Many of us have doubts about LASIK. It sounds like a very high-end technology to us. There are so many questions surrounding us. Here are few questions probably will come to your mind when LASIK is mentioned. These may help you in understanding more about LASIK.


Q. What is LASER light?

LASER is an acronym for Light Amplification by Stimulated Emission of Radiation. Laser light is made of a single wavelength of light with all the rays traveling in the same direction and in phase so that each ray contains the same amount of energy. Laser can be used to cure many sight-debilitating diseases such as narrow angle glaucoma, diabetes and age-related macula degeneration. Each disease is treated using laser of different wavelength best suited for the condition. For the LASIK procedure, we use the excimer laser light, which is produced by passing an electric current through a tube containing a special gas called argon fluoride. Its wavelength of 193 nm allows it to have maximum effect at the point of focus and is able to remove tissue at that point without affecting adjacent tissue structures unlike other lasers. It is this unique property that enables the excimer laser to produce reliable results without many problems.



Q. What is LASIK?

LASIK (known as Laser Assisted Stromal In-Situ Keratomileusis) involves the creation of a corneal flap in combination with the accuracy of the excimer laser technology to correct refractive errors without pain and minimal scarring. The laser corrects vision by reshaping the cornea so that its focusing power can be corrected and the image can be focused onto the retina without the use of spectacles or contact lenses.



Q. What are the steps involved in LASIK surgery?

The procedure is performed as an 'outpatient basis' on the day of surgery. Anaesthetic eyedrops is instilled to numb the eye for a painless surgery. The overall procedure takes around 20 minutes to perform while the duration of laser is less than 1 minute.

During the surgery, the patient is conscious but is not in pain at any time. The eyelids will be kept open using a speculum while the patient is requested to maintain fixation on a red target light during the procedure. An instrument called a microkeratome will be placed onto they eye to create a corneal flap, which is lifted up so that the laser can be used to reshape the cornea. During this time, the patient is required to look at a fixation light to allow accurate delivery of the laser light. A camera-tracking device is also used during this time to ensure that the laser light is constantly on target. The computer, based on the refractive error has already calculated the laser power required for each patient.

At the end of the procedure, the corneal flap is replaced. The patient will be given eye-drops to protect against infection and to facilitate healing.



Q. Who is an ideal candidate for LASIK?

People who have shortsightedness (myopia) and astigmatism are ideal candidates because the results after surgery are excellent. Mild degrees of long-sightedness (hyperopia) also do well. As LASIK has no effect on the lens, it cannot be used to treat presbyopia. To be eligible for LASIK surgery, you must be over the age of 18 years, be in good general health and not be pregnant. The eye must also be in good health with a refractive error, which has been stable for the last 12 months. Some people are better candidates than others and it is therefore important to consult your eye doctor to discuss the realistic benefits, which differ from patient to patient. LASIK procedure can correct the following range of refractive errors with a great deal of accuracy. Nonetheless, the maximum correction may be limited by a number of factors including the thickness of the cornea.

	Short-sightedness (myopia) up to -12.00 dioptres
	Long-sightedness (hypermetropia) up to + 4.00 dioptres
	Astigmatism up to 4.00 dioptres

Q. Can LASIK be used to treat presbyopia?

No. Presbyopia is due to the aging process of the lens. As LASIK can only change the focusing power of the cornea, it cannot cure presbyopia, as it has no effect on the focusing power of the lens. Therefore, even after LASIK surgery for shortsightedness or astigmatism, patient will still require spectacles for near vision after the age of 40 years. Nonetheless, after LASIK, the patient will be able to see distant vision clearly without spectacles.



Q. How accurate is LASIK in correcting vision?

LASIK is very successful with over 90-95% of patients expressing satisfaction with their vision after the procedure. The LASIK machine produces accurate results in nearly all the time but on occasions, there may be some residual refractive errors, especially in patients with higher degrees of refractive errors. This can be cured by a minor procedure called enhancement to fine-tune the result. Like any other surgical procedure, no one can give the patient a 100% guarantee of perfect vision after the operation. Nonetheless, it can be said that the vast majority of patients, of all nationalities from all over the world have expressed great satisfaction with their improved vision after LASIK.



Q. Can the vision get worse after LASIK?

With the older techniques like photo-refractive keratoplasty (PRK), the quality of the vision can be reduced because of glare or haloes resulting from the scarring associated with the technique. As LASIK heals with less scarring, the risk of vision getting worse is much reduced. Nonetheless, in rare cases, vision can be worse than it was before the operation.



Q. What are the risks involved with LASIK?

No operation is without risks. There are operative and post-operative risks but with the latest technology and good surgical skills, the risk of problems is reduced to a minimum. During the procedure, there may be problems with the creation of a corneal flap of an inappropriate size or problems with the healing process or infection after the procedure. These problems are rare and can be rectified in most cases.



Q. Can the refractive error return after LASIK?

Although there has been a return of the original refractive error (a process known as regression) after operations such as radial keratotomy or photo-refractive keratoplasty, the superior results obtained with LASIK have remained relatively stable. As such, the vision should stay corrected forever. Even if the refractive error returns, this can be corrected by an enhancement procedure.



Q. Will my eye be weaker after LASIK?

Although some tissue is removed using the laser, there are safeguards present to ensure that the strength of the cornea remains intact. There are no restrictions to any physical activities after the operation unlike in radial keratotomy where the cornea is weakened as a result of several cuts being made into the eye.



Q. Am I awake during the procedure?

Although the patient is awake, he or she will not feel any pain during the entire procedure. There may be a slight feeling of pressure during the creation of the corneal flap and some light sensitivity from the microscope lighting. Sometimes a mild sedative is given to calm those who may be anxious in nature.

Q. What do I look at during the procedure?

The eye is kept open using an eyelid speculum and the patient is requested to look at a fixation target during the operation. Even if the patient moves the eye during the procedure, the machine has a sophisticated camera-tracking device so that the laser beam is continuously kept on target. This allows an extremely accurate delivery of the laser power and hence consistently achieves excellent visual results.



Q. When can I go back to work?

In most cases, patients can resume normal activities within 1-2 days after the procedure although this may vary between individuals. Patients usually notice the improved vision within 1-2 days of the operation, which continues to get better with time.



Q. When do I need to be seen after the procedure?

The patient is required to be followed by the doctor the next day and at 1 week after the procedure. Medication will be provided after the operation to facilitate healing and prevent infection. These check-ups are necessary to ensure satisfactory healing.




Q. When can the 2nd eye be operated on?

Most of the patients will do the treatment for both eyes at one time.



Q. How can I find out more about LASIK?

It is difficult to explain every single detail of the procedure in a short. For more information, you should contact us on our toll-free number for a LASIK consultation. Here you will undergo a thorough eye examination and discussion to determine if you are an ideal candidate for LASIK. These professionals can deal with any further queries at this visit to ensure you obtain a truly honest opinion. Remember to stop wearing your contact lenses for 1 week (if soft lenses) or 1 month (if hard lenses) prior to this visit. This is necessary because wearing contact lenses can alter the refractive power from its original form.