Spectacles and contact lenses have literally been miracle cures for those individuals who have refractive errors. However, Spectacles have their limitations – inconvenience, discomfort, poor cosmetic appeal, problems in side vision and object magnification / minification. Contact Lenses solve some of these issues, but they require a lot of care and are expensive to replace periodically. They can also lead to infections. They are inconvenient for some professions like sports, and organizations like the army & railways have restrictions on employing people with refractive errors. So a good alternate to wearing spectacles or contact lenses is necessary.
LASIK-Laser vision correction
Q. What is LASIK ?
LASIK is a procedure that improves vision and takes away the glasses number by changing the shape of the cornea( Front of eye ) to change its focusing power with a state of art shaping device, an excimer laser and is very effective treatment for a wide range of vision problems. LASIK continue to grow in popularity and is the choice for people who do not wish to be dependent on glasses & contact lenses for clear vision.
Q. What are Common Refractive Errors/ Focusing problems.
- Nearsightedness (Myopia)
This is the most common focusing problem. Myopes can see near objects clearly but not distant objects. The image here is formed in front of the retina as the eyeball is elongated.
- Farsightedness (Hyperopia)
is a focusing problem caused by an eyeball that is shorter than normal. Here the image falls behind the retina. Near objects become increasingly difficult to see.
Astigmatism is a result of uneven curvatures of the cornea. Instead of being spherical, it is oblong resulting in blurred image at any distance. This focusing problem usually occurs with near or far sightedness.
Q. Why do people have lasik surgery?
There are five main reasons that people choose to have LASIK:
- Life simplification: No longer having to deal with glasses or contact lenses.
- Independence: Freedom from dependance on glasses or contact lenses.
- Performance: Ability to perform better in sports related activity.
- To choose professions: Like army, navy,air force & railways which require normal vision without glasses.
- Safety: From any contact lens infection.
Q. What results can a person hope to achieve?
LASIK has proven overwhelmingly successful in reducing dependence on glasses & contact lenses. Clinical studies show that most LASIK patients (with mild to moderate number )have the potential to achieve 6/6 vision or better. Generally , this means they no longer need glasses or contacts to drive , play sports, watch movies & TV, or participate in careers requiring excellent vision.
Q. Who is good candidate for lasik?
LASIK can treat broad range of nearsightedness, farsightedness & astigmatism. The best way to determine is with a thorough eye exam. Candidates must be 18 years of age or older, in good health, & have good eye health with no diseases such as cataract or glaucoma.Lasik should be avoided during pregnancy & breast feeding.
Q.What is doctor looking for during my evaluation?
For us your SAFETY is our first concern. We look for risk factors prior to surgery that may make you a less than ideal candidate for surgery and discuss any abnormal findings with you at length. The following are considered to be risk factors for refractive surgery.
- High prescriptions: Patients with extreme eyeglass prescriptions (high myopia) will need retinal evaluation.
- Thin corneas: The thickness of your corneas must be measured before surgery (Pachymetry). Patients who have very thin corneas may not be good candidates for LASIK. In these cases other procedures may be more appropriate.
- Abnormal corneal curvature: Topography is done to measure the overall shape and curvature of your cornea. Abnormalities in the shape and curvature of your cornea will exclude you from having LASIK safely.
Other important aspects are dry eyes, pupil size,contact lens history, any previous eye surgery,any squint and any treatment you are taking. Lasik is not done when you are pregnant & feeding your child.
Q. How long will the LASIK procedure take ?
The LASIK usually takes about 20 minutes in the operating room. The entire procedure takes approximately seven to ten minutes for each eye , but actual laser time is than one minute.
Q. How is Lasik Done
- Step 1 : After putting anesthetic eye drop, a partial thickness corneal flap is made with a microkeratome.
- Step 2 : LASIK is applied on the corneal bed. It corrects vision by reshaping cornea so that light rays focus precisely on the retina.
- Step 3 : Flap is replaced back after completion of laser. Eye drops and procedure is complete.
Q. Does the LASIK procedure hurt ?
There is almost no pain involved with LASIK. Anesthetic drops are used to numb the eye just before surgery begins.There can be little discomfort if you are very anxious. So to be relaxed is very important. After lasik there is watering and irritation for one hour. You go to home and sleep and when you wake up , you are fine.
Q. Are there any risks associated with LASIK ?
The latest technology used today is very safe in expert hands. Although pre-lasik check up done thoroughly ensures that we can identify if there is any risk. The chances of eye infection is very less & it is less than contact lens infection. Rarely we have to re-wash the tissue below the flap, may have to do a enhancement procedure or repeat the procedure after three months.
Q. Are result permanent?
Yes, removal of you number is permanent.
Q. What is the recovery process like ?
Most LASIK patients usually see quite well the day following their procedure & may be able to resume most of their normal activities in 3-4 days. Although speed of visual recovery vary from person to person.
Q. What are types of lasik?
A. STANDARD LASIK
STANDARD LASIK is the ablation pattern that treats directly based upon the patient’s glasses prescription, with fixed treatment parameters for each patient. This type of treatment do not differentiate between eyes of different patients,and do not correct aberrations.
B. CUSTOM – Wavefront-guided LASIK
Custom laser vision correction procedure that helps your LASIK surgeon customize the laser treatment to your individual eyes by treating your Visual Aberrations.
About Visual Aberrations
Several types of visual imperfections, referred to Aberrations, exists within the eye. . These aberrations are specific to individual eye and can affect vision quality, contrast sensitivity, and night vision.
Wavefront-guided LASIK, also referred to as Custom LASIK ,in addition to treating a patient’s basic refractive error , It also treats Aberrations in a patient’s eye. In wavefront-guided LASIK, special mapping ( wavefront analysis ) is performed prior to surgery to identify aberrations-irregularities in the patient’s optical system. Wavefront mapping identifies these aberrations and wavefront-guided LASIK treatment will be based on the wavefront-map generated. This new level of measurement is more precise and provides better vision than is possible with glasses or contact lenses and is unique for each eye. This procedure may result in your vision being clearer and sharper than ever before.
C. BLADELESS FEMTO LASIK- BLADE FREE/ ALL -LASER LASIK
This is most used procedure in LASIK surgeries worldwide. When performing bladeless LASIK, the LASIK surgeon uses a gentle laser to create the corneal flap. This technology allows the LASIK surgeon to better customize the corneal flap for each patient. As the name implies, no blades are used in this kind of laser eye surgery.
How Bladeless LASIK Works:
IT is very safe, very fast ,very accurate and leads to very quick recovery
- Custom diagnosis (before the procedure)
- Custom corneal flap (Bladeless LASIK) by most advanced FEMTO LASER.
- Custom vision treatment (Wavefront guided LASIK)
Q. If I can’t undergo LASIK then What other types of refractive surgery are available?
Other types of refractive surgery are available and may be more appropriate than LASIK for certain individuals.
- Advanced surface ablation: There are a variety of other techniques that utilize the excimer laser to reshape the cornea in much the same way as LASIK, but without the creation of a corneal flap. These include photorefractive keratectomy (PRK), laser subepithelial keratomileusis (LASEK) and epipolis laser in situ keratomileusis (Epi-LASIK). All of these techniques involve first removing the most superficial corneal layer (epithelium) and then performing excimer laser ablation.
- Phakic intraocular lenses: For patients with extreme myopia, LASIK and advanced surface ablation are not reasonable options. In these cases, a phakic intraocular lens may be used. This lens is implanted inside the eye and can effectively treat nearsightedness up to -20 diopters.
- Intracorneal ring segments: Intacs are approved for the correction of low myopia and for patients with keratoconus. Intacs are micro-thin plastic segments that are implanted into the peripheral cornea in order to flatten the cornea centrally. Once implanted, the rings generally cannot be felt by the patient. These rings can be removed, and their effect is usually completely reversible. They are only able to correct up to -3 diopters of myopia, and visual recovery is generally slower and less predictable than LASIK.
Q. What if Iam diagnosed with Keratoconus during Pre-Lasik examination?
Keratoconus is a progressive condition affecting the cornea of the eye. We have latest nonsurgical treatment called C3R (Corneal collagen crosslinking with Riboflavin) that is proven to prevent the progression of keratoconus, and it may even be able to reverse the condition to some extent.
PREOPERATIVE INSTRUCTIONS :
- Stop wearing contact lenses for one week before LASIK.
- Do not use eye make-up two days before LASIK.
- Do not apply any deodoront or perfume on the day of the laser.
- Have regular breakfast or lunch on the day of surgery.
OPERATIVE INSTRUCTIONS :
- On your arrival , pre-lasik check up is done (if not done prior), which takes about half an hour.
- The check is followed by the laser procedure
- The area around the eyes will be prepared with antiseptic solutions.Do not touch your face after this.
- After that anesthetic eye drops are put to numb your eyes against any pain.
- You will be taken into the laser suite where you will undergo laser treatment.
- All you have to do is to follow your doctor’s instructions and look at a flashing light above you. Please focus your eye on this light .
- The procedure takes about 7-10minutes per eye.The actual laser time required to correct the number is less than one minute.
- After the treatment, you will rest with your eyes closed in a recovery area for an hour & you will be given eye drops & protective glasses to wear.
We will see you after one hour, then you can go home.
- Put eye drops as instructed. While putting the drops pull your lower lid & look upwards
- You will have no pain, but in case of watering of eyes, wipe the tears with tissue paper from the cheek.You will be quite comfortable in the evening. Your vision starts to improve by this time and will be quite good by the next morning.
- Do not rub or touch your eyes for five days.Wear protective glasses for five days. Eyes must be protected from direct pressure, injury or blow.
You can brush your teeth normally, shave, sponge wipe your face and bath below neck from the very next day. Head bath is permitted after five days. Water should not enter your eyes for five days.
- Watching TV, reading & working on computer is permitted afer LASIK , but do not stress.You can sit in normal bright light.
- No diet restrictions , but avoid cooking for five days.
- You can resume your work afer 3-4 days. Avoid racquet sports & swimming for three months after the LASIK.
- Eye make-up, fasial & threading should be avoided for two weeks.
- The operated eye may have slight redness, watering, irritation for a few days, this is NORMAL, but in case there is pain, increased redness or drop in your vision , please contact us.
Next day you will come to see us smiling without glasses.
WE CARE FOR QUALITY
Dr Rajesh Kapoor
Medical Director, Suruchi Eye centre