It corrects visual defects less and less invasively, quickly and accurately. The new laser made in Germany active at Humanitas Ophthalmic Centre chases eye movements in 7 dimensions and predicts exactly, thanks to a supercomputer, where it will be when it is hit by the beam of light. A scientific study also reveals the biological mechanisms of corneal repair, predicting how it will react to laser correction over the years.
It allows the correction of visual defects – myopia, astigmatism, hypermetropia – in an increasingly precise, fast and less invasive way, preserving the cornea as much as possible (saving tissue). It is the laser “that sees the future”, active at Humanitas Ophthalmic Centre.
“This laser is equipped with an innovative system of “tracking” in 7 dimensions – explains Dr. Paolo Vinciguerra, Director of Humanitas Ophthalmology Centro – and combines the speed of execution with the ability to achieve the visual correction programmed before the operation exactly during surgery”.
It is the fastest of the 193 nanometer wavelength excimer lasers – the most common. “During the operation – continues Dr. Vinciguerra – it is able to take into account not only the possible involuntary movements of the eye on all reference planes (right, left, high, low, forward, backward and circular and angular movements), but also to predict, through sophisticated calculations, where the eye will be when it is struck by the laser”. For extremely precise operations: a latest-generation computer makes the laser capable of making 1.6 billion calculations per second.
This laser, made by the German company Schwind, also has a system of CROT (Coherent Radiation Optical Tomography) that allows you to obtain images of the eye at very high resolution and to measure the cornea with extreme precision (one micron) both in the preliminary stages of surgery and during surgery. In this way it is possible to constantly check and verify, in real time in the operating room, the course of the operation, i.e. the work that the laser does on the cornea and the exact thickness of the cornea and of the covering tissue of the eye (epithelium), favoring a less painful and faster post-operative recovery. This precision also allows alternative treatments to corneal transplantation.
Study reveals corneal reaction mechanisms
Humanitas Ophthalmology Center combines the latest technology of this laser with the experience of professionals, who have always been able to innovate in the field of refractive surgery. A study published in the scientific journal Journal of Refractive Surgery, conducted by Dr. Vinciguerra and his team, reveals the mechanisms of action of the cornea and allows us to predict, based on mathematical formulas, how the cornea changes, from the biological point of view, after the action of the laser.
“Before – explains Dr. Vinciguerra – we relied on the so-called normograms, i.e. we compared the expectations of laser correction with the real post-operation result empirically. Today, however, our studies have clarified the biological mechanisms of the laser reaction of the cornea: in this way, by applying extremely complex mathematical formulas, we can predict with a scientific method how the cornea will respond, from the biological point of view, to the correction made by the laser, thus affecting the quality of vision of the patient”.
A super-specialist center in the heart of the hospital
The new laser(2) is one of the spearheads of the Ophthalmic Centre of Humanitas, super-specialist and completely dedicated to vision problems, in the heart of the polyclinic: a team of 40 professionals, 21 of whom are specialists; 7 pathology courses; 20 surgeries and operating theatres dedicated to microsurgery; innovative techniques and cutting-edge technologies to manage over 200 patients per day from all over Italy and abroad.
In 18 years of activity, the Centre has carried out over 14,000 interventions, produced 91 scientific publications, written 50 chapters of scientific books and 2 books, and registered 8 patents. The Centre is directed by Dr. Paolo Vinciguerra, a pioneer of refractive surgery: one of the first in Italy to perform laser operations to correct visual defects (since 1989), he was the scientific organizer of the first Italian congress focused on the excimer laser with live surgery.
1] Corneal Curvature Gradient Map: A New Corneal Topography Map to Predict the Corneal Healing Process
Paolo Vinciguerra, MD; Cynthia J. Roberts, PhD; Elena Albé, MD; Mario R. Roman, MD, PhD; Ashraf Mahmoud, BS; Silvia Trazza, Orth; Riccardo Vinciguerra, MD
2] The benefit scheme is guided by regional regulations, which punctually establish the conditions for payment by the SSR. All other information is subject to the private system only.