Are you eligible for laser treatment or lens implantation?

Do you wish to live your life without (reading) glasses or contact lenses? Then you’ve made the right choice coming to us. Our surgeons are internationally respected pioneers in the field of laser and lens surgery and are performing around 2.500 refractive surgeries per year in total, from the ultra-modern ReLEx® SMILE to the implantation of contact lenses or intraocular lenses by micro-incision.

We know it from experience: The more precise the preliminary examination is, the better is the operation result. We do not only use preliminary examinations to determine your eligibility for refractive surgery but also as the basis for precise planning of the operation. This applies in particular for the laser operation of presbyopia and cataract in the presence of astigmatism. In this case, the new LED cornea topographer Cassini offers extraordinary measurement accuracy and the option to directly feed the results to the LENSAR laser – a milestone in cataract surgery.

To achieve utmost precision and the best possible visual acuity for you, we are using more devices than required on principle. In particular, we achieve accurate calculation of the ametropia by using diagnostic technology of various manufacturers. In addition to the operation itself, this contributes significantly to the treatment’s success.

Preliminary examination with Atlantis OCT.

Preliminary examination with Pentacam® HR

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Pentacam® HR is an automatically rotating camera measuring the anterior sector. Within just under 2 seconds, it analyses the cornea and enables 3D analysis of the anterior chamber. Among others, it creates a corneal topography, cataract analysis and measurement of the corneal thickness.

Consider this examination an investment in surgical safety and your later visual acuity: The more precisely your ametropia is determined and your eye is measured, the better the result of the corrective laser or lens surgery. In the video below Dr. Breyer describes why a highly precise operation requires diagnostics just as precise - in german language.

Four things are measured with Pentacam:

  • The eye’s surface. It provides additional information about a possibly existing astigmatism and its manifestation. On this basis, the surgeon will decide if corrective surgery is advisable.
  • The back of the cornea. It should be healthy to avoid any surgical risks.
  • The corneal thickness. It is the factor deciding which special incisions can be made to remove an existing astigmatism during the operation or whether femto-LASIK is possible.
  • The anterior chamber’s depth. It is important for the implantation of phakic lenses.

Diagnosis of aberrations of the optical system

Aberrometrie des Auges
Aberrometry of the eye

Aberrations are deviations from an optimum eye surface which can be responsible for glares and reflections around light sources in the dark, for example. They are identified by improved diagnostics with which the eye’s refractive power is measured in at least 250 locations depending on the system. The TOPCON aberrometer enables simultaneous measurement of the aberrations of the optical system as a whole and of the visual axis and keratography. The highly precise results garnered by this method are then incorporated into calculation of a custom-made laser or lens surgery treatment.

Learn more about LED-Corneal Topography with Cassini

Since August 2015, we have been one of two refractive centers in Europe to offer an improved laser surgery of cataract and presbyopia that could not be more individual. This possibility is provided by a so-called corneal topography using the new Cassini color LED shape analyzer. The Cassini corneal shape analyzer measures the anterior and the posterior surfaces of the cornea and visualizes them like a relief by means of 672 color-coded LEDs in red, green, yellow, and blue arranged in exactly defined patterns. A “corneal mirror image” is assigned to every spot. Cassini identifies astigmatism and even the smallest high-order aberrations from the normal surface of a sphere precisely and reproducibly with an unprecedented accuracy of less than 1 μm.

Subsequently, this data is fed to LENSAR’s Streamline laser system by wireless transfer. By the way, the LENSAR® laser is the first cataract laser to offer this function. The true axis of astigmatism presented by Cassini is marked by the laser in a way to enable the surgeon to align the artificial lens congruently later. This possibility perfects the implantation of a toric lens since, by its very nature, laser marking is far more precise than the manual marking used so far.

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Examination with Visante® omni

Messung der Hornhautdicke
Measuring of the corneal thickness

The Visante® omni by Carl Zeiss Meditec combines several technologies to enable a highly precise examination of the anterior sector. For example, it not only measures the corneal thickness which is important for laser surgery but also checks whether the cornea is intact.

For example, clouding of the cornea could be a sign for a disease which would count against refractive surgery. Complete imaging and measurement of the anterior iridocorneal angle is performed which is important for implantation of a lens. In addition, the residual corneal thickness remaining after laser surgery can be calculated precisely. All of this is necessary for exact planning of the operation to provide you with the best possible visual acuity and maximum safety.

Safety due to state-of-the-art diagnostics: The non-contact tonometer Corvis® ST

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Preventive eye care with the non-contact tonometer Corvis® ST by Oculus

One objective of the preliminary examination before eye laser treatment is to determine whether there are any risks for the patient by the procedure. The new non-contact tonometer Corvis® ST by Corvis is a huge step forward in this regard: It not only measures the corneal thickness and intraocular pressure (IOP) but also the cornea’s biomechanical characteristics after an air impulse has been applied to it.

The cornea’s oscillations are recorded and compared to the figures of a healthy eye. Some typical deviations can indicate weakness of the cornea, for example.

Non-Contact-Tonometer Corvis<sup>®</sup> ST
Non-contact tonometer Corvis® ST

This may not be dangerous for the patient but would be a risk factor for refractive surgery. Globally, only two non-contact tonometers are in use so far. We are very proud to be among the first able to offer this modern diagnostic tool to their patients. We will analyze our experiences with it scientifically and make them available in professional circles.