The benefits and harms of new 'no touch' myopia surgery in Vietnam

Do not touch "does not mean no touch and no pain.

Today, many people with refractive errors on their eyes often have the desire to have surgery to treat them. However, in the middle of a forest of methods, there are strange names such as LASIK, Femto LASIK, SMILE, LASEK, TransPRK . , choose for yourself the most suitable surgery is not something that anyone can do.

Recently, in Vietnam, a new type of surgery has appeared, which is of interest to many people. Called SmartSurfACE , this method has been dubbed 'eye surgery without touching the eyes'.

That is so, but where does the magic in SmartSurfACE surgery method come from? Is it true that what you imagine when you first hear about "untouched eye surgery" ? Let's find out:

SmartSurfACE, this method has been dubbed 'eye surgery without touching eyes'.

Why does eye surgery do not need to 'touch' the eye?

Without touching, "touch-free" or "no touch" are words used to describe a type of surgery to treat eye refraction. In it, doctors only use one agent as a laser , acting on the outer surface of the cornea.

While, one touch is defined as when two surfaces of two objects come into contact. The laser itself has no surface like a scalpel. So, surgery only uses laser, literally, obviously an 'untouchable' surgery .

This type of surgery distinguishes from another type of eye surgery, the 'flap' procedure . In particular, in addition to laser beams often require additional surgical instruments (knives, tweezers .), to manipulate (cut, curl, brush .) on the surface and the substrate side in the cornea.

A popular eye surgery method, LASIK belongs to the 'flap' procedure, in which doctors use microsurgery or laser blades (with Femto LASIK and SMILE LASIK) to cut a nearly round flap on the cornea, leaving only only one hinge.

After that, they temporarily flipped the round flap aside as a flap, allowing the laser to enter and erode the inner part of the cornea, thereby overcoming eye problems such as paralysis, hypertrophy, and vision. When the laser finishes the job, the round flap is flipped to the previous position, but the cut does not need to be stitched.

Eye surgery by LASIK method, using micro-scalpel.

Unlike LASIK surgery, SmartSurfACE is a technology of surface manipulation and 'no touch' groups. Basically, it is one of the advanced technologies from TransPRK eye surgery (Transepithelial photorefractive keratectomy).

Developed by SCHWIND, a German biomedical engineering company, SmartSurfACE is considered the best TransPRK method today.

Without scalpels and 'no touches' , SmartSurfACE uses only one tool, a laser to create invasive light according to the corneal thickness. This method is especially suitable for people with thin corneas.

The reason is because when the cornea is thin, the use of all LASIK methods poses great risks, this technique requires deep intervention into the corneal parenchyma. Doctors now advise patients to switch to TransPRK surgery.

General principles of non-touching TransPRK surgeries.

During a TransPRK operation as well as SmartSurfACE, everything will happen within minutes. A laser beam is projected on the corneal epithelial surface. It bombarded the epithelium at the same time and deepened into the corneal substrate.

The purpose of this bombardment process is to reach a new corneal shaping. It must be calculated very carefully on the computer model, based on the patient's refractive error parameters. How to create this shape acts as a lens that corrects light, converges the right retina and gives clear images back to each case of nearsightedness, farsightedness, as well as astigmatism.

While the epithelium below the epithelium is permanently shaped after surgery, the corneal epithelium has a magical property. It can be regenerated after only a few days. The reason is because right away the cornea is always stocked with stem cells. Stem cells will turn into epithelial cells and replace their positions after being destroyed by lasers.

The process takes time, so at the end of TransPRK surgery, the doctors will temporarily cover a contact lens on the flawed epithelium. Patients will have to wait about 5-7 days for the epithelium to heal before they are allowed to remove contact lenses.

Benefits and harms of 'untouched' surgery

Compared to LASIK, ' Touchless ' TransPRK has a faster execution time . In case of SmartSurfACE, it is 2 minutes compared to 5-10 minutes of LASIK.

By using only a laser and a single cutting operation, doctors save a lot of time in using a scalpel, interfere with the patient's cornea, flap and then cover it again. It can also be said that TransPRK is less invasive than traditional LASIK, but this comes mainly from the fact that the corneal epithelium can regenerate.

Another advantage, no touch and no flap makes TransPRK eliminate some complications related to corneal flap . Examples include infection, wrinkles or flaking. People who play strong motor sports should probably use the non-touch TransPRK method to avoid eye flakes later.

However, there are many drawbacks to the TransPRK that make it impossible to overcome LASIK. The fact that it is difficult to deny, this method destroys a large area of ​​corneal epithelium. Although it is a "non-touch" and "non-touch" surgery , TransPRK makes patients more painful, sometimes requiring painkillers.

Compare non-touch surgery Trans PRK and LASIK.

In fact, during TransPRK surgery, epithelial destruction causes patients to wait longer to recover. On average, it will take 1-3 months after surgery, compared to 1 month of LASIK surgery.

The patient will face blurred vision for the first 3-7 days. Eye drops must be used for 3 months to prevent dry eyes and infections. After surgery, patients often wear eye protection in many cases.

However, these are only short-term limitations. On the long-term basis, the surgery of TransPRK and LASIK is evaluated by experts as equally effective.

SmartsurfACE: the best current TransPRK method

The first prototypes of TransPRK surgery have been around since 1978. However, because of the limitations of laser technology and the many weaknesses mentioned above, TransPRK is not as popular as LASIK.

To overcome these weaknesses, and to revive this nearly 40-year-old surgical procedure, SCHWIND sought to improve laser technology during TransPRK surgery. They invented SmartSurfACE, by applying TransPRK's basic principle, in conjunction with a smart pulse technology called SmartPulse.

Using Germany's Amaris 1050RS system, SmartSurfACE projects lasers at 1050 Hz to bombard the outer surface of the cornea, just like any other TransPRK method. However, the difference is that SmartPulse's algorithm has the ability to optimize the position of each laser point bombarded on the cornea.

It helps surgery faster, smooth corneal cut surface than regular TransPRK. Both of these factors contribute to increased safety and rate of epithelial regeneration. SmartSurfACE surgery also limits eye discomfort.

See all "untouched" eye surgery with SmartSurfACE technology.

According to SCHWIND, SmartSurfACE surgery with Amaris 1050RS can increase the time for postoperative recovery to the level of LASIK surgery. This means that the patient can immediately regain vision after leaving the surgery room.

SmartSurfACE is judged to be superior to traditional TransPRK methods. However, it will still exist basic weaknesses such as destroying a large area of ​​the cornea causing pain, slow recovery time and need to protect the eyes carefully, during the corneal epithelium has not healed yet.

Summary

It can be seen that the continuous improvement of eye surgery methods is an encouraging thing. Over a century in this area, many leading eye surgery technologies are approaching the same level of effectiveness. This inadvertently makes it difficult for patients to choose.

For example, in the case of SmartSurfACE surgery and LASIK technologies, each method has its own strengths and weaknesses. However, the term 'no touch' of SmartSurfACE is misleading.

"Do not touch" does not mean that during the SmartSurfACE surgery, doctors do not touch your eyes. The truth is that during preparation, they will still spray the liquid into your eyes, use a duckling clip to squash your eyelids, wipe the corneal surface and cover it with a contact lens.

'Do not touch' also does not mean that it is painless and has a complete advantage over surgery using multiple corneal intervention devices such as LASIK.

1. The advantage of touchless surgery is that it creates less invasiveness to the cornea, accuracy and efficacy comparable to LASIK surgery, but the price is cheaper. Do not create corneal flap, making untreated surgery completely remove complications of flaking, deflection or scar corneal flap.
2. The downside of touchless surgery is that it destroys large areas of the corneal epithelium, causing pain although insignificant and corneal epithelium will heal itself. Besides, untreated surgery makes patients take longer to recover.

With the above features, non-touch surgery like SmartsurfACE is especially suitable for people with thin corneas, strong movement and sports, who may be subject to many risks associated with corneal flap. .

It is also suitable for people who have had eye surgery before, and are often used as an additional measure if LASIK surgery does not give the desired effect.

In other cases, patients will still have to consider the advantages and disadvantages of SmartsurfACE. Experts say that this 'non-touch' eye surgery method is competitive, but it certainly cannot surpass current advanced LASIK methods.

Application of non-touch eye surgery technology SmartSurfACE in Vietnam.(Photo of HCM City Eye Hospital).

In Vietnam, LASIK surgery has long been quite popular. In contrast, SmartsurfACE surgical technology has just been introduced for the first time in Hanoi at the end of 2016.

Last week, Ho Chi Minh City Eye Hospital also introduced SmartsurfACE surgical technology into the application. Accordingly, only more than 10 patients in the city. HCM is allowed to perform surgery with this new touch technology.

In comparison of reference cost, SmartsurfACE surgery price is relatively cheap (about 20 million / 2 eyes). This price is more expensive than conventional LASIK surgery (about 14 million / 2 eyes) with corneal flap, but much cheaper than SMILE LASIK surgery (about 70 million / 2 eyes) without corneal flap.