LASIK Eye Surgery – Procedure, Benefits, Risk & more
What is LASIK eye surgery?
Eyes are captivatingly beautiful. It has many parts, including the cornea, pupil, lens, sclera, conjunctiva and more. These all parts work together to help us see clearly. There is a possibility that some people might get vision problems like nearsightedness, farsightedness and astigmatism. In eyes with normal vision, the cornea bends (refracts) light onto the retina at the back of the eye. But with nearsightedness (myopia), farsightedness (hyperopia) or astigmatism, the light bends incorrectly, which results in blurred vision. There is a popular surgery known as LASIK Surgery (Laser-assisted in situ keratomileusis) to correct vision problems. It is an excellent alternative to replace glasses or contact lenses. During LASIK surgery, a special type of reshaping laser is used to change the shape of the dome-shaped clear tissue at the front of your eye (cornea) to improve vision.
Why is it done?
LASIK is pain-free and requires only about 15 minutes to treat both eyes. Vision improvement is immediate and often stabilizes within 24 hours. LASIK surgery may be an option for the correction of one of these vision problems:
- * Nearsightedness (myopia)- When your eyeball is slightly longer than normal or when the cornea curves too sharply, light rays focus in front of the retina and blur distant vision. You can see objects that are close, but not those that are far away.
- * Farsightedness (hyperopia)- When you have a shorter than average eyeball or a cornea that is too flat, light focuses behind the retina instead of on it. It can make near vision, and sometimes distant vision, blurry.
- * Astigmatism- When the cornea curves or flattens unevenly, it disrupts focus of near and distant vision.
Conditions for surgery
You shouldn’t have the surgery if you:
- * Are younger than 18
- * Are pregnant or nursing
- * Take certain medications
- * Have a lot of recent changes to your vision prescription
- * Have thin or uneven corneas
- * Have eye conditions such as very dry eyes
- * Have other health issues such as diabetes, lupus, or rheumatoid arthritis
Risks of LASIK surgery include:
- * Dry eyes- LASIK surgery causes a temporary decrease in tear production. For the first six months or so after your surgery, your eyes may feel dry as they heal. Dry eyes can decrease the quality of vision. Your doctor might recommend eyedrops.
- * Glare, halos and double vision- You may have difficulty seeing at night after surgery, which usually lasts a few days to a few weeks. You might witness increase in light sensitivity, glare, halos around bright lights or double vision.
- * Under corrections- Rarely, if the laser removes too little tissue from your eye, you would not get the clearer vision results you were hoping for. Undercorrections are more common in people who have nearsightedness.
- * Over corrections- It is rarely possible that the laser will remove too much tissue from your eye. Overcorrections may be more difficult to fix than undercorrections.
- * Astigmatism- It can be caused by uneven tissue removal. It might require additional surgery, glasses or contact lenses.
- * Flap problems- Folding back or removing the flap from the front of your eye during surgery can cause complications, including infection and excess tears.
- * Regression- It is when your vision slowly changes back toward your original prescription. This is a less common complication.
- * Vision loss- Rarely, surgical complications can result in loss of vision. Some people might not be able to see as sharply or clearly as they could see earlier.
There are various advantages of LASIK Eye surgery which includes:
- * LASIK is associated with very little pain because of the numbing drops that are used
- * Vision is corrected nearly immediately or by the day after LASIK
- * No bandages or stitches are required after LASIK
- * Adjustments can be made years after LASIK to further correct vision if vision changes while you get old
- * After having LASIK, most patients have a dramatic reduction in eyeglass or contact lens dependence and many patients no longer need them at all.
How to prepare?
- * Cost- LASIK surgery is usually considered elective surgery, so most insurance companies would not cover the cost of the surgery. You have to pay out-of-pocket for your expenses. Powers in excess of 7 diopters may be covered in insurance.
- * Arrange for a ride home- You need to have someone drive you to and from your place of surgery. Immediately after surgery, you might still feel the effects of medicine given to you before surgery, and your vision may be blurry.
- * Avoid eye makeup- Do not use eye makeup, cream, perfumes or lotions on the day before and the day of your surgery. Your doctor may also instruct you to clean your eyelashes daily or more often in the days leading up to surgery, to remove debris and minimize your risk of infection.
Careful evaluation by the doctor has to be done. You will need to completely stop wearing contact lenses and wear only glasses for atleast 3 days before the evaluation. During the evaluation, eye doctor will ask about your medical and surgical history and give you a comprehensive eye examination to evaluate your vision and assess whether you can undergo the procedure safely.
Your doctor will look for signs of:
- * Eye infection
- * Inflammation
- * Dry eyes
- * Large pupils
- * High eye pressure
Doctor will also scan the cornea, noting the shape, contour, thickness and any irregularities. And also will evaluate which areas of your cornea need reshaping and determine the precise amount of tissue to remove from your cornea
Your cornea would be reshaped by using a laser. Here is what to expect:
- * Your eye will be numbed with eye drops.
- * Your eye surgeon will place an eyelid holder on your eye to keep you from blinking. He or she would also place a suction ring on your eye to prevent it from moving. You will feel pressure on your eyelid. This is the time when your vision will go dim or black. A device called a microkeratome or a laser is used by your ophthalmologist to make a paper-thin flap in the cornea tissue followed by lifting the flap and folding it back. You will be asked to stare at a target light so that your eyes will not move. The ophthalmologist then uses a laser to reshape your cornea. The laser is a instrument that has been designed with measurements for your eye.
- * While your ophthalmologist is using the laser, you will hear a buzzing sound. After reshaping of the cornea, your eye surgeon will fold the flap back down and smoothes the edges. Then the flap attaches on its own within 2–3 minutes, where it will heal in place.
- * The ophthalmologist may ask you to wear a shield while sleeping for a few days. This helps to protect your eye while it heals.
- * You should go home and take a nap or just relax after the surgery.
- * or a few hours, your eyes may feel scratchy or feel like they are burning. You would be given some special eye drops to reduce dryness and to heal eye.
Difference between LASIK and SMILE Surgery
- LASIK can be used to treat all types of refractive errors, whereas SMILE is used to treat myopia with or without astigmatism.
- LASIK is not done in those with thin corneas whereas SMILE is done
- The risk of scarring is higher in LASIK than in SMILE
- LASIK involves a flap to be surgically made in the cornea whereas SMILE is flapless technique to flatten and reshape the cornea
- LASIK is a two-stage procedure while SMILE is done in a single stage
Dr. Prashaant Chaudhry,
Senior Consultant & HOD
Ophthalmology & Refractive Surgery