Before and After LASIK Eye Surgery |Who Should Not Have Laser Eye Surgery

Understand The Benefits Of Laser Eye Surgery

Lasik Eye Surgery or laser in situ keratomileusis is a surgical procedure for the correction of myopia, hypermetropia, and LASIK for astigmatism. Other similar procedures include PRK(photorefractive keratectomy) and LASEK (laser epithelial keratomileusis).

In the present era, LASIK is the most widely used surgery for the removal of glasses and contact lenses.

The procedure is performed with a laser and microkeratome that plays a role in reshaping the cornea. It will improve the visual acuity near the normal level depending on the initial visual equity and co-existing conditions. 

The corneal flap is created with the help of the microkeratome and surface ablation is performed with laser eye surgery.

Like any other surgical procedure, LASIK has got some risks and benefits which need to be kept in mind while opting for the procedure.

The article will help you provide knowledge about the procedure of LASIK refractive surgery, its risks and benefits, and inclusion and exclusion criteria.

PRK vs LASIK eye surgery

Is there any treatment option to get rid of glasses or contact lenses?

Yes, with the advancement made in refractive surgery, you can get rid of glasses or contact lenses with various laser procedures.

What is the most popular laser refractive procedure?

LASIK Eye Surgery (laser in situ keratomileuses) is one of the most popular procedures performed.

What type of patient should be discouraged for LASIK Eye surgery?

Patients with unrealistic expectations or not willing to accept risks should be discouraged to undergo laser surgery.

What is the age limit for LASIK Eye surgery?

The lower age limit is 18-21 years or when refractive stability is reached (no change of >0.50D in 2 years).

What is the refractive error range for LASIK surgery?

The range of refractive error correction may vary according to the thickness of the cornea. On average +6 to -12D covers the main range of LASIK, PRP, and LASEK. Up to 5D astigmatism can be corrected.

who should not have laser eye surgery?

You may be using medications or have an illness that affects how well wounds heal. Diabetes, HIV, inflammatory illnesses like lupus and rheumatoid arthritis, and some drugs like retinoic acid and steroids can all interfere with a patient’s ability to recuperate well from a refractive operation.

Before LASIK eye surgery

What types of investigations are done before the laser Eye procedure?

The ophthalmologist will carry out a full ophthalmic examination to determine if you are a good candidate for LASIK surgery. During this doctor will ensure that you are in good health, have healthy eyes, and have a sufficient thick cornea for LASIK surgery. If your corneas are too thin for LASIK, you may still be a candidate for the PRK procedure. Other investigations like pachymetry, corneal topography, and keratometry are also performed.

What are pachymetry, corneal topography, and keratometry?

1.     Pachymetry:

 Corneal thickness is a limiting factor for laser correction. With the help of pachymetry, the thickness of your cornea is evaluated. The minimal residual bed of the cornea should be >250 microns, in order to avoid any ectasia.

2.     Corneal topography:

This test is mandatory for all patients undergoing laser procedures. It is a topographical mapping of the cornea. Any type of ectatic disease (keratoconus, pellucid marginal degeneration, etc) should be excluded.

If not evaluated carefully the laser surgery will further weaken the cornea, leading to further ectasia.

3.     Keratometry:

The diopter power of your eye is measured with keratometry. The accepted values are a minimum of 38D after myopic correction and a maximum of 50D after hypermetropic correction.

What technique is used during the Lasik eye surgery

The technique involves creating a thin flap of the cornea with a microkeratome blade or a femtosecond laser. The flap is then lifted and the stromal bed is reshaped with the excimer laser. The flap is then replaced and adheres to the bed within a few minutes.

does laser eye surgery hurt

Luckily, LASIK eye surgery doesn’t hurt. Your surgeon will put numbing eye drops in both of your eyes just before the procedure. While the process may still cause you to feel some pressure, you shouldn’t experience any pain.

What is the advantage of LASIK eye surgery?

LASIK eye surgery is less painful with rapid visual rehabilitation

Complications

What are the complications of LASIK eye surgery

LASIK Eye Surgery Complications can be divided into the following

1.     Microkeratome or flap-related problems:

a.     Irregular flap:

Due to poor suction or mechanical failure, the flap may be irregularly formed. The management depends on the extent of the flap. If the flap is adequate, ablation is completed.

If the flap is inadequate, the procedure is stopped and postponed for up to 3-6 months.

b.     Free cap:

In case a free flap is formed, the flap is carefully placed and allowed for healing.

c.      Buttonhole:

The buttonhole is associated with poor visual outcomes. Management involves abortion of the procedure and planning surface ablation at later date.

2.     Early postoperative complications:

a.     Under or over-correction:

Under correction is a frequent complication. It can be treated if needed. Overcorrection is a less common complication and needs observation, as regression may occur.

b.     Sliding or dislodged flap:

It is most common in the first 24hr. Treatment involves immediate placement of the flap in its position.

c.      Free flap:

The free flap can be caused due to eye rubbing or attachment to the eye patch. Treatment involves placement of the flap with sutures if viable.

d.     Diffuse lamellar keratitis:

It is most common in the first 24hrs. The etiology is unknown. Treatment involves aggressive topical steroids.

e.      Infectious keratitis:

Invading organisms can lead to infectious keratitis. Treatment involves the use of antibiotics and samples are taken for culture.

3.     Late post-operative complications:

a.     Regression:

Return of the refractive error after 3-6 months. If significant retreatment is required.

b.     Glare and haloes:

Usually occurs at night. It is associated with a small treatment zone. Treatment involves observation.

c.      Dry eyes:

LASIK may induce or exaggerate preexisting dry eye. It is the most frequent complication. The creation of a flap causes corneal nerve damage which takes 6-12 months to regenerate. Treatment involves topical lubricants and artificial tears.

What is the most common complication of LASIK Eye Surgery

The most common complication is a dry eye disease.

After LASIK Eye Surgery

When can I go back to work after LASIK eye surgery?

you are most likely wondering how soon after the surgery you can start your normal activities. Although it’s different for everyone, here are the recommended wait times for different activities.

  • Work: you can join the office work after a day or two.
  • Driving: your vision will clear immediately after the surgery but you must have someone drive you home. The eye drops used during the surgery cause your eyes to be sensitive to light for some hours.
  • Swimming: Showering is allowed the day after surgery avoid getting soap or shampoo in your eyes. avoid pools, tubs, and lakes, for at least two weeks.
  • Exercising: resuming exercise within a few days. Be careful not to touch your eyes for at least two weeks

What if I accidentally rub my eye after LASIK eye surgery?

There might be a chance that your corneal flap may be displaced if you rub your eye
immediately after the procedure. The replacement may need surgical advice.

Is LASIK permanent?

Ideally, the LASIK procedure is permanent. In some cases, a regression can happen and you may develop the old refractive error once again.

How many times you can have LASIK eye surgery?

LASIK can be performed more than one time, however, more than three times may render its effect useless and may harm your health.

Can you go blind from LASIK?

No, the majority of the patients do not become blind with LASIK, however, there are complications explained above that can cause distortion in vision or lead to blindness.

Conclusion

LASIK eye surgery is a popular procedure that uses a laser to reshape the cornea and correct myopia, hypermetropia, and astigmatism. It can eliminate the need for glasses or contacts. Before the surgery, the ophthalmologist will perform a full eye exam and other tests to ensure that the patient is a good candidate for LASIK. The surgery involves creating a thin flap of the cornea, reshaping the stromal bed with the laser, and then replacing the flap. The procedure is relatively painless and has a quick recovery time. However, there are potential complications, including irregular flap formation, under or over-correction, and dislodged flaps. Patients with unrealistic expectations or certain medical conditions may not be good candidates for LASIK.

FAQ

How long does the LASIK eye surgery take?

The actual LASIK procedure usually takes less than 15 minutes per eye, but you should plan to be at the surgery center for an hour or two.

Can LASIK eye surgery be performed on both eyes at the same time?

Yes, LASIK eye surgery can be performed on both eyes at the same time.

How long does it take to recover from LASIK eye surgery?

Most people return to work and normal activities within a day or two after the procedure, although some may take a week or two to fully recover.

Is LASIK eye surgery permanent?

LASIK eye surgery is intended to be permanent, but there is a small chance that your vision could change again in the future.

Will I need glasses after LASIK eye surgery?

Many people who have LASIK eye surgery no longer need glasses or contacts for most activities, but some may still need glasses for certain activities, such as reading or driving at night.

What are the risks of LASIK eye surgery?

Although LASIK eye surgery is generally considered safe, there are some risks involved, including dry eyes, halos or glare, and vision loss.

Is LASIK eye surgery covered by insurance?

LASIK eye surgery is considered an elective procedure, so it is usually not covered by insurance. However, some insurance plans may offer a discount or financing options for the procedure.

Dr Sadia Ayaz
Dr Sadia Ayaz

I am an ophthalmologist and eye surgeon

Articles: 47

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