and their teams, the mayority of refractive errors can be sucessfully solved.

Intraocular lens surgery is performed ambulatory, and visual acuity recovery begans inmediately after the operation.

Dr. Iradier is one of the greatest experts in the surgical correction of myopia, hyperopia and astigmatism with intraocular phakic lenses, having published a book with international diffusion about the issue.

Fig.4: Dr. Iradier's book about phakic lenses.