LASIK for Refractive Errors

LASIK or Laser-Assisted Insitu Keratomileusis is a procedure that permanently changes the shape of the cornea, using an excimer laser. This is mainly indicated for those who dislike glasses or find that contact lenses are troublesome. The procedure is performed with an excimer laser and it is a painless procedure.

The surgery takes less than 30 minutes and is done under topical anesthetic drops. The procedure involves using a unique knife, called a microkeratome, to cut a flap in the cornea. A hinge is left at one end of this flap. The flap is then folded back, revealing the stroma of the cornea. Pulses from a computer-controlled laser vaporize a portion of the stroma according to preset parameters, and the flap is replaced. No stitches are used, and the patient can return home immediately. Topical antibiotic drops are prescribed. Following the procedure, it is advisable to avoid strenuous contact sports such as boxing, football, etc for at least three to four weeks after surgery. It is important to protect the eyes from external injuries.

LASIK Contraindications: Patients in their early 20s or younger, who are pregnant or breastfeeding, or who are taking medications that may cause fluctuations in vision. These people are more likely to have refractive instability. Currently, LASIK is not approved for those under the age of 18.

Certain conditions, such as autoimmune diseases (e.g., rheumatoid arthritis), immunodeficiency states (e.g., HIV) and diabetes etc can prevent proper healing of the cornea and thus are not suitable for LASIK.

Those who participate in contact sports like boxing, wrestling, etc or other activities, in which blows to the face and eyes are common, are not advised to undergo LASIK. Patients with very high refractive errors are also not suitable candidates.

Precautions: The safety and effectiveness of LASIK is not established in diseases like Herpes simplex or Herpes zoster involving the eye, glaucoma, ocular hypertension, uveitis, eye injuries or previous eye surgeries, and keratoconus. A careful discussion with the doctor can help in deciding if LASIK is appropriate. Other risk factors include blepharitis, those with large pupils, thin corneas, those who have undergone previous refractive surgery (e.g., RK, PRK), and patients with dry eyes.

Risks involved in LASIK: Although many patients have a good visual outcome after LASIK, just like any other medical procedure, there are risks. These may include, halos, glare, and/or double vision. Some may still need glasses or contact lenses after surgery, especially if there has been significant astigmatism before. Severe dry eye syndrome, migration of the flap, inflammation or infection leading to lead to temporary or even irreversible loss of vision can occur rarely.

LASIK is generally a safe procedure with definite indications. The risk-benefit aspects should be discussed with your doctor before deciding to undergo the procedure. It should not be considered as a miracle treatment, and has some definite contraindications. Selection of the right candidate by proper screening methods can avoid complications or patient dissatisfaction and improve the treatment outcomes significantly.