Break free from glasses with Flow 2.0 laser eye surgery in Tallinn & Tartu

Laser eye surgery candidates
The aim of the initial eye exam is to find out whether or not You are a suitable candidate for laser eye surgery, but You should know certain criteria before the first appointment. In case You have any questions, please don't hesitate to ask the specialists at KSA Vision Clinic for an explanation.

You are a suitable candidate for laser procedure at KSA Vision Clinic when You meet the following requirements:

• At the age of 18–45 years – the best age for a laser procedure is between 20 and 40 years of age
• A stable refractive error – i.e. a change of less than 0.5 dioptres in the previous year
• Glasses between -1 and -9 dioptres – KSA Vision Clinic is specialized in treating short-sightedness
• Generally healthy eyes
• Good overall health
• Positive attitude

Certain conditions may question your suitability, involve additional risks or cause complications. These conditions may impair the healing process and require additional treatment. KSA Vision Clinic provides a thorough initial examination to find out whether or not you are a suitable candidate for laser surgery.

You are not a suitable candidate for laser procedure in the following cases:

• You have had to change the prescription of your contact lenses or glasses by more than 0.5 dioptres during the past year
• You are suffering from a disease or taking medications that may affect the healing of wounds. Certain conditions, such as autoimmune diseases (lupus, rheumatoid arthritis), immunodeficiency conditions (HIV infection) and diabetes and some medications (such as retinoic acid and steroids) may hinder proper recovery after refractive surgery

With certain patients refractive instability is more likely to occur. Thus laser procedure is probably not suitable for them. This group includes patients

• who are in their early twenties or younger
• whose hormonal level is unstable due to illnesses, such as diabetes
• who are pregnant or breastfeeding
• who take medications that cause visual disturbance

Precautions
The safety and efficiency of refractive surgery on patients with certain illnesses have not been proved. Be sure to let Dr. Haavel know if you take medications or are suffering or have suffered from any of the following diseases:

• herpes simplex or herpes zoster (shingles) in the eye area
• glaucoma, suspicion of glaucoma or increased eye pressure
• eye conditions such as uveitis or iritis (eye inflammations)
• eye traumas or previous eye surgeries
• keratoconus
• Other risk factors

In case of the conditions described below or circumstances increasing the risk of complications, you will need an additional medical examination prior to your laser eye surgery.

• Blefaritis. Inflammation of the eyelids, accompanied by scales on the eyelid that may increase the risk of corneal infection of inflammation after the refractive surgery.
• Large pupils. Young patients and patients who take certain medications run a high risk of large pupils in dim light. After the surgery, this may cause symptoms such as glowing, halos, starbursts and shadows behind objects (double vision). For example, the patient may not be able to drive a car at night or under certain weather conditions, such as fog. The size of Your pupils is measured by an optometrist at KSA during the initial examination.
• Thin cornea. The cornea is the thin transparent cover of the eye above the colored part of the eye, i.e. iris. Refractive surgery on a cornea that is too thin may cause loss of vision. The thickness of the cornea is also measured by the optometrist during the examination.
• Previous refractive surgery. Performing additional refractive procedures may not be recommended. The decision in favor of an additional refractive surgical procedure has to be made together with Dr. Haavel after careful consideration of the relevant circumstances.

In order to find out if you're a suitable candidate for Flow 2.0 come to the examination!

Common vision errors treated at KSA vision clinic

What is refraction?
The cornea is the part of the eye that helps focus light rays to allow sharp and focused images to appear on the retina (in the back of the eye). It functions much like camera lens that focuses entering light rays to create an image on the film. The bending and focusing of the light is called refraction.

What is a refractive error?
With normal vision the eye refracts the light, making it focus in the right point on the retina. But several people do not have a perfect curvature of the cornea and the image that appears on the retina is out of focus (blurred) or distorted. These light focusing errors are called refractive errors.

What are the primary refractive errors?
There are three types of primary refractive errors: myopia, hyperopia and astigmatism. For people with myopia or near-sightedness it is more difficult to see distant objects clearly than to see object located nearby clearly. For people with hyperopia or farsightedness, seeing nearby objects clearly is more difficult than viewing distant ones. Astigmatism is a distortion of the image that appears on the retina due to irregular curvature of the cornea or the lens. People with a vision error usually have a combination of myopia and astigmatism or hyperopia and astigmatism.

How can refractive errors be corrected?
Glasses or contact lenses have been developed to compensate for the deficiencies in the eye function. The focusing of the eye can also be improved by a surgical procedure. Such surgery is called refractive surgery. KSA performs one type of eye surgery: Flow no-contact no-cut laser eye surgery. With this method, a small amount of tissue is removed from the cornea with a special laser and the cornea is then reshaped to improve eye focusing.

Procedure itself is quick and comfortable

Before the operation both eyes will be thoroughly checked and measured with diagnostic devices designed especially for this purpose.

Directly before the laser procedure, eye surgeon checks the results obtained from the exam and measures the vision once again. The results will be entered into a software program that plans the laser procedures. Based on this data, the technology will determine the area treated by laser, its accurate location on the eye and the profile necessary for changing the shape of the cornea of the eye. Contemporary laser technology is highly accurate and the thickness of the polished layer will be calculated with micrometre accuracy.

Unlike LASIK, FemtoLasik or Smile laser procedure, FLOW 2.0 will not make cuts into your cornea. Laser beams will only polish your corneal surface, which eliminates a lot of risks and complications that old procedures may have had.

Flow 2.0 laser procedure is comfortable for the patient and the visual acuity is 60–80 % on the chart only seconds after procedure. This is enough for walking or travelling alone, but not for driving in the first five days. After the procedure, eyes will be protected with ultra-thin contact lenses that transmit oxygen and promote comfortable and quick recovery of eyes. The contact lenses will be removed in 6–7 days.

After the procedure, visual acuity will be good enough to safely travel around, and the day the protective contact lenses will be removed, your visual acuity will be good enough to continue your active lifestyle. Usually 100 % vision acuity will come within a few weeks and the maxium visual acuity within 2–3 months.

The Flow 2.0 laser vision correction procedure is performed by the highly experienced and respected ophthalmologist Ants Haavel. The Flow 2.0 laser procedure is performed at the KSA Eye Centre Tallinn.

Flow 2.0 now includes SmartSurfACE and SmartPulse technologies

Flow is a no-touch, superficial surgical procedure that is performed fully by Schwind Amaris 1050RS laser without cutting the eye. Recovery from the procedure is natural, smooth and you can return to your active lifestyle in no time.

In January 2016, KSA Vision Clinic upgraded Flow 2.0 procedure with SmartSurfACE and SmartPulse technologies, which are developed by Schwind EyeTech company. Those are the latest and most advanced technologies in the field of refractive surgery. Since May 2019 procedures were performed with the newest model of Scwhind Amaris 1050RS. The Schwind Amaris 1050RS is the world’s highest-performance eye laser system for refractive and therapeutic corneal surgery. It brings together the most advanced technology in existence.

Since January 2022 procedures are performed with the newest model of Scwhind Amaris 1050RS. The Schwind Amaris 1050RS is the world’s highest-performance eye laser system for refractive and therapeutic corneal surgery. Eye laser procedures have never been as safe as they are today, in 2023.

KSA Vision Clinic is dedicated to providing the latest treatments to all of their vision correction patients from Estonia, Finland, Russia and Europe. In addition to providing advanced surgical treatment, KSA Vision Clinic also offers round-the-clock consultation service, so our patients can get help and support whenever they need it.

Why to choose Flow 2.0 eye procedure
KSA Vision Clinic has done over 30,000 laser procedures and over 200,000 eye examinations. We have corrected nearsightedness with two procedures - LASIK and a no-cut method called Flow. In fact, during the years 2007-2009 KSA Vision Clinic did the most LASIK procedures in the Baltic states, but in 2011 we decided to specialize in no-cut laser procedures.

What kind of advantages did we see?
First of all, no-cut procedures are gentler to the cornea. After we quit doing LASIK procedures in 2010, we have not seen any classic dry eye cases, which were common in people whose eyes had been cut during the laser procedure. Mostly it affected females who worked in an office or used air conditioning in their car. Although temporary eye dryness may also occur after the no-cut procedure, it is much milder and affects the eyes usually in the mornings after waking up. During the day the vision quality is sharp and eyes feel comfortable.

Secondly, after having done thousands of procedures we can say that no-cut procedures do not cause ectasia or keratoconus in the whole cornea. Ectasia and keratoconus affect 90 % of men under the age of 30. Keratoconus may occur many years after a procedure that included cutting the cornea and it may occur even when the patient had had thorough eye exams and had been cleared for the procedure. Therefore, if you wish to avoid secondary keratoconus or ectasia, then our message is simple - avoid procedures that include cutting the cornea. It doesn't matter what they use to make the cut (either microkeratome or femtosecond laser), the risk of developing keratoconus after the procedure is too high - about 2-3 out of every 1000 patients.

You may have to put those glasses back on.
Whether you choose to have a LASIK or a no-cut procedure, it's going to be expensive, and after paying that kind of money, you obviously want to get a result that lasts for a lifetime, especially because that's what all the eye clinics are promising on their web pages. Unfortunately we have experienced that LASIK (and other methods that include cutting the cornea) may not always guarantee the long-term result the patient was hoping for. Here are some factors that cause this.

1. Cutting the cornea is an irreversible act - the cut will never fully heal. The cornea becomes softer and more unstable, which means the fluctuation of refraction will be higher later on. Every eye doctor and optometrist knows what the fluctuation of refraction was like in 1970 after radial keratomy, when they made many cuts in order to fix nearsightedness. Even the tiniest cut makes the cornea unstable, so there is a bigger chance that the minus will return and the bigger the minus the more likely it will return. It is quite typcial that clients who have had LASIK will need a follow-up procedure 5-10 years later.

2. Small optical zones. Previous lasers polished many mikrometers off the cornea in order to get rid of the minuses. The same thing happens when the laser procedure includes cutting the cornea, because the cut takes away about 100-120 mikrometers (cornea is approximately 520 mikrometers thick) and the surgeon has to decide how to maintain the minimal thickness of the cornea (which is about 300-350 mikrometers). There are 2 ways to do this - either to choose a flatter nomogram, which can make a patient's vision worse in the dark, or to reduce the optical zone's diameter (the area of the eye where the laser works). Generally procedures that have been made by cutting the cornea have an optical zone of 6-6,5 mm, whereas the no-cut procedures' optical zones are 7,5-8,5 mm (the cornea itself is about 9,5-11 mm). Our clients are typically young people under the age of 45, whose pupils are still large and for better results the optical zones have to cover the whole pupil. If the optical zone is smaller than the pupil, visual acuity will decrease in the dark and the patient may see halos (circles around lights). Small optical zones are also one of the main reasons why people with a small minus have to wear glasses to drive a car or to watch a movie in the cinema.

3. Patients do not like follow-up procedures, even when they're free. When we compared the outcomes of the two procedures, the need for a follow-up procedure was remarkably lower for the no-cut procedure, and this is one of the main reasons why we now only do no-cut procedures.

Fast recovery and the ability to continue an active lifestyle only a week after the procedure are the main reasons why people choose KSA Vision Clinic. Right after the procedure, the visual acuity is about 50 %, which means that the patient can leave our clinic on his own. During the first week we recommend taking some time off and giving rest to your eyes. A week after the procedure the visual acuity should be 80-100 %, but will not be quite perfect yet for reading or using a computer. However, there are no more physical restrictions and you can continue with your trainings, go to sauna, go swimming or play sports. The visual acuity will rise within the next 3-6 months to at least 120 % and the vision will be excellent both in the daylight and in the dark.

Every medical procedure involves risks, which is why it is so important to undergo comprehensive eye exams and a consultation. If you would like to know whether you are a suitable candidate for Flow 2.0, please contact us by sending your basic information and prescription, so we could give you our initial opinion. However, since it is not possible to determine your suitability for the procedure via telephone or over the internet, we ask you to register for an eye exam in one of our eye clinics in Tallinn or Tartu.Register now

Preparations before the Flow 2.0 laser procedure
At least 10 days before the procedure, you mustn't use contact lenses, because they cause your cornea to change it's shape and refraction. It might be only about 0,5 diopters, but for the best result possible, we don't want that kind of change in your vision before the procedure.

In general, there are no restrictions on what not to eat or what medications you may take on the day before the procedure. However, it is important to tell Dr. Haavel and his staff about all the medications you are currently taking.

Please remove all eye make-up at least 8 hours before the procedure. Make sure that your face and eyes are absolutely free of make-up on the day of your procedure. If you are wearing make-up on the day of surgery, the procedure may be postponed as a safety precaution.

We would like to point out that perfume and alcohol affect laser's work, so we ask you not to drink any alcohol at least 24 hours before the procedure and not to put on any perfume in the morning. You should also avoid hair products that contain alcohol, such as a hairspay or a styling foam.

Procedure Day
It is only normal and natural to feel nervous or anxious before the procedure. However, do not take any anti-anxiety medicines on your own; instead you may request such medicines from us before the procedure if you feel the need for them.

Wear comfortable clothes and avoid fluffy ones that may give off puffs during the surgery (e.g. woollen clothing).

Do not worry about sunglasses. KSA Vision Clinic will give you a pair for free, as your eyes will be irritated and sensitive to light. The sensitivity to light will usually pass within 24 hours after the procedure.

In order to respect other patients and to make your stay at the clinic as comfortable as possible, we suggest you do not take small children or infants to the clinic, if possible. Your visit to the clinic on the procedure day lasts for approximately 1–1.5 hours.

Recommendations
1. It is important to rest on the day of your surgery. Dr. Haavel and his staff recommend clearing your schedule for the next 24 hours after the procedure.

2. Come to our clinic with a positive attitude, full stomach and arrive 10 minutes before your actual time. Here you'll find everything you need to relax – good music, tea, coffee, snacks and refreshing drinks.

3. The laser procedure is simple and relatively comfortable, but people are different and tolerate situations differently. So we will give you enough time to relax and feel good before the beginning of the procedure.

4. Always avoid rubbing your eyes. Rubbing is never a good idea – in case of irritation, use lubricating eye drops or gently splash cold water onto closed eyelids.

5. Right after the procedure you will stand up and see relatively good and you may leave our clinic. First hours after the procedure your eyes are still under the effect of numbing eye drops, which make you feel like your eyes are dry, so in the first 3 hours we advise you use lubricating eye drops in every 15 minutes. After that you can use them every hour or whenever you feel necessary.

6. Our nurses will give you written guides and medication schemes which show you how to use the eyedrops after the procedure. All these schemes will be explained thoroughly before the procedure, too. You will also be given a phone number, for 24/7 phone support – we're always here for you.

7. We will order you a taxi after the procedure, and will send you home for free within Tallinn or to the airport, harbour, bus station or train terminal.

8. Every surgical procedure is a teamwork and You are one of the team members. Provided you follow our medication schemes and recommendations, the result will make us all happy. So take time off for one week of your life to get a supreme vision for the rest of your life!

After the procedure
Post-procedure care and regimen are just as important as the procedure itself. It is especially necessary to use the included eye drops as precisely as possible according to the prescribed scheme. Read the recommendations below carefully and contact the KSA Eye Center if you have any questions. We are also there for you during the recovery period.

Days and weeks follow
During the first few days after the procedure, keep your eyes as moist as possible. Feel free to touch your closed eyes and wipe away the tears. A disposable soft tissue should be used to wipe away tears and hands should be washed before instilling drops.

On the day of the procedure, the nurse will teach you how to use eye drops without touching your eyes again, provide you with the moisturizing drops you need for the next week, and provide you with high-quality sunglasses that provide comfortable protection from bright light during the first week.

Immediately after the Flow 2.0 laser procedure, the surgeon will place thin, oxygen-permeable contact lenses on your eyes, which will remain on your eyes for the next 6-8 days. The contact lens offers protection to the operated eye surface and sufficiently good vision.

Visual acuity immediately after surgery is 50-70% on the visual acuity chart, which is sufficient for independent movement and travel, but insufficient for safe self-driving. Therefore, it is forbidden to drive a car within 72 hours after the procedure.

Week 1
The first post-procedural check-up, during which protective contact lenses are removed from the eyes, takes place 6-8 days after Flow 2.0 laser surgery. The time of your first check-up will be determined on the day of surgery at the KSA Eye Center. At the first checkup, the contact lenses are removed and, as a rule, visual acuity has already risen to the level of 70-100% by that time.

Physical restrictions such as sports, heavy physical work, saunas, etc. cease 24 hours after removing the contact lenses. Such a quick recovery and return to an active life is the deciding factor for many to choose the Flow 2.0 procedure.

1st month
The second post-procedural check-up usually takes place one month after removing the contact lenses. Here we already measure vision parameters and, if necessary, replenish your supply of eye drops; if necessary, we adjust the treatment regimen.

3rd month
In the third post-procedure checkup, we make summaries, perform measurements and exchange information. As a rule, visual acuity by this time is close to the later maximum.

6th month
In the case of large minuses and astigmatism, we add a fourth follow-up after 6 months, because the bigger the minus, the more recovery energy and time the body's tissues need. Usually, the quality of vision in such eyes is already very good after one month, but here we are based on the recommendations of the US military, where such operations are performed the most in the world.

We recommend listening to your body and intuition. You are probably in this situation for the first and last time in your life, so if you have any questions, there is no point in investigating them at home alone, but it is always worth calling us.

Kuidas kasutada silmatilku
For some time after the surgery you will need to use eye drops, some of which are anti-inflammatory and some have a lubricating effect. Applying eye drops may seem difficult at first, but it gets easier with practice. Follow these instructions to ensure the utmost comfort after Your procedure.

Wash Your hands before applying eye drops.

Remove the cap. Do not touch the tip of the dropper.

Lean Your head slightly backwards.

Pull the lower eyelid a little bit further from the eye and form a “pocket” either by pulling the eyelid downwards with your forefinger or by pulling the eyelid outwards with your thumb and forefinger.

Hold the tip of the dropper right above the “eyelid pocket” (you can lean your hand against your face or forehead to keep it steady).

Look up and let the drop fall into the “pocket”. Do not touch the eye or eyelid with the tip of the dropper.

Close your eyes for 30-60 seconds, after the drop is in Your eye.

Before opening Your eyes carefully wipe off the excessive drops from Your closed eyelids with a clean tissue. Then open Your eyes

If You need to use more than one medication at a time, wait for 3 minutes before applying the next one.

If you have any questions, always contact us!

Every eye is unique! Nowadays, maximum results in laser eye surgery are achieved by minimum shape adjustments by laser to delicate eye structures – i.e. with a blade-free procedure, using only a laser beam. With the most up-to-date technology and our long-term experience, we are proud to present Flow 2.0, a true no-touch no-cut laser eye surgery.

In the case of no-cut procedure, based on the expertise of KSA Vision Clinic and numerous scientific researches, the long-term results of no-cut methodology in regard to the quality and contrast of sight, and the comfort of eyes are the same or even better than those of a laser procedure performed with a microkeratome.

How is it possible that one can continue with his active lifestyle only one week after the procedure?

Being able to do everything you did before the procedure again only a week after the procedure is a big surprise for most of our clients. Since the procedure doesn't include cutting the cornea it's such a small trauma for the eye that it doesn't take more than a week to recover, which is why you can go boxing, swimming or even skydiving shortly after the procedure.

How can the vision be very good in the dark and how come there are no halos?

Thanks to our laser, we can cure bigger optical zones which cover even the biggest pupils 99 % of the time. At night your pupils are the biggest, that's why it's possible to achieve very good vision at night and to avoid halos.

Thanks to specializing in just one no-cut procedure KSA is an expert at its field and all our 17 employees who have had their vision fixed with Flow 2.0, are a living proof of why the no-cut method is the way forward.