Lasik Eye Surgery | Laser Eye Surgery

Welcome to Lasik Eye Surgery Information

LASIK is commonly referred to as Traditional LASIK or LASER EYE SURGERY , is a safe and effective procedure for correcting myopia, hyperopia, and astigmatism. LASIK EYE SURGERY is performed at an eye laser center and it is suitable not only for treating higher prescriptions but also for treating patients with moderate to low amounts of myopia, hyperopia, and astigmatism.

LASIK has a remarkable success rate, with 96% of patients achieving 20/20 vision or better, according to the American Society of Cataracts and Refractive Surgery (ASCRS).

LASIK is similar to other surgical corrective procedures such as photorefractive keratectomy, PRK, though it provides benefits such as faster patient recovery and are thus viable alternatives to wearing corrective eyeglasses or contact lenses for many patients.

Here is how LASIK works:

Normally, your eye "sees" with your cornea (front part of the eye) focusing light onto the retina (back part of the eye) to create an image. If the cornea is imperfectly shaped or if the eyeball is longer or shorter than normal, a distorted image is projected onto the retina resulting in blurry vision.

For many years the only solution to this problem was corrective eyewear. Since the FDA's approval in 1998, LASIK has been the solution for more than 10.9 million people.

LASIK uses an excimer laser (a cool beam of light) to reshape the cornea in order to decrease or eliminate the need for glasses or contact lenses. LASIK helps you see and look your best!

The LASIK procedure works by removing tiny amounts of tissue from the cornea slightly changing its shape and the angle at which light enters through it and is projected onto the retina.

Corneal reshaping involves a two-step process: first, the LASIK surgeon exposes the cornea to the laser. On the cornea surface, the LASIK surgeon creates a tiny "flap" (the cornea surface layer is called the epithelium).

Once this is done, the laser gently reshapes the exposed cornea. Each pulse of the laser removes 39-millionths of an inch of tissue, enabling surgeons to achieve remarkable accuracy while maintaining excellent control throughout the procedure.

The flap is then replaced, adhering naturally and securely to the eye, and you are on your way to better vision.

Lasik Surgery Results

The surveys with LASIK Eye Surgery Proceedures have found that most patients are generaly satisfied, with satisfaction range being 92–98 percent.

A meta-analysis dated March 2008 performed by the American Society of Cataract and Refractive Surgery over 3,000 peer-reviewed articles published over the past 10 years in clinical journals from around the world, including 19 studies comprising 2,200 patients that looked directly at satisfaction, revealed a 95.4 percent patient satisfaction rate among LASIK patients worldwide.

Some patients with poor outcomes from LASIK surgical procedures report a significantly reduced quality of life because of vision problems or physical pain associated with the surgery.

Patients who have suffered Lasik Eye Surgery complications have created websites and discussion forums to educate the public about the risks, where prospective and past patients can discuss Lasik Eye Surgery.

Am I Suitable for Laser Eye Surgery?

If you are considering laser eye surgery, you must undergo a thorough eye examination at a Lasik Centre to determine your suitability.

Only after this examination, in consultation with you, can a decision be made as to whether or not refractive surgery is appropriate and suitable. In particular, your eye specialist can diagnose any conditions that may make surgery a poor choice for you, and recommend an alternative solution. There are many Lasik centres so do your research and find one that you are comfortable with and has the experience and qualifications.

Most Suitable Candidate

1. You are over 18 years of age and have had a stable glasses or contact lens prescription for at least two years.

2. You are affected by one of the common types of refractive error such as short-sightedness, long-sightedness, or astigmatism.

3. You do not suffer from any disease, ocular or general, that may affect the effectiveness of the surgery, or the ability to heal properly and quickly. You are in good general health.

4. You are adequately informed about the benefits and risks of the procedure, as well as any suitable alternatives. These include non-surgical solutions, such as glasses, contact lenses, or orthokeratology (ortho-K), and other surgical procedures, such as radial keratotomy (RK), conductive keratoplasty (CK), lens implant, or lensectomy with intra-ocular lens implants.

5. You have realistic expectations, and understand that the surgery should reduce your dependency on glasses and contact lenses, but may not completely eliminate them.

Less Suitable Candidate

The surgeon may still be able to perform the surgery safely in some cases, provided you and the surgeon have discussed the risks, benefits and expected results.

1. You have certain eye problems or a history of eye problems, such as amblyopia (lazy eye), strabismus (muscle imbalance), severe dry eyes, previous eye surgery or injury, or any recurrent, residual or active eye conditions which may affect healing. Other conditions that you should tell your doctor include keloid scarring with previous surgical healing, back problems, claustrophobia or other psychological problems, which may affect the surgery or recovery.

2. You are undergoing treatment with medications such as steroids and immuno-suppressants. Any medication that renders you immuno-compromised can adversely affect the healing process.

3. You are suffering from conditions or diseases that slow healing (e.g. auto-immune or collagen-vascular disorders, uncontrolled diabetes), or certain eye viruses including herpes simplex and herpes zoster.

4. You have significant scarring of the cornea.

May be a Suitable Candidate in Future

Prevailing circumstances may make you unsuitable for laser eye surgery immediatley, but do not necessarily preclude future treatment.

1. You are under 18 years old.

2. You have unstable vision, which means that there have been fluctuations within the past two years.

3. You are pregnant or nursing. Women may be eligible for laser eye surgery two months after nursing has been discontinued. This is to allow for stabilisation of hormone levels so as to ensure effective surgery and prescriptions.

4. You have a history of ocular herpes within one year prior to having surgery. Surgery can be considered after one year has passed since diagnosis of the condition.

5. You have refractive errors outside the range for treatment with current available technology:

· Short-sightedness (myopia) over -12.0 diopters.

· Long-sightedness (hyperopia) over +6 diopters.

· Astigmatism higher than 6 diopters.

How Successful is Laser Eye Surgery?

Nevertheless, people interested in having the laser eye surgery need to keep in mind that it is not possible to exactly predict the level of vision that will occur after surgery.

This is because, like any surgery, the healing characteristics of your eyes are not the same as another persons. However, based on the clinical measurements obtained at the initial consultation, your surgeon will be able to fairly closely indicate the expected result.

Experience has shown that, after LASIK treatment, the vast majority of people with low to moderate short-sightedness (myopia) achieve 20/40 vision or better, which is the level required to pass the vision test for obtaining a driver's licence in most States.

Many people can and do achieve 20/20 vision. However, even if 20/20 is not achieved, most people find that laser eye surgery has improved their vision to an extent that they are able to perform daily activities without glasses or contact lenses, and they enjoy significant freedom from having improved their vision.

Occasionally, the outcome may not meet all expectations. In some instances, a follow-up procedure, called an enhancement, can help to achieve more precise vision correction. If you are not happy with your outcome you should talk to your surgeon because there is often something that can be done to improve the situation.

Lasik Risks

Lasik Surgery Risks are often minimal but most prospective surgical patients are aware that any surgery has inherent risks. LASIK eye surgery carries risks, as well.

Though rare (occurring in about 1 to 5 percent of cases), some patients do experience laser eye surgery complications. To learn more about the potential complications of LASIK surgery, please read the page below.

Over/Undercorrection

With LASIK eye surgery, overcorrection and undercorrection are both possible.

These and other potential laser eye surgery complications can usually be attributed to the fact that corneas can vary greatly from patient to patient, in terms of water content, healing ability, and other variables that are beyond the control of the surgeon.

While extreme cases of over- or undercorrection may necessitate further treatment, mild cases can be effectively addressed by wearing glasses when necessary.

Infection

As with any surgery, a risk of infection is possible with LASIK. If left untreated, eye infections can result in scarring on the cornea or significant and permanent loss of vision.

However, eye infections from LASIK surgery are very rare. Antibiotic eye drops are normally prescribed after surgery to prevent infections, and patients should schedule regular post-operative visits to make sure eyes heal properly.

If an eye infection does develop after your LASIK treatment, your surgeon will discuss treatment options with you.

Flap Wrinkles

Small folds in the corneal flap are among the most common complications of LASIK surgery, but the surgeon can easily identify and remove them. Also, within the first few hours following surgery, wrinkles can form in the corneal flap if the patient tightly shuts the eye. The surgeon can fix this by re-laying the corneal flap to smooth out any wrinkles. However, flap wrinkles are a rare laser eye surgery complication and occur in less than 1 percent of cases.

Central Corneal Islands

Central corneal islands are small areas of raised tissue that show up on the cornea when the laser used during surgery does not remove tissue uniformly.

This type of complication occurs in less than 1 percent of LASIK cases, and can usually resolve itself after a few months. If central islands persist, the surgeon may prescribe contact lenses to smooth out the cornea surface or a laser touchup if necessary.

Epithelial Ingrowths

Another LASIK risk occurs when cells from the corneal epithelium start growing under the corneal flap. In some cases, this epithelial ingrowth will stop growing, die, and be absorbed into the cornea. But if the epithelial cells continue to grow, they can significantly affect vision.

To treat this, the surgeon must lift the LASIK flap and remove the ingrown cells. However, this eye complication happens in less than 1 percent of LASIK cases.

Corneal Ecstasia

Corneal ectasia refers to a weakened cornea that may bulge out months after LASIK surgery. This occurs when the surgeon makes too deep an incision during the flap creation process or removes too much corneal tissue during surgery.

Ectasia can only be treated with a corneal transplant. If left untreated, the patient may have a recurrence of nearsightedness or astigmatism.

This LASIK complication is rare and can be prevented if the thickness of a patient’s cornea is measured prior to surgery.

Diffuse Lamellar Keratitis (DLK)

Diffuse lamellar keratitis (DLK) is a post-operative LASIK risk that occurs when foreign bodies become trapped behind the corneal flap.

Patients with DLK may experience pain, sensitivity to light, blurred vision, or the sensation that there is something trapped in their eye.

Some patients experience no symptoms at all, but DLK can be detected during follow-up examinations after surgery.

Symptoms typically present themselves within a week of LASIK surgery, but DLK complications have been known to occur even years after surgery if patients experience corneal trauma.

Patients who experience any sort of eye trauma should be evaluated by an eye care professional. Though DLK is one of the more dangerous post- LASIK risks, it is easily treatable with topical and oral medication when caught in its earlier stages.

Astigmatism

In rare instances of laser eye surgery complications, a patient’s cornea can permanently warp as a result of scarring.

This may lead to astigmatism and an inability to use traditional contact lenses. Astigmatism after LASIK surgery, known as induced astigmatism, may cause blurred or distorted vision. Patients who encounter astigmatism as a result of LASIK usually must continue to use corrective eyeglasses.

Presbyopia and LASIK Surgery

Prospective LASIK candidates should be aware that LASIK surgery does not prevent presbyopia – the decline of near vision as an individual enters middle age.

Generally thought to be caused by a gradual loss of flexibility in the eye’s natural crystalline lens, presbyopia affects virtually everyone and generally requires the use of reading glasses. Learn more about presbyopia and other presbyopia treatments, such as IOLs, by visiting the appropriate DocShop pages.

Reducing Your Risk of Complications after LASIK

Advances in LASIK technology provide patients with choices that can reduce the risk of post- laser eye surgery complications and provide more precise results.

With IntraLASIK, the surgeon uses a laser instead of a blade, or microkeratome, when creating the corneal flap, ensuring fewer flap-related complications.

During custom LASIK surgery, a three-dimensional map of the eye is used to guide the excimer laser, providing superior visual results and less risk of corneal irregularity and over- or undercorrection. While these methods are considered safer, LASIK – like any surgery – does pose some risks, and some LASIK patients do experience complications.

Intraoperative complications

The incidence of flap complications has been estimated to be 0.244%.Flap complications (such as displaced flaps or folds in the flaps that necessitate repositioning, diffuse lamellar keratitis, and epithelial ingrowth) are common in lamellar corneal surgeries but rarely lead to permanent visual acuity loss; the incidence of these microkeratome-related complications decreases with increased physician experience. According to proponents of such techniques, this risk is further reduced by the use of IntraLasik and other non-microkeratome related approaches, although this is not proven and carries its own set of risks of complications from the IntraLasik procedure.
A slipped flap (a corneal flap that detaches from the rest of the cornea) is one of the most common complications. The chances of this are greatest immediately after surgery, so patients typically are advised to go home and sleep to let the flap heal. Patients are usually given sleep goggles or eye shields to wear for several nights to prevent them from dislodging the flap in their sleep. A faster operation may decrease the chance of this complication, as there is less time for the flap to dry.
Flap interface particles are another finding whose clinical significance is undetermined.] A Finnish study found that particles of various sizes and reflectivity were clinically visible in 38.7% of eyes examined via slit lamp biomicroscopy, but apparent in 100% of eyes using confocal microscopy.

Early postoperative complications

The incidence of dry eye varies widely from research studies. A study by Hovanesian et al. reported that 50% of patients experienced dry eye symptoms at 6 months period post surgery.
The incidence of diffuse lamellar keratitis, also known as the Sands of Sahara syndrome, has been estimated at 2.3% DLK is an inflammatory process that involves an accumulation of white blood cells at the interface between the LASIK flap and the underlying corneal stroma. It is most commonly treated with steroid eye drops, and sometimes it is necessary for the eye surgeon to lift the flap and manually remove the accumulated cells.
The incidence of infection responsive to treatment has been estimated at 0.4%.under the corneal flap is possible. It is also possible that a patient has the genetic condition keratoconus that causes the cornea to thin after surgery. Although this condition is screened in the preoperative exam, it is possible in rare cases (about 1 in 5,000) for the condition to remain dormant until later in life (the mid-40s). If this occurs, the patient may need rigid gas permeable contact lenses, Intrastromal Corneal Ring Segments (Intacs)Corneal Collagen Crosslinking with Riboflavin or a corneal transplant.
The incidence of persistent dry eye has been estimated to be as high as 28% in Asian eyes and 5% in Caucasian eyes. Nerve fibers in the cornea are important for stimulating tear production. A year after LASIK, subbasal nerve fiber bundles remain reduced by more than half. Some patients experience reactive tearing, in part to compensate for chronic decreased basal wetting tear production.
The incidence of subconjunctival hemorrhage has been estimated at 10.5%(according to a study undertaken in China; thus results may not be generally applicable due to racial and geographic factors).

Late postoperative complications

The incidence of epithelial ingrowth has been estimated at 0.1%
Glare is another commonly reported complication of those who have had LASIK.
Halos or starbursts around bright lights at night are caused by the irregularity between the lasered part and the untouched part. It is not practical to perform the surgery so that it covers the width of the pupil at full dilation at night, and the pupil may expand so that light passes through the edge of the flap into the pupil. In daytime, the pupil is smaller than the edge. Modern equipment is better suited to treat those with large pupils, and responsible physicians will check for them during examination.
Late traumatic flap dislocations have been reported 1–7 years post-LASIK.
Dry eye or in severe cases Chronic Dry eye. Due to nerves that are severed during the Lasik operation (around 70% of corneal nerves are severed), the lubrication system of the eye is affected and nerves may never recover to pre-operative condition. This may leave the patient with potential permanent dry eyes

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Lasik Eye Surgery |Laser Eye Surgery | Lasik Surgery