Spectacle Removal

Wave Front Lasik

In this procedure , aberrometry is performed to note the aberrations of the eye undergoing laser in addition to the refractive error present. In this procedure a thin flap of cornea is made using a microkeratome(blade) following which a personalized laser treatment is performed with eximer laser to correct the refractive error and aberrations present. It gives better quality of vision then regular LASIK.

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Rs 30,000 for both eyes.

FEMTO LASIK/ BLADE FREE LASIK/ ALL LASER LASIK

In this procedure, the corneal flap is raised with the help of a femto laser with higher precision as compared to a microkeratome which is then followed by routine eximer laser treatment for refractive correction.

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Rs. 60,000 for both eyes.

SMILE (Small incision lenticular extraction) BLADE FREE/ FLAP FREE LASER TREATMENT

This is a minimally invasive , advanced flapless procedure for refractive error correction. A small piece of tissue (lenticule) is created inside the cornea with the femto laser and is removed with a forceps which leads to correction of refractive error.

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Rs 90,000 for both eyes.

Differences between treatments

The table below shows the differences between the various procedures. Obviously, this is a general overview, and individual recovery terms may vary.

However, this table gives a clear overview of the advantages and disadvantages of each technique Where a technique provides a relative advantage compared to the other techniques, this is indicated with a

PRK/LASEK Femto-LASIK ReLEx smile
In use for 30 years 10 years 5 years
Recovery of eyesight 7 day 24 hours 24 hrs
Full stabilisation of eyesight 3 months 6 weeks 6 weeks
side effects after treatment Irrition, lasting 3 days, occasional pain possible irrition lasting 24 hours irrition lasting 6 hours
Risk of dislocation tearingor loss of corneal flap No Yes No
Dryness of the eye after treatment Yes
Temporary
Yes
Permanent cases
No
Re-treatment rate 4% 7% 1%

Commonly ask quotations ?

Contoura Vision and LASIK are very very safe procedures. These procedures are also US -FDA approved, which means they have been given safety clearance for Human Eyes. However, like any other surgical procedure it can have some complications which are extremely rare if a proper screening check is done prior to the procedure. Some patients might experience mild dryness in eyes which usually relieved by lubricating drops and disappears over time. Some may also experience temporary halos during night time which also reduces with time. Immediately after Lasik one might experience mild heaviness and blurring of vision. These are due to the effects of numbing eye drops used during procedure. All these are very very rare and can be easily managed by your doctor. Nobody in our surgical experience has ever lost sight due to this procedure.

To be a suitable candidate for Laser Vision Correction Surgery, you should be:

  • At least 18 years’ old
  • Your specs number should be stable for about a year – minor changes do not disqualify you
  • Your cornea should be of adequate thickness as seen by corneal scanning or ultrasound
  • Ladies should not be pregnant or breast feeding
  • You should not have eye diseases like keratoconus or dry eye syndrome
  • Controlled diabetes is not a contraindication

Preparations before coming for Lasik

  • Put the anti-biotic eye drops in both the eyes as recommended by your eye doctor, 6 times a day, one day before the procedure.
  • Do not use perfumes, powder, makeup on eyes and face on the day of Lasik.
  • It is preferable to stop using contact lens 1 week before surgery. A small relaxation is permissible in consultation with your doctor
  • Wash your hair on the day of Lasik so that you don’t feel the urge to wash them for next 2-3 days.
  • Take a normal light meal before coming for Lasik.

On reaching the Lasik centre

  • A final re-check on your vision will be done by an optometrist
  • You would be asked to sign a consent form
  • Just before the procedure, an instruction card will be given to you. Read the instructions carefully
  • A Lasik executive will explain the steps of the procedure to you

During Lasik

  • Lasik is done on both eyes in the same sitting
  • It takes about 15 minutes to do Lasik on both the eyes
  • The actual laser time is about 10 seconds per eye
  • If you are undergoing a bladeless Lasik or Contoura Vision, you need to go through two laser machines, a Femto laser and an Excimer laser, however, if you are undergoing any other Lasik type, you need to go through only an Excimer laser Under the Excimer laser, you are to fix your sight to a green blinking light in the machine
  • Numbing eye drops will be instilled in your eyes
  • The procedure is pain free
  • There are no injections used
  • No bandage is used on the eyes
  • It is a walk in – walk out procedure and the person can be sent home 15 minutes after the procedure.
  • Immediately after the laser treatment, you may feel heaviness in eyes because of the numbing eye drops. There is also a little fogging of vision which starts clearing up in about 40 minutes.
  • As the effect of the numbing drops wears off, you may experience some grittiness, irritation and watering from eyes. This may last for a few hours.
  • You are advised to put on dark glasses before leaving the centre. Dark glasses are essentially protective for the eye against dust and from fingers inadvertently rubbing the eyes. No protection is required from room light and day light.

By next day the vision is fairly clear, however some people may experience mild variations due to varying healing patterns of the eye.

The laser procedure itself does not hurt. A slight pressure may be felt during the procedure. There is a possibility of some degree of discomfort after the procedure for 3 to 4 hours, which is easily controlled by medication. If discomfort persists, you should contact your eye doctor.

97% of the people will be totally free from their spectacles. 3% will have mild variation from their zero targeted correction due to varying healing patterns in different individuals, but will have their dependency reduced on spectacles. After 3 to 6 months’ laser enhancement can be attempted to correct these individuals further. People over the age of 45 who opt for distance vision correction, may need reading glasses.

When we think of correcting vision, we think of Laser or Lasik. Lasik is the ideal procedure for vision correction. Day by day, as the technology is advancing, so are hopes and expectations from Lasik. But even with the latest techniques of LASIK, there are always situations where Lasik cannot be done. Limitations of Lasik can be described as follows:

1: Limitation of age:

  • Minimum 18 years:By 18 years, the number tends to become stable in most of the people. However, in a human system, there can be no hard and fast rule. This means that in some people the number may become stable even by 16 years, while in some it may not be stable even at 22 years. Even if the number is stable by 16 years, Lasik should preferably not be done at this stage, because the future cannot be predicted, and if the number increases later, it can only lead to regrets. As a general observation, it is seen that low numbers like -1.0 to -3.0 tend to become stable even before 18 years of age. Numbers from 3.0 to 6.0 may become stable by 18 to 20 years. Number from 6.0 to 9.0 may become stable by 22 years, while numbers beyond 9 may or may not be absolutely stable even beyond 22 years.
  • Maximum age:There is no limit to maximum age. We have done Lasik in people even at the age of 60 years. It is a question of when one decides in life that enough is enough, and that one would like to see the world without these ‘optical crutches’. In our personal experience of 20 years of Lasik, we have seen that Indians usually accept glasses as part of their identity by the age of 40. Rarely have I seen people asking for Lasik beyond this age. However, in the last few years, I have noticed a definite social change. Mothers and father of children, who have got Lasik done successfully, are now asking whether they too can get rid of their glasses at this stage. So, I would now put the Indian mind set at 50, and the western country mind set at 60.
  • Ideal age:There is always an age band when people feel that this is the ideal age for Lasik. We feel that this band is within the age of 20 to 40 years. During this period, there is a strong desire to look good without glasses. Matrimony is a major reason in India, while other reasons like lifestyle freedom, sports, personality enhancement and self confidence booster play an important role.

2: Limitation of pregnancy or breast feeding:

Lasik is not advisable during pregnancy or breast feeding. During this period, the hormonal levels in the female body are high, and there is an associated relaxing of tissues and increase in spectacle power. Even though this increase in spectacle power may happen in only 10 % of the ladies, still this number is pretty high to caution against Lasik during this period. In those females where the number increases during pregnancy, it is observed that the change is usually between 0.5 to 1.0 D spectacle power. It is also observed, that if the spectacle power increases in first pregnancy, there may be a similar increase in the subsequent pregnancy.

3: Limitations of corneal thickness:

Cornea should be adequately thick to perform Lasik. Too thin a cornea becomes is a limiting factor. A normal Indian cornea has a central thickness of 530 microns or 0.53 mm. In this thickness, one can safely correct a number of -8.0 by SBK (thin flap Lasik) or the Bladeless Femto lasik. A cornea which is less than 495 microns is considered thin, while a thickness of less than 450 microns is a ‘no go’. The natural assumption from these figures is that if the cornea is thicker than 530 microns, then more spectacle number can be corrected. This is not correct as treatment of more than -8.0 leads to excessive flattening of the cornea and resultant disturbances in vision called spherical aberration. It is therefore recommended that the ideal upper limit is -8.0, while the acceptable upper limit is -10.0. Beyond this number, Lasik should be avoided, and a better way would be to go in for an ICL. The upper limit of correction by Lasik for a plus number i.e. hypermetropia is +5.0.

4: Limitations of corneal curvature:

Too flat a cornea or too steep a cornea can also be a limiting factor.

  • Flat Cornea:A normal human cornea has a curvature of 44.0 D. A cornea with a curvature of 41.0 D or less is considered a flat cornea. Since Lasik involves lifting up of a cornea flap, in a very flat cornea, the size of the flap lifted may be too small. This means that the area of cornea available for laser treatment may have to be reduced, which may result in visual problems like halo’s and glare around lights at night. Femto Second Laser made flaps do better even in flat cornea.
  • Steep Cornea:A cornea which is more than 48.5 D is considered a steep cornea. In such steep corneas, lifting the flap may result in button holing of the flap, or an irregular thickness of the flap. This happens in only a very small percentage of steep corneas. In case of button holing of the flap, the flap is re-positioned bask without doing the laser treatment, and allowed to heal. The flap may be re-lifted after 3 months, preferably with a Femto Second Laser, as the latter gives more dependable flaps in extremes of corneal curvatures.

5: Limitations in corneal pathology:

Keratoconus is a corneal condition where the corneal tissue is inherently weak. Due to the normal eye pressure within the eye ball, the cornea starts bulging out. This makes the cornea steep and irregular. Rays of light entering the eye through such corneas get irregularly scattered thereby resulting in loss of quality of focus and decrease in vision. Lasik involves ablating the cornea to change its curvature. Ablating the cornea makes the cornea thin. Acceptable level of thinning does not weaken a healthy cornea. However, in an inherently weak cornea, the Lasik induced thinning may weaken the cornea to an extent that it will start to bulge causing optical distortions and decrease of vision. This abnormal bulging of the cornea may then be stopped by ‘C3R’ or what is called Collagen Cross Linking. The importance of cornea screening is to detect sub-clinical or hidden Keratoconus, and reject these cases, so that the rest of the eyes undergoing Lasik treatment are safe. With modern methods of corneal scanning like Pentacam, it is possible to detect most of these hidden Keratoconus cases, thereby making lasik very safe. However, very rarely, one may still have to face a tricky situation, and Collagen Cross Linking may then have to be done to arrest the progress of the disease.

Usually a patient is on medicated eye drops for 4 weeks and has to use lubricating eye drops for at-least three months

Eye makeup can usually be used after two week of treatment. However, one should consult a doctor before for the same.

After Laser treatment, eye behaves like a normal eye. This means that you may require glasses for reading after 40 due to normal ageing process of eye..

The effects of Lasik on the cornea are permanent. Sometimes, internal changes within an eye may come with age and these may have some effect on the overall visual status. For example, myopia may progress even in later years, or a person may require reading glasses with normal ageing process usually seen after 40 years of age.

Infection is a serious complication and could lead to deterioration of the cornea. Infection is usually rare and can be well controlled with medications with little or no loss of quality of vision. At our Centre, we have had no case of infection till date

Yes, in most of the cases. However, one eye may be done at a time by choice.

Before every Laser Procedure, a detailed examination is done for dry eyes to ensure you have a comfortable experience after surgery. Some patients might experience mild dryness in eyes after the procedure, which usually relieved by lubricating drops and disappears over time. If however you are found to have dry eyes before procedure, your doctor may suggest you alternative procedures such as ICL which are considered best in such situations. These are best discussed with your doctor.

No. Even though vision is fairly clear after Lasik, one might experience heaviness and blurring immediately after the procedure. These are due to the numbing eye drops used during the surgery. Also one might experience sensitivity to light and watering. It is best to ask you friend or a family member to take you safely back home. Also you will be required to wear protective glasses to prevent touching the eyes accidently and avoid any exposure to dust etc. During the next follow up the doctor will check your vision suggest accordingly. A patient is legal to drive when one eye is seeing 6/9 (20/30) or better. In practical terms, drive when you are comfortable with the newly set vision.

The laser treatment itself usually takes around one minute. The whole procedure takes about 10 minutes for one eye.

After the procedure majority of the people can return to work after 2-3 days. Most of the routine work can be done after 7 days. Jobs that are more physically demanding and involve exposure to liquids or dust might require a more graduated return to full activities, but are best discussed with your surge

If you Have Any Questions Call Us On 0562 401 3731