Frequent questions

You can answer some questions by consulting our list of frequently asked questions at the administrative and surgical level below:

ADMINISTRATIVE QUESTIONS

No, in the Clinic we do not attend by EPS, since we are a private entity that does not handle agreements with any EPS.

At the Clinic, we take care of patients through the consultation scheme: Agreements that include Prepaid Medicines with whom the contract is in force.

All surgeries, if the patient’s contract with his Pre-paid is not qualified as a pre-existence.

The Pre-paid do NOT cover surgery for correction such as myopia, farsightedness or astigmatism since it is classified as cosmetic surgery.

When requesting the appointment through any of the channels, it must be informed that it is desired that it be covered by the Pre-paid, and the identification number and the contract number of the Pre-paid must be left in order to request authorization and Tell us what percentage of the payment the patient should cover.

The main difference between the two types of appointment is in the Ophthalmological consultation: in the Appointment by private the assessment is carried out by the specialists directly, in the institutional appointment the ophthalmological consultation is performed by the resident doctors under the supervision of the Specialists.

The institutional care model is based on comprehensive consultation. You as a private patient can request a consultation with the ophthalmologist or only with the optometrist. In the Barraquer Clinic as an ophthalmological center, to give the patient more specialized care, they work in teams. Ophthalmologists are responsible for the ocular well-being of patients and need to know how vision is before and after any treatment, whether surgical or clinical.

No, the value of the consultations does not vary depending on the doctor who attends the query, the rates are the same for everyone.

SURGICAL QUESTIONS

REFRACTIVE DEFECTS

The word LASER means: Light Amplification by Stimulated Emission of Radiation.

The word Excimer means: Excited dimers of inert gases.

The laser equipment is an instrument capable of producing and controlling a coherent beam of light. Laser light can be directed, focused and controlled more precisely than normal light and can be generated in very short and intense pulses. Each pulse extracts a microscopic proportion of tissue, evaporating it with very low heat release, leaving the underlying tissue without injury. The laser most frequently used in corneal surgery is the Excimer Argon fluoride laser that emits at 193 nm. Its mechanism of action is photochemical.

It is not a surgical technique but a magnitude of correction. One eye is usually corrected for distant vision and the other for near vision.

When the person reaches the age of 40, must decide according to the professional life or the activity what prefers; good distance vision or good near vision, the monovision represents an intermediate possibility.

Yes, there are several brands in Excimer laser equipment and with different stages of development between them. In general, for routine procedures most of these machines are suitable; But with any of them the experience of the surgeon is a very important factor.

The correction of refractive defects can be done in 3 ways:

Glasses, Contact Lenses or Refractive Surgery; therefore, the operation is one of the treatment alternatives and can be carried out in all people who want it, as long as it is a healthy eye.

For this reason, before operating, specialized tests are performed that allow the ophthalmologist to determine that the case is appropriate, and the patient is suitable for surgery.

Those who have corneal deformations, who have suffered inflammatory diseases of the eyeball, who are being treated for chronic diseases such as Glaucoma or who have had severe tear secretion disorders, do not meet the first requirement of refractive surgery, “Eye Healthy”.

As always, there are exceptions in which the surgeon may advise the intervention despite the risks, agreeing with the person concerned.

All surgery is susceptible to complications during the procedure or in the postoperative period. In laminar refractive surgery (LASIK), since it is an extraocular surgery, the risks of a complication are limited to the superficial layers of the cornea and any inappropriate result can be corrected with one or several complementary surgeries.

The predictability of the result at present is above 85% depending on the defect and the technique used for the correction; There is therefore the possibility of requiring a touch up to obtain the desired correction.

Intraocular refractive surgery, such as phakic lenses, may have other complications that must be clearly explained by your ophthalmologist.

During the postoperative period, it is important to strictly follow the medical instructions even if your vision is good and you do not feel any discomfort.

Refractive surgery does not work miracles and your maximum corrected vision will be equal to preoperative or slightly better. The difference is seen in vision without glasses. Usually, postoperative vision allows the person to live a normal life without the need to wear glasses.

Current algorithms of the Excimer laser always make the total correction of the refractive defect, both for myopia and for farsightedness. Therefore, astigmatism, whether myopic or hypermetropia, will be corrected in the same intervention. It is important to know, however, that astigmatism is the most difficult defect to correct in its entirety and it is very common that a small remnant remains.

There are technical expenses that must be covered, but usually the cost of a reoperation does not entail fees.

These surgeries must be performed by ophthalmologists specializing in anterior segment and cornea, with experience in refractive surgery techniques. Not all ophthalmologists are trained for it. The ideal place to perform it is a medical center that has the usual requirements of a surgery room in terms of hygiene and sterility to avoid complications.

CATARACTS

It is an opaque area in the lens of the eye. A normal lens as the name implies, is transparent, allows light to pass to the retina and is the lens that allows us to focus.

A cataract prevents free entry of light and as it opacifies, the person has difficulty seeing.

It is a normal evolution of aging. Approximately 50% of people between 65 and 75 years old and 70% of people over 75 have a cataract.

In general, it appears in both eyes simultaneously, however, one eye may have less vision than the other because they can evolve with different density.

  •   Blurred, cloudy, blurred vision
  •   Changes in color vision
  •   Difficulty driving at night due to glare with lights
  •   More glare in the sun
  •   Frequent glasses prescription changes
  •   Double image vision
  •   Improvement of near vision.

At first, a change of glasses, better reading lighting, or the use of magnifying glasses may be enough.

Having a cataract does not involve immediate surgery, with some exceptions, it can be operated when the patient feels uncomfortable with decreased vision.

Surgical treatment involves removing the opaque lens and replacing it with an artificial intra-ocular lens.

Your Ophthalmologist will tell you when surgery is necessary, only a small number of people require surgery. There are exceptions such as vitreous and retinal diseases, which require surgery to be treated.

Your doctor cannot make the decision for you but talking with him can help you decide. Most people can take a long time to decide on surgery.

  •     Observe the visual discomfort you have and check with your doctor.
  •     I need to drive my car, but I dazzle a lot with the sun or the lights of other cars.
  •     I don’t see well to do routine things in my house.
  •     I do not see well to do the things that I like (Ex. play cards, read, watch TV., Sew, go out with friends).
  •     I am afraid of falling or hitting myself when walking.
  •     Due to my cataract, I have lost my independence.
  •     My glasses don’t help me see enough.
  •     My vision bothers me a lot.

Most people do not need to spend the night in the Clinic after cataract surgery, you can go home when the doctor tells you that you can do it. However, you will need a family member or friend to accompany you to your home and someone who stays with you for at least a day or two to help you with the postoperative care instructions.

Complete recovery of the eye takes a few months; The ophthalmologist should monitor your progress until you recover completely.

There are 3 ways or techniques for surgery:

  • Phacoemulsification surgery: the surgeon fractures or softens the cataract inside the eye with the help of ultrasound and then aspirates, leaving the lens capsule. It is the technique that allows faster vision recovery.
  • Extracapsular surgery: the surgeon removes the entire cataract, leaving the posterior capsule. A large incision is required for extraction.
  • Intracapsular surgery: the surgeon removes the cataract completely, that is, the capsule and the nucleus. A large incision is required for extraction. This technique is done very rarely.

When performing cataract surgery, the lens is usually replaced with an artificial lens inside the capsule, other alternatives to focus on are contact lenses or glasses.

Your doctor can explain and indicate what method you are going to require.

No, the cataract cannot be reproduced however, in 50% of people the posterior capsule that is left with extracapsular or phacoemulsification techniques can become opacified over time. The opacity of the posterior capsule when it occurs, is observed approximately after 6 months of surgery or even later and causes decreased vision.

The treatment is a procedure known as “Capsulotomy with Yag ” which involves making a small hole in the capsule with the help of a light beam (laser) to allow light to freely enter the eye. It does not require hospitalization.

Most people have better vision after capsulotomy, but there may be complications.

  • Increased eye pressure
  • Hemorrhage inside the eye
  • Infection
  • Damage or displacement of the artificial lens
  • Eyelid droop
  • Detached retina
  • Edema and opacity of the cornea
  • Blindness
  • Loss of the eyeball

GLAUCOMA

The aqueous humor occurs in the ciliary body and is eliminated through the trabecular meshwork and the uveoscleral route ; In addition to having nutritional properties, it is responsible for maintaining an adequate tone within the eye and for this to happen, it is required that there be balance between the amount of liquid that is produced and the amount of liquid that is removed.

When there is interference somewhere along the path that such humor must travel, it accumulates, evacuating itself in a smaller amount, thus producing an increase in intraocular pressure and consequently, an increase in the excavation of the optic nerve, due to damage of its fibers, which will lead the individual to a loss of the visual field, which begins at the periphery and as it progresses, reduces it concentrically, taking it slowly, to have limited vision in front, what is known as tubular vision, being able to reach to irreversible blindness, if not timely controlled.

KERATOCONUS

There are currently several therapeutic possibilities for the medical management of corneal Ectasias, which allow postponing the need for corneal grafting. In some cases, you can achieve good vision with glasses, but usually the Contact Lenses are more suitable.

Within the surgical procedures there are the Intracorneal Segments that can be placed in cases of small Keratoconus with refractive defect that does not exceed 8 diopters. Their visual results are unpredictable, but some patients gain vision without correction.

Intraocular Phakic Lenses can be placed which allow the correction of any type of refractive defect and visual recovery is very satisfactory without modifying the shape of the cornea.

The cornea graft is the treatment of choice when the keratoconus due to its size and deformation does not allow obtaining good vision with any other procedure.

A treatment is being initiated to increase the cross-linking of the collagen in the cornea and thus reinforce it; Corneal reinforcement or Crosslinking   consists in the application of ultraviolet light associated with Riboflavin. It is a procedure that is performed on the corneal surface under topical anesthesia and on which there is still no information on the long-term results.

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