Demystifying laser eye surgery | Dr Frikkie Hartog


Demystifying laser eye surgery

Many lasers are used in eye surgery, but we are specifically going to talk about the excimer laser used for refractive surgery.  Refractive eye surgery is a process where the laser is used to change the shape of the cornea (the front clear membrane of the eye) to enable a person to gain excellent vision without the need for spectacles or contact lenses.

The first laser eye surgery was performed as far back as 1990 and the technology, accuracy and safety have improved vastly since. Laser eye surgery is the most commonly used procedure to correct myopia (nearsightedness), hypermetropia (farsightedness) as well as astigmatism (the front of the eye is shaped like a rugby ball). It is a safe and predictable procedure that leads to satisfactory outcomes for the patient and the surgeon.

The excimer laser is used to accurately change the shape of the cornea.The procedure can essentially be done in one of two ways. The first is where the treatment is done on the surface of the cornea. This is referred to as PRK. The second is where a thin flap (essentially a very thin superficial shave) is made and the laser treatment performed underneath this flap. This is referred to as LASIK. The choice between these are sometimes a personal choice for the patient after he or she was fully informed, but sometimes the choice will be made by the surgeon after a thorough examination.

The most commonly performed procedure is LASIK, where a thin flap is made, due to the fast healing and comfort associated with the procedure. When the treatment is performed on the surface (PRK), the visual result is exactly the same as that of LASIK, but there is some discomfort that last for approximately two days, and the vision recovers slower. The discomfort is addressed with a bandage contact lens, drops that numb the eye as well as pain relieving tablets. The patient can see well after PRK without the need for spectacles or contact lenses, but the patient will experience a halo around the edge of objects. These halos improve daily and the image sharpness improves very quickly.

Dr. Frikkie Hartog uses the latest technology in the Wavelight laser system. The vast improvement in software translates to major advantages for both the patient and the doctor. Very accurate measurements are taken of each individual eye to be treated, providing the surgeon with a magnitude of information. The advantage to the patient is the fact that customised treatment is performed i.e. the treatment is customised not only to every patient, but also each individual eye. Our eyes are not perfectly round and smooth surfaces but actually have many imperfections, and these imperfections are treated with customised ablation. With a topography guided treatment all the superficial irregularities of the cornea is smoothed out to provide an optimal surface to provide excellent vision. The most commonly performed procedure however is wavefront optimised treatments where the focusing power and imperfections of the  eye as a whole is optimised to establish sharp focusing vision in all conditions without any need for spectacles.

 Laser surgery comprises two components: the preparation of the cornea and the laser treatment itself. The preparation of the cornea will differ according to the choice of procedure (whether PRK, LASIK or a small variation i.e. LASEK or epi-LASIK), but the laser treatment is identical in all procedures. The patient will lie down on a comfortable bed with a small  block above his face. The duration of the laser treatment itself will only be around 30 seconds and during the treatment the patient will look straight at a blinking green light. The laser system uses an eye tracker to compensate for any eye movement dramatically improving the accuracy of the treatment.



The visual recovery and improvement can be appreciated within a few hours after LASIK surgery and approximately two days after PRK procedures. Topical drops are used for two weeks after the procedures. The follow-up examinations at the practice will be after one or two days, one week and one month. The patient might experience some further improvement in his or her vision up to one month after the procedure and he or she can expect longterm happiness with their newfound excellent vision.

Dr. Frikkie Hartog

Dr. Frikkie Hartog is an ophthalmic surgeon specializing in cataract and laser refractive surgery. The aim of all types of refractive surgery is to rid a patient of his spectacle or contact lens dependence. Dr Frikkie Hartog has a special interest in affording his patients the best possible results using the latest and safest technology. It is also essential to balance the increasing cost of these technologies with the financial expectation of your patients. Dr.Frikkie Hartog studied at the University of Stellenbosch and acquired his MMed Opth as well as FC Ophth degree in 2004. He has been performing cataract surgery since 2000 and laser surgery since 2005, and he has an excellent safety and success record. Frequent attendance of not only local but also overseas specialist congresses forms part of a continued learning interest. Dr. Frikkie Hartog is an avid cyclist and loves reading and spending time with his family.