Lasik Eye Surgery Information - Lasik Surgery Questions Answered
What is LASIK Eye Surgery?
LASIK is a surgical procedure intended to reduce a person’s dependency on glasses or contact lenses and not, as is usually thought, designed to totally eliminate the spectacle power, which is often, impossible. There are certain things you need to understand about LASIK treatment.
- The accuracy of the post LASIK residual power is based on many factors like pre-operative high myopia or you may not need to use glasses for over 85% of the time, but some residual power is to be expected.
- LASIK is for all practical purposes a painless procedure though you will feel a little tightness and mild discomfort when the initial clip is used to open the eye lids, and when the Microkeratome makes your initial flap.
Why has LASIK Eye Surgery become so popular all over the World?
LASIK has the big advantage that it is, for all practical purposes, A painless procedure. Following the completion of the entire procedure the patient may occasionally complain of a feeling like a hair in the eye and that too not too often. The feeling goes away in about 4 hours and after that, its simply progressive improvement of vision with virtually no discomfort.
How is LASIK Surgery done?
Microkeratome is placed on the cornea thin perfectly transparent flap on the cornea. The patient only feels a little buzzing on the The flap is simply lifted up, rolled out of the A super specialized little device called a way and the Laser is applied. The laser utilizes remove the tissue from the cornea, literally desired which will eliminate the spectacle power. The flap is put back in place and the procedure is over.
What are the essential components of the LASIK technique?
The two essential components of the LASIK procedure are the Excimer Laser and the Microkeratome.
The day Before the LASIK procedure
- You should start the antibiotic drops you have been given, and stop using any eye makeup, lash extenders kajal, surma.
- Please discontinue the use of any makeup, eye creams or lotions as they tend to work into the eye. You should have an early night.
- Try to minimize any exposure to excessive cigarette smoke or dust as for that day we want the eye completely quiet.
On The Day of the LASIK procedure
- On the day of the procedure, wash your face with hot water and lots of soap. Wash your eyes out thoroughly with water prior coming.
- Remember to bring all your papers, your fresh spectacle refraction, topography maps abberometry details with you when you come for the LASIK.
- LASIK is true ambulatory procedure. There is no admission. You simply lie on the laser bed, and once complete, you can walk out. The actual laser time is literally measured in seconds. There is no pain at all. Numbing drops are all that is used.
What should I expect before, during and after Lasik Eye Surgery?
Before Lasik Surgery
If you decide to go ahead with Lasik eye surgery, you will need to be evaluated in detail as to whether your eye is fit for Lasik Surgery. This is termed as a “Baseline LASIK evaluation”. It is mandatory that the use of contact lenses be discontinued and switch to wearing your glasses, full-time prior the initial examination, termed the “baseline evaluation”.
Contact lenses tend to change the shape of your eye. Especially if you have been wearing the lenses for a prolonged period of time. Especially with high powered lenses and RGP or hard lenses the cornea literally moulds itself to the shape of the lens. After the lens is removed the cornea gradually reverts back to its resting stage. If Lasik surgery is done too soon the cornea will change in shape and lead to irregular results. It also produces inaccurate measurements which lead to an inadequate result. Often one is hasty in wanting to do a Lasik procedure fast and most contact lens wearers do not want to be seen in glasses but it is a wise precaution and makes sense that you should discontinue wearing
- Soft contact lenses, for 5 days before your evaluation and surgery.
- Toric soft lenses, should be stopped at least 8 days prior the procedure.
- Rigid (hard) or gas permeable (RGP) lenses, you should stop wearing them for at least 2 weeks before your initial evaluation.
The doctor will carry out a full eye examination including a retinal evaluation to be sure your eyes are normal in every way. You should be careful to tell him about your past and present medical and eye conditions, any history of trauma, infection, red eyes, hazy vision, and about all the medications you are taking or you may be allergic to.
During the LASIK procedure
The entire Lasik surgery procedure is very fast. You will be given a cap to wear and requested to lie under the Excimer Laser operating microscope. Numbing drops will be put in the eye. You will be asked to keep your eyes shut as the outside of the eye is cleaned with Betadine (antibiotic) solution and then dried again. As a next step a smooth clip will be placed to keep the lids apart. You will be asked to open your eyes as wide open as you can . There is no pressure on the lids at all. Then a small suction ring is applied on the white of the eye to immobilize the globe at the time of lifting the very fine flap. You will only feel a little tightness, but there is no pain, or for that matter, even discomfort.
The Microkeratome is simply placed in the arms of the suction ring and for exactly 3 seconds it automatically moves forwards. You will feel a slight buzzing and then the machine reverses itself automatically to its initial position. The entire procedure is over in exactly 6 seconds. The instrument is lifted off, and the suction is released and the ring is removed. While the suction ring is on the machine is working on the front of the eye you will naturally not be able to see as the machine is in front of your eyes, but again its only for the 6 seconds.
The surgeon will lift off and fold the flap back. Next the red blinking light will be properly focused for you to see and the room will be darkened so you can focus on the light properly. When the surgeon is fully satisfied that you are fixating properly on the light he will tell you that the laser will go on. The laser makes a clicking sound and will stay on for anytime between 15 to 40 seconds depending on the power of the eye which is to be corrected. You will feel nothing.
Each individual pulse of the laser is designed to remove a very fine quantum of tissue. Since with wave front controlled LASIK, the data has already been fed into the computer of the Excimer laser, it will do exactly the correct amount and automatically stop. The eye will then be well washed with a balanced salt solution, the flap aligned back into place and then a bandage contact lens is placed on the eye. The bandage lens makes sure that the flap exactly sits back into place and no dust or dirt can get in. Antibiotic solution is then applied and the procedure for that eye is over. After both eyes are completed, you will be asked if you feel OK and then you walk out of the laser room with new vision.
Immediately after LASIK procedure
There is always a tendency to feel a bit itchy and a little poky in the operated eyes. Often one eye seems to be more than the other. Though you will feel no pain, they may feel a bit heavy for some time. All this is normal. The eyes will also have a tendency to run with a little water for at least 4 hours after the LASIK procedure. Please do not worry. It’s fine.
The vision will be little blurry for the first 4 hours and then gradually settle down. You will be given some tablets to take to make it more comfortable for you. It is also important that you do not rub your eyes as rubbing will dislodge the bandage contact lenses and may even misalign the flap below.
The whites of your eyes may have a few fine red spots on it following the laser. This again is quite normal and occurs due to the suction ring which was placed on the eye. These go away in 10 days and are of no significance.
You should see your doctor the next day after surgery and at regular intervals after that. The routine 1st day, 10th day, 1st month, 3 months, 6 month and 1 year following the procedure. For at least the first six months. At the first postoperative visit, your doctor will remove the bandage contact lens and test your vision and examine your eyes.
Unless your number was very high or was a complex mix of astigmatism, you will be able to see the second last line on the very first day. It will appear a little misty, but you can read it. It all settles down in time. You will be given antibiotic/anti-inflammatory eye drops to take at home to help prevent infection and/or inflammation, and will also be advised to use artificial tears to help lubricate the eye.
You can have a head bath and even wash your face after 4 days following the LASIK, but please no eye make up for 15 days following the LASIK and no kajal and surma for a month following the procedure. Try to avoid using any creams or lotions around the eyes for 15 days and do not go for a swim for a month. Naturally you will avoid contact sports like karate and jujitsu for at least 3 months.
How soon will my vision stabilize after Lasik Surgery?
The speed at which the vision returns is very much dependant on the power which has been corrected and the complexity (associated astigmatism and irregularities on the cornea). Simple powers up to -4.00 usually recover very fast and in a period of 5-7 days, quite good vision is attained and the vision is stable.
In higher powers the computer has in its software designed to overcorrect by 5-7%. This is because in higher powers in a period of a month, a certain amount of power returns. After this small component returns it remains stable. Based on the experience of over 75,000 cases done all over the world, the software buykit into the Laser does the appropriate correction. Thus for a power of -10.00 an over correction of 0.7 would be done which over a month or 6 weeks gradually recedes so that at the end of the period you are left without any power. This also means the for the 1st month, reading will require you to take your reading material or your mobile a little further then you would normally do so and the vision will remain a little misty for distance. All this is quite normal and will recover in due course.
Following power correction of more than 7.00D, even if wavefront controlled, some glare, haloes around point sources of light and a little difficult in driving is normal but usually settles down in about 2-3 months after which time usually it is not noticeable.
When is LASIK treatment not suitable for you?
- High Cost of the lasik treatment is a major issue. Mediclaim medical insurance will not pay for refractive surgery. As it is classified as a cosmetic procedure. On the other hand some Mediclaim providers permit it for one eyes if the power is more than 7.00D. Ask your Mediclaim provider before undergoing LASIK.
- Repeated changes of spectacle power over the last year. This type of instability tends to occur in the earlier age group.
- Appearing for or have to appears for major examination where excessive night time study is involved.
- Pregnant or breast feeding.
- You have an illness which may affect wound healing. Certain conditions, such as autoimmune diseases (e.g. lupus, rheumatoid arthritis), immunodeficiency states (e.g. HIV) and unstable diabetes, and some medications long term use of steroids and retinoic acid may prevent proper healing after a refractive procedure.
- Contact sports are your love or career. Any career or sport where blows on the face are expected, like boxing, wrestling, martial arts, judo jujitsu etc. Should not have LASIK though PRK is perfectly acceptable
- You are not an adult. Currently, no lasers are approved for LASIK on persons under the age of 14 years unless it is done for therapeutic reasons (unilateral amblyopia with abberopia)
- It is not advisable to undergo LASIK if you have or have had eye diseases, such as uveitis/iritis (inflammations of the eye)
- Eye injuries or previous eye surgeries unless carried out for polishing and smoothing as after keratoplasty or corneal trauma with surface irregularities.
- Keratoconus is a complete contraindication unless following or in conjunction with U-Vex laser
- Herpes of the face or long standing face or lid infections.
Side Effects of Lasik Eye Surgery
No vision correction procedure is without the risk of complications or side effects. Though LASIK has been in use since 14 years, is a relatively new procedure, it is possible that there may be longer-term risks that are unknown at this time. Risks and discomforts that might be associated with the LASIK procedure can be read at the link below. All are rare but possible.