Since when do you use the LASIK technique in your clinic?
The laser we have at the Health Center of Pilar is very new, acquired earlier this year. However, in the Autonomous Community of the Basque Country this technique began to be applied 7 years ago, specifically in Bilbao.
What type of patient undergoes a laser operation?
The first condition to meet is to have a stabilized defect refractory, which occurs around age 18, although I prefer to wait until age 25. Most patients are myopic from 25 to 40 years, but increasingly we treat hyperopia and astigmatism. With the previous lasers could not be corrected well, but with the new laser we have we are getting very good results.
Is it possible to receive these laser treatments at Osakidetza?
No, not in principle. Osakidetza believes that these types of interventions are aesthetic surgeries, so they are not included in their services. Anyone who wants to correct refractive errors by laser must go to private centers. However, the Excimer laser is also used to cure some diseases of the cornea, which in some cases can be treated in Osakidetza. But never to remove the diopters.
Recently it is news that the official US commission FDA has approved the first Excimer laser. But LASIK has spent almost 10 years in practice both there and in many other places. Is it not a big contradiction?
Yes and no. There are great economic interests around the FDA, according to which one laser or another will be approved, which does not mean that this laser is the best or safest on the market. I am quite critical of the FDA. Control is absolutely necessary, I agree, but in recent years the FDA has become a great barrier to research and technological development in the United States, at least in the field of ophthalmology, and that is not good either.
What is the safety level of the LASIK technique?
LASIK is a very safe technique. All steps of the intervention are computer-controlled and extremely mechanical; the surgeon's intervention is minimal. But what I want to make clear is that this is an operation and, therefore, it has risks, I can not offer the patient a 100% safety level because I would have lied. The risk in medicine is never 0%.
There are many people who come to the North to carry out this type of operations. There seems to be more experience there. Is the North a reference for the South?
No, the results we get here are as good or better than ours. In the south we started working with lasers in Bilbao in 1993, but in San Juan de Luz the first laser was installed before in Donostia, so many people from Gipuzkoa take the north as a reference. But today the laser we have is better than that in San Juan de Luz, just because it is newer. In fact, in this field technology is also developing very quickly.
Is there laser treatment for presbyopia?
No, there is currently no adequate technique that can correct presbyopia. There are three techniques, very experimental, that still do not have good results. That's why we don't use them.
LASIK is an expensive patient treatment. How much does the laser device cost?
A lot. The existing laser devices on the market exceed 50-60 million euros and at this cost we must add maintenance. On the other hand, technological innovations are constantly appearing and we have to buy them because the quality of the service we offer depends almost exclusively on technology. The better the laser, the better results we get.