LASIK (Laser
Assisted In Situ Keratomileosis)
LASIK combines two
techniques of surgery to correct refractive error.
First, a micro thin flap
is created on the front surface of the eye (cornea) that is then lifted back
and preserved.
Next, a cool beam excimer laser sculpts the underlying cornea into a
new shape to correct the refractive error. The flap is then repositioned and
adheres on its own without sutures after only a few minutes.
Vision recovery typically
is rapid, and there is little or no post-operative pain. You can usually return
to work, and even drive, within 24 hours of surgery.
LASIK surgery to improve
refractive errors may last a lifetime. Once your refraction has stabilised
experience shows that the reshaped cornea tends to stay modified permanently.
Customised Lasik
Customised Lasik takes Lasik to a new level of vision
quality. Its sophisticated Wavefront technology allows surgeons to map your
eyes' unique shape and visual characteristics. It can uncover subtle
imperfections and helps develop a customised LASIK procedure to correct them.
Your assessment will determine the
detail and range of your refractive errors and recommend the best solution for
your eyes.
PRK (Photo refractive Keratectomy and LASEK)
Like LASIK PRK,
LASEK and Epilasik use the excimer laser to shape the cornea.
These surface ablation techniques are sometimes recommended instead of LASIK
for people with thin corneas because they do not penetrate as deeply into the
eye's surface.
In PRK, the epithelium, the layer of cells covering
the cornea, is removed and the excimer laser sculpts the cornea to correct
refractive error. A 'bandage' contact lens is placed on the eye following the
procedure to speed the epithelial regeneration, which usually takes three to
four days.
LASEK,
unlike PRK, attempts to preserve the epithelium. In LASEK, the epithelium is
loosened and peeled back to expose the cornea. The excimer laser then reshapes
the cornea and the epithelium is placed back into position. Like LASIK,
recovery time is rapid but discomfort is somewhat increased.
Epilasik like Lasek, preserves a thin sheet of the
corneal epithelial cells but unlike Lasek the cells are not damaged by chemical
loosening. The excimer laser then reshapes the cornea and the epithelium is
placed back into position. Like LASIK, recovery time is rapid but discomfort is
somewhat increased.
OVERVIEW
A thin flap of epithelium and superficial cornea is cut
and reflected exposing a central area of deeper cornea. A UV laser removes
corneal tissue from the deeper surface in the central area. The flap is
repositioned and allowed to naturally adhere.
·
After
instillation of a drop of anaesthetic, the area is cleaned and sterilized.
·
The
eyelids are held widely open by a speculum to allow good access.
·
A
suction ring is applied to the eye this stabilizes the eye, increases the
pressure in the eye and securely attaches to the eye.
 |
| Procdure |
·
Once
the microkeratome (a motorised plane) is attached to the suction ring it can
pass across the cornea, cutting a thin flap as it goes.
·
The
flap consists of the surface epithelium and some of the anterior stroma of the
cornea.
·
The
flap is left attached (hinged) at one edge so it can be gently reflected.
·
The
layer of the cornea deep to the flap is then reshaped using the excimer laser
(very similar to PRK).
·
The
flap is then repositioned and sticks back in place. Because the front surface
has been replaced there is less pain than in PRK and vision recovers very
rapidly with good vision common after 1 day.
LASIK THE PROCEDURE
This information sheet is
designed to help you understand the operation and expected postoperative
course. If you know what to expect during the operation you should be more
relaxed and able to assist me making the whole procedure much easier for both
of us.
The operation will be
performed under topical anaesthetic as an outpatient. There
is a purpose built operating complex with a
state of the art laser Carl Zeiss Mel 80 and other fully equipped operation
rooms. The laser operating room is precisely controlled for both temperature
and humidity so light comfortable clothes are all that will be needed. It is
better to have only a light snack and drink well prior to the operation as
anxiety and a full stomach can make you uncomfortable when lying flat.
Some antibiotic eyedrops
will be instilled in your eye to prevent infection. Prior to the operation
several drops of local anaesthetic will be inserted. Then you will be taken
into the laser theatre and will lie flat on a bed with your head under a
microscope. Initially the light from the microscope is a little bright but you
will rapidly adjust and it should not be any problem. After I have cleaned your
eye and eyelids with antiseptic I will use a sterile plastic drape to cover
your eyelashes, eyelids, cheek and forehead. Only once I am perfectly happy
with your position will the operation start. The process is quite complex so we
have a series of safety checks in place. I will endeavour to talk to you at
every step so you know exactly what to expect and what I would like you to do.
You can talk to me and ask questions as we proceed. There are some times when
movement is not allowed and I will ask you then to keep still and quiet. A
suction ring will be placed on your eye. This holds your eye steady and raises
the pressure in the eye to enable the flap to be cut. The microkeratome is
attached to the suction ring and the flap created. As the flap is created there
is quite a loud vibrating buzz and it is much easier and safer if you do not
squeeze your eye or move during the few seconds that this will take.
There are a few steps
getting organised and setting the laser to track your eye movements, then the
laser treatment commences. The computer controlling the laser divides the
treatment into a number of fractions and I will be monitoring your eye and
telling you how the treatment is progressing. The laser makes a noise but is
painless and over in about 1 minute. On completion the flap is repositioned and
washed with sterile saline. After about 3 minutes of drying the flap has
adhered so the speculum and drape are removed. Antibiotic drops are instilled
and a clear plastic protective shield is applied. Often, despite the after
effects of the microscope light and the shield you may see quite well
immediately.
Once the anaesthetic wears
off the eye will feel quite gritty and irritable for a few hours. You may find
the best solution is to go to bed for those few hours and keep both eyes still
and closed. It is imperative that the eye should not be rubbed in the first
week as the flap could be dislodged. Vision will fluctuate the first night but
if there is uncomfortable pain with reduced vision you should contact me.
Normally vision is quite
reasonable the next morning and will improve over the next week. Most normal
activities can be resumed immediately but remember that the flap is not secure
for some time. For safety swimming should be avoided for 2 weeks, rubbing
should be avoided and any situation where the eye could be knocked (eg. contact
sports) avoided for at least 3 months. Eyedrops are routinely used for 2 weeks
to help the eye heal and prevent infection. It is not uncommon for the eye to
feel a little dry and irritable for several months and during this time a
lubricant eyedrop may be used for comfort.
Lasik
Frequently Asked Questions
Who can LASIK benefit?
LASIK can benefit a great number of people with myopia, hyperopia and astigmatism with stable refraction. Candidates should have a strong desire to be less dependent on corrective lenses, have established realistic expectations, and understand the risks associated with the surgery.
How
long has LASIK been performed?
LASIK has been performed internationally for approximately 20 years. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
LASIK has been performed internationally for approximately 20 years. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
Is LASIK successful ?
Yes. LASIK is a permanent treatment. However, patients who are 40 years and
above may require reading glasses. Millions of patients worldwide and thousands
at our centre have had an Excimer laser refractive procedure done on them
successfully.
Are there other refractive
procedures ?
You may have heard about PRK [photo refractive keratectomy]. You may have also heard about the surgery known as RK [radial keratotomy]. You need to understand that these are two completely different procedures from LASIK with less predictable results.
Is this the latest technology ?
The latest and most reliable procedure is wavefront-guided LASIK, a customized
treatment for each eye. Our excimer lasers use high-speed sensitive eye
trackers to ensure perfectly centered treatments. Wavefront procedures even
often leave patients with eyesight better than normal. We are committed to
providing our patients with the best that technology and technique has to
offer. This is one of the best laser in Mumbai, India
Does this procedure hurt?
No. There is no pain during the procedure. There may be mild discomfort for a
few hours after the procedure.
How does wavefront LASIK compare to conventional
LASIK?
A: Wavefront adds an automatic measurement of more subtle
distortions (called higher order aberrations) than just nearsightedness,
farsightedness, and astigmatism corrected by conventional LASIK. However, these
“higher order aberrations” account for only a small amount (probably no more
than 10%) of the total refractive error of the average person’s eye.
Conventional LASIK increases higher order aberrations. Although
wavefront-guided treatments attempt to eliminate higher order aberrations,
results from the clinical studies have shown that the average aberrations still
increase, but less than they do after conventional LASIK. In a few studies
comparing wavefront-guided LASIK to conventional LASIK, a slightly larger
percentage of subjects treated with wavefront LASIK achieved 20/20 vision
without glasses or contact lenses compared to subjects treated with
conventional LASIK.
After
LASIK, how will my vision be at night or in low light?
Most patients do not
notice a change; however some patients will notice glare, halos or starburst
around objects in dim or low-light conditions. For the vast majority, these
symptoms are temporary. Although these symptoms do not necessarily interfere
with visual acuity as it is measured by an eye chart.
Will
my eyes be dry after LASIK?
Some patients who seek
LASIK have underlying dry eye syndrome that has not been diagnosed. There
appears to be a correlation between pre-operative dry eye syndrome and
developing more pronounced dry eye symptoms post-operatively. Therefore, many
doctors test for dry eye prior to making a decision regarding eligibility.
Are
the results achieved from LASIK permanent?
LASIK is a surgical
procedure that permanently removes corneal tissue to reshape the eye in order
to improve refraction. The physical results are permanent. However, you should
be aware that since the eyes can still change with time, and LASIK does not affect
a number of visual conditions associated with age. For example, LASIK does not
prevent presbyopia or affect this condition once it does occur.
If
I have LASIK and my vision changes later in life, can it be redone?
Depending on the cause,
retreatment may be a viable solution to vision changes later in life, and other
treatment options exist. You would need to see your ophthalmologist to
determine the cause of the change and to determine which option is best for
you.
What
kind of anesthetic is used for LASIK?
The procedure is done
with topical anesthetic (eye drops) to numb the eye. Patients may be given a
small amount of oral sedative to help them relax.
Can
I have both eyes done with LASIK at the same time?
You can have bilateral
simultaneous LASIK (both eyes done at the same time). In fact, the practice is
common.
How
long will I be out of work after having LASIK?
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.
It depends on your occupation. Certain jobs that require intense clarity of vision (dentistry and surgery, for example) may be difficult to perform for one or two days. Most patients can return to work the next day, assuming their vision is adequate for their job. However, some people may feel fatigued for a day or so following surgery.
Can
I play sports after LASIK surgery?
You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, your surgeon may recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks. It is important to talk specifically with your doctor about limitations on activities after LASIK.
You can resume most normal activities immediately after surgery. However, for at least two weeks you will need to avoid activities that would cause perspiration to run into the eyes. You should wear safety glasses while playing contact sports whether or not you have had surgery. But if you do not routinely wear safety glasses, your surgeon may recommend wearing them for at least one month after LASIK. You will also need to avoid such activities as contact sports and swimming for several weeks. It is important to talk specifically with your doctor about limitations on activities after LASIK.
Can
I drive immediately after having LASIK?
Patients may experience some discomfort and/or blurred vision for a few hours after surgery. And most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.
Patients may experience some discomfort and/or blurred vision for a few hours after surgery. And most patients receive a sedative prior to surgery. Therefore, you cannot drive home after undergoing the procedure, and you should plan not to drive for at least twenty-four hours.
No. Your eyes will look exactly the same.
