Refractive Lens Surgery

**Chittychangchang** · 04-02-2020, 05:31 PM

Originally Posted by Pragmatic

You'd best stop watching 'Pornhub' then. Probably what affected your eyesight in the first place.

Either that or get on the wagon and back in training...

**Dillinger** · 04-02-2020, 05:52 PM

Originally Posted by Seekingasylum

There seems to be some confusion here.

From what I gather, RLE is the same as cataract surgery and IOL surgery, ie. exchange of your retractive or intra ocular lens but you can now have it done by blade or laser

For £4,888 in Malaysia you can get it done by laser which is quicker and cuts a perfect circle and with no waiting around like you'd get in an NHS waiting room for what takes less time than it does to get a filling at the dentist.

And yes there's a week I think before they start on the second eye.

Originally Posted by Pragmatic

I had Lasik done about 17 years ago aged 50. Never a problem.

Thats not what the poor old one legged guy on the scooter thought as you mowed him down, playing air guitar to Only the Lonely

**bowie** · 04-02-2020, 06:39 PM

Good luck with it Dill.

Mother had both lens replaced (a week apart). Couldn't believe how good you can see. Vision degrades slowly over time. Unnoticeable as you lose your comparative frame of reference. Quote "If I had know how good it would turn out I would have done it years ago".

**Seekingasylum** · 05-02-2020, 12:52 AM

Originally Posted by Dillinger

From what I gather, RLE is the same as cataract surgery and IOL surgery, ie. exchange of your retractive or intra ocular lens but you can now have it done by blade or laser

For £4,888 in Malaysia you can get it done by laser which is quicker and cuts a perfect circle and with no waiting around like you'd get in an NHS waiting room for what takes less time than it does to get a filling at the dentist.

And yes there's a week I think before they start on the second eye.

Thats not what the poor old one legged guy on the scooter thought as you mowed him down, playing air guitar to Only the Lonely

I think you have misunderstood but there it is.

HAs your ophthalmologist diagnosed a cataract development in your eye to a degree that no lens prescription can correct your eyesight?

If so then the solution is an IOL implant. I have no idea what you mean by a laser cutting a perfect hole - the IOL is implanted by injection after your natural lens is removed by suction once it has been phaecoemulsified i.e the lens within the capsule containing it is destroyed by ultra-high vibration. The plastic lens is inserted into the "lens capsule" in a folded up state by a tiny syringe which then unfolds automatically once inside the lens capsule into the shape of your erstwhile natural lens. It takes about 15 minutes. If done privately in the UK you can have it as quick as you like, within days of initial consultation.

Sounds as if you don't know what you are talking about but then, no surprise there.

LASIK is simply the laser correction of an aberrant curvature of the cornea curing myopia and astigmatism. Some folk are not suited to it but opt for IOL replacement which solves the problem but that is not as a consequence of a cataract forming and accordingly cannot be undertaken within the NHS scheme. I think this is what you mean by RLE.

Cataracts that affect eyesight to a degree that 6/10ths function is lost qualify for NHS treatment but the average waiting time for a consultation is around 10 weeks and then a further 4 weeks for the actual procedure.

Fuck knows what you mean by a "perfectly tasered hole". The IOL incision is microscopically small and requires no post-op stitches, the "cut" is self healing.

The actual process whereby you are prepared for the op involves the periodic application of a topical anaesthetic given in the form of eye drops which takes around twenty minutes to kick in. You feel nothing at all and if you wish you can have two diazepam to help you relax - most do. You feel nothing during the procedure and your face including your good eye is covered so you see nothing either. When I had it they also provided a nurse to hold your hands and comfort you - they are heart scared you might freak out at the wrong moment and move suddenly which some folk do apparently.

The eye drops after the op combat any likely infection and contain an antibiotic and a steroid. You should have a follow up examination about two weeks later in which, inter alia, they test the pressure in the eye which can build up because of the drops, in which event they will give another prescription to reduce it and two weeks later you should have your final exam. and get signed off, good to go. They also give you a perspex eye guard to cover your eye socket while you sleep at night to prevent you rubbing your eye or knocking it. This should BE worn for the length of time you take the drops. Also, you should make sure you avoid any water contamination, so one has to be wary when washing the face and hair. Any strenuous straining, heavy lifting or the like should be avoided.

**Chittychangchang** · 05-02-2020, 01:30 AM

I put off having Lasik coz I keep getting poked in the eye

**Dillinger** · 05-02-2020, 05:04 AM

Originally Posted by Seekingasylum

HAs your ophthalmologist diagnosed a cataract development in your eye to a degree that no lens prescription can correct your eyesight?

No. I haven't had any tests yet but by telling them I am far sighted and need glasses for reading too they tell me I am not suitable for Lasik being over the age of 48. I could wear multi-focal glasses and see properly.
But to get away from glasses I need RFE or IOL surgery as you call it, which are the same thing and the surgery used for cataracts also. So having clear lenses and no cataracts I wouldn't qualify on that shitty NHS anyway.

You seem to know what you are talking about but the only thing you are missing is that it is possible now to have the lens lasered instead of a blade being used and it makes a perfect 'circle' not hole PRIOR to this part of the operation...

Originally Posted by Seekingasylum

the IOL is implanted by injection after your natural lens is removed by suction once it has been phaecoemulsified i.e the lens within the capsule containing it is destroyed by ultra-high vibration

... which they charge an extra 1998myr an eye for.

Look on the pamphlet below for the circled areas and you will see I need trifocals @ 9999myr per eye and to have it performed by laser instead of a blade at 1998myr per eye instead of 2998myr as in the brochure...

I take it you can't see that brochure too well old chap?

If you zoom in you can see on the right of the brochure FOR A BETTER SAFER AND FASTER SURGERY, they've crossed out the 2998myr and pencilled in 1998myr.
Can you also see the words NO BLADE you blind fukker?

**Dillinger** · 05-02-2020, 05:23 AM

So Gent, if I did have cataracts and had the same procedure as done on the NHS which would I imagine invole a blade to start with not a laser, it is still cheaper here...

The price with a blade incision per eye, here...

The total price using a laser to cut through your membrane initially...

The way they mentioned you get a perfect circle with the laser and some Harold Shipmanesque fucker can't slip or have a hand spasm and that it's faster and safer makes it compulsory in my eyes

**Pragmatic** · 05-02-2020, 06:52 AM

Originally Posted by Dillinger

Originally Posted by Pragmatic
I had Lasik done about 17 years ago aged 50. Never a problem.
Thats not what the poor old one legged guy on the scooter thought as you mowed him down, playing air guitar to Only the Lonely

Okay, may be just one problem.

**lom** · 05-02-2020, 07:24 AM

Originally Posted by Chittychangchang

I put off having Lasik coz I keep getting poked in the eye

You can avoid that by keeping your trousers on.

**bowie** · 05-02-2020, 07:24 AM

^^ Hey, I saw that video. KUDO's to Somchai - his aim was true. Twas a most difficult shot at a moving target. He zero'd in on Prag's front bumper and nailed it.

By the way Prag - belated thanks for taking the time to post that video. Got me off my fat ass and got a front and back video recorder for my ride. Moved task from the "gotta do that one day" column to the "completed - past history" column.

**Attilla the Hen** · 05-02-2020, 07:29 AM

Don't understand this cutting a perfect circle business.
When they replaced my natural lens with a multi-focal plastic one, they made a 3mm incision where the iris meets the sclera and inserted the rolled up plastic lens. No cutting circles in anything.

**Dillinger** · 05-02-2020, 07:45 AM

^ When was yours done. Read the following and you should understand what a perfect circular capsulotomy is.

VISTA Eye Specialist Unveils a New Cataract Surgery Advancement in Asia.
Mar. 3, 2019, 07:00 PM
Combining the Ziemer LDV Z8 Femtosecond Laser and the Oculentis FEMTIS Intraocular Lens (IOL) , toofferover five times the precision of a manual procedure during surgery.

KUALA LUMPUR, Malaysia, March 4, 2019 /PRNewswire/ -- VISTA Eye Specialist(VISTA), one of the leading Eye Specialist Centers in Malaysia, today announced a new advancement in Cataract Surgery by uniting the Z8 Femtosecond Laser and the FEMTIS. This combination offers high level precision and results to the procedure, ensuring optimum vision that lasts.

"We have definitely impressed upon the future of eye surgery by providing a highly precise and accurate procedure in a Cataract Surgery which satisfies the high expectations of surgeons and their patients. We have also committed a dedicated team of experts and the resources to redefine the way we improve eyesight after surgery as part of our efforts to set Malaysia as one of the top medical destination globally," said Lim Boon Siong, CEO of VISTA.

"As one of Asia's pioneers in offering this new combination, VISTA is now leading a new effort to combine the top two emerging Cataract technologies, which have previously been developed separately, to exponentially increase the stability and safety of Cataract Surgery as a whole. This combination has multiple possibilities to evolve and change the future of how Cataract Surgery is done and elevate Eye Care to the next stage," added Lim Boon Siong.

Voted no.6 on the Top Ten Medical Innovations by Cleveland Clinic, one of the world's top healthcare providers, Femtosecond Laser-Assisted Cataract Surgery (FLACS) was introduced in 2009 and has since seen its popularity and usage surge all over the world. As the forefront of FLACS technology, VISTA's Z8 Femtosecond Laser by Ziemer Ophthalmic Systems from Switzerland, allows Cataract Surgery an unsurpassed level of precision, over five times that of the manual processes. The treatment, supported by real-time analysis and mapping via an intelligent Optical Coherence Tomography (OCT) visualization system, will create incisions, lens fragmentation, and perform a much more precise capsulotomy (a circular incision in the lens capsular bag).

"This laser technology helps overcome many challenges experienced in the manual Cataract procedure, especially when creating the opening in the capsular bag. An improperly created opening may cause for higher risks of shrinkage, resulting in a decentered, tilted or rotated lens. This could significantly affect the quality of vision as patients' age. With longer life expectancies and more active lifestyles, there is a rising demand for quality vision during the patient's golden years," added Dr. Aloysius Joseph Low, Chief Consultant Ophthalmic Surgeon at VISTA.

Taking advantage of the benefits of a superior capsular opening done by a laser, the FEMTIS IOL by Oculentis from Germany, sought to solve the problem by introducing specially designed haptics that can be anchored to the perfectly circular capsulotomy. Studies have shown that this allows the lens to stay right in the middle of the capsular opening, resulting in a perfect centration with high rotational stability to optimize the lens function, thus allowing patients to enjoy lasting visual quality even as they age.

"There's also a strong demand from younger patients in their forties, particularly those who experience problems reading, a condition known as presbyopia. A Refractive Lens Exchange (RLE) procedure employing the above combination would certainly help," mentions Dr Alan Koh, Senior Consultant Ophthalmologist at VISTA.

"A RLE procedure involves removing the patient's natural lens before it becomes a Cataract and replacing it with premium multifocal IOLs, allowing for greater ease in their daily activities, such as reading, driving, and using a computer. The FEMTIS IOL and Ziemer LDV Z8 combination offers an opportunity for the patient to enjoy that vision longer and better than it would have been."

References:

Femtosecond Laser–Assisted Cataract Surgery with Integrated Optical Coherence Tomography , Femtosecond Laser–Assisted Cataract Surgery with Integrated Optical Coherence Tomography | Science Translational Medicine
Top Ten Medical Innovations: #6 - Femtosecond Laser Cataract Surgery
Oculentis FEMTIS Intraocular Lenses -- A Revolutionary New Design Oculentis FEMTIS Intraocular Lenses - A Revolutionary New Design - mivision
Best Kept Secrets -- Femtis Laser Lens CRSTEurope | The Lens: Femtis Laser Lens
About VISTA Eye Specialist

VISTA is one of the largest Eye Specialist Centers in Malaysia, with 8 branches that specializes in Cataract and Refractive Surgeries - including FemtoLASIK and Visian ICL (Implantable Contact Lenses), Cataract Surgeries with the Ziemer Z8 Femtosecond Laser, and the Oculentis Family of lenses among its large selection of IOL lenses and many more. As of to date, VISTA has performed over 30,000 surgeries and has now a dedicated team of over 80 highly trained and committed staff that has served over 230,000 patients since 1999.

VISTA is also one of the pioneer centers in the world to be involved in Femtosecond Cataract Surgeries since 2011 and has gone on to perform over 5,000 FLACS surgeries as of this writing. VISTA has also been implanting the Oculentis Family of LENTIS lenses since 2012 - offering the most complete range of IOLs to provide patients with unique visual needs the right lens for their lifestyle.

For more information, visit: Vista Eye Specialist | Lasik Eye Surgery Malaysia

KKLIU: 0352/2019

Logo - https://photos.prnasia.com/prnh/20190301/2390451-1logo

SOURCE VISTA Eye Specialist

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**Seekingasylum** · 05-02-2020, 11:48 AM

I think you are exaggerating the differences in the procedures.

Femtosecond laser assisted cataract surgeries ( Flacs ) are an improvement to the established IOL procedure in that the initial incision and fragmentation of the redundant lens is quicker and less traumatic to the surrounding wallet but the differences are marginal and not that significant overall according to research but it is now in use in the NHS already - your reference to the surgeon's 'blade' is misleading in that the standard IOL excision requires no stitches and is self healing in much the same way the Flacs system is.

It is not quicker to any significant degree and is no more efficient than a skilled surgeon at the top of his game - my chap had 12,000 procedures under his belt and lectured at Moorfields on technique.

The improvement is marginal but nevertheless is becoming the new standard but in the end it resolves to the same thing - a plastic implant inserted surgically.

The thing is, if I did not need to remove my lens there is no way in hell I would risk the procedure - although minimal, the danger of retinal detachment is still there and why would you risk invasive surgery for no reason other than vanity?

But if I did, then it would be in the UK where I can research the consultant doing the biz.

As postscript, the femtosecond blast of hot energy is infinitesimally short in duration but if it were to fail albeit in nano terms then vaporised cells on the retina wall would be the fallout and there ain't no way back from that.

Just saying like in case you thought it was sans risk.

**baldrick** · 05-02-2020, 12:45 PM

on the upside - he would not be able to see the ladyboy horror sucking on his knob

**Dillinger** · 05-02-2020, 02:06 PM

Or be able to read all this horseshit

My eyes are still not great even with these specs on. I still need to photograph jar labels with my phone and zoom in.
I want this crystal clear HD vision I hear people talking about.
As for vanity, I have never been vain, just an adonis of a man with a huge penis(previous surgery

)

**Iceman123** · 05-02-2020, 03:16 PM

Just get it done Dils

Look on the bright side - if it all goes to shit, get back to the UK - you will get a free Labrador.

**Mendip** · 05-02-2020, 03:36 PM

^ Or get back to Thailand and I'll find you a free 'substitute' Labrador!

**Shy Guava** · 06-02-2020, 10:21 AM

I had the IOL procedure done in one eye just over a month ago. It was performed at an Army hospital. My thinking was that if they buggered it up completely I could bung them a few extra baht and they could scoop a replacement eyeball out of a passing conscript. I was sure that the young chap would (probably) be chuffed and honoured to know that his youthful mince pie was now lodged in the socket of an elderly farang gentleman.

It's a bit hard to tell when it is you on the slab, but I think the procedure was done exactly as described by SeekingAsylum. The doctor operated through a machine looking like an upside down periscope and it took less than 30 minutes. After the initial examination, I heard the assistants being told that a "6.5" measurement was involved. It would seem to me that a 6.5mm diameter would be too large for a lens so I don't know what was referred to.

The cheapskates did not offer me any valium as I must have looked like I was made of sterner stuff. I was also forced to spend one night confined to barracks in a private room before being released after the surgeon examined his work the next day. I suspect that this was more of an income generator than a medical necessity. The Army hospital is quite close to the local jail and it seemed like they might share the same catering arrangements.

There were three types of lens on offer: one to correct longsight with glasses required for other distances, the same arrangement for short sight or the trifocal type which is supposed to cover all distances. The last option costs 3-4 times as much for the lens but is the one I chose. There were also options on the lens - a Carl Zeiss or an Indian made one. I selected the German one as the surgeon told me that the Indian ones worked OK but you had to bobble your head to remain in focus.

The quack seems to think that my other eye may adjust if left long enough. The corrected eye is much better than before but not totally sharp, although it seems to gradually be improving. My age (72) may have something to do with this. The upshot of it is that I can read and drive without glasses, which I couldn't do before. I'll give it some more time to decide on what to do with the other eye.

**Seekingasylum** · 06-02-2020, 11:38 AM

Good point about the replacement lens. The UK's NHS offers the German made lenses as opposed to the Indian manufactured products.

Dillinger being a credulous chap probably believes that the Malaysian clinic is implanting the Kraut one rather than the cheapo version from Mangalore. He's sucked up all their promotional literature and swallowed it hook, line and seeker .......

**aging one** · 06-02-2020, 12:02 PM

Originally Posted by Seekingasylum

Dillinger being a credulous chap probably believes that the Malaysian clinic is implanting the Kraut one rather than the cheapo version from Mangalore. He's sucked up all their promotional literature and swallowed it hook, line and seeker .......

You forgot IMHO. Pretty important part there..

**Seekingasylum** · 06-02-2020, 12:11 PM

You say?

**NamPikToot** · 06-02-2020, 12:14 PM

Originally Posted by Dillinger

I still need to photograph jar labels with my phone and zoom in.

Kin hell Dill, thank God for phones. Bet you were getting sick of sardines in tomato and sausages on toast

**baldrick** · 06-02-2020, 12:58 PM

Originally Posted by Shy Guava

the trifocal type

are you required to move your head for the different focuses and only see a slice ?

**Iceman123** · 06-02-2020, 01:41 PM

Originally Posted by baldrick

are you required to move your head for the different focuses and only see a slice ?

Not at all - I have the these and no adjustments of any kind required

**Attilla the Hen** · 06-02-2020, 01:57 PM

When I got mine done, I was really disappointed with the results. Went back to see the doctor and told him I wasn't impressed.
He told me that it takes a while for the brain to adapt.

Three weeks later, as I was having a leisurely beer in the sala, in seconds, my brain had it figured out and I could suddenly count the ants crawling up a tree 10 metres away.
Just warning you about this.
Also, with the muti-focal lenses, you do see coronas around lights at night, but over time this gradually gets less, but, doesn't completely go away. You'll get used to it.

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