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Trans-Epithelial Surface Treatment Eye Correction
 
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Trans-Epithelial Surface Treatment Eye Correction
   

 

Trans-Epithelial Surface Treatment at TLVC is a No Blade No Flap No Excimer based ablation with Wavefront Guided central Optical Zone, Iris Registration & Topography Enhanced Transition Zones.

 

 
   
 

The cornea is a transparent curved lens at the front of the eye. It bends light onto the back of the eye so that a clear image can be produced on the retina. By reshaping the cornea with a Solid State laser it is possible to adjust the focusing power to improve unaided vision.

Trans-Epithelial Surface Treatment is an advanced form of surface laser treatment.

Trans-Epithelial Surface Treatment is performed in two stages:Firstly, the laser is used to ablate the corneas surface layer with pinpoint accuracy and regularity. Secondly, the laser is programmed to remove exactly the right amount of corneal stromal tissue to achieve the shape change required from the cornea to improve your vision. Following treatment a bandage contact lens is placed over the cornea for a few days as the epithelial layer heals.

Advantages over other  laser eye treatments e.g. Conventional LASIK/LASEK/EPI-LASEK:

    • It is the safest procedure with relation to intra operative complications as it is a Flapless All Laser procedure. There are no chances of intra operative flap complications or late flap dislocations.(NO FLAP)
    • It is a NO TOUCH procedure at no time does any surgical instrument (microkeretome blade etc.) other than the laser touch the eye.(NO BLADE)
    • At TLVC we use a Solid State Pulzar Z1(NO EXCIMER) laser which causes less temperature rise on cornea and less corneal dryness intraoperatively.The SolidState laser is also less susseptable to corneal hydration as compared to an Excimer laser hence results are more Reproducable.
    • No High Pressure Suction is used to stabilize the eye so there are no chances of Subconjunctival Haeomorrhage or severe complications like Retinal Detachment.
    • TEST saves between 90 to 160 microns of corneal tissue that would have been lost to the flap so it can be used safely in patients having thin corneas and high errors.
    • The Biomechanical Stability of the cornea is very high as compared to other procedure patient can go for contact sports like Rugby, Boxing etc. once healing is complete.
    • As it has Topography Enhanced Transition zones Night Vision is better and chances of Regression are lower.
    • No alcohol or mechanical separation of epithelial layer occurs. The removal of the epithelium is achieved by the laser to microns of accuracy and avoids poor quality epithelial flaps, alcohol toxicity and requires no suction during laser eye correction treatment.
    • Quicker healing (re-epithelialisation) occurs following treatment. Less pain and faster vision stabilisation is experienced by patients compared to other surface laser eye correction treatments.
   
   

 

 

COMPARISON OF VARIOUS LASER PROCEDURES FOR GLASSES REMOVAL

LASER TYPES

Excimer Laser PRK

Conventional LASIK Micro-keratome

Femto-LASIK

Small Incision Lenticule Extraction (SMILE)

Trans epithelial surface treatment (TEST)

Pre-Op Patient Selection

1

Suitability for Various Spectacle Numbers

For Low to Moderate Numbers

For all Low to High Numbers

For all Low to High Numbers

Moderate suitability only. Can not correct Low -0.5 or any plus numbers

High suitability. Can correct Very Low -0.5 to Very High Numbers

2

Suitability for Thin Cornea

Yes

No

No

Moderate but causes more corneal tissue loss

Maximum safety & accuracy

3

Suitability for previously Operated Lasik or Repeat

Yes (conditional)

Yes (conditional)

Yes (conditional)

No

Yes

4

Safety for High Risk Jobs & Contact Sports

High

Moderate

Moderate

High

Highest

5

Multifocal Number Correction after age 40

No

Possible

Possible

No

Possible

Operative Conditions

6

Flap Complications,
Flap Displacement

No Flap

1 in 100 eyes

1 in 250 eyes

Flapless so no flap complication

Flapless so no flap complication

7

Corneal Cut

No

Nearly 300/ 20 mm

Nearly 300/ 20 mm

Nearly 45 / 2 to 3 mm

No Cut

8

Splitting or separation of Corneal Layers

No

Yes

Yes

Yes

No

9

Microkeratome Blade Complications

No

Yes

No

No

No

10

Advanced Astigmatism Cylinder Cyclotorsion & Wavefront Treatment for axis & better contrast

No

Yes

Yes

Not Possible so Less Accurate Cylinder Axis Alignment

Yes

11

Permanent Mark on Cornea

Moderate

Cut Mark Visible

Cut mark visible

Cut mark visible

No mark, so safer for medical test

12

Incomplete Lenticule Extraction Complication

No

No

No

Yes

No

13

Corneal Bowman's Layer Wrinkles Complication

No

Yes

Yes

Yes

No

14

Gas Bubble Breakthrough Complication

No

No

Yes

Yes

No

15

Maintenance of Corneal Architecture

Some Compromise

Some Compromise

Some Compromise

Less Compromise

Least or no Compromise

Post-Operative Consideration

16

Pain after the procedure

Intense for 48 hours

Discomfort for a few hours

Discomfort for a few hours

Mild Discomfort for a few hours

Mild to moderate

17

Vision Recovery

Poor for 3-4 days, recovers gradually over a few weeks

Quick ( 12 to 24 hours )

Quick ( 24 hours )

24-48 hrs, Moderate

72 hrs,Slow but very safe and end result is same or better

18

Corneal Haze

Moderate

No

No

Minimal,transient

Rare (MMC)

19

Enhancement in case of residual power

Difficult

Possible

Possible

Not Possible have to convert to LASIK or PRK

Possible

20

Dry Eyes after Laser

Mild

Mild to moderate

Mild to moderate

Mild or none

Mild or none

21

Return to Routine Activities

7 to 10 days

1 day

1 day

1 day

3 days

22

Night Glare and Large Pupil Problems

Moderate(if haze)

Mild

Mild

Mild

Least or none as large Optic zone

23

Restrictions on Swimming

2 Months

1 Months

1 Months

1 Week

2 weeks

24

Steroid Eye Drops

8 to 10 weeks

3 Weeks

3 Weeks

2 to 3 Weeks

4 weeks (optional)

Conclusion

25

Overall Safety

Safe

Fairly Safe

Safer

More Safe

Safest

26

Accuracy

0.25 microns

0.25 microns

0.25 microns

4.0 microns error

0.25 microns

27

Glasses Number Correction Accuracy

+ /- 0.02 Diopter but regression

+/- 0.02 Diopters

+/- 0.02 Diopters

+/- 0.33 to 0.66 Diopters error

+/- 0.02 Diopters

28

Keratoconus & Corneal Ectasia Risk

Low

Moderate

Moderate

Low to Moderate

Least

29

Long term Results

Average

Very Good

Very Good

Under Investigation

Extremely Good

30

US - FDA APPROVED

Yes

Yes

Yes

Limited Approval

Yes