Blog


All you wanted to know about LASIK BY DR NITESH NARAYAN

All you wanted to know about LASIK BY DR NITESH NARAYAN
  • December 19, 2018
  • Win Vision

All you wanted to know about LASIK!!

What is LASIK? Why, When and Who can undergo LASIK surgery ?

LASIK stands for Laser assisted in situ keratomileusis, a kind of laser surgery designed to change the
shape of cornea ( the transparent structure in the front part of the eye) to eliminate the need for
wearing glasses or contact lenses.
Why? – LASIK is a cosmetic surgery and if anyone is not interested in wearing glasses or contact
lenses can opt for this procedure.
When? – Patients who are above the age of 18 years can undergo surgery (that is when normally the
power of the eye is stable) and definitely there is no upper age limit for undergoing LASIK surgery.
Who? – We need to do some scans of your cornea (thickness and curvature of the cornea) to know if
you are suitable for surgery.

How much time does it take to do surgery and what is the recovery period?

Normally we operate both eyes at a time, one after the other. It takes 20-30 minutes for the entire
procedure and vision is slightly blurred on the day of surgery. From very next day the clarity of
vision improves and you can go back to your normal routine activities. The doctor would advise you
some drops which you would be using as prescribed and it is important to maintain proper hygiene
for a week around your eyes.
For check ups post operatively you need to follow your doctor’s advise. Normally we review patients
the very next day, one week and one month after surgery.
There is no rest required after surgery, you can start doing your all normal routine activites from the
very next day.

What are the complications which one can expect in LASIK surgery?

No surgery is 100% safe and the same goes with LASIK surgery.
However less than 1% of patients develop surgical complications and most of them are manageable
with good surgical outcomes. The two most dreaded and vision threatening complications are
infection and Post LASIK ectasia.
To prevent infection it is important to use preoperative antibiotic prophylaxis, maintain proper
hygiene around your eyes after surgery and use medication properly as prescribed by your doctor.
Post LASIK ectasia is when the power comes back to your eyes after surgery, which can be reduced
by proper pre operative screening of patients. Nowadays we do have various treatment options to
improve vision in these patients as well.

What are the various kinds of LASIK available?

In LASIK surgery a flap is cut on the cornea which is lifted and subsequently laser correction is done
on the stromal bed. Subsequently the flap is placed back which stays in place because of the
curvature of the cornea and suction of the endothelium ( the inner most layer of the cornea ).
There are 2 methods to cut the flap : when we use a blade it is called Microkeratome LASIK and
when we use Femtosecond laser it is called Femtosecond laser enabled LASIK ( Bladefree LASIK).
The advantage with Femto LASIK is the cut which we get is very much precise with an accuracy of +/-
2 microns. The kind of flap which is get is planar there by reducing the incidence of post operative
dry eyes. Another advantage with laser is the side cut of the flap, so that post operatively the flap
fits snugly thereby reducing the chances of flap displacement after any minor trauma to the eyes.
Most of the complications which are reported in LASIK surgery are flap related and with Femtolaser
assisted LASIK they can be negated.

There are so many different LASIK treatments available so how do we choose which one is good
for us?

With the kind of machines available to us we can not only correct the power of glasses or contact
lenses which we wear but also correct the aberrations which we have in our eye. The aberrations
cause glare and haloes around light, star bursts and light sensitivity and effect your quality of vision,
so based on the aberrations you have which can be seen in the scans of the cornea the doctor can
advise which kind of treatment is suitable or best for you. The different treatment options are
wavefront guided or optimised treatments available in various treatment platforms of the different
LASIK machines.
We have the latest CONTOURA treatment which is basically a wavefront guided treatment which
gives a better quality of vision post operatively. The study done for the FDA approval showed that
almost 30% of patients had one line vision improvement and better quality of vision after they
underwent CONTOURA treatment.
If patient is not suitable for LASIK what are other surgical options to get rid of glasses or contact
lenses ?
Almost a third of patients who undergo LASIK screening are not suitable for surgery. For them based
on the power of your glasses and the scan reports of the cornea and anterior chamber of the eye,
you can undergo PRK ( Photorefractive keratectomy) or Permanent contact lenses ( Phakic IOLs)
which are placed inside the eye.
Unlike in LASIK, in PRK flap is not made and is preferred for lower myopes with borderline
pachymetry of the cornea.

How long does the vision correction last and will I again require glasses during my lifetime?

The distance vision correction is fairly permanent following laser vision correction. However, as with
the course of nature, there are some age related changes that will occur regardless of whether or
not you had LASIK surgery. But you will definitely require reading glasses as you near 40 regardless
of you undergoing LASIK surgery or not as this is a physiological phenomenon which we call as
Presbyopia.

How frequently should one undergo eye check up after LASIK surgery?

It is advisable to get a complete eye examination at least once a year irrespective of whether you
are undergoing any surgery or not and the same applies after LASIK surgery.