Utilizing the LATEST "AMARIS"
Once Again, not only for the 1st time in India
but, for the first time in South East Asia,
The Mehta International Eye Institute
|An ISO 9001-2000 Certified Institute
Faster, stronger, more precise: At
the ESCRS Congress (European
Society of Cataract and Refractive
Surgeons) in Stockholm, SCHWIND
eye-techsolutions presents a new
perfection in refractive corneal
surgery. ”With the SCHWIND AMARIS,
we have developed an all-rounder with
offering an extraordinarily high level of
combine all available state-of-the-art
technologies in one system“, says CEO
adapted fluence values, ensures perfect ablation control. Depending on the refraction to be corrected, the
treatment. Fine correction takes place with a low fluence level, improving the resolution. With this
intelligent process, the laser treatment is significantly shortened, especially when higher refractions are
corrected, and at the same time carried out with exceptional precision. The correction of one diopter takes
on average less than 2.5 seconds with the SCHWIND AMARIS. Thereby, the stroma is preserved
through thermally optimized laser pulse distribution.
Whats Different? You may ask?
The new excimer laser generation,
SCHWIND AMARIS, impresses with a
multitude ofgroundbreaking innovations.
From the very beginning, the development activities for
this ambitious project concentrated on setting new
outstanding technological and clinical standards in
refractive surgery. SCHWIND engineers with different
specializations, mathematicians and physicists worked
towards a single goal: To realize the maximum of today’s
technological possibilities and to integrate the experience
gained through the up to now successful laser
generations from SCHWIND.
|The LATEST SCHWIND AMARIS.
developed especially for use with excimer lasers
and with a 14° stereopsis, suits natural,
threedimensional vision and delivers very good
contrast, true color brilliance and a superior depth
of focus. High flexibility also ranks among the core
characteristics of the all-rounder. Both the laser arm
and the patient bed can be swiveled independently.
The entire construction was carried out three-
dimensionally in order to allow the performance of
optimal software-supported material and load
analysis from the very beginning. This ensured –
already in the planning phase – extremely high
mechanical stability of the laser.
The Carriazo Pendular Microkerartome
literally guarantees total safety with perfect
computer controlled system.
How is LASIK done?
Why has LASIK become so popular all over the
LASIK has the big advantage that it is, for all practical purposes, A painless procedure. Following the
completion of the entire procedure the patient may occasionally complain of a feeling like a hair in the eye
and that too not too often. The feeling goes away in about 4 hours and after that, its simply progressive
improvement of vision with virtually no discomfort.
Microkeratome is placed on the cornea
thin perfectly transparent flap on the cornea.
The patient only feels a little buzzing on the
The flap is simply lifted up, rolled out of the
A super specialized little device called a way
and the Laser is applied. The laser utilizes
remove the tissue from the cornea, literally
desired which will eliminate the spectacle
power. The flap is put back in place and the
procedure is over.
- LASIK is a surgical procedure intended to reduce a person's dependency on glasses or contact lenses
and not, as is usually thought, designed to totally eliminate the spectacle power, which is often, impossible.
- The accuracy of the post LASIK residual power is based on many factors like pre-operative high myopia or
you may not need to use glasses for over 85% of the time, but some residual power is to be expected.
|What you need to understand
about LASIK !
- Radial Keratotomy: An older technique still being used in parts of India, where a sharp diamond knife, at
a present depth is allowed to make radial cuts on the cornea. Only used in powers up to – 5.00 and
leaves a great deal of surface irregularities.
- Photorefractive Keratectomy or PRK: Done on the same laser where Lasik is done, but no flap is
raised as is with Lasik. Here the surface of the eye is abraded with a rotating brush or scraped off and the
laser is applied directly on the surface. Since there is no flap there is nothing to displace in future years.
Disadvantage is that for the first 7 days it is quite painful despite all medicines and a bandage lens and
the drops have to be instilled for a prolonged of time. Sometimes there is thickening which may need to be
repolished of again later used to induce a low plus power and is used to correct presbyopia in a single
eye . Has not become very popular as it makes the patient monovision. The eye done is for near while the
other eye is for distance.
|What other types of Refractive
Surgeries are there besides LASIK?
LASIK is for all practical purposes a painless procedure though you will feel a little tightness and mild
discomfort when the initial clip is used to open the eye lids, and when the Microkeratome makes your initial
flap (though completed in 6 seconds flat with the new Carriazo Microkeratome.
is fit for LASIK surgery. This is termed as a “Baseline LASIK evaluation”.
It is mandatory that the use of contact lenses be discontinued and switch to wearing your glasses, full-time
prior the initial examination, termed the “baseline evaluation”.
Contact lenses tend to change the shape of your eye. Especially if you have been wearing the lenses for a
prolonged period of time. Especially with high powered lenses and RGP or hard lenses the cornea literally
moulds itself to the shape of the lens. After the lens is removed the cornea gradually reverts back to its
resting stage. If LASIK is done too soon the cornea will change in shape and lead to irregular results. It also
produces inaccurate measurements which lead to an inadequate result. Often one is hasty in wanting to do
a LASIK procedure fast and most contact lens wearers do not want to be seen in glasses but it is a wise
precaution and makes sense.
You should discontinue wearing
- Soft contact lenses, for 5 days before your evaluation and surgery.
- Toric soft lenses, should be stopped at least 8 days prior the procedure
- Rigid (hard) or gas permeable (RGP) lenses, you should stop wearing them for at least 2 weeks
before your initial evaluation.
The doctor will carry out a full eye examination including a retinal evaluation to be sure your eyes are
normal in every way. You should be careful to tell him about your past and present medical and eye
conditions, any history of trauma, infection, red eyes, hazy vision, and about all the medications you are
taking or you may be allergic to.
|What should I expect
before, during, and after surgery?
the cornea to be plotted out almost like the whorls and grooves of the fingerprint . This is individual to each
eye and forms the basis of the entire procedure. The keratometer evaluates the cornea for any irregularity
or any surface defect and looks for keratoconus or coning of the cornea which would preclude LASIK, with
an automatic detection system.
The Optikon Scout Computerized Corneal Topographer utilizes a very sophisticated system which has
an illuminated small cone with 28 mires (or lines) which reflect on the corneal surface and analyze almost
80,000 points on the cornea. It covers 90% of the corneal surface in normal eyes and has the resolution of
+/- 0.01D with an accuracy of 1 micron.
Positioning Control System (patented), automatic acquisition, with decentration correction.
This computerized map creation is the first step to doing wavefront controlled LASIK and is an important test.
Pacchymetry and Endothelial Cell Analysis:
The Topcon ( Japan) SP-2000P captures the image of the endothelium cells and calculates cornea
thickness by a unique non-contact operation, image acquisition can be obtain through contact lenses which
allows the cell condition to be observed while fitting contacts. The system uses a very innovative 3D
alignment and auto capture system ensures perfect focusing, ease of operation and reliable results. It has a
very fast cell measurement system and in less than one minute, a provides the cell count, and in the
selected measurement area, gives the cell measurement results and displays the cells morphology,
configuration and structure.
Using the new COAS Shack-Hartman System a Helium-Neon laser is reflected and focused to the subject's
retina for hardly 0.5 second. The laser reflects out from the retina through a series of very fine lenses eye
as compared to the one which has emerged, the aberrations (or optical irregularities) are measured and
quantified. Using the wavefront map generated by the computer to do a Excimer laser correction also called
wavefront guided LASIK, gives the patient the best chance of achieving 6/6 vision as well as a improvement
|What specific tests are to be done
prior the LASIK procedure?
|Visit the SCHWIND site for further detailed information regarding the product and
specifications on the link mentioned below:
|The Mehta International Eye Institute
The Center for Advanced Eye Care, Surgery, Education and
Asia's most advanced Eye Center
|The entire procedure is very fast. You will be given a cap to wear and requested to lie under the Excimer
Laser operating microscope.
Numbing drops will be put in the eye. You will be asked to keep your eyes shut as the outside of the eye is
cleaned with Betadine (antibiotic) solution and then dried again.
As a next step a smooth clip will be placed to keep the lids apart. You will be asked to open your eyes as
wide open as you can . There is no pressure on the lids at all.
Then a small suction ring is applied on the white of the eye to immobilize the globe at the time of lifting the
very fine flap. You will only feel a little tightness, but there is no pain, or for that matter, even discomfort.
The new Carriazo Pendular Microkeratome is simply placed in the arms of the suction ring and for exactly 3
seconds it automatically moves forwards. You will feel a slight buzzing and then the machine reverses itself
automatically to its initial position. The entire procedure is over in exactly 6 seconds. The instrument is lifted
off, and the suction is released and the ring is removed. While the suction ring is on the machine is working
on the front of the eye you will naturally not be able to see as the machine is in front of your eyes, but again
its only for the 6 seconds.
The surgeon will lift off and fold the flap back. Next the red blinking light will be properly focused for you to
see and the room will be darkened so you can focus on the light properly. When the surgeon is fully satisfied
that you are fixating properly on the light he will tell you that the laser will go on. The laser makes a clicking
sound and will stay on for anytime between 15 to 40 seconds depending on the power of the eye which is to
be corrected. You will feel nothing.
Each individual pulse of the laser is designed to remove a very fine quantum of tissue. Since with wave front
controlled LASIK, the data has already been fed into the computer of the Excimer laser, it will do exactly the
correct amount and automatically stop.
The eye will then be well washed with a balanced salt solution, the flap aligned back into place and then a
bandage contact lens is placed on the eye. The bandage lens makes sure that the flap exactly sits back into
place and no dust or dirt can get in.
Antibiotic solution is then applied and the procedure for that eye is over.
After both eyes are completed, you will be asked if you feel OK and then you walk out of the laser room with
- There is always a tendency to feel a bit itchy and a little poky in the operated eyes. Often one eye
seems to be more than the other. Though you will feel no pain, they may feel a bit heavy for some
time.. All this is normal. The eyes will also have a tendency to run with a little water for at least 4 hours
after the LASIK procedure. Please do not worry.. Its fine.
- The vision will be little blurry for the first 4 hours and then gradually settle down. You will be given
some tablets to take to make it more comfortable for you.
- It is also important that you do not rub your eyes as rubbing will dislodge the bandage contact lenses
and may even misalign the flap below.
- The whites of your eyes may have a few fine red spots on it following the laser. This again is quite
normal and occurs due to the suction ring which was placed on the eye. These go away in 10 days
and are of no significance.
- You should see your doctor the next day after surgery and at regular intervals after that. The routine
1st day, 10th day, 1st month, 3 months, 6 month and 1 year following the procedure. For at least the
first six months. At the first postoperative visit, your doctor will remove the bandage contact lens and
test your vision and examine your eyes.
- Unless your number was very high or was a complex mix of astigmatism, you will be able to see the
second last line on the very first day. It will appear a little misty, but you can read it. It all settles down
- You will be given antibiotic /anti-inflammatory eye drops to take at home to help prevent infection
and/or inflammation, and will also be advised to use artificial tears to help lubricate the eye.
- You can have a head bath and even wash your face after 4 days following the LASIK, but please no
eye make up for 15 days following the LASIK and no kajal and surma for a month following the
procedure. Try to avoid using any creams or lotions around the eyes for 15 days and do not go for a
swim for a month. Naturally you will avoid contact sports like karate and jujitsu for at least 3 months.
The speed at which the vision returns is very much dependant on the power which has been corrected and
the complexity (associated astigmatism and irregularities on the cornea).
Simple powers up to -4.00 usually recover very fast and in a period of 5-7 days, quite good vision is attained
and the vision is stable.
In higher powers the computer has in its software designed to overcorrect by 5-7%. This is because in
higher powers in a period of a month, a certain amount of power returns. After this small component returns
it remains stable. Based on the experience of over 75,000 cases done all over the world, the software buykit
into the Laser does the appropriate correction. Thus for a power of -10.00 an over correction of 0.7 would
be done which over a month or 6 weeks gradually recedes so that at the end of the period you are left
without any power. This also means the for the 1st month, reading will require you to take your reading
material or your mobile a little further then you would normally do so and the vision will remain a little misty
for distance. All this is quite normal and will recover in due course.
Following power correction of more than 7.00D, even if wavefront controlled, some glare, haloes around
point sources of light and a little difficult in driving is normal but usually settles down in about 2-3 months
after which time usually it is not noticeable.
|During the LASIK procedure
|Immediately after LASIK procedure
|How soon will my vision
stabilize?When will I see the best I
|What are the different types of
LASIK offered at
the Mehta International Eye
What do they mean?
LASIK has achieved exceptional success all over the world. As can well be expected, different eyes have
different indications. There are three types of LASIK service we can offer you at the MIEI.
Premium LASIK is a good basic technique for correction of low powers (< 3.00D )in myopia (near-
sightedness), hyperopia (<2.00) (far-sightedness), and astigmatism (<0.75) and has good results. Here the
data is directly fed onto the Excimer laser without going through any intermediary steps. For low powers the
results are more than adequate. This also is comparatively more economical.
Optimum LASIK uses a specialized laser algorithm called Optimization built in the computer which is
essentially designed to once again restore the normal shape of the cornea after doing the laser. Optimum
LASIK has been shown to provide a better quality of vision than Premium LASIK in cases where the power is
high or with astigmatism and significantly reduces aberration which make for glare and flare. It is essential to
use Optimized for all powers above -3.00 in Myopia. +2.00 in hyperopia ( plus powers) and +/- 0.75 in
Astigmats. However Optimized LASIK cannot correct any irregularities or aberrations on the corneal surface.
Also termed as Wavefront Guided LASIK ,This is considered the most advanced, the most accurate and
the most reproducible form of LASIK. What it does that it takes a high resolution picture of the front of the
cornea and using advanced algorhythms, generates a very detailed map of the cornea (very much like your
finger print). Using this data, the power calculations are modified and the Excimer gives the best possible
correction. Unlike Optimum LASIK which can only control the basic spectacle power, Wave front guided
LASIK can control the aberrations or irregularities which are complex ‘higher order’ aberrations that are not
correctable with glasses or contact lenses but can also decrease the quality of vision in the cornea. Using
Wave front guided LASIK can give an perfectly smooth, optimal surface thus actually enhancing vision.
|When is LASIK not for you?
- Cost is an issue: Mediclaim medical insurance will not pay for refractive surgery. As it is classified as a
cosmetic procedure. On the other hand some Mediclaim providers permit it for one eyes if the power
is more than 7.00D. Ask your Mediclaim provider before undergoing LASIK .
- Repeated changes of spectacle power over the last year. This type of instability tends to occur in the
earlier age group.
- Appearing for or have to appears for major examination where excessive night time study is involved
- Pregnant or breast feeding.
- You have an illness which may affect wound healing. Certain conditions, such as autoimmune
diseases (e.g. lupus, rheumatoid arthritis), immunodeficiency states (e.g. HIV) and unstable diabetes,
and some medications long term use of steroids and retinoic acid may prevent proper healing after a
- Contact sports are your love or career. Any career or sport where blows on the face are expected, like
boxing, wrestling, martial arts, judo jujitsu etc. Should not have LASIK though PRK is perfectly
- You are not an adult. Currently, no lasers are approved for LASIK on persons under the age of 14
years unless it is done for therapeutic reasons (unilateral amblyopia with abberopia)
- It is not advisable to undergo LASIK if you have or have had eye diseases, such as uveitis/iritis
(inflammations of the eye)
- Eye injuries or previous eye surgeries unless carried out for polishing and smoothing as after
keratoplasty or corneal trauma with surface irregularities.
- Keratoconus is a complete contraindication unless following or in conjunction with U-Vex laser (see
- Herpes of the face or long standing face or lid infections.
|Relative Contraindications to
pupil size is customarily measured on the auto-refractokeratometer which has a pupillary measuring device.
If the power is high and the pupil is large (>6.00mm), the chances of flare haloes , glare , starbursts and
ghost symptoms increase. Your doctor will explain it to you.
- Thin Corneas. The cornea is the guiding tissue for doing PRK or LASIK. It is measured with a
pacchymeter, a device which measures corneal thickness in microns using ultrasound. Since with all
corneal shaping procedures, tissue is removed, the quantum of residual thickness (which should
always be 300u) is important.
- Previous refractive surgery (e.g, RK, PRK, LASIK). If previous surgery has already been done,
enhancement may not be possible if there is inadequate tissue or there is some problem.
- Excessive dry eyes. Are always a relative contraindication but there will be tests to see how dry is
dry. Very dry eyes should not undergo LASIK.
- No vision correction procedure is without the risk of complications or side effects. Though LASIK has
been in use since 14 years, is a relatively new procedure, it is possible that there may be longer-term
risks that are unknown at this time.
- Risks and discomforts that might be associated with the LASIK procedure are as follows. All are rare
|Risks and Other Considerations
- What is LASIK?
- Why is everyone suddenly talking about LASIK?
- Dr. Keiki Mehta's latest highly advanced LATEST SCHWIND AMARIS, it's new, but how safe is it?
- How does it work?
|but can also be changed or expanded and saved. With the
particle aspiration system, developed on the basis of
comprehensive flow analysis, energy-reducing particles are
efficiently removed during ablation. This concept of maximum
safety is completed through the integration of high-resolution
online pachymetry. Unique ergonomic advantages that optimize the treatment process are also included.
The laser arm and the patient bed, for example, can be swiveled 90°. This makes patient preparation and
the combination with other medical devices easy and comfortable. The treatment monitor is adjustable in
any direction – assisting personnel can work with it comfortably too.
1050 Hz Turbo Eyetracker
An eyetracker must work at a significantly higher
frequency than the laser in order to safely allow a
very short ablation time. The SCHWIND AMARIS’
1050 Hz turbo eyetracker, with a response time of
less than three milliseconds, serves to provide
unsurpassed precision in the positioning of each
laser pulse. The extreme speed and other
groundbreaking features, Innovative particle aspiration
system such as rotation balance, limbus tracking and
static as well asdynamic cyclotorsion control, ensure
exact compensation of every eye movement, on into the fifth dimension.
|you take time and view them.
Please note: Buffering will take time, depending on the speed of your connection.
For a VIDEO tutorial, on the LATEST "AMARIS" LASER, please click on the listed
links below, which will take you directly to the trailer.
For more information on the "Amaris", in text, scroll below.
|is minimum 2 mins.
(recommended you wait)