Lasik Eye Surgery

Contents
1. What is LASIK ?
2. Am I a good candidate for LASIK ?
3. How is LASIK performed ?
4. What to expect after the surgery
5. What side effects, risks and complications should I be aware of?
6. What will my vision be like after LASIK?
7. Can LASIK correct presbyopia?
8. What if I am not suitable for LASIK?

What is LASIK ?

LASIK or laser in situ keratomileusis is an outpatient surgical procedure used to treat:

• • Short-sightedness (myopia)
  • Far-sightedness (hyperopia)
  • Astigmatism

Your lasik surgeon uses a special laser to reshape the cornea (the transparent covering of the eye) to improve the way light rays focus on the retina (the light-sensitive “film” at the back of the eye).

LASIK eye surgery is performed to decrease your reliance on glasses and contact lenses. In most cases, spectacle and contact lens independence is achieved.
Do note that if you are beyond 45 years of age and require glasses for reading (a condition called presbyopia), you will probably still need your reading glasses after LASIK.

Am I a good candidate for LASIK ?

Not everyone can have LASIK or will benefit from it. Your lasik surgeon will advise you in detail on the conditions that prevent you from being a good candidate for the procedure.

Generally, in order to undergo LASIK eye surgery, you should

1. Be at least 21 years of age
2. Not be pregnant
3. Be free of other eye diseases
4. Have a stable refraction i.e the prescription for your glasses should not have changed much in the last one year
5. Fulfill certain criteria with regards to cornea thickness, cornea shape and refractive error (degree). Patients with thin or irregular corneas, severe dry eye, cataract, glaucoma, uncontrolled diabetes, rheumatoid arthritis and other collagen vascular diseases are unsuitable for LASIK.

Most importantly, you must have realistic expectations about the outcome of the procedure, and be willing to accept the potential risks associated with it. Fortunately, LASIK is very safe, and the results excellent, and most patients are extremely happy with how the procedure has changed their lives.

How is LASIK performed ?

LASIK is performed as an outpatient procedure.
This is what happens:

1. You will be awake during the surgery and no sedation is necessary.
2. The surgery is generally a comfortable experience with minimal pain.
3. The eye is numbed with anaesthetic eye drops.
4. A first laser called the femtosecond laser is used to create a thin piece of tissue (the flap) on the cornea.
5. The flap is gently lifted
6. A second laser, the excimer laser is then used to reshape your cornea.
7. The flap is replaced and smoothed out. No sutures (stitches) are necessary. The flap adheres (sticks) on its own.
8. It takes generally 10-15 minutes to perform LASIK in both eyes.

In some cases, a contact lens that acts like a bandage is placed over the cornea to allow proper healing of the flap to occur. This will be removed by your lasik surgeon, usually the next day.

A video showing how Femtosecond (Bladeless) LASIK is performed. The flap created by the femtosecond laser is lifted by the surgeon who subsequently applies an excimer laser to alter the shape of the cornea. The flap is then repositioned. The flap adheres nicely to the cornea without the need for sutures (stitches).

What to expect after the surgery

Here are important points to note:

1. Visual recovery after LASIK is amazingly quick, but it is never instantaneous.
2. You will find that your eye sight is still foggy immediately after LASIK. The vision usually improves gradually over the next 6 to 8 hours.By the next day, you will be able to see well enough to perform most of your daily activities.
3. When the effect of the anaesthetic eyedrops wears off, some patients may experience pain, tearing, burning sensation, scratchiness and/or difficulty opening their eyes, the severity of which varies from patient to patient.These symptoms usually disappear after 6-8 hours.Most patients find the discomfort mild and bearable.
4. Healing after LASIK is usually more comfortable than with other methods of surgery as the laser removes tissue from the inside of the cornea rather than from the more sensitive surface of the cornea.
5. You will be prescribed antibiotic and steroid eye drops as well as artificial tears to keep the eyes moist.

Overall, the surgery and post-surgery recovery is a pleasant experience for most patients.

Most patients are able to return to work a day or two later. Stabilization of vision takes a few weeks, and varies from patient to patient.

What side effects, risks and complications should I be aware of?

Like any surgery, LASIK has side effects that you need to know about and carefully consider before deciding on having the surgery. Fortunately, LASIK is a very safe procedure and most of the side effects are mild and temporary. These include redness, dry eyes, discomfort, hazy vision, fluctuating vision, haloes, glare, starbursts and light sensitivity. Over- or under-correction may occur, and additional surgery (enhancement surgery) may be required in some cases. The serious side-effects that can result in permanent loss of vision are very rare, and these include severe inflammation, infection and cornea ectasia (weakening and thinning of the cornea).

What will my vision be like after LASIK?

Imagine being able to see the face of the clock when you open your eyes the first thing in the morning. Imagine not needing to wear your glasses and contact lenses to read, drive, use the computer, swim and during other sporting activities. This is the freedom that LASIK can give you. The surgery is life-changing, and is gratifiying for both patient and surgeon.

However, it is important for you to have realistic expectations when considering LASIK for yourself. LASIK allows most patients to perform their everyday tasks without glasses or contact lenses, but in some cases, these corrective aids may still be required.

Can LASIK correct presbyopia?

Standard LASIK cannot correct presbyopia, the age-related loss of near near vision due to a loss of autofocusing power of the eye. With or without LASIK, most patients will require glasses for reading after the age of 45. Some people choose a vision correction method called monovision, which leaves one eye slightly short-sighted to allow for close work, while the other eye is adjusted for distance vision. Monovison works well for many patients. Your eye doctor will help you decide if you are suitable for this.

What if I am not suitable for LASIK?

Do not despair! Alternatives to LASIK are available. Dr Cordelia Chan performs a wide variety of refractive surgical procedures that aim to give good vision, and if you are not suitable for LASIK, there are likely to be alternatives for you. In fact, for every patient, Dr Chan selects a procedure that best suits their needs, rather than to see if they fit into the criteria of just one particular procedure.

If you’re not suitable for LASIK, other options are available to you.

These include:

• ReLEx SMILE eye surgery
• Advanced surface ablations (LASEK eye surgery, PRK)
• Implantable Contact Lens (ICL) insertion