Wed 26 Sep 2007
LASIK is the acronym for Laser-Assisted in Situ K eratomileusis, a type of refractive laser eye surgery performed by ophthalmologists for correcting myopia, hyperopia, and astigmatism. The procedure is generally preferred to photorefractive keratectomy, PRK, (also called ASA, Advanced Surface Ablation) because it requires less time for the patient’s recovery, and the patient feels less pain, overall; however, there are instances where PRK/ASA is medically indicated as a better alternative to LASIK. Many patients choose LASIK as an alternative to wearing corrective eyeglasses or contact lenses.
The lens of your eye should be an easy terrain for the visiting visual. The door and walls of the eye should be elegant enough to host the light and darkness that flow in. The tear operators should provide the much needed flush, once in a while. And the nerve hotline to the HQ (the brain) should be intact.
If these conditions (and a few others) are fulfilled, then the black and white equipment, famous for its subtle ways of communication, could very well help you distinguish the beauty from the beast.
If not, the adage stands changed: Beauty lies in the specs of the beholder!
According to available data, 75 million people wake up every morning groping in broad daylight for their eyeglasses, or, squinting to see without their contact lenses. But more than a million people, each year, give up their daily struggle and make the decision to have laser vision correction.
Yes. We are on the threshold of an ophthalmic revolution.
Call it LASIK (Laser Assisted In-Situ Keratomileusis).
Laser is not a new admission to the Ophthalmologist’s dictionary. In fact, doctors all over the world have been using laser since 1951 in the treatment of eye disorders. LASIK is the latest arrival, and it is far more precise than other laser treatments such as PRK (Photorefracive Keractomy). It is also the most significant, since it promises a life free from the transparent, gold-rimmed wall that prevents your eyes from feeling the world in front.
With LASIK there is less pain and discomfort in comparison to PRK. Patients experience faster visual recovery with LASIK, which allows them to return to work very soon. Many people experience dramatic improvement in vision within hours of the operation.
Says Dr. George Thomas, Professor, Regional Institute of Ophtalmology: “If you are thinking of a life without glasses, LASIK is the safest bet. LASIK can treat and rectify vision errors caused by nearsightedness, far sightedness and astigmatism. It is the procedure of choice for myopic errors from -1.5 to -15.0 points. For long sightedness, it is effective up to +3.0 points. While PRK treats the surface of the cornea, LASIK treats the inner tissue of the cornea.”
So, if you are the bespectacled genius who feels deprived of the natural ability of the living thing to communicate through its eyes, LASIK holds a promise. You can go after your ambitions, be a pilot, a movie star or even a boxer.
The only place in Kerala with LASIK treatment facility is Little Flower Hospital, Angamali. “On an average, 100 patients come here monthly for LASIK treatment. And the results are amazing.” says Mathew. K. Karingattil (Manager, MEDEA, Excimer Laser and LASIK centre, Little Flower Hospital).
The affectivity of LASIK is widely acknowledged. Then, what is preventing it from reaching the masses?
“The cost,” says Dr. George Thomas. “It would cost the patient around Rs. 9000 per eye. Although the cost is coming down it is still significant. Moreover, the capital investment is too big.”
Mathew Karingattil testifies to this. “The LASIK equipment at Little Flower Hospital cost us around Rs. 2 crore. The maintenance, too, is a costly affair.”
Moreover, most medical insurance companies do not pay for refractive surgery since it is wrongly placed under the category of cosmetic surgery.
Government hospitals too are reluctant to welcome the new technology, the major stumbling block being the lack of adequate funds.
“Quality is important,” says Dr. George Thomas. “The success of LASIK largely depends upon the quality of the machine and the expertise of the man behind it. The upkeep of the equipment alone would drain the pocket. Moreover, the government way of calling tenders and ushering in the lowest bidder is not going to ensure quality equipment,” he adds.
LASIK was first performed in the U. S. in 1991 during clinical trials. Even though the treatment is considered 99 per cent safe, there are a few voices of dissent as well. The fact that the treatment is too recent to gauge its aftermaths has definitely distanced LASIK from the sceptic.
“I am doubtful of its long term effects. I think it is too early to go for it. I will rather wait,” says Rajesh. C.V, a software professional who wears contacts for short sight.
Even experts agree to the one per cent risk that faces the LASIK candidate. ” But then, it is the case with every other operation,” says Dr. George Thomas.
However, the truth is that rare cases of post-LASIK damage have been reported. The most common post-operation disorders are dry eyes, aura, halo and resistance to light, which usually cease after a couple of months. There are a few pre-requisites for LASIK.
To the relief of optical shop owners (whose firms face the threat of extinction if LASIK becomes cheap and popular), laser treatment is not prescribed for people who are “weak-eyed”. The pre-surgery tests are meant to make sure that the patient is the right choice for the surgery. LASIK on wrong candidates could result in major complications. “A fair percentage of those coming for LASIK surgery does not pass the pre-LASIK tests,” says Mr. Mathew.
Ophthalmology is a fast changing science. Even as LASIK conquers the world, another invention, known by the name, Wavefront technology, is making headlines in the West. This new invention promises to give man what it claims to be `super vision’. In simpler terms, it is all about giving man the eye of the eagle.
“At this pace, LASIK could very well become obsolete by the end of the next decade,” says Dr. George Thomas.
For the time being, LASIK is all. We have seen it to believe it!
Flap and Zap
LASIK surgery, is also referred to as `Flap and Zap’, since it involves the removing of the corneal flap. First, a thin layer (about 3 hair strands thick) of the cornea is lifted up as the Microkeratome glides across the cornea. Then, in less than 30 seconds, ultraviolet and high laser energy pulses from the excimer laser reshapes the internal corneal tissue by removing about 1-2 hair strands thick of cornea. The corneal flap is replaced to its original position. Because of the cornea’s extraordinary natural bonding qualities, healing is rapid and does not require stiches.
The entire procedure takes less than two minutes. This procedure also works on the surface of the eye and never enters inside the eye.The pre-surgey tests play a crucial role in ensuring the safety and success of LASIK.
The screening of LASIK candidates are based on strict norms. You are not advised LASIK surgey if you have a history of one of the following.
1. Herpes simplex or Herpes Zoster (Shingler)
2. Glaucoma, Glaucoma suspect, or ocular hypertension
3. Eye diseases such as ureitis/iritis (inflammation of the eye and Blepharitis (inflammation of the eyelids with crusting of the eyelashes)
4. Eye injuries
Patients who are below 18 years, whose hormones are fluctuating due to disease such as diabetes, who are pregnant or breast-feeding, who are taking medications that may cause fluctuation in vision are not ideal choices for LASIK.
If you have a disease or are on medications that may affect wound healing, this may not be a wise option.
Those with immunodefficency states (eg: AIDS) and diabetes or those who are taking certain medications (eg: steroids) may not have proper healing after refractive procedure.
surgery details !!!
LASIK is not usually performed on those with large pupils, thin cornea and dry eyes.
