Refractive Surgery/Laser Vision Correction
With technological advancements happening at a rapid pace, the options for refractive vision correction have increased dramatically during the last few years. We, at Itek Vision Centre are keeping up with the latest technological trends to give you the best possible treatments options available worldwide.
Laser Vision Correction (Refractive Surgery) is a term given to the surgical procedures designed to correct certain vision problems such as myopia (nearsightedness), hyperopia (farsightedness), and astigmatism. These procedures use an excimer laser beam to help reshape the cornea. An excimer laser produces “cool” light beams, which are ideal for refractive surgery. These procedures are done on an outpatient basis. The two most common procedures performed with the excimer laser are Laser In-Situ Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK).
There are risks involved with laser vision correction just as there are with any other surgical procedure. Some risks include dryness to the eyes, and visual side effects such as hazy vision, glare, halos, and other night vision disturbances. An in-depth review of the various risks associated with refractive surgery is included in our surgical consent forms. The U.S. Food and Drug Administration (FDA) has approved the use of several excimer lasers, for the treatment of myopia, myopia with astigmatism, hyperopia, and hyperopia with astigmatism.
Laser Vision Correction Surgery
The procedures offered include:
- PRK(Photorefractive Keratotomy)
- LASIK (Laser Assisted In Situ Keratomileusis)
- PTK (Phototherapeutic Keratectomy)
- Phakic Intraocular Lenses(ICL/EyePCL)
- Refractive/Clear Lens Exchange
PRK (Photorefractive Keratotomy)
An Excimer laser beam that emits ultra violet light reshapes the cornea after removing the epithelial surface layers of the cornea. It is indicated in patients with thin cornea and who cannot undergo Lasik but are highly motivated to undergo vision correction procedure owing to their lifestyle and cosmetic needs.
LASIK (Laser Assisted In-Situ Keratomileusis)
LASIK can correct varying degrees of nearsightedness (myopia), farsightedness (hyperopia), and astigmatism and is generally the treatment of choice for patients with mild to moderate degrees of myopia or hyperopia. In LASIK surgery, the underlying surface of the cornea is reshaped with the laser, allowing light to be refocused and vision improved. LASIK surgery generally results in little or no post-operative pain and rapid recovery of vision. Detailed corneal profile (adequate thickness and appropriate curvature) must be evaluated to decide if you are eligible to undergo LASIK.
Accurate refraction assessment and detailed corneal profile (i.e. thickness, curvature,etc.) is evaluated with the help of pentacam before choosing the type of refractive procedure for your eyes.
a) Depending on the thickness of your cornea a microkeratome (either Moria microkeratome, Hansatome or an SBK) is chosen to create a flap of differential thickness.
b) Femtosecond Lasers, such as the FS200 or the Intralase®, are an all laser approach to vision correction; they create thin flaps in the eye using short laser pulses. The flaps are then lifted from the eye’s surface, and the curvature of the eye is corrected. Its popularly known as the’ bladefree’ approach.
Excimer Lasers, such as the ALLEGRETTO WAVE® or VISX CustomVue™, are used to produce beams of invisible ultraviolet light energy, and remove microscopic amounts of tissue in the eye; this process reshapes the curvature of the eye.
Various treatment algorithms are available that are customized according to individual patient profile.
- Standard LASIK
- C-LASIK (Customvue LASIK)
- Topography guided LASIK
- Aspheric LASIK
LASIK improves the uncorrected vision — one’s visual capacity while not wearing corrective lenses — in most patients who have the procedure. Many patients can also expect to see better than 20/40 uncorrected. However, there are no guarantee that you will have perfect vision, and patients with high myopia (more than -7D) and high hyperopia (more than +4D) should have low expectations.
The effects of LASIK are permanent and do not wear off over time therefore, a stable prescription for over a period of 1 year is required before proceeding with this procedure. Patients should also note that while results are stable long-term, a mild regression of the laser effect may occur during the first few post-operative months. This occurs in approximately 10% of patients and if noted, may require an enhancement procedure if your doctor feels it to be appropriate.
PTK (Phototherapeutic Keratectomy)
This procedure is used for removing minute irregularities and opacities in superficial layers of cornea as in certain corneal dystrophies.
Phakic Intraocular Lenses
Phakic Intraocular Lenses are clear, implantable lenses that are surgically placed between the cornea and iris. The lenses allow light to focus on the retina, which causes clearer vision without glasses or contact lenses. The phakic intraocular lenses work from within the eye, unlike corrective lenses, which work from the surface of the eye.
STAAR Visian ICL™ intraocular lenses are made to remain in the eye for a lifetime. Visian ICL™ lenses are able to treat patients with thin corneas, dry eyes, and patients with extreme refractive errors.
Refractive/Clear Lens Exchange
Refractive/Clear Lens Exchange is typically performed on patients with high degrees of hyperopia (farsightedness). In this procedure, the eye’s natural lens is replaced with an artificial, intraocular lens. This corrects refractive error and helps achieve sharper focus.
Frequently Asked Lasik Questions
How long does the surgery take?
Lasik is performed as an in-office procedure in our laser center. Although, the treatment takes approximately 10 minutes per eye, you should expect to be at the laser center about 2 to 3 hours for the total process.
Should I expect any pain after my Lasik procedure?
The procedure itself is relatively painless. It is common, however, to have a foreign-body sensation or burning with tearing for 4 to 6 hours following the treatment.
How soon can I return to work after Lasik?
Often the next day, although, it may be difficult to perform prolonged reading or computer tasks right away.
How soon after the laser procedure can I bathe or take a shower?
Typically, you can shower or bathe the following day, but you should avoid getting shampoo, soap, or water directly into your eyes.
When can I wear eye makeup?
Please do not wear mascara, eye shadow or eyeliner for 3 days prior to treatment. On the day of treatment, please refrain from wearing any makeup, after shave and lotion or moisturizer or a deodorant. You can start wearing eye makeup approximately 1 week after the procedure. Purchasing new makeup, especially mascara, is strongly recommended.
How long before I can exercise?
Strenuous exercise should be avoided for approximately 1 month. Sweat in the eye should be avoided for at least 2 weeks due to bacteria on the skin. Otherwise, non-contact sports can be resumed as soon as you feel comfortable. If you are involved in any kind of contact sports, remember to wear sports goggles for protection.
How soon can I swim, sauna, or hot tub?
Swimming, saunas, and hot tubs should be avoided for 2 weeks, minimum.
When can I travel on an airplane?
Unless it is an emergency, and we advise you to stay locally for approximately 1 week after your surgery in case of an emergency.
TAKE HOME MESSAGE
People who are most satisfied with the results of laser correction clearly understand the potential risks and complications of the surgery and possess realistic expectations of what their vision will be like following the surgery.