Technological advances part 1

It is said that we currently live in a liquid society. It is a concept that tries to reflect the speed at which everything moves today and that any change can have immediate consequences on the other side of the world. It is a concept associated with globalization. But what is it that allows all these changes to happen so fast? It is undoubtedly a question with multiple edges and possible answers, but what is certain is that without technological advances acting as a driving force these changes would not be possible.

In medicine in particular, it is one of the fields in which most changes are constantly being generated. New techniques, new methods, new devices that improve the accuracy of diagnosis or existing treatments emerge.

And in the case of ophthalmology this fact is especially notable. Sight is one of the most – if not the most – appreciated senses. A great deal of precision is required in both diagnosis and the effectiveness of treatments to achieve an appreciable improvement on the part of the patient. When we talk about ophthalmological or vision-related advances, we all tend to think of a solution for blindness. The reality is that remedying the loss of the sense of sight is a very, very complicated task, mainly due to anatomical factors. But this would give for another post.

Now, this does not mean that progress is not being made in many other aspects. Improvements are constantly appearing that allow us to see better and better, with higher quality, for longer and with maximum guarantees. Below, we would like to talk about the latest technological advances in ophthalmology, what they consist of and what benefits they bring us.


A few years ago, a true revolution took place with the arrival of the first Excimer lasers. Thanks to them, it was possible to offer a treatment to eliminate myopia, hyperopia or astigmatism and forget about the daily use of glasses or contact lenses forever. This type of laser makes it possible to reshape the shape of the cornea to give it the appropriate dioptric power and eliminate the refractive defect. It does so thanks to a laser that, with a precision of microns, evaporates the tissue in a very controlled manner. The only drawback to this treatment is that in order to apply the laser, a corneal flap must first be made, that is to say, a very thin layer of the cornea must be cut using an instrument called a microkeratome. The laser treatment to correct the refractive defect is applied on the bed that leaves this flap exposed.

Dr. Fernando Castanera was the one who introduced the first of these lasers in Spain back in 1988 and since then both he and Dr. Diego Castanera have become great experts in this type of treatment.

A few years ago, the natural evolution of this laser has taken place: the femtosecond laser. The great advantage of the femtosecond laser is that it is able to detail the flap and vaporize the corneal tissue with even greater precision than the excimer laser. Due to its characteristics, this laser is able to act like a scalpel with great precision on transparent tissues, as is the case of the cornea. Thus, with a single instrument we can perform the carving of the flap and then apply the treatment.


The great alternative to laser surgery has always been the implantation of pericrystalline collamer lenses. The main advantage of this type of procedure is that no tissue is removed. A lens is simply placed inside the eye and positioned in front of the crystalline lens and behind the iris. With this, the refractive defect is corrected. If for whatever reason this lens has to be removed, all ocular structures remain intact.

Collamer lenses emerged more than 25 years ago and from the beginning they were a great revolution in order to correct refractive defects without permanently altering any tissue. Dr. Fernando Castanera had it very clear and bet on this surgical technique from the first minute. So much so that he was the first surgeon to implant this type of lens in Spain. Subsequently, he became an expert in this type of intervention and was the great trainer of most of the surgeons who practice this technique in the country today. Currently his son, Dr. Diego Castanera, follows the path marked by his father and is one of the best specialists in the implantation of collamer lenses. So if you are thinking of getting rid of your glasses or contact lenses forever, at Clínica Oftalmológica Castanera you will find the best specialists in this type of implants.


When presbyopia appears -from 45 years of age- or cataracts -from 55 years of age- we begin to suffer from a series of problems associated with a structure: the crystalline lens. Both presbyopia -also known as eyestrain- and cataracts have their own particularities, but both have in common that vision becomes more difficult day after day, less sharp and we have more problems when focusing at different distances. The only way to solve this loss of vision is to replace the affected lens with another lens that performs its function, which we call intraocular lens or artificial lens.

The first intraocular lenses that appeared were rigid, so in order to implant them it was necessary to make a very large incision. This implied more risks and above all a longer recovery period. In addition, these first lenses only allowed focusing at a single distance, either near or far, which is why they are known as monofocal lenses. They still exist and are still being implanted, but they are less and less requested since with this type of lenses we will still need to wear glasses to be able to focus at a distance that is not covered by the lens.

Currently, the most precise lenses are known as multifocal lenses, which allow us to focus at any distance without the need to use glasses or contact lenses. This is achieved thanks to the difference in dioptric power offered by the different concentric rings that we can see in the image. Another great advantage is that they are made of a very flexible material, so they can be inserted folded through a minimal incision of just 2mm. This allows the recovery to be much faster and the visual quality is very good after only a few days.

We remind you that at Clínica Oftalmológica Castanera we are pioneers in performing all these surgical treatments. We have the best and most trained specialists in this type of surgical techniques that ensure maximum guarantees of success.

We have a few more remarkable advances. But we keep them in the chamber for the next publication. In it we will tell you about intracorneal rings to correct keratoconus, intravitreal injections to treat AMD and the latest advances in the treatment of dry eye.