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July 2009
Lasik Vision Correction
Dr Sreedevi Yadavalli with Dr Rajesh Fogla

Celebrities who underwent LASIK
  • Tiger Woods in 1999, following
    which he won four golf championships
  • Cindy Crawford
  • Brad Pitt
  • Kenny G
  • Nicole Kidman

Eyewear these days are a fashion accessory. But as fashionable as they may be, for those who need to wear them on a regular basis for correcting refractive errors of the eye, they certainly do not seem chic and trendy.

In a bid to rid themselves of those distasteful frames that sit so heavily on the nose, and yet achieve vision correction, many opt for using contact lenses. Then again, contact lenses can never achieve the objective of allowing you to just wake up in the morning and be ready to see the world.

So what is it that the doctor would prescribe that approximates "wearing no lenses at all"? The answer is LASIK, an exciting surgical procedure capable of correcting nearsightedness (myopia), farsightedness (hyperopia) and astigmatism.

"While spectacles contain lenses that alter the incoming rays of light to enable them to focus on the retina, contact lenses enhance vision performance – especially for higher refractive errors - because they are placed on the cornea.

But with LASIK, you really 'wear no lenses at all' and achieve the ultimate in comfort," says Dr Rajesh Fogla, Senior Consultant, Corneal Surgeon at Apollo Health City, Hyderabad.

What is Lasik?
"LASIK is the acronym for laser assisted in-situ keratomileusis, and is currently the most commonly performed refractive procedure worldwide, including India," informs Dr Fogla.

LASIK is a variant of photorefractive keratectomy (PRK) – also called Advanced Surface Ablation (ASA). PRK or ASA involves removal of the corneal surface tissue, whereas LASIK combines the precision of the excimer laser used in PRK with the 'flap' technique. What this means is that using advanced technology, a thin flap of cornea is first created. This is then folded back, and laser treatment performed under this flap. "This exquisite precision in tissue removal helps in reshaping the corneal contour and correcting different refractive errors, even while the flap technique ensures far less pain for the patient," says Dr Fogla.

Other advantages of LASIK include:
  • Patient feels less pain, hence recovers faster.
  • Visual recovery is usually faster as well, because the surface layer of the eye does not need to re-heal after being removed as it does in PRK.
  • There is less corneal scarring in the long-term, less change due to healing (regression) and thus greater stability of the correction.
  • The effects of LASIK are permanent.
However, as advantageous as LASIK may be, PRK/ASA is at times medically justified as being a better alternative to LASIK in some cases. "There are times when pre-operative evaluation of the patient reveals that the corneal thickness of the eye is not sufficient enough to create a corneal flap, which is necessary for LASIK. In such cases, we recommend ASA, and take extra precautions to ensure that the outcome is similar or even better than customized LASIK," explains Dr Fogla.

In any case, LASIK is emerging as a much-in-demand procedure for vision correction. Almost anyone with refractive errors is eligible, except those under 18 years of age as such persons' eyes are likely to still undergo internal changes. Of course, the eligibility also depends upon the curvature and thickness of the cornea, and other factors that the ophthalmologist will evaluate during the pre-operative check.

What you can expect if you opt for Lasik
  • Performed as an outpatient procedure using topical anaesthetic drops
  • Entire procedure lasts 10-15 minutes only, and actual laser treatment lasts for only 5-30 seconds.
  • You will be awake during the procedure.
  • You can return home right after the procedure, but will need to arrange for someone to drive you home.
  • You will not need your spectacles or contact lenses after correction using LASIK.
  • Some patients with high refractive errors of over -10 may still need low-powered corrective lenses. The residual refractive error may be corrected in some through a second refractive procedure.
Possible side-effects
  • Most patients are comfortable following LASIK.
  • Some of those opting for ASA may experience mild to moderate discomfort the first day following procedure, which reduces subsequently.
  • When treating higher refractive errors (over -10), a slight under-correction or over-correction can occur.

     
Dr Rajesh Fogla is Senior Consultant, Corneal Surgeon at Apollo Health City, Hyderabad.

    
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