Back To Top

eye

diseases

cataract

centre

cornea

centre

near

vision

other

options

laser

vision

info

on eyes

read more >

Our Technology

Advanced and sophisticated technology by itself does not guarantee good results.  For example, a good set of golf clubs in the hands of a high handicap player could produce mediocre results, whereas the same set of clubs in the hands of a professional could produce spectacular results.

The same argument applies to the use of technology in the treatment of eyes.

At Optimed Eye and Laser Clinic we have the in-depth knowledge, years of experience and the very best technologies available on the market today.  This combination ensures the best possible outcomes in corrective laser treatments and eye surgery for our patients.  It is part of our commitment to our patients to provide them with the best possible options.

Blended with our technology, our patients experience top quality treatment and surgical skill, making our clinic and the dedicated team of ophthalmic assistants, optometrists and nursing staff the favourite of referring ophthalmologists and optometrists, as well as patients in need of eye surgery.

Optimed is one of a few truly specialised refractive centers in South Africa.  A substantial portion of the technology we use is unique to ophthalmology in this country and, as a result, we often receive tertiary referrals from colleagues all over Southern Africa to diagnose and manage complex cases.

To learn more about some of our equipment, click on the corresponding link below:

Instrument Categories

Equipment used for corrective laser treatments

Bausch and Lomb ZyOptix XP Microkeratome

Bausch and Lomb Hansatome ZyOptix XP Microkeratome

What is this?  A Microkeratome is a specialised, highly-refined microscopic scalpel the surgeon uses to create a flap on the surface of a corneaThe cornea is the clear, transparent 'front window' of the eye through which light enters the eye. It handles about two-thirds of the focusing power of the eye and is critical for good vision. See Info on Eyes – Anatomy. for a LasikLasik is one of several types of laser treatments to permanently correct refractive errors of the eye. See Laser Vision – Introduction to Laser Treatment. treatment or other lamellar corneal surgery.

The Hansatome was the first 'swivelling' motorised Microkeratome that came on the market in 1998.  The picture on the left shows what such a Microkeratome looks like.  We have both the initial Hansatome, as well as the ZyOptix XP Microkeratome at Optimed.

How does it work?  The oscillating blade of the Microkeratome is used to create a flap of 120 micron thickness on the surface area of the cornea.  This is the critical part of a Lasik treatment, because the success of the procedure is dependent on the precision and quality of this corneal flapA corneal flap is made with a microkeratome or femtosecond laser to perform a lasik treatment on a cornea. See Laser Vision – Lasik..  Although rare, complications with Lasik usually relate to a defective flap.

How do you benefit?  If you select a Lasik refractive treatment, the ZyOptix XP consistently creates a very high-quality flap.  It minimises the risk of complications afterwards and has a variety of safety features, which include:

  • Computerised monitoring to ensure optimum quality.
  • The hinging of the flap under the upper eyelid minimizes the probability of a flap dislocation afterwards, as the blinking of the eyelid facilitates adhesion of the flap.
  • An uninterrupted power supply is integrated into the power module, which ensures completion of the flap formation, even if the main power fails while you are in theatre.

The Bausch and Lomb ZyOptix XP Microkeratome is widely regarded as a gold standard in the industry.

Footnote:  The flap for corneal laser treatment can be made with a microkeratome or a femtosecond laser.  We offer both types of technology and the type chosen for your procedure will depend on your specific diagnosis and requirements.

Moria CB Microkeratome and Artificial Anterior Chamber

Moria CB Microkeratome and Artificial Anterior  Chamber

What is this?  A Microkeratome is a specialised, highly-refined microscopic scalpel the surgeon uses to create a flap on the surface of a cornea for a Lasik treatment or other lamellar corneal surgery.

An Artificial Anterior Chamber is a device that enables the surgeon to mount donor corneal tissue from an eye bank for corneal transplantation, in order to make high-precision lamellar cuts on the donor tissue instead of doing a less accurate manual dissection.  The company Moria invented the artificial chamber, onto which the microkeratome head couples when a lamella of the cornea is required for a transplant.

How does it work?  The high-speed oscillating blade of the Microkeratome cuts a corneal lamella of specified thickness from the donor cornea.  This lamella is then utilised in modern lamellar (or non-penetrating, partial) corneal transplant surgery.

How do you benefit?  At Optimed Eye and Laser Clinic, we strive to offer you the latest technologies in refractive cornea treatments and surgery.  Lamellar corneal transplant surgery is the new 'buzz word' in corneal transplantation, with many advantages over conventional penetrating surgery.  Some of these advantages include a quicker recovery, increased safety, less invasive and a smaller probability of rejection of the transplant.  We are one of very few centres in South Africa offering the full range of lamellar transplant techniques.

Zeiss MEL-80 Excimer Laser

Zeiss MEL-80 Excimer Laser

What is this?  The excimer laserAn Excimer laser is a high-tech laser device used to permanently and very accurately reshape the curvature of the cornea to treat a refractive error or corneal pathology. See About Us – Our Technology – Excimer laser. is an extremely accurate high-tech device used to perform Laser vision correction on the surface of a cornea to restore vision in patients who wear glasses or contact lenses.

How does it work?  Under the control of a computer, the excimer laser removes 0.25 microns of corneal tissue per pulse.  To place this in perspective:  a red blood cell, which carries oxygen in the bloodstream, is typically seven microns (0.007 mm) thick.  This laser will, therefore, need approximately 28 pulses to evaporate such a cell!

When Laser vision correction takes place, each pulse of the Excimer laser literally evaporates a precise microscopic amount of tissue at pre-determined positions on the surface of the cornea.

Should your eye accidentally wander, the automatic eye tracking mechanism of the laser monitors the position of the eye more than 1000 times per second and, if required, it will redirect each laser pulse to ensure that it is still precisely placed on the intended areas during the full treatment.  This is the only laser that adjusts the position of each pulse accurately if the eye should move.  In a worst case scenario, if the movement of the eye is outside its tracking ability, the laser will stop and wait until the eye is back within its normal range again before resuming treatment.

Some of the other competing laser systems on the market, although also equipped with eye tracking abilities, may only adjust between 30% and 50% of the laser pulses delivered.

How do you benefit?  Glasses or contact lenses do not correct the causes of poor vision - they only attempt to correct the symptoms.  An excimer laser treatment, on the other hand, removes the root cause of poor vision by permanently reshaping the cornea to restore vision to normal.  The process causes little discomfort and takes less than an hour for two eyes.  Should you receive a laser treatment, you can resume most of your normal activities within 2 to 3 days.  To date (July 2013), more than 20 million eyes have been corrected by refractive laser treatments worldwide.

The sub-micron accuracy of the Excimer laser is demonstrated in these 2 examples.  In the first, the laser made transverse cuts into a human hair, while in the second example, it wrote the word

The sub-micron accuracy of the excimer laser is demonstrated in these two examples.  In the first, the laser made transverse cuts into a human hair, while in the second example, it wrote the word 'LASER' into the hair.

For the more technically-minded:  The excimer laser emits low-energy light pulses of approximately 10 to 20 nanoseconds duration.  A nanosecond is one billionth of a second or, in mathematical terms, 10−9 seconds.  Since light travels at a speed of 300 000 kilometers per second, it will only travel approximately 30 cm in one nanosecond.  Therefore, during a 10-nanoseond pulse of an excimer laser, a beam of light travels approximately 3 metres.

Zeiss VisuMax Femtosecond Laser

Zeiss VisuMax Femtosecond Laser

What is this?  The Visumax femtosecond laserThe Zeiss Visumax femtosecond laser is an extremely high-precision, state-of-the-art laser device used to make incisions into the eye. See About Us – Our Technology – Zeiss Visumax Femtosecond Laser. is the very latest technology, developed to perform surgery and refractive corrections on a cornea.  It differs from the Excimer laser in that it functions within a cornea instead of on its surface.

How does it work?  The laser's near-infrared beam is focused to within sub-micron accuracy at different depths within the clear cornea (which is only about 0.5 mm thick!).  Controlled by a proprietary software algorithm, the laser beam creates millions of microscopic bubbles at predetermined points inside the corneal substance.  These bubbles expand instantaneously and gently separate the corneal tissue at each point.

Example 1 - A cornea transplant:  The laser removes a precise profile of corneal tissue out of a damaged or diseased cornea and then precisely matches that same profile from a donor cornea.  Within micron tolerances, this donor cornea will fit exactly into the space created by the laser on the recipient.  The surgeon then attaches the new cornea to the recipient eye with microscopic sutures.

Example 2 - Refractive laser correctionA laser correction is the permanent reshaping of a cornea with a deficient curvature by laser to improve vision. See Laser Vision – About Laser Vision Correction.:  The laser creates a precisely-shaped corneal lenticuleA lenticule resembles a very thin contact lens and is formed within submicron accuracy inside the corneal stroma with a femtosecond laser. It may be removed through a very small incision on the side of the cornea, or from the corneal bed under a flap, depending upon the technique employed by the surgeon, which then achieves a refractive correction on the cornea. See About Us – Our Technology – Zeiss Femtosecond Laser. within the stroma, followed by a small 3-4 mm incision on the side of the cornea.  The shape of the lenticule is similar to a thin contact lens and its dimensions are within sub-micron tolerances of the correction required.  The surgeon then frees the lenticule and removes it through the small incision.  No sutures are required, since the tiny wound seals by itself.  This permanently changes the corneal curvature, which corrects the refractive error.

Because there is no flap, the cornea is not weakened.  The result is that it becomes possible to increase the level of correction.  Moreover, some people who  cannot wear contact lenses can now become candidates for corrective laser treatments, as there is little or no 'dry eye' symptoms afterwards.

According to trials conducted on over 1 000 patients in the UK, Germany, France and Denmark, the main advantages cited by patients are that the procedure only takes 4 to 5 minutes per eye, vision is immediately 80% better and reaches 100% within a few days.

On average, 15% of all patients who seek laser treatments have corneas that are too thin or too dry for laser treatments.  In contrast to Lasik, Refractive Lenticule Extraction (ReLExReLEx is an acronym for Refractive Lenticule Extraction. See Laser Vision – ReLEx – Flex and Smile.) can in some cases help patients with thin corneas and very high prescriptions of up to -14 dioptres of myopiamyopia is also known as nearsightedness. It results from an eye that is larger in size compared to a normal sized eye and/or a cornea that is relatively too steep, causing the image to focus in front of the retina instead of on the retina itself. See Info on Eyes, Optics and Refractive Errors - myopia..

The illustration below shows the SMall Incision Lenticule Extraction (SmileSmile is the latest and most modern laser technique to restore vision by permanently reshaping the cornea with a femtosecond laser. See Laser Vision – RELEx - Smile.) procedure graphically. 

A femtosecond laser creates a lenticule inside the cornea, which corresponds exactly to the correction required.

A femtosecond laser creates a lenticule inside the cornea, which corresponds exactly to the correction required.

The laser then creates a 4 mm incision on the side of the cornea, through which the lenticule is manually extracted.

The laser then creates a 4 mm incision on the side of the cornea, through which the lenticule is manually extracted.

Because the incision is so small, it heals quickly and the structural integrity of the cornea is largely preserved.

Because the incision is so small, it heals quickly and the structural integrity of the cornea is largely preserved.

How do you benefit?  

A survey of patients who elected to undergo this procedure for refractive vision correction show that they are very satisfied with the procedure and the results.

  • The visual outcome is similar to that seen with Lasik and Photo Refractive Keratectomy (PRKPRK is one of the laser treatment options to restore vision by permanently reshaping the cornea with an Excimer Laser. See Laser Vision – PRK.).
  • Because of the advanced all-laser procedure and small incision:
    • There is no risk of flap complications, as there is no flap.
    • The risk of infection is extremely small, since the only portal for entry of organisms is the 4  mm incision as opposed to the whole edge of the flap in Lasik and Femtosecond Lenticule Extraction (FLExFLEx is one of the the latest techniques to restore vision by permanently reshaping the cornea with a femtosecond laser. See Laser Vision – RELEx - FLEx.).
    • The integrity and biomechanical stability of the cornea is largely preserved, which means that your corrected vision should remain stable for many years.
    • The procedure has excellent predictability, even for high levels of myopia.  Therefore, the need for a second procedure to enhance the first is rare.
    • Because most of the corneal nerves remain intact, patients generally experience less 'dry eyes' than with Lasik.
    • It made Laser vision correction possible for some patients who would previously have been regarded as unsuitable candidates.
    • A survey of patients, who had the Smile procedure, shows very high levels of satisfaction with their overall experience and the advantages they feel the procedure offers: 
    • The unimaginable precision of the equipment.
    • The extremely good visual results.
    • The gentle treatment method.
    • The considerably more freedom without visual aids.
    • The ability to practice professions, hobbies and sport without restriction.
    • The increased personal self-confidence.
  • Smile is a relatively new procedure.  As at January 2013 there were only approximately 40 centers worldwide with the ability to do Smile procedures - Optimed being one of them.  However, surgeons who use it and patients that have received treatments are generally very happy with the results, as outlined above.
  • Because of its extremely high precision and sophistication, Femtosecond laser equipment is considerably more expensive than Excimer lasers, which affects the cost of a Smile procedure.   Many patients nevertheless regard its advantages sufficiently important to choose it instead of one of the other laser alternatives.
Zeiss Femtosecond Laser

To provide the full spectrum of laser treatment options to our patients, a Zeiss VisuMax laser and a MEL-80 excimer laser have been installed at Optimed in a configuration similar to this picture.  The VisuMax is on the left and the MEL-80 on the right.

Note that the bed, on which you recline during the treatment, can swivel between the two machines.  Without moving, you can be treated on the VisuMax, the MEL-80 or both, depending on your unique circumstances or needs.

For the more technically-minded:  The femtosecond laser derives its name from its extremely short laser pulses.  The femtosecond laser emits much shorter optical pulses than the Excimer laser, with the result that its pulse duration is measured in femtoseconds.  A femtosecond is one millionth of a nanosecond or, in mathematical terms, 10-15 second.

To illustrate these incomprehensible numbers, let's use the same argument like we did for the excimer laser.  Since light travels at 300 000 kilometers per second, it can travel only 3 microns or 0.003 millimeters in 10 femtoseconds!  That distance is much smaller than even our eyes can see. 

This is high-tech in its most amazing form - at your service!

For the even more technically-minded:  The Zeiss VisuMax femtosecond laser differs from other similar lasers in several unique ways.  To describe the differences, it is necessary to briefly trace its development.

Since femtosecond lasers were first introduced to do refractive treatments, the ultimate goal has been to create an intrastromal lenticule that can be manually removed in one piece, thereby circumventing the need for incremental removal of tissue by an Excimer laser.  Following the introduction in 2007 of the VisuMax Femtosecond Laser, the intrastromal lenticule method was introduced in an experimental procedure at the time called FLEx.  With this procedure a flap was created and lifted to allow the lenticule to be removed.

Following the successful implementation of FLEx, a new procedure known as  Smile, was developed.  With this procedure a lenticule is created within the corneal stromaThe cornea consists of 5 distinct layers. The third layer forms the main body of the cornea and is known as the corneal stroma. See Info on Eyes – Anatomy. and then, though a small 3-4 mm incision, the lenticular interfaces are separated followed by manual removal of the lenticule, thus eliminating the need for a flap.  The results of the first prospective trials of Smile was highly successful and there are now more than 50 laser specialists routinely performing this procedure worldwide -  Dr Potgieter being one of them.

A number of femtosecond lasers are commercially available, but the VisuMax is the only one used for an intrastromal lenticular cut.  There are six distinct design elements of the VisuMax that represent how the device was conceived from the ground up as a high-precision intracorneal lenticular cutting tool.  Central to the VisuMax mode of operation is the extremely light-touch coupling system that minimises corneal distortion and a rapid, high-precision femtosecond pulse placement to achieve sufficient 3-dimensional geometric cutting precision, such that refractive lenticules can be created accurately within the body of the stroma.

The main characteristics that distinguish the VisuMax from other femtosecond lasers are: 

  • A curved coupling contact glass which causes minimal corneal distortion.
  • The coupling suction applied to the peripheral cornea allows for a low suction force to immobilise the cornea, which also reduces tissue distortion.
  • Each contact glass is individually calibrated, based on confocal detection of radiation.
  • The optical beam path and headrest maintains a consistent position and contact glass force onto the cornea, thereby further minimising tissue distortion.
  • The high numerical aperture of the beam is designed to deliver a tight concentration of femtosecond energy with low per-pulse energy load.
  • The pulse rate of 500 000 pulses per second is 2000 times higher than that of an excimer laser, which further minimises treatment time.

The advantages of ReLEx Smile over Lasik

These new femtosecond procedures offer a number of advantages:

  • The removal of tissue is more accurate and repeatable.  All the potential errors associated with excimer laser ablation are avoided, such as stromal hydration, laser fluence projection, reflection losses and other environmental factors.  The tissue removal is only determined by the accuracy of the laser, which is not affected by environmental conditions.  Moreover, the accuracy is the same for low and high corrections.
  • Since no flap is created, Bowman's membrane and the stromal lamellae of the upper cornea remain intact, except for the small 3-4 mm incision.  The remaining cornea, therefore, has relatively more biomechanical strength and a reduced variability of the biomechanical effects produced as a result of the removal of refractive tissue by an excimer laser.
  • Since no side cut is created in the cornea, there is less strain in the cornea compared to the thin Lasik flap and a significant difference in corneal strain compared to Lasik with a thicker flap.  In practice it means that the Smile lenticule can be created at any depth within the corneal stroma.  Therefore, Smile can be used to treat a greater range of myopia than the excimer laser.
  • Smile patients generally experience less 'dry eye' than with PRK and Lasik.
  • The cornea is one of the most densely nerve-populated peripheral tissues in humans. Nerve bundles within the anterior stroma grow radially from the periphery toward the central cornea.  In Lasik, several nerve bundles are cut, with only nerves entering the flap through the hinge region being spared.  Subsequent excimer laser ablation severs stromal nerve fibre bundles.  It means that the patient may have 'dry eye' symptoms and decreased corneal sensitivity while the nerves regenerate.  With Smile, the anterior corneal anatomy is largely preserved and the anterior nerves are disrupted significantly less.  Corneal sensation recovers to the baseline level 3 months after Smile compared with 6 to 12 months after Lasik.  

Equipment used for corrective laser treatments and other corneal surgery

Heidelberg Spectralis

Heidelberg  Spectralis

What is this?  Optical Coherence Tomography (OCT) is an optical signal acquisition and processing methodology.  The Spectralis system is a state-of-the-art diagnostic tool to obtain detailed images of the cornea, anterior segment (iris, lensThe lens fulfils the same role as the lens in a camera. It handles about one-third of the focusing power of the eye and is critical for good vision.See Info on Eyes – Anatomy. and drainage angle) as well as inside the eye from the retinaThe retina is the receptor of light at the back of the eye. It fulfils the same function as the film in a film camera or the image sensor in a digital camera. The retina translates the images into electrical signals that are sent via the optic nerve to the visual cortex in the brain, where it is interpreted as the images we see. See Info on Eyes – Anatomy. and deeper structures.

How does it work?  The OCT system captures 3-dimensional images of the inside of the eye with submicron-accuracy, using an interferometric technique that works with near-infrared light.  The system measures the echoed time delays of a reflected laser beam.  While the beam scans, it generates a cross-sectional image of the eye, which is displayed on a screen, or printed in colour.

The green and red imaging lasers for FA and ICG imaging, as well as the blue peak laser for auto fluorescence, are synchronized with the OCT.  It is, therefore, possible to combine all the imaging data acquired into one 3-dimensional model.  This provides the ophthalmologist with a comprehensive analysis, which is unique to the Spectralis.

How do you benefit?  Within a few seconds the ophthalmologist can get detailed, multi-dimensional images of the inside of your eye, which clearly shows the state of your eye and any problem areas there may be.  It helps the specialist to accurately diagnose any problems and design a custom treatment for your particular condition.

This high-tech instrument from Heidelberg Technologies in Germany is at the forefront of modern imaging technology within the field of ophthalmology.  It consists of 4 separate modules, integrated into one compact instrument.

The 4 different components are:

  • OCT.
  • A green dye laser for fluorescein angiography.
  • An infra-red laser for indocyanine-green angiography.
  • A blue laser for capturing auto fluorescence images.

Fluorescein angiography (FA) is used to display pathology of the iris, as well as the retina and choroid, with the emphasis on retinal pathology.

Indocyanine angiography (ICG) supplements fluorescein angiography to study the choroid (the vascular layer beneath the retina).

Between the retina and the choroid, a single layer of cells, the retinal pigment epithelium (RPE) and 'Bruch's membrane' forms a barrier between the two.  This is where a variety of pathologies often have their origin.  The “Blue Peak” Auto Fluorescence ability of the Spectralis enables the eye specialist to diagnose problems in this layer before they are clinically evident during a routine eye examination.

Since the early 1990s, OCT has revolutionised the way retinal and glaucomaGlaucoma is an eye condition that sets in when the optic nerve of the eye is damaged by the pressure in the eye being too high, leading to a compromised blood supply to the optic nerve or a combination of these. See Eye Diseases – Glaucoma. problems are diagnosed, as it is a very accurate diagnostic tool for glaucoma, cataractA cataract forms when the natural lens in the eye is, or is starting to become, opaque. If not treated, it can lead to blindness, which in most cases can be treated. See Cataract Centre – Understanding Cataracts.s, anterior segment, corneal- and retinal diseases.

Nidek Confoscan

Nidek Corneal Confocal Microscope (Confoscan)

What is this?  The Nidek Confoscan is a unique, state-of-the-art diagnostic instrument that combines a Confocal Microscope, a non-contact Endothelial Microscope and a precision Pachymeter into one compact unit.  This instrument is the only one of its kind in South Africa and enables the ophthalmologist to obtain optical sections from the cornea, very similar to looking at the cornea with a light microscope.  It may be seen as a 'virtual in vivo light microscope'.

How does it work?  The unit automatically aligns itself and then does a fast and fully automatic endothelial analysis of the eye.  It can do full thickness cornea measurements and can localise any intra-corneal pathology and structural problems.  Moreover, it is not affected by corneal clarity and may, for example, analyse scars.

How do you benefit?  This instrument enables the ophthalmologist to look at the cornea at a microscopic level, as if an actual specimen was taken from it and examined under a conventional microscope.  It is therefore possible to make certain diagnoses (for example identifying certain micro-organisms causing a corneal infection), which would not be possible otherwise.  It also forms a critical part of evaluating the cornea's internal endothelial layer to track its health before and after the placement of phakic Intra-ocular lenses.  Its non-contact characteristics and floating probe system is comfortable and safe, even if your eye is light sensitive or if you recently had eye surgery.

Orbscan II Corneal Tomography

Orbscan II Corneal Tomography System

What is this?  Corneal tomography implies a sophisticated eye analysis that utilises computer technology to compile an extremely accurate mathematical model of the cornea and full front section of the eye.

How does it work?  The Orbscan uses a slit light beam to show the profile of the cornea in 3 dimensions.  This accuracy is essential in the planning of a refractive treatment procedure, as the calculations have to be accurate within sub-micron tolerances to ensure that refractive and safety parameters are adhered to during the actual procedure.

accurate  within sub-micron tolerances to ensure that refractive and safety parameters  are adhered to during the actual procedure

How do you benefit?  If there is any doubt as to whether you will be a suitable candidate for corrective laser treatment, the system can generate a computer simulation of your vision as though the procedure has already taken place.

By means of modern 'ray-tracing' technology, the computer simulates the expected visual outcome before you are treated, leaving the decision to you as to whether to continue or not.

The example below illustrates how it works.

An Orbscan convolved image, displaying the anticipated visual outcome for an intended treatment. This tool is valuable to help you and the surgeon decide whether to proceed with a corneal laser vision correction, or rather use alternative means to achieve a refractive correction.

An Orbscan convolved image, displaying the anticipated visual outcome for an intended treatment. This tool is valuable to help you and the surgeon decide whether to proceed with a corneal Laser vision correction, or rather use alternative means to achieve a refractive correction.

Reichert Ocular Response Analyser

Reichert Ocular  Response Analyser  (ORA)

What is this?  Our Ocular Response Analyser is the only one currently (Febr 2013) available in South Africa and measures the so-called Corneal Hysteresis (CH) of a cornea. 

CH gives an indication of the biomechanical response of the cornea, which is different from the corneal thicknessOn average, a normal cornea is roughly 500 microns (0.5mm) thick. A minimum corneal thickness is required for various corrective laser treatments and surgical procedures. See Laser Vision - About Laser Vision Correction. or the topographyTopography is a term used to describe the surface characteristics of an object, such as the 'hills and valleys' of the surface. It can apply to a landscape or a cornea. of the cornea. CH represents the pliability and distortion properties of corneal tissue, which provides more comprehensive information about the biomechanics of the cornea.

How does it work?  The analyser uses a dynamic process to measure the biomechanical properties of the cornea as well as the intraocular pressure of the eye.  A precisely metered air pulse is applied to the cornea, which causes the apex of the cornea to instantaneously move inwards.  As the air pulse force decreases, the cornea returns to its normal state.  The system has an ultra-high speed camera that takes 400 measurements during the 20-millisecond process.  The system then computes the biomechanical response of the cornea to the pulse of air and provides the CH value.

How do you benefit?  This instrument finds its application specifically in the field of corneal diagnostics, and the management of glaucoma.

For the safe practice of Laser vision corrections on the cornea, it is critical to determine whether there are sub-clinical abnormalities in the cornea and how a specific cornea will respond biomechanically to a laser correction.  The measurements supplied by the ORA therefore provide important pre-operative information to the refractive surgeon about the safety of prospective laser treatments in the long-term, that are not possible to get by any other means.   Since September 2012,  Optimed is the only facility in South Africa to offer you this added safety net in corneal vision corrections.

The measurement values also enable the specialist to establish whether your eyes are at risk of the development of keratoconus.

In its early stages, glaucoma has no or very little symptoms.  When the actual symptoms of glaucoma manifest, the condition may already be well underway.  Especially in its advanced stages, successful treatment of glaucoma becomes very difficult, so it is critically important to diagnose glaucoma as early as possible.

The CH measurement helps the ophthalmologist to identify the risk of glaucoma progression and therefore determine whether your treatment is sufficient, or whether you have to be managed in a more aggressive way by means of laser or other surgical intervention.

Zeiss Atlas Corneal Topographer

Zeiss Atlas Corneal Topographer

What is this?  The corneal topographer is a diagnostic tool used to create a 3-dimensional map of the curvature of a cornea.  An eye with normal vision has an evenly rounded cornea, but if the cornea is too flat, too steep or uneven, it affects your vision.

How does it work?  The topographer is a lighted bowl that contains a pattern of concentric rings, linked to a computer.  During the diagnostic test, you sit in front of the bowl with your head pressed against a bar while a series of data points are generated.  The computer software digitises the measurements and produces a printout of the shape of the cornea, similar to a topographic map of the earth that displays changes in terrain.

How do you benefit?  The information supplied by the instrument has a diagnostic as well as a therapeutic function.

Diagnostic:  The test detects irregularities in your cornea that is invisible to most other conventional testing.  And, because the computer saves the information it generates, the ophthalmologist can monitor any changes to your cornea and/or your corneal stability over time.

Corneal mapping reveals patterns indicating conditions that may affect the selection of the most suitable type of vision correction treatment for you.  These patterns are colour-coded in a continuous rainbow order according to highs and lows - red being the highest and blue/purple being the lowest.

To illustrate, a few examples of such corneal maps are shown below.

Corneal maps
  1. A typical round cornea that changes uniformly from the centre to the edge. 
  2. Balanced astigmatismAstigmatism is a condition caused by a cornea that has more than one curvature, similar to a rugby ball. The same image, therefore, focuses on multiple points in front of, on and/or behind the cornea, creating multiple and ghost images. Astigmatism may also be found in association with either myopia or hyperopia, which complicates the condition substantially. See Info on Eyes, Optics and Refractive Errors - Astigmatism., where the cornea has two similar focusing powers. 
  3. Asymmetric astigmatism, where the cornea has two imbalanced focusing powers. 
  4. Keratoconus, where an area of the cornea assumes a cone-like shape.

Therapeutic:  In selected cases, the curvature information derived from the cornea is used for the generation of an optimised corneal ablation profile for Laser vision correction.  If required, a personalised laser treatment for patients with irregular corneas can be generated.  This type of laser profiles is known as a 'topography-linked laser treatment'.

Dr Potgieter was the first laser vision surgeon in South Africa, and in 1999, among one of the first in the world  to apply this kind of corrections in clinical practice.

Zeiss WASCA Wavefront Analyser and CRS-Master Software

Zeiss WASCA Wavefront Analyser

What is this?  The WASCA Wavefront Analyser measures and analyses the refractive imperfections of your eye and customises the amount of laser correction required on every point on the cornea to restore your vision.

How does it work?  The analyser accurately measures the deviation on 800 individual points on a seven mm diameter area of the cornea.  (Other similar devices can only analyse up to 240 points in a six mm area).  Wavefront technology compares distorted waves of light exiting the eye to flat waves of light that would have returned in a perfect optical system.  This information is converted to a 3-dimensional map that is interpreted by a software algorithm to determine how much corneal tissue has to be removed at every point on the cornea.

The measurements are analysed and interpreted by the patented proprietary Zeiss CRS-Master software.

On the basis of the wavefront data, which includes higher-order aberrations, the software calculates the amount of laser correction that is required at each of the 800 points on the cornea.  It all happens in less than half-a-second!  The measurements are then transferred to the MEL-80 excimer laser.  It uses those measurements to remove precise, pre-determined amounts of corneal tissue from each of those 800 points on the cornea.  Bear in mind that the average cornea is approximately 12 mm in diameter!

How do you benefit?  Instead of the one-size-fits-all approach of some laser treatments, you get a personalised, precise custom correction on every point of your cornea for even the smallest irregular refractive errors.  Although the surgeon still has the final say, the process ensures that human error is virtually eliminated.

In addition to its mathematical sophistication, the CRS-Master software monitors the residual corneal thickness during all phases of treatment planning.  It will, therefore, pre-warn the surgeon of any risks that may be associated with the laser treatment.

The result?  The root cause of your poor vision is removed and your cornea is permanently reshaped into the most optimal configuration for each individual eye, leading to an enhanced visual outcome.

Footnote:  Until fairly recently, Lasik treatments were exclusively based on a patient's optical prescription.  The treatments did not take into account that the eyes of each patient have a unique set of naturally-occurring optical imperfections.  This was known as 'conventional Lasik' and was to a large extent based on a one-size-fits-all approach.

Custom Lasik, on the other hand, is like having a suit custom-made for you rather than buying one off the shelf.  For custom Lasik, more measurements are taken from your eye to create an individualised surgical procedure that is custom-designed for each eye, which may be based upon wavefront data, topography information and/or a blend thereof.

With the advent of topography, wavefront diagnostic technology and our new laser, we are able to treat you according to the uniqueness of your eyes – not just their prescription.

Equipment used for corneal transplants

Bausch and Lomb ZyOptix XP Microkeratome

Bausch and Lomb Hansatome ZyOptix XP Microkeratome

What is this?  A Microkeratome is a specialised, highly-refined microscopic scalpel the surgeon uses to create a flap on the surface of a cornea for a Lasik treatment or other lamellar corneal surgery.

The Hansatome was the first 'swivelling' motorised Microkeratome that came on the market in 1998.  The picture on the left shows what such a Microkeratome looks like.  We have both the initial Hansatome, as well as the ZyOptix XP Microkeratome available at our facility.

How does it work?  The oscillating blade of the Microkeratome is used to create a flap of 120 micron thickness on the surface area of the cornea.  This is the critical part of a Lasik treatment, because the success of the procedure is dependent on the precision and quality of this corneal flap.  Although rare, complications with Lasik usually relate to a defective flap.

How do you benefit?  If you select a Lasik refractive treatment, the ZyOptix XP consistently creates a very high-quality flap.  It minimises the risk of complications afterwards and has a variety of safety features, which include:

  • Computerised monitoring to ensure optimum quality.
  • The hinging of the flap under the upper eyelid minimizes the probability of a flap dislocation afterwards, as the blinking of the eyelid facilitates adhesion of the flap.
  • An uninterrupted power supply is integrated into the power module, which ensures completion of the flap formation, even if the main power fails while you are in theatre.

The Bausch and Lomb ZyOptix XP Microkeratome is widely regarded as a gold standard in the industry.

Footnote:  The flap for corneal laser treatment can be made with a microkeratome or a femtosecond laser.  We offer both types of technology and the type chosen for your procedure will depend on your specific diagnosis and requirements.

Moria CB Microkeratome and Artificial Anterior Chamber

Moria CB Microkeratome and Artificial Anterior  Chamber

What is this?  A Microkeratome is a specialised, highly-refined microscopic scalpel the surgeon uses to create a flap on the surface of a cornea for a Lasik treatment or other lamellar corneal surgery.

An Artificial Anterior Chamber is a device that enables the surgeon to mount donor corneal tissue from an eye bank for corneal transplantation, in order to make high-precision lamellar cuts on the donor tissue instead of doing a less accurate manual dissection.  The company Moria invented the artificial chamber, onto which the microkeratome head couples when a lamella of the cornea is required for a transplant.

How does it work?  The high-speed oscillating blade of the Microkeratome cuts a corneal lamella of specified thickness from the donor cornea.  This lamella is then utilised in modern lamellar (or non-penetrating, partial) corneal transplant surgery.

How do you benefit?  At Optimed Eye and Laser Clinic, we strive to offer you the latest technologies in refractive cornea treatments and surgery.  Lamellar corneal transplant surgery is the new 'buzz word' in corneal transplantation, with many advantages over conventional penetrating surgery.  Some of these advantages include a quicker recovery, increased safety, less invasive and a smaller probability of rejection of the transplant.  We are one of very few centres in South Africa offering the full range of lamellar transplant techniques.

Zeiss MEL-80 Excimer Laser

Zeiss MEL-80 Excimer Laser

What is this?  The excimer laser is an extremely accurate high-tech device used to perform Laser vision correction on the surface of a cornea to restore vision in patients who wear glasses or contact lenses.

How does it work?  Under the control of a computer, the excimer laser removes 0.25 microns of corneal tissue per pulse.  To place this in perspective:  a red blood cell, which carries oxygen in the bloodstream, is typically seven microns (0.007 mm) thick.  This laser will, therefore, need approximately 28 pulses to evaporate such a cell!

When Laser vision correction takes place, each pulse of the Excimer laser literally evaporates a precise microscopic amount of tissue at pre-determined positions on the surface of the cornea.

Should your eye accidentally wander, the automatic eye tracking mechanism of the laser monitors the position of the eye more than 1000 times per second and, if required, it will redirect each laser pulse to ensure that it is still precisely placed on the intended areas during the full treatment.  This is the only laser that adjusts the position of each pulse accurately if the eye should move.  In a worst case scenario, if the movement of the eye is outside its tracking ability, the laser will stop and wait until the eye is back within its normal range again before resuming treatment.

Some of the other competing laser systems on the market, although also equipped with eye tracking abilities, may only adjust between 30% and 50% of the laser pulses delivered.

How do you benefit?  Glasses or contact lenses do not correct the causes of poor vision - they only attempt to correct the symptoms.  An excimer laser treatment, on the other hand, removes the root cause of poor vision by permanently reshaping the cornea to restore vision to normal.  The process causes little discomfort and takes less than an hour for two eyes.  Should you receive a laser treatment, you can resume most of your normal activities within 2 to 3 days.  To date (January 2013), more than 20 million eyes have been corrected by refractive laser treatments worldwide.

The sub-micron accuracy of the Excimer laser is demonstrated in these two examples.  In the first, the laser made transverse cuts into a human hair, while in the second example, it wrote the word

The sub-micron accuracy of the excimer laser is demonstrated in these two examples.  In the first, the laser made transverse cuts into a human hair, while in the second example, it wrote the word 'LASER' into the hair.

For the more technically-minded:  The excimer laser emits low-energy light pulses of approximately 10 to 20 nanoseconds duration.  A nanosecond is one billionth of a second or, in mathematical terms, 10−9 seconds.  Since light travels at a speed of 300 000 kilometers per second, it will only travel approximately 30 cm in one nanosecond.  Therefore, during a 10-nanoseond pulse of an excimer laser, a beam of light travels approximately 3 metres.

Zeiss VisuMax Femtosecond Laser

Zeiss VisuMax Femtosecond Laser

What is this?  The VisuMax femtosecond laser is the very latest technology, developed to perform surgery and refractive corrections on a cornea.  It differs from the Excimer laser in that it functions within a cornea instead of on its surface.

How does it work?  The laser's near-infrared beam is focused to within sub-micron accuracy at different depths within the clear cornea (which is only about 0.5 mm thick!).  Controlled by a proprietary software algorithm, the laser beam creates millions of microscopic bubbles at predetermined points inside the corneal substance.  These bubbles expand instantaneously and gently separate the corneal tissue at each point.

Example 1 - A cornea transplant:  The laser removes a precise profile of corneal tissue out of a damaged or diseased cornea and then precisely matches that same profile from a donor cornea.  Within micron tolerances, this donor cornea will fit exactly into the space created by the laser on the recipient.  The surgeon then attaches the new cornea to the recipient eye with microscopic sutures.

Example 2 - Refractive laser correction:  The laser creates a precisely-shaped corneal lenticule within the stroma, followed by a small 3-4 mm incision on the side of the cornea.  The shape of the lenticule is similar to a thin contact lens and its dimensions are within sub-micron tolerances of the correction required.  The surgeon then frees the lenticule and removes it through the small incision.  No sutures are required, since the tiny wound seals by itself.  This permanently changes the corneal curvature, which corrects the refractive error.

Because there is no flap, the cornea is not weakened.  The result is that it becomes possible to increase the level of correction.  Moreover, some people who  cannot wear contact lenses can now become candidates for corrective laser treatments, as there is little or no 'dry eye' symptoms afterwards.

According to trials conducted on over 1 000 patients in the UK, Germany, France and Denmark, the main advantages cited by patients are that the procedure only takes 4 to 5 minutes per eye, vision is immediately 80% better and reaches 100% within a few days.

On average, 15% of all patients who seek laser treatments have corneas that are too thin or too dry for laser treatments.  In contrast to Lasik, Refractive Lenticule Extraction (ReLEx) can in some cases help patients with thin corneas and very high prescriptions of up to -14 dioptres of myopia.

The illustration below shows the SMall Incision Lenticule Extraction (Smile) procedure graphically. 

A femtosecond laser creates a lenticule inside the cornea, which corresponds exactly to the correction required.

A femtosecond laser creates a lenticule inside the cornea, which corresponds exactly to the correction required.

The laser then creates a 4 mm incision on the side of the cornea, through which the lenticule is manually extracted.

The laser then creates a 4 mm incision on the side of the cornea, through which the lenticule is manually extracted.

Because the incision is so small, it heals quickly and the structural integrity of the cornea is largely preserved.

Because the incision is so small, it heals quickly and the structural integrity of the cornea is largely preserved.

How do you benefit?  

A survey of patients who elected to undergo this procedure for refractive vision correction show that they are very satisfied with the procedure and the results.

  • The visual outcome is similar to that seen with Lasik and Photo Refractive Keratectomy (PRK).
  • Because of the advanced all-laser procedure and small incision:
    • There is no risk of flap complications, as there is no flap.
    • The risk of infection is extremely small, since the only portal for entry of organisms is the 4  mm incision as opposed to the whole edge of the flap in Lasik and Femtosecond Lenticule Extraction (FLEx).
    • The integrity and biomechanical stability of the cornea is largely preserved, which means that your corrected vision should remain stable for many years.
    • The procedure has excellent predictability, even for high levels of myopia.  Therefore, the need for a second procedure to enhance the first is rare.
    • Because most of the corneal nerves remain intact, patients generally experience less 'dry eyes' than with Lasik.
    • It made Laser vision correction possible for some patients who would previously have been regarded as unsuitable candidates.
    • A survey of patients, who had the Smile procedure, shows very high levels of satisfaction with their overall experience and the advantages they feel the procedure offers: 
    • The unimaginable precision of the equipment.
    • The extremely good visual results.
    • The gentle treatment method.
    • The considerably more freedom without visual aids.
    • The ability to practice professions, hobbies and sport without restriction.
    • The increased personal self-confidence.
  • Smile is a relatively new procedure.  As at January 2013 there were only approximately 40 centers worldwide with the ability to do Smile procedures - Optimed being one of them.  However, surgeons who use it and patients that have received treatments are generally very happy with the results, as outlined above.
  • Because of its extremely high precision and sophistication, Femtosecond laser equipment is considerably more expensive than Excimer lasers, which affects the cost of a Smile procedure.   Many patients nevertheless regard its advantages sufficiently important to choose it instead of one of the other laser alternatives.
Zeiss Femtosecond Laser

To provide the full spectrum of laser treatment options to our patients, a Zeiss VisuMax laser and a MEL-80 excimer laser have been installed at Optimed in a configuration similar to this picture.  The VisuMax is on the left and the MEL-80 on the right.

Note that the bed, on which you recline during the treatment, can swivel between the two machines.  Without moving, you can be treated on the VisuMax, the MEL-80 or both, depending on your unique circumstances or needs.

For the more technically-minded:  The femtosecond laser derives its name from its extremely short laser pulses.  The femtosecond laser emits much shorter optical pulses than the Excimer laser, with the result that its pulse duration is measured in femtoseconds.  A femtosecond is one millionth of a nanosecond or, in mathematical terms, 10-15 second.

To illustrate these incomprehensible numbers, let's use the same argument like we did for the excimer laser.  Since light travels at 300 000 kilometers per second, it can travel only 3 microns or 0.003 millimeters in 10 femtoseconds!  That distance is much smaller than even our eyes can see. 

This is high-tech in its most amazing form - at your service!

For the even more technically-minded:  The Zeiss VisuMax femtosecond laser differs from other similar lasers in several unique ways.  To describe the differences, it is necessary to briefly trace its development.

Since femtosecond lasers were first introduced to do refractive treatments, the ultimate goal has been to create an intrastromal lenticule that can be manually removed in one piece, thereby circumventing the need for incremental removal of tissue by an Excimer laser.  Following the introduction in 2007 of the VisuMax Femtosecond Laser, the intrastromal lenticule method was introduced in an experimental procedure at the time called FLEx.  With this procedure a flap was created and lifted to allow the lenticule to be removed.

Following the successful implementation of FLEx, a new procedure known as  Smile, was developed.  With this procedure a lenticule is created within the corneal stroma and then, though a small 3-4 mm incision, the lenticular interfaces are separated followed by manual removal of the lenticule, thus eliminating the need for a flap.  The results of the first prospective trials of Smile was highly successful and there are now more than 50 laser specialists routinely performing this procedure worldwide -  Dr Potgieter being one of them.

A number of femtosecond lasers are commercially available, but the VisuMax is the only one used for an intrastromal lenticular cut.  There are six distinct design elements of the VisuMax that represent how the device was conceived from the ground up as a high-precision intracorneal lenticular cutting tool.  Central to the VisuMax mode of operation is the extremely light-touch coupling system that minimises corneal distortion and a rapid, high-precision femtosecond pulse placement to achieve sufficient 3-dimensional geometric cutting precision, such that refractive lenticules can be created accurately within the body of the stroma.

The main characteristics that distinguish the VisuMax from other femtosecond lasers are: 

  • A curved coupling contact glass which causes minimal corneal distortion.
  • The coupling suction applied to the peripheral cornea allows for a low suction force to immobilise the cornea, which also reduces tissue distortion.
  • Each contact glass is individually calibrated, based on confocal detection of radiation.
  • The optical beam path and headrest maintains a consistent position and contact glass force onto the cornea, thereby further minimising tissue distortion.
  • The high numerical aperture of the beam is designed to deliver a tight concentration of femtosecond energy with low per-pulse energy load.
  • The pulse rate of 500 000 pulses per second is 2000 times higher than that of an excimer laser, which further minimises treatment time.

The advantages of ReLEx Smile over Lasik

These new femtosecond procedures offer a number of advantages:

  • The removal of tissue is more accurate and repeatable.  All the potential errors associated with excimer laser ablation are avoided, such as stromal hydration, laser fluence projection, reflection losses and other environmental factors.  The tissue removal is only determined by the accuracy of the laser, which is not affected by environmental conditions.  Moreover, the accuracy is the same for low and high corrections.
  • Since no flap is created, Bowman's membrane and the stromal lamellae of the upper cornea remain intact, except for the small 3-4 mm incision.  The remaining cornea, therefore, has relatively more biomechanical strength and a reduced variability of the biomechanical effects produced as a result of the removal of refractive tissue by an excimer laser.
  • Since no side cut is created in the cornea, there is less strain in the cornea compared to the thin Lasik flap and a significant difference in corneal strain compared to Lasik with a thicker flap.  In practice it means that the Smile lenticule can be created at any depth within the corneal stroma.  Therefore, Smile can be used to treat a greater range of myopia than the excimer laser.
  • Smile patients generally experience less 'dry eye' than with PRK and Lasik.
  • The cornea is one of the most densely nerve-populated peripheral tissues in humans. Nerve bundles within the anterior stroma grow radially from the periphery toward the central cornea.  In Lasik, several nerve bundles are cut, with only nerves entering the flap through the hinge region being spared.  Subsequent excimer laser ablation severs stromal nerve fibre bundles.  It means that the patient may have 'dry eye' symptoms and decreased corneal sensitivity while the nerves regenerate.  With Smile, the anterior corneal anatomy is largely preserved and the anterior nerves are disrupted significantly less.  Corneal sensation recovers to the baseline level 3 months after Smile compared with 6 to 12 months after Lasik.  

Equipment used for cataract surgery

Alcon Infinity Phaco-emulsification System

Alcon Infinity Phaco-emulsification System

What is this?  The Alcon Infinity Phaco-emulsification system is an advanced, computerised and specialised system used to remove the natural lens from an eye when a patient has a cataractA cataract forms when the natural lens in the eye is, or is starting to become, opaque. If not treated, it can lead to blindness, which in most cases can be treated. See Cataract Centre – Understanding Cataracts. or needs a lens replacement.

How does it work?  The machine has an ultrasonic hand piece with a titanium or steel needle.  The tip of the needle vibrates at ultrasonic frequency to emulsify (liquidise) the cataract or damaged lens.  The liquefied particles are extracted through the tip of the probe, through a tiny, self-sealing incision of only 2.75 mm on the side of the eye.

How do you benefit?  As the lens removal procedure is very delicate and precise, this equipment ensures that the replacement lens goes into a cleanly-sculpted capsule inside your eye and that the new artificial lens implant will yield the results you would expect. 

The picture shows what the machine looks like. 

Note the foot pedal that activates the machine.

The unique benefits of using this instrument are:

  • A variety of cataracts with different densities can be removed with minimal collateral impact on the other structures within the front section of the eye.
  • This technique enables the surgeon to remove the cataract through a very small, self-sealing incision, in most cases without the need to suture the wound.  This leads to:
    • A quick recovery of vision.
    • Minimally induced (if any) astigmatism, which if present, affects vision after the procedure.
    • A smaller probability of complications like infectionsInfections may be caused by bacteria, viral or fungal agents that penetrate and affect any part of the body, including the eyes. Treatment of an infection depends on the source and nature of the agent that caused it., since the incision is smaller.

Alcon Nd:YAG Laser System

Alcon Nd: YAG Laser System

What is this?  In a small percentage of patients, after the natural lens in the eye was replaced due to the formation of a cataract or for other reasons, a scar may form in the lens capsule into which the artificial lens was inserted, leading to a 'secondary cataract'.  In addition to other uses, the YAG laser is used to remove such scars.

How does it work?  This precision laser works like microscopic scissors – it can accurately 'snip' through the scar at the back of the capsule to create an aperture in the capsule to allow light to enter the eye again without the need to formally operate on the eye.  The entire process is done through the pupil of the eye and, because of the almost infrared wavelength of the laser, you will not even be aware that it is happening.

How do you benefit?  The procedure to remove such a scar is quick, painless and inexpensive.  The machine is also used to treat certain forms of glaucoma and other non-invasive surgical procedures.

The above picture shows an Alcon YAG laser.

For the technically-minded:  The unusual name of this instrument, Nd: YAG is an abbreviation of the words Neodymium-doped Yttrium Aluminium Garnet, which is the name of the crystal used in the solid-state laser.

Holladay IOL Consultant

What is this?  If you should need a lens implant, the Holladay IOL Consultant software programme assists the ophthalmologist with standard and advanced intra-ocular lensAn intra-ocular lens is an artificial lens that is implanted into the eye to either correct severe refractive errors, or to replace an opacified natural lens (cataract) during a cataract procedure. See Cataract Centre - Intra-ocular Lens Options. calculations, as well as the tracking and analysis of the state of your eye afterwards.  The Holladay IOL Consultant was the first of the so-called 'fourth generation' calculation formulas, developed by Dr Jack Holladay from Houston, Texas, a personal friend of Dr Potgieter.  It is a 'smart' database programme that automatically minimises the surgeon's prediction error for intraocular lens power calculations each time results are entered after a procedure.

How does it work?  The programme calculates the implant power for up to 4 different lens options for your eye that the ophthalmologist can select.  It also generates appropriate warnings for conditions that may require the attention of the surgeon before the procedure takes place.

How do you benefit?  The Holladay Consultant has an extremely high predictive value in lens calculations and assists the ophthalmologist to select a lens with the correct strength and other vital characteristics to be implanted into your eye, thereby ensuring the best possible outcome – excellent uncorrected vision after the operation.

Zeiss IOL Master

Zeiss  IOL Master

What is this? The Zeiss IOL Master is used in preparation for cataract surgery. It measures the axial lengthAxial length is the distance between the front surface (cornea) and the area for sharp vision (macula) at the back of the eye, expressed in millimetres (mm). It is measured by ultrasonography or partial coherence interferometry. At birth, the axial length is approximately 17mm and reaches approximately 24mm in adulthood. In people who are shortsighted, the axial length is longer and in farsighted people shorter than 24mm. Each 1mm change in the axial length corresponds to a spectacle power change of approximately 2.50 dioptres. of the eye, keratometryKeratometry is the measurement of the curvature of the cornea to determine its power. and anterior chamber depthAnterior Chamber depth is measured from the innermost layer of the cornea (endothelium) to the iris. The normal depth is between 2.50 and 3.50mm..

How does it work? This machine is a non-contact optical device, which measures the distance from the corneal vertexCorneal vertex is the point located at the intersection of the patient's line of sight (visual axis) and the corneal surface. to the retinal pigment epitheliumRetinal pigment epithelium (RPE) is the pigmented cell layer just outside the neurosensory part of the retina. This specialized tissue has numerous functions, including the nourishment and maintenance of the retinal visual cells. See Info on Eyes – Anatomy. by partial coherence interferometry. The IOL Master is consistently accurate to within ± 0.02 mm or better. It is calibrated against the ultra-high resolution 40-MHz Grieshaber Biometric System, an internal algorithm which approximates the distance to the vitreo-retinal interfaceThe vitreo-retinal interface is the plane at the outermost extremity of the vitreous where the vitreous is in contact with the retina., for the equivalent of an immersion A-scan ultrasonicAn A-scan ultrasound is an instrument that uses ultrasound to measure various structures of the eye. axial length.

How do you benefit? During cataract surgery, the opaque or cloudy natural lens in the eye is replaced with a clear artificial intra-ocular lens (IOL), which improves the vision of a patient afterwards. IOLs come in different powers and sizes to compensate for each patient's individual needs. For the best vision after cataract surgery, precise measurements need to be taken to determine which IOL to implant.

The IOL Master is a high-precision instrument, which has revolutionized all previous techniques and has set a new standard for IOL power calculations. This new technology has substantially improved our ability to calculate IOL powers with even greater accuracy than before. This helps our cataract patients to attain even better focused vision, with minimal dependence upon glasses, due to the improved accuracy of the lens calculations. We are thus able to make a better decision when choosing the ideal implant for each patient's eye.

Equipment used for the diagnosis and treatment of glaucoma

Heidelberg Spectralis

Heidelberg  Spectralis

What is this?  Optical Coherence Tomography (OCT) is an optical signal acquisition and processing methodology.  The Spectralis system is a state-of-the-art diagnostic tool to obtain detailed images of the cornea, anterior segment (iris, lens and drainage angle) as well as inside the eye from the retina and deeper structures.

How does it work?  The OCT system captures 3-dimensional images of the inside of the eye with submicron-accuracy, using an interferometric technique that works with near-infrared light.  The system measures the echoed time delays of a reflected laser beam.  While the beam scans, it generates a cross-sectional image of the eye, which is displayed on a screen, or printed in colour.

The green and red imaging lasers for FA and ICG imaging, as well as the blue peak laser for auto fluorescence, are synchronized with the OCT.  It is, therefore, possible to combine all the imaging data acquired into one 3-dimensional model.  This provides the ophthalmologist with a comprehensive analysis, which is unique to the Spectralis.

How do you benefit?  Within a few seconds the ophthalmologist can get detailed, multi-dimensional images of the inside of your eye, which clearly shows the state of your eye and any problem areas there may be.  It helps the specialist to accurately diagnose any problems and design a custom treatment for your particular condition.

This high-tech instrument from Heidelberg Technologies in Germany is at the forefront of modern imaging technology within the field of ophthalmology.  It consists of 4 separate modules, integrated into one compact instrument.

The 4 different components are:

  • OCT.
  • A green dye laser for fluorescein angiography.
  • An infra-red laser for indocyanine-green angiography.
  • A blue laser for capturing auto fluorescence images.

Fluorescein angiography (FA) is used to display pathology of the iris, as well as the retina and choroid, with the emphasis on retinal pathology.

Indocyanine angiography (ICG) supplements fluorescein angiography to study the choroid (the vascular layer beneath the retina).

Between the retina and the choroid, a single layer of cells, the retinal pigment epithelium (RPE) and 'Bruch's membrane' forms a barrier between the two.  This is where a variety of pathologies often have their origin.  The “Blue Peak” Auto Fluorescence ability of the Spectralis enables the eye specialist to diagnose problems in this layer before they are clinically evident during a routine eye examination.

Since the early 1990s, OCT has revolutionised the way retinal and glaucoma problems are diagnosed, as it is a very accurate diagnostic tool for glaucoma, cataracts, anterior segment, corneal- and retinal diseases.

Humphrey Field Analyser

Zeiss Humphreys Field Analyser

What is this?  The Humphrey Field Analyser is used for the diagnosis and management of glaucoma as well as neuro-pathology affecting the visual system.

How does it work?  The machine utilises a series of light flashes of varying intensity, which is presented at different positions within your visual field.  The routine of flashes is computer controlled.  The patient fixates into the machine and has to record each flash of light seen by pressing a hand-held button.  The software of the machine then compares the patient response to a normalised database and determines visual field defects.

How do you benefit?  A visual field analysis forms one of the principal diagnostic criteria for the diagnosis and management of glaucoma, as well as other neurological diseases that affect vision.  The Humphreys Field Analyser is the global gold standard in visual field analysis, with the most comprehensive database to detect visual defects.

Equipment used for the diagnosis of retinal problems

Heidelberg Spectralis

Heidelberg  Spectralis

What is this?  Optical Coherence Tomography (OCT) is an optical signal acquisition and processing methodology.  The Spectralis system is a state-of-the-art diagnostic tool to obtain detailed images of the cornea, anterior segment (iris, lens and drainage angle) as well as inside the eye from the retina and deeper structures.

How does it work?  The OCT system captures 3-dimensional images of the inside of the eye with submicron-accuracy, using an interferometric technique that works with near-infrared light.  The system measures the echoed time delays of a reflected laser beam.  While the beam scans, it generates a cross-sectional image of the eye, which is displayed on a screen, or printed in colour.

The green and red imaging lasers for FA and ICG imaging, as well as the blue peak laser for auto fluorescence, are synchronized with the OCT.  It is, therefore, possible to combine all the imaging data acquired into one 3-dimensional model.  This provides the ophthalmologist with a comprehensive analysis, which is unique to the Spectralis.

How do you benefit?  Within a few seconds the ophthalmologist can get detailed, multi-dimensional images of the inside of your eye, which clearly shows the state of your eye and any problem areas there may be.  It helps the specialist to accurately diagnose any problems and design a custom treatment for your particular condition.

This high-tech instrument from Heidelberg Technologies in Germany is at the forefront of modern imaging technology within the field of ophthalmology.  It consists of 4 separate modules, integrated into one compact instrument.

The 4 different components are:

  • OCT.
  • A green dye laser for fluorescein angiography.
  • An infra-red laser for indocyanine-green angiography.
  • A blue laser for capturing auto fluorescence images.

Fluorescein angiography (FA) is used to display pathology of the iris, as well as the retina and choroid, with the emphasis on retinal pathology.

Indocyanine angiography (ICG) supplements fluorescein angiography to study the choroid (the vascular layer beneath the retina).

Between the retina and the choroid, a single layer of cells, the retinal pigment epithelium (RPE) and 'Bruch's membrane' forms a barrier between the two.  This is where a variety of pathologies often have their origin.  The “Blue Peak” Auto Fluorescence ability of the Spectralis enables the eye specialist to diagnose problems in this layer before they are clinically evident during a routine eye examination.

Since the early 1990s, OCT has revolutionised the way retinal and glaucoma problems are diagnosed, as it is a very accurate diagnostic tool for glaucoma, cataracts, anterior segment, corneal- and retinal diseases.