Treatment Services

Excimer Laser Treatment

What is Excimer Laser Treatment?

It is an advanced surgical method that uses laser energy to correct refractive errors such as myopia, hyperopia, and astigmatism. Since its inception in the 1980s, it has been planned/developed to correct distance vision needs and refractive errors. In recent years, there are software/programs being developed to correct near vision/glasses needs. Basic Principle

Excimer Laser is applied to the cornea, the transparent, dome-shaped layer on the outermost part of the eye, like a watch glass. The cornea acts like a dome-shaped lens. The need for glasses, i.e., refractive errors such as myopia, hyperopia, and astigmatism, mostly arises because this layer does not refract the light rays entering our eyes correctly. We see blurry because the light rays passing through the cornea do not focus precisely on the visual center on the retina. With Excimer Laser Treatment, the cornea is reshaped, correcting the refractive errors of the cornea, i.e., the need for glasses. The goal of laser vision correction is to ensure that light rays that are not perfectly focused on the center of vision are now perfectly focused on the center of vision.

Is Excimer Laser Treatment a "scratching" surgery on the eye?

Excimer Laser is not such a primitive surgery. Because it is performed using a laser, the most precise scalpel ever invented by humankind, it is one of the most advanced and reliable eye surgeries in the world. Excimer Laser shaves the corneal tissue by vaporizing the molecular bonds, giving it a new shape. It performs this process with very high precision. With each touch of the Excimer Laser on the cornea, approximately 0.25 microns (one four-hundredth of the thickness of a human hair) of tissue is shaved away.

Is Excimer Laser Treatment the same as other lasers used in the treatment of eye diseases?

No. Laser devices have many different applications in medicine. Different types of laser devices are also used extensively in the treatment of some eye diseases.

There are several methods in Excimer Laser Treatment:

1. PRK
2. LASEK
3. NO TOUCH
4. LASIK

All methods are performed with anesthetic eye drops. No pain is felt during surgery.

1.PRK

PRK stands for Photorefractive Keratectomy. It was the first method used. The outermost layer of the cornea is covered by a thin layer of cells called the epithelium, which resembles a cobblestone. In PRK, this layer is removed with a surgical instrument, and an Excimer Laser is applied to the underlying tissue to correct the refractive error, thus eliminating the need for glasses. Then, a contact lens with a prescription of 0, acting as a bandage, is placed on the cornea. It remains in the eye for approximately 3-4 days. After that, it is removed. During this time, the epithelial layer regenerates and closes.

2.LASEK

LASEK stands for Laser Epithelial Keratomileusis. In the LASEK procedure, a ring-like instrument is placed on the corneal surface. A certain amount of diluted alcohol is placed inside, and it is left for about 30 seconds. The epithelial layer is lifted in a single, round layer. To correct the refractive error and thus the need for glasses, it is placed back in the underlying bed tissue after Excimer Laser application. However, since the epithelial layer lifted with alcohol loses its vitality, a 0-number bandage contact lens, which acts as a bandage, is placed on the cornea. It remains in the eye for approximately 3-4 days. Then it is removed. During this time, the epithelial layer regenerates and closes.

3.NO TOUCH

NO TOUCH can be defined as "without touching." Today, advanced diagnostic devices can measure the thickness of the epithelial layer. It is approximately 55-60 microns thick. This epithelial layer thickness is entered into the Excimer Laser device's computer.

The epithelial layer is removed with the Excimer Laser. Then, to correct the refractive error, i.e., the need for glasses, the Excimer Laser is applied to the underlying bed tissue. Afterwards, a 0-number bandage contact lens, which acts as a bandage, is placed on the cornea. The contact lens remains in the eye for approximately 3-4 days. Then it is removed. During this time, the epithelial layer regenerates and closes.

These three methods are defined as superficial correction methods. The main difference between them is the way the epithelial layer is removed. Today, the NO TOUCH method is used more frequently.

4.LASIK

LASIK stands for Laser In Situ Keratomileusis. A thin, round layer, 90-130 microns thick, is cut from the upper surface of the cornea using a device called a keratome. This layer is called a flap. Unless there is a special situation, a thin layer of 90 microns is usually cut. There is no pain during the incision. A mild burning sensation may occur. The flap is lifted, and the underlying cornea is treated with an Excimer Laser. Then, a contact lens with a size 0 bandage, acting as a wound dressing, is placed on the cornea. The contact lens remains in the eye for approximately 1-2 days. Then it is removed. During this time, the flap adheres to its original position. Since the flap naturally adheres to its original position, stitches are not used in these operations. However, it is important not to rub the eye. Otherwise, the flap will wrinkle. It can be reshaped, but it will require a second procedure and stress. There are two types of keratome devices:

1. Mechanical keratome: Operates with a vacuum-powered motorized precision blade. It completes the procedure in as little as 10 seconds. It creates a very smooth surface. The surface it creates is very smooth, which positively affects the success of the surgery. Today, mechanical keratomes are very advanced and experience far fewer problems. They are also inexpensive.
2. Femto Keratome: These are keratomes that work with a vacuum femtosecond laser, a new surgical laser developed after mechanical keratomes. The flap is created more precisely and at the desired depth and smoothness. It is also described as the iLASIK method. However, it also has its own complications (undesirable situations). The microsurface it creates is more irregular. Your doctor will decide which one to use. It is a device as large and complex as the Excimer Laser device. The application time is long. It is expensive.

Is Excimer Laser Treatment Safe?

LASIK is a surgical procedure that has been approved by the US Food and Drug Administration (FDA), a renowned institution for its strict regulations on medical treatments, and is considered very safe by all health authorities. Since the late 1980s, Excimer Laser treatment has established itself in the medical world as a reliable method when performed on suitable eyes with proper planning, due to its established rules, satisfactory results, and low risks. In America, it has even been approved for use on fighter pilots. In Türkiye, it is permitted for use on police officers and civilian pilots. Contrary to popular belief, many physicians and ophthalmologists have benefited from this treatment.

What is the Success Rate of Excimer Laser Treatment?

The success rate is high in appropriate surgeries performed on correctly selected eyes. However, it is necessary to first define the criteria for success. The goal is to bring the patient to a refractive error of 0.50, eliminating the need for glasses, with a single intervention. The success rate for corrective refractive errors (myopia, hyperopia, and astigmatism) smaller than -8.00 diopters, +4.00 diopters, and +4.00 diopters is 98%, while it is 96% for higher diopters. If regression (an increase in refractive error) occurs, a second intervention is aimed at bringing the refractive error back to zero. The success rate for these second treatments, which may be necessary in 2% to 4% of cases, is 80-90?pending on experience. In recent years, correcting refractive errors higher than 8.00 diopters, +4.00 diopters, and +4.00 diopters is not preferred.

Can Excimer Laser surgery only be performed once?

It can be repeated up to two times, provided eye health permits and the surgery is worthwhile.

Is it impossible to have other eye surgeries after Excimer Laser surgery?

This belief is completely a myth. A patient who has undergone Excimer Laser surgery can have all necessary eye surgeries, including cataract surgery.

Why is Excimer Laser surgery expensive?

Because the development, production, and maintenance costs of high-tech systems are high. Laser systems require continuous maintenance and a stable sanitary environment. Today, the investment averages 350,000 Euros. It also requires significant effort and experience. Furthermore, if an additional system like a femto laser keratome is used, another 350,000 Euros in costs must be added.

Is Excimer Laser a medically necessary treatment? Except for certain special cases (such as correcting superficial corneal opacity, reducing refractive error (i.e., the need for glasses) in suitable keratoconus patients, or correcting refractive errors greater than 2 diopters between the two eyes), it is not a medically mandatory type of surgery. It is an elective surgery. It is applied to patients with suitable eye structures who do not want to wear glasses and/or use them. It also appeals to the person's psychology, freeing them from dependence on things. In a sense, it sets them free.

Advantages of Excimer Laser Treatment

• You can easily see your watch and your face in the mirror,
• You can achieve a natural look and vision without glasses or contact lenses,
• You can achieve comfort and higher success in sports activities,
• You can experience less discomfort from weather events such as wind and rain,
• You can get rid of situations such as losing your lenses or breaking your glasses,
• You can move around without glasses and contact lenses in natural disasters, accidents and social events,
• You can save money and time on glasses and lenses for a lifetime.

What is the Application Process Like?

Examination and Preliminary Assessment

Not everyone has the chance to undergo this procedure. When you want to have this surgery, there is roughly only a 50% chance you will have it.

One of the most important stages is answering the following questions:

• What are your expectations from laser treatment?
• How much of your expectations can be met?
• What will be its contribution to your life?
• Will your eye health allow this treatment to be applied?
• An examination and some tests are performed to thoroughly examine the eyeglass prescription, the structure of the front part of the eye, the health of the cornea and retina, and the condition of the natural lens. Certain criteria are necessary for application.
• Individuals over 18 years of age (usually over 20 years of age is preferred) and whose eye prescription has been stable for the last year.
• Individuals whose cornea and other intraocular structures (corneal thickness, curvature and strength values, etc.) are suitable.
• Depending on corneal thickness, curvature, and force values, and your refractive error (i.e., whether you need glasses), one of the superficial correction methods (PRK, LASEK, NO TOUCH) or LASIK can be chosen. LASIK is preferred if your corneal structure is suitable. There are two reasons for this:
• Postoperative patient comfort is better. You can return to your daily life the next day.
• The risk of the corrected refractive error recurring is lower.

Who are superficial correction methods (PRK, LASEK, NO TOUCH) preferred for?

• Eyes where the cornea is not thick enough for LASIK
• Eyes with suspicious or irregular corneal changes
• In individuals who participate in sports where they may receive a blow to the eye (such as karate or boxing)
• In some eye structures where the corneal thickness is not suitable for LASIK, even though the eye degree is small (up to 4 diopters of myopia and astigmatism - up to 3.5 diopters of hyperopia)
• It can also be the individual's own preference. (If there is no obstacle to its application)

In some cases, it can be specially planned according to the structure of your cornea.

Who is not suitable for Excimer Laser treatment?

• Patients with cataracts
• Individuals with unsuitable corneal health and structure
• Individuals with severe retinal diseases (such as diabetic retinopathy, previous major retinal surgery)
• Individuals with severe glaucoma
• Individuals who have previously had intraocular inflammation (such as uveitis)

Surgical Procedure

1- Pre-operative

EXCIMER LASER is a treatment method that takes approximately 5 minutes per eye and does not cause significant difficulties for the patient. There is no harm in eating a light meal on the day of treatment. You are only expected not to wear eye makeup, use perfume, or take blood-thinning medications such as Aspirin. Patients who wear contact lenses should remove them 1 or 2 weeks before the treatment, as recommended by their doctor. If you have dry eyes, they should be treated according to their severity before the surgery, as the surgery will worsen dry eyes. Since you cannot wash your face or shower after the surgery, it is advisable to shower on the morning of the surgery. You will be given a sedative before the surgery. If that is not sufficient, it can also be given intravenously. This reduces the anxiety of the surgery and increases compliance. Immediately before the surgery, anesthetic drops will be instilled into your eyes, so you will not feel any serious pain or discomfort.

2-During Surgery

After lying on the operating table, your eyelids will be wiped with an antiseptic solution and covered with a sterile drape. A special eyelid separator will be fitted to keep your eyelids open. This prevents you from closing your eyes even if you want to. What you will then see is the bright light of the microscope and a green point light in the center. Your doctor will ask you not to take your eyes off this green light during the surgery. You just need to listen to your doctor and the surgical team. Since the LASER device is locked onto the pupil during the treatment, it tracks the small movements of your eye and targets the correct spot. After the surgery, a 0-number bandage contact lens that acts as a bandage is placed on your eye. It acts as a wound dressing. Protective dark glasses are given to you to wear while sleeping on the night of the surgery. The purpose is to prevent you from accidentally rubbing your eyes and damaging them while you sleep. You do not need to stay in the hospital. You can go home the same day.

3- Post-operative and recovery process

Healing drops and artificial tears will be given for the first ten days. After the 10th day, you will need to use artificial tears for 2-3 months. This is because the surgery will increase dry eyes. This period may be longer depending on the severity of dry eyes.

The recovery process varies depending on the method used:

In superficial correction methods (PRK, LASEK, NO TOUCH), the recovery process is longer.

• For the first 3-4 hours, there will be pain, tearing, light sensitivity, and redness in the eye, along with a feeling of a foreign object in the eye. Painkillers may be needed. Painkiller drops mixed with artificial tears will be given.
• Even if there is some blurred vision, it will be better than seeing without glasses.
• All these complaints will decrease and disappear within 24-48 hours.
• Resting at home for the first 24 hours is appropriate.
• Eyes should absolutely not be rubbed. • You need to wear the protective dark-tinted glasses given to you to wear while sleeping on the night of the surgery.
• Washing your face and showering are not recommended within the first 24 hours.
• You can return to your daily life after 24 hours.
• The epithelial layer takes 3 or 4 days to close/heal.
• Your contact lenses will be removed at the follow-up appointment on the 3rd or 4th day.
• Your vision will be better after your contact lenses are removed.
• It may take 7-10 days for your vision to become clear.
• You need to wear sunglasses for 7-10 days. This is necessary to protect you from sunlight, impacts, and foreign objects in your eyes. • Your check-ups will be done on the 1st day, 3-4th day, 10th day, and at 2-month intervals.
• Driving is not recommended for the first week.
• You can return to your daily activities after 7-10 days. You can do all your sports and social activities such as walking, cycling, and aerobics. You can fly. To prevent infection, swimming in pools or the sea should be avoided for approximately the first 10 days. After the second month, you can start using colored contact lenses for cosmetic purposes if you wish.

The recovery process is shorter with LASIK correction.

• For the first 3-4 hours, there will be tearing and redness along with a slight feeling of a foreign object in the eye. Pain relief may be needed. Pain relief eye drops mixed with artificial tears will be given. • There will be no light sensitivity.
• Even if there is some blurred vision, it will be better than seeing without glasses.
• All these complaints will decrease and disappear within 24 hours.
• Resting at home for the first 24 hours is advisable.
• Eyes should absolutely not be rubbed. You should wear the protective dark glasses given to you to wear while sleeping on the night of the surgery.
• Washing your face and showering are not recommended within the first 24 hours.
• You can return to your daily life after 24 hours.
• Contact lenses remain in the eye for approximately 1-2 days. They are then removed. During this time, the flap layer adheres to its place.
• Your contact lenses will be removed at the follow-up appointment on the 1st or 2nd day. • Your vision will improve after your contact lenses are removed.
• It may take 1-2 days for your vision to clear.
• You should wear sunglasses for 7-10 days. This is necessary to protect your eyes from impacts and foreign objects.
• Your check-ups will be done on day 1, day 10, and at 2-month intervals.
• Driving is not recommended for the first 1-2 days.
• You can return to your daily activities after day 1. You can do all your sports and social activities such as walking, cycling, and aerobics. You can fly. Swimming in pools or the sea should be avoided for approximately the first 10 days, especially to prevent infection. After the second month, you can start using colored contact lenses for cosmetic purposes if you wish.

Rare but Possible Problems After Excimer Laser Surgery

Remaining refractive error: If refractive error persists, it can be corrected again if the corneal structure is suitable.

Cornea opacities: This occurs during the healing process in superficial correction methods (PRK, LASEK, NO TOUCH). It will usually resolve with eye drops prescribed by your doctor. Very rarely, it may be minor and permanent.

Improper formation of the keratome flap: This is rarely seen, especially in cases where the eye structure is not elliptical or round after LASIK surgery. In this case, the laser flap is closed. After 3 months of healing, depending on the suitability of the corneal structure, it can be repeated with a 130 micron flap (thicker than 90 microns) using the LASIK or NO TOUCH method.

Eye infection: Infections after intraocular surgery can occur, although very rarely. This is an important condition and requires early intervention. Retinal tear: This can occur in eyes that have undergone LASIK surgery due to the vacuum effect of the keratome device. This is a rare occurrence after surgeries. Intervention by a retina specialist is required.

Halos and glare: These are quite rare. They become almost imperceptible within approximately 3 months.

It is not a surgery with a risk of blindness.

*Since every surgery has its own risks, the risks written above, although rare, must be explained to the patient.

*HOWEVER, IT ENDS WITHOUT PROBLEMS IN A HIGH RATE.

If refractive errors such as hyperopia, myopia, and astigmatism are too high to be corrected with Excimer Laser (LASIK or No-touch) treatment, or if the corneal structure/thickness is not sufficient for LASIK treatment, Phakic IOL (intraocular lens) application is an alternative method that can be preferred.

“The results of any surgical or interventional procedure can vary from person to person. It is recommended that you get a detailed consultation with your doctor before the procedure.”

Publication Date: 20.01.2026

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