Lasik Refractive 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 PRP(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 laser and microkeratome that plays a role in reshaping the cornea. It will improve the visual acuity near to 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 the LASIK refractive surgery and its risks and benefits along with inclusion and exclusion criteria.
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 Surgery (laser in situ keratomileusis) is one of the most popular procedure performed.
What type of patient should be discouraged for lasik 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 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.
What types of investigations are done before laser Eye procedure ?
The ophthalmologist will carry out a full ophthalmic examination to exclude any type of contraindications. Other investigations like pachymetry, corneal topography, and keratometry are also performed.
What is pachymetry, corneal topography and keratometry?
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 cornea should be >250 microns, in order to avoid any type of ectasia.
2. Corneal topography:
This test is mandatory for all patients undergoing laser procedure. 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.
The diopter power of your eye is measured with keratometry. The accepted values are minimum of 38D after myopic correction and a maximum of 50D after hypermetropic correction.
What technique is used during the Lasik eye procedure?
The technique involves creating a thin flap of 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.
What is the advantage of LASIK eye surgery?
LASIK Procedure is less painful with rapid visual rehabilitation
What are the complications of LASIK eye surgery?
LASIK 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 extend of the flap. If the flap is adequate, ablation is completed.
If the flap is inadequate, the procedure is stopped and postponed 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. Button hole:
The buttonhole is associated with poor visual outcomes. Management involves abortion of the procedure, and to plan 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:
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. 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:
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 flap causes corneal nerves damage which takes 6-12 months to regenerate. Treatment involves topical lubricants and artificial tears.
What is the most common complication of LASIK procedure ?
The most common complication is dry eye disease.
When can I go back to work after LASIK surgery?
You can join the office work after a day or two.
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 surgery?
LASIK can be performed more than one time, however, more then three times may render its effect useless and may harm your health.
What if I accidently rub my eye after LASIK?
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.
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.