LASIK eye surgery

Overview

LASIK is a well-known refractive eye surgery that helps in vision correction by reshaping the cornea. This surgery helps rectify vision for those suffering from astigmatism, farsightedness (hyperopia), and near-sightedness (myopia).

LASIK, which denotes laser in-situ keratomileusis, rectifies vision issues by working on the cornea. The procedure uses a laser to alter the shape of the cornea, the clear tissue in front of the eye. This improves vision by helping the light to focus on the retina, at the back of the eye. Those who undergo LASIK will not have to use contact lenses and glasses to improve their vision.

When should you go for LASIK eye surgery?

Those enjoying normal vision do so because the light precisely focuses on the retina, at the back of the eye. In patients with myopia, astigmatism, or hyperopia, the light does not refract correctly. This causes problems in vision.

Although contact lenses and glasses can rectify the vision, LASIK surgery reshapes the cornea to acquire the required refraction.

LASIK surgery helps correct vision when patients experience the following conditions:

Astigmatism: The cornea of patients suffering astigmatism experiences an irregular flattening or curving of the cornea. The condition is called astigmatism- both distant and near vision is affected in such patients.

Near-sightedness (myopia): In this condition, the curve of the cornea is too sharp or the size of the eyeball is more than it should be. At this time, the light falls in front of the retina. This can cause distant vision to blur.  The patients are able to see the closer objects clearly, but the farther ones are unclear.

Farsightedness (hyperopia):  This occurs when the eyeball is shorter than normal or if the cornea is flat. This causes the light to fall behind the retina, and the vision is blurred. The distant vision is also not clear in this condition.

Most patients thinking of LASIK surgery are already wearing either glasses or lenses.  If anyone wishes to go for LASIK surgery, they must have a detailed discussion with the eye surgeon and take the decision.

Cost of surgery

LASIK eye surgery in India is less expensive compared to the UK, Singapore, and the U.S. Most insurance companies do not cover LASIK surgery. This is because it is thought to be an elective procedure.

The cost of LASIK surgery can range between INR 85,000 up to Rs.1 00,000, depending upon the hospital offering the service, extent of refractive error, and the specialist’s skill in performing the surgery.

Preparation

Evaluation and preparation for the surgery is important to improve the outcome of the surgery. It is during this time the surgeon evaluates if the patient will fit into all the parameters required for a successful LASIK surgery.

• The surgeon makes a complete evaluation using the wave front-guided technology to scan the eye. The report is very detailed that maps the interior of the eye with incisive measurements, so that the surgeon can get the exact picture to remove the corneal tissue.
• The surgeon assesses the cornea, its thickness, shape, and contour. These statistics helps evaluate and plan the procedure to reshape the cornea, and the right amount of tissue to remove from the cornea
• It is at this time the surgeon clarifies your queries and concerns. He will also lay the risks and benefits clearly in front of you
• You will need to inform him about your medical history and information about surgeries undergone in the past
• Before the surgery, you should keep the eyelashes clean. It is good to clean them every day. This will clear all the debris and reduce the risk of infection
• You will not be able to drive after the surgery. This is because the effects of the medicine will be lingering and the vision will not be clear. It is a good idea to arrange for the drive back home
• Eye makeup is not a good idea before the surgery. Infact, lotions, perfumes, creams and other cosmetics that can reach the eye, should not be used before the day of the surgery
• In order that the doctor is able to make a correct assessment before the surgery, you need to stop wearing contact lenses. You can wear your glasses a few weeks before the surgery.

Some of the signs the surgeon will observe and make a note are:

• Big pupils
• Swelling
• Infection in the eye
• Dry eyes
• Abnormal pressure in the eye

Procedure

• You will be on a reclining chair on your back. The surgeon may prescribe a medicine to help you relax.
• Drops with an effect to numb the area is  used in the eye. The procedure does not take more than 30 minutes.
• The surgeon keeps the eyelids open using a device. A cutting laser or blade is used to cut a small flap from the eye. The surgeon folds the flap and this helps gain access to the region of the cornea to be reshaped.
• You need to focus your gaze on a point of light during the procedure. This helps you keep the eye fixed and at this time, the laser beam gives a new shape to the cornea.
• The surgeon now uses the laser beam to remove a small amount of the corneal tissue. After reshaping the cornea, the flap is put back the way it was. This does not need any stitches and heals on its own.
• Incase, the surgery is required in both eyes, the surgeon usually performs the procedure on the same day.

Risks of LASIK eye surgery

The risk of loss of vision is uncommon. What patients do report as side effects are transient problems with vision, such as glare and dry eyes.

These side effects last few weeks to months and do not pose a problem in the long-term

Under-corrections

In certain cases, patients may not be able to realize the clear vision they were expecting after LASIK surgery.  This happens if the laser does away with too little tissue from the eye. Patients with nearsightedness happen to face this situation much more and   may need to undergo repeat LASIK procedure within a year to have more tissue removed.

Astigmatism

In certain cases, the tissue is removed unevenly. This can result in astigmatism, which can be set right with glasses, lenses or repeat surgery.

Issues with the flap

Complications can come up while removing the flap from the front of the eye or folding it back in the course of the surgery. There can be infection. Excess tears is also another complication. Further, the tissue on the outermost layer of the cornea may begin to grow underneath the flap.

Dry eyes

During certain times, LASIK surgery may result in decreased production of tears especially in the initial six months after surgery. This causes the eye to feel very dry and may result in poor vision quality. The treatment for dry eyes is eye drops. Incase, the condition becomes unmanageable, even with eye drops, another procedure is possible, in which plugs are inserted in the tear ducts, so that tears do not drain way from the eye surface.

Double vision and glare

Some patients report extreme difficulty with night vision post LASIK surgery. This sensitivity to light may remain for few weeks. Some patients also report double vision, or extreme glare and seeing halos around bright light. These side effects reduce on their own in few weeks.

Difficulty with vision in dim light may get pronounced after the surgery, compared to before the surgery.  

Over corrections

In certain patients, the laser removes too much tissue from the eye. This situation is much more complex to remedy, than the under corrections.

Regression

This is a rare complication, when the vision goes back to the original prescription.

Vision loss or changes

This is an extremely rare complication where it results in loss of vision. Patients may not be able to see as clearly as they were able to see before the surgery.

Contraindications

The presence of a few health conditions exacerbates the risks connected to LASIK surgery. Doctors may not recommend laser refractive surgery if you suffer from the following health conditions:

• Eye diseases
• Glaucoma
• Constant dry eyes
• Cataracts
• Vision changes that could be triggered by age, alterations in hormones , medications, pregnancy, breast feeding
• Eye injuries
• Disorders  of the lid
• Inflammation of the cornea
• Presence of autoimmune disorders
• Those with a weak immune system on immuno-suppressive medications

LASIK surgery cannot be performed if patients have the following:

• Big pupils
• Eye disease that causes the cornea to bulge and become thin
• Overall good vision
• Age associated eye changes that cause reduced vision
• Acute near sightedness

It is imperative to have a discussion with your doctor before you go for LASIK surgery.

Post-op care and things to keep in mind

Post-surgery, most patients experience blurred vision. It might also itch, water or burn. In the hours following surgery, patients complain of moderate pain. The vision will improve very quickly.

• Doctor will usually prescribe drops for the eye and will give painkillers so that you are fine for many hours following the procedure. It is a good idea to keep the eye protected from any sort of injury, until it completely heals.
• The eye will take about two to three months to completely heal and for the vision to stabilise.
• Your surgeon will advise you about the time frame to resume your activities, although contact sports, and swimming is to be avoided for few months.
• You will need to visit your doctor within one or two days following the surgery. This is the time when the doctor checks for any complications of surgery. You will need to have follow-up appointments for few months after the surgery.

Best option

It is extremely rare that the patients’ eyes go back to the level of vision they had before surgery.  Although in some cases, patients may need another surgery due to under correction.

Statistics show that nearly 8 out of 10 people that undergo LASIK surgery can do away with lenses or glasses.  Patients can hope to enjoy 20/25 vision after this surgery.

The outcome of this surgery hinges on the refractive error. The patients that enjoy better vision after LASIK are the ones with a low degree of nearsightedness

Getting all the services of consultation, surgery, post-op support, and help with recovery, under one roof will assist patients immensely.

goficure offers all of these healthcare services as a one-stop solution for patients. The service also includes handling the logistics of transportation for the patients before and after the procedure.

References