Laser Refractive Surgery
LASIK (laser in-situ keratomileusis) is a widely used refractive eye surgery to correct near-sightedness, farsightedness, presbyopia (loss of ability to focus on nearby objects), and astigmatism (improper curvature of the eye’s surface).
The surgery works by remoulding the cornea (transparent dome-shaped front part of the eye), allowing proper focusing of the light that passes through the cornea onto the retina (light-sensitive membrane at the back of the eye).
To prepare for LASIK you will have to
- Stop wearing contact lenses and switch over to glasses at least a few weeks before the procedure
- Avoid using eye makeup the day before and day after surgery
- Maintain good hygiene of the eyelashes to reduce infection
Your doctor will review your medical history and conduct a detailed eye examination to measure your cornea, making a note of the shape and any irregularities. This helps the surgeon determine the exact regions that need reshaping. The wavefront-guided technology uses a scanner to generate a detailed chart of the eye’s topography.
You will be seated in a reclining chair and given medication to relax you. Eye drops will be instilled to numb your eyes. Your doctor will use a special instrument to keep your eyes open during the procedure. You will be asked to focus on a source of light in order to keep your eye fixed during the procedure. Your doctor will then use a special cutting laser to cut a thin flap in the cornea similar to a hinge. The flap will then be peeled back and the underlying corneal tissue will be remoulded. Once the cornea is reshaped appropriately so that it properly focuses light onto the retina, your surgery will be completed by folding the cornea flap back into place, where it will heal normally without the need for stitches. The entire procedure takes 30 minutes or less.
Following the surgery, you can expect some irritation as your eyes will be dry. You will be given medicines and eye drops to keep your eyes moist and to prevent pain and infection. Your doctor may advise you to use a patch over your eyes at night until they heal. You may have problems with vision for the first day after the procedure, but healing occurs fairly rapidly, and you may experience improved vision in a few days.
You will need to follow up with your eye doctor in one or two days and keep regular follow up appointments periodically during the first six months. During your recovery period, you will have to avoid strenuous activities, contact sports, and swimming for a few weeks.
As with any surgery, LASIK carries its own set of risks which include:
- Under correction: You will not experience clear vision if the procedure removes too little tissue from your eyes. Under correction can be corrected by performing a second refractive surgery within a year.
- Overcorrection: Overcorrection can be more difficult to rectify than under correction, as more than the required amount of tissue is removed.
- Astigmatism: Uneven tissue removal can alter the shape of the cornea and may require additional surgery.
- Dry eyes: Temporary decrease in tear production can be expected after LASIK for up to six months. You may require additional surgery in severe cases.
- Vision abnormalities: You may experience glares, halo, or double vision temporarily for some days after LASIK. You may require additional surgery if they worsen.
Conditions such as rheumatoid arthritis, immunodeficiency, pregnancy, persistent dry eyes, unstable vision, and abnormal shape of the cornea can increase the risks associated with LASIK. Your doctor will be able to address all your concerns before you consider LASIK.
LASIK is preferred over other methods due to the following benefits:
- It has been proven to correct vision in about 90% of the patients
- Your vision may be corrected almost immediately
- You will have less pain
- You won't require adhesive dressings (no stitches or bandages)
- Your dependence on eyeglasses and contact lenses may be reduced. Most patients no longer require assistive devices after LASIK.