Lasik & Refractive Surgeries

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WHAT IS LASIK ?

LASIK EYE SURGERY – HOW IT WORKS, RISKS, RECOVERY

Lasik eye surgery is the most common elective procedure and is performed to correct nearsightedness, farsightedness and astigmatism. In most cases, LASIK is painless and completed within several minutes per eye. The results improve your vision to reduce and in most cases eliminate the need for eyeglasses or contact lenses, and the results of the procedure can usually be noticed within 24 hours. Like most types of laser eye surgery, LASIK reshapes the cornea to allow the light entering the eye to be specifically focused on the proper part of the retina to obtain clearer vision. There are multiple laser vision correction surgeries available such as PRK, LASEK, Custom and All laser Bladeless LASIK. An examination with a LASIK surgeon will determine if LASIK surgery is right for you.

LASIK EYE SURGERY EXPLANATION- HOW IT WORKS

Prior to your lasik eye surgery, numbing eye drops are used to alleviate any discomfort to the eye. Some surgeons may also prescribe medications to help you relax. LASIK requires only topical anaesthetic drops, and no stitches are required for healing. Your eye will be positioned under the laser, and an instrument called lid speculum is used to keep your eyes open. The surgeon uses either an instrument called microkeratome or a laser to create a thin semicircular flap in the cornea on the surface of the eye. The surgeon will then use the excimer laser to treat your specific glass prescription by using a cool ultraviolet beam of light to reshape the cornea.
This allows the light re-entering the eye to be refocused for a more accurate vision. The surgery is painless; however you may feel some pressure on your eyes. LASIK is performed on each eye independently with the entire surgery taking only a a few minutes. After the laser reshapes the cornea, the flap is repositioned and serves as a natural bandage for healing process. For extracare to avoid flap related problems, a bandage contact lens is placed for a day for your safety.

LASIK EYE SURGERY POSTOPEARTIVE INFORMATION

After LASIK eye surgery, you will need someone to drive you home. You may experience temporary itching sensation in your eyes and should expect some blurry vision or haziness immediately after the procedure, which genrally lasts 8-12 hours.
The next day your vsion and clarity shuld continue to improve. Most people return to work and drive themselves to their follow up appointment the next very day. Additionally, majority of the doctors request an additional follow up after 2-4 weeks after the LASIK surgery and 2-3 months after the surgery. During your LASIK recovery, your doctor will want to see after surgery to ensure your eyes are healing correctly. Most people can return to work the next day or within a few daysof their LASIK eye surgery.
In the first few weeks after Lasik laser eye surgery, you may feel a slight discomfort during your recovery time. It is important to keep your eye lubricated for the first few weeks to three months ater the laser procedure. Even when your eyes don’t feel dry, you should use lubricating eye drops 3-4 times a day, to prevent your eyes getting dry.
Patients can also experience sensitivity to light because of which they are advised to wear sunglasses anytime they are outside. Yur doctor may limit swimming, exercise, yoga like om vilom, wearing eye make up or any makeup for weeks to 1 month. Contact sports, hot tubs and whirlpools are limited for atleast 3 months. You should follow your doctor’s postoperative instructions during your LASIK recovery to help the healing as much as possible. If you think you are having any issues during your LASIK recovery, you should call your doctor who has access to your complete medical history to confirm if any further postoperative care will be required.

2-3 MONTHS AFTER LASER EYE SURGERY

it is common for the eyes to continue to heal for at least 3 months after LASIK surgery, which means your vision also continue to improve. Patients with more severe / higher prescriptions can continue to heal for upto 6 months. Since everyone heals differently, it is not possible to know exactly how your eyes will heal and in a few cases (3-5%) of patients may require an enhancement or Touch up after their LASIK recovery phase has passed and the eyes are stable.

AM I FIT FOR LASIK?

Some clinics turn away up to 20% of people as they believe that they are not suitable for laser eye surgery. But that doesn’t always mean those people can’t be helped. We can treat 98% of those who come to us.
Why are so many more patients suitable for laser eye surgery at our clinic?
Our Laser eye Surgeons are among the very best in the world.
We believe in helping all patients, not just the quick and easy cases.
We take the time to deeply analyze each patient’s eyes and have the expertize to customize treatments for each eye.
Many clinics aim to ensure consistent results, and a quick turnaround, by focusing on the least complicated cases. Many simply do not have the experience or expertise to tackle more complex or unusual conditions. Our Clinic is different on both counts.
Candidates before going under a Lasik treatment must fulfill the following criteria:

Age : A patient must be above 18 years of age and preferably less than 40 years of age before he or she take appointment for having a Lasik surgery.
Stability in vision : Patient’s glasses power must be stable almost for one year prior to this surgery.
Dry Eye : Patient’s must not be having dry eyes. For this Schirmer’s test is done. And if you are found to have dry eyes better get that treated first before planning Lasik Laser procedure.
General Health : Patient should not have any other systemic problem like diabetes or collagen disease or be under any other medical treatment.
Lasik is not for a pregnant/ Lactating patient : An Ophthalmologist should avoid Lasik surgery of those patients who are under the course of pregnancy or is lactating (Breast feeding her child). This is because; there may be some effects on hormones.
LASER SIGHT CORRECTION TREATMENT
Assessment for LASIK, LASEK, and Other Refractive Surgery Procedures at Our Eye Practice
Whether you are shortsighted, long-sighted or just astigmatic, we can advise.
Lasik in Delhi is very common & famous due to availability of best Lasik laser technology, best expertise & reasonable rates.
Hence, from the above it is quite clear that if one wants to have Lasik surgery, then at first one must have a proper consultation with a doctor. Then, after having confirmation from doctors, patients should decide on where they will get the best treatment. However, all know it that Lasik laser surgery in Delhi is best within India.

ASSESSMENT FOR LASER EYE TREATMENT/ TESTS DONE BEFORE PLANNING LASIK

Proper assessment is absolutely essential prior to treatment. Not all Lasik treatment centres have time to go through the Individual’s vision requirements in relation to their life style and expectations. We have been doing laser surgery since years and we offer a wide range of ophthalmic medical services.

LASIK EYE SURGERY- PREOPERATIVE EXAMINATION

Your LASIK doctor will perform a dilated eye exam to ensure your eyes are healthy for LASIK eye surgery. The surgeon will evaluate the shape and thickness of your cornea, refractive errors, pupil size and general overall health to determine if you are a candidate for LASIK. The chance of developing dry eyes will also be evaluated, and a treatment plan may be recommended to reduce your risk of developing dry eyes after LASIK surgery. If you are having a Custom LASIK you likely will have a 3D imaging of your eye, referred to as Wave front analysis, which creates a more precise map of overall aberrations affecting your vision. Because Contact lenses alter the natural shape of your eye, you will be asked to stop wearing conatacts for a specified period of tie prior to your surgery date. Typically the time to remove soft contact lenses is 3 days to 1 eek and for Hard or RGP lenses is 3-4 weeks.

Tests performed before LASIK are:

  • Glass power testing
  • Corneal thickness (Pachymetry)
  • Corneal Topography/ Aberrometry
  • Intraocular Pressure (IOP testing)
  • Schirmers Test (Dry Eye Testing)
  • Retina check up (Dilated check up)

Before going under a Lasik surgery, Checking of these is important as corneal thickness has an important role in this Lasik Surgery. As a International standard, a 250-μm residual stromal bed (RSB) is fairly accepted as the minimum tissue that must remain after Lasik Surgery; however, some surgeons have more conservative approach – prefers to keep 300-μm residual stromal bed (RSB). Hence, it is the responsibility of eye specialists to verify these problems thoroughly and then suggest the patients for having a Lasik eye surgery. Any patient may have any type of eye injury. Every eye specialist should take this matter for further verification. Patients are having dry eyes problems then they must not go for a Lasik treatment.
The original optical properties of the cornea need to be taken into account in advising on a corrective treatment, otherwise visual quality may be degraded causing side-effects like glare and poor night vision. Some treatments change the shape of the cornea in an arbitrary way that is unsympathetic to the original optics, the way our eyes work. Dr Abhiyan Kumar Pattnaik will advise you, taking into account your expectations, your life style, your occupation and the main purpose that you want eye correction for.
We use maps of the eyes optics (wave-front) or maps of the shape of the surface of the eye (topographic) at our eye practice to take into consideration any distortion of the surface of the eye, for example by injury or other surgery.
Contact at our clinic, to learn more about receiving advice on which is the most appropriate treatment for you.

LASIK (LASER ASSISTED IN-SITU KERATOMILEUSIS)

LASIK is the mainstay of modern laser refractive surgery. When performing LASIK a thin flap of corneal tissue is made with a special laser called a ‘femtosecond’ laser (I-LASIK) or with a surgical instrument called a microkeratome (Standard & Customized LASIK). The underlying corneal tissue is then reshaped with a laser beam and the corneal flap is replaced. The surface skin of the eye is not disturbed in LASIK eye surgery because it is attached to the flap.
‘All-laser LASIK’, where the flap is made with a femtosecond laser, is preferred for many treatments for reasons of safety and accuracy. However, some treatments call for the use of a microkeratome.
The advantages of LASIK eye surgery are that minimal, if any, discomfort follows the procedure. The visual recovery is very fast, with most people meeting the driving standard in about twenty-four hours. Final visual stability is usually reached within a few days, although there may be a very small change over a couple of months or so. Up to approximately 8 dioptres of myopia with or without astigmatism and about 3 dioptres of hyperopia with or without astigmatism may be treatable, depending on the individual.
WHAT IF I AM UNFIT FOR LASIK SURGERY

NEW TREATMENTS

Latest advances allow tissue to be removed from within the cornea with barely any disturbance to the surface at all. This can have advantages in retaining corneal strength and allowing higher amounts of correction.
Whichever method is appropriate for your eyes, we will advise what is the safest and most dependable way. To learn more about treatments, contact our clinic.
PRK (PHOTOREFRACTIVE KERATECTOMY) AND LASEK (LASER ASSISTED SUB-EPITHELIAL KERATOMILEUSIS)
For patients who are unsuitable for LASIK surgery, PRK, LASEK and epi-LASIK can be done. All are surface treatments that differ from one another only in detail. All involve sculpting the corneal material that is directly beneath the surface skin of the eye.
Surface refractive surgery procedures can be used with confidence for correcting myopia up to four dioptres, astigmatism up to three dioptres, and hyperopia up to two dioptres. It is possible to treat more dioptres, but generally less reliably than with LASIK. Visual recovery is slower than with LASIK so it is usually sensible to treat one eye at a time.
PHAKIC IOLs/ ICL
KERATOCONUS
If you are not fit for LASIK, you may be suffering from Keratoconus.
CLEAR LENS EXTRACTION (CLE)/ REFRACTIVE LENS EXCHANGE (RLE)/ Presbyopic Lens Exchange (PRELEX)

The procedure done in Clear Lens Extraction (CLE) is similar to cataract surgery, wherein natural crystalline lens is replaced with an artificial lens correcting the vision problem of patient. Most of the times, the artificial lens corrects vision for distance only if mono focal lens is chosen. In that case, usually person needs a pair of reading glasses for near work, if monofocal lens is placed and does not need any glasses both for distance and near if Multifocal lens is placed. There are variety of lenses available which correct both near & distance & astigmatism related refractive error of eye. The selection of lens is purely based on patient lifestyle & recommendation by treating surgeon. Clear Lens Extraction (CLE) procedure can be done for patients who do not have cataract but unfit for Lasik Surgery for vision correction. These patients can have farsightedness or nearsightedness combined with astigmatism.
Refractive Lens Exchange (RLE): A lens transplant for older patients with refractive errors who are not candidates for laser vision correction.
Presbyopic Lens Exchange (PRELEX): A multifocal lens implant replaces the current lens of the eye to help patients over 40 with their near vision.
Good points
An option for patients who are unfit for lasik laser surgery
CLE even corrects high myopia & hyperopia that cannot be done through lasik laser surgery and phakic IOLs.

No requirement of Cataract Surgery in future because natural lens has been removed and replaced by a artificial lens implant
Negative Points

In case of mono focal lens implant, patient tends to lose the ability to accommodate. Therefore one requires reading glasses for near vision
More invasive than laser refractive surgery. This procedure is done in the Operating room with topical and/or local anesthesia.

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