A corneal laser can correct short-sightedness, long-sightedness and astigmatism, so you become more independent of glasses and contact lenses in everyday life. There are several methods for this, none is universally "the best". Which one suits you depends on your cornea, your refractive error and your daily life. We work that out together.
The methods differ mainly in how the cornea is accessed and how the tissue is reshaped. Each has its own profile, with strengths and with trade-offs.
The cornea is reshaped directly at the surface, without creating a flap. With transPRK, the laser also removes the topmost cell layer without contact.
Profile: works without a flap and leaves the deeper corneal layers untouched, an option when the cornea is thinner or borderline, or when certain risk or occupational profiles favour it. In return, the surface heals over a few days, during which vision can be blurry and the eye irritated.
A femtosecond laser first creates a thin, hinged corneal flap. Beneath it, an excimer laser reshapes the cornea; the flap is then folded back.
Profile: usually fast visual recovery and little discomfort after the procedure, broadly applicable and readily re-treatable if needed. It requires sufficient corneal thickness; the flap is a factor of its own that we take into account in the suitability assessment.
A femtosecond laser shapes a fine disc of tissue (lenticule) inside the cornea, which is removed through a small incision, without a flap.
Profile: flapless and with a small access incision. The treatment range and the way a possible later re-treatment is handled differ from LASIK. What that means for you depends on your measurements.
It is not only the method that matters, but also the ablation profile, how the laser reshapes the cornea in detail. Depending on the findings, I choose:
Which profile fits follows from your diagnostics, not from a blanket rule.
For cataract surgery too, a femtosecond laser can take over individual steps (FLACS). As this is a question about cataract surgery, I explain it fully and honestly there: → FLACS in cataract surgery.
Precise calculation aims to hit your vision exactly after lens surgery. The eye, however, is biology, and in some cases a small residual refractive error remains. This is not a problem without a remedy: it can be fine-tuned afterwards, with a corneal laser or with an additional, supplementary lens (add-on lens). Which route fits depends on your eye and the type of deviation; for me, that too is part of reaching the desired result together.
Not every laser treatment serves independence from glasses. For certain diseases of the corneal surface, the laser can be used therapeutically (phototherapeutic keratectomy, PTK), for example in epithelial basement membrane dystrophy (map-dot-fingerprint dystrophy, EBMD), recurrent erosions or superficial corneal scars. The aim is a smoother, more stable corneal surface and fewer symptoms, not the correction of a refractive error. Whether PTK makes sense in your case is determined by the examination.
The honest answer: it isn't the method that decides, but your eye. Corneal thickness and shape, the degree of your refractive error, your ocular surface and your visual priorities in daily life determine what makes sense, and whether laser is the right path at all, or a lens-based solution such as the ICL or lens surgery fits better. That is exactly what we examine together in consultation.
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Laser-related equipment. Full device and lens equipment (incl. biometry & lens surgery): → Technology & research. Reflects current practice (IROC Zurich); location-dependent and may change.