Have you been told LASIK is not for you?

LASIK reshapes the cornea for refractive correction in various degrees of Myopia (nearsightedness), Astigmatism and Hyperopia (far-sightedness) using  Excimer laser.

It is quite possible sometimes you may be told that you are not suitable for LASIK although you are willing and wish to opt for it.

The possible reasons to opt out of LASIK:

  • Age: If you are under 18, LASIK cannot be undertaken as no lasers are approved (according to FDA guidelines) for LASIK below 18 as refractive errors are required to stabilize and as you may be still growing anatomically, there is a likelihood that you powers may also change.
  • Active contact sports participant: Contact Sports like boxing, martial arts could interfere in LASIK treatment as probability of eye injury occurrence is higher. In LASIK, one needs to take what is termed “corneal flap” which is needed to be lifted (similar to lifting a page of the book). There is a chance that this flap shifts or moves out of its place during an injury. Hence, LASIK is also disallowed in the Indian Army and Navy.
  • Refractive instability: In case you have been experiencing a frequent change in prescription of either your contact lenses or glass prescription within the past one year then LASIK may not get you the desired results, as powers may not be stable.
  • Medications: Certain medications like retinoic acid and steroids taken in the long term can change your powers post LASIK and hence interfere in LASIK results. Some such medications can cause fluctuations in vision.
  • Diseases and other conditions: Certain diseases delay wound healing like uncontrolled diabetes, immune compromised conditions etc. Other conditions like Pregnancy, nursing or child birth could be unsuitable for LASIK as hormones could distort prescription stability. Even previous eye injury could be an impediment for LASIK.
  • Size of measurement of pupil: Large pupils could have side effects like glare, halos etc.
  • Dry eyes: Those who have been treated for Dry eyes or having extreme dry eye symptoms prior to LASIK, there are chances it could worsen.
  • Thin/Irregular corneas: A certain corneal thickness is required for LASIK depending on your prescription.
  • Corneal abnormalities: Unsuitable for LASIK In case of presence of corneal abnormalities like scarring, Keratoconus.
  • Other factors: Refractive surgeries could also be a disqualification for certain professions.

So, not just eye health, overall health matters.

Not a candidate for LASIK?  What next?

You need not worry in case you are not suitable for LASIK. We look into the other advanced procedures that could be just perfectly fine and would give you the desired results.

  • Testing: We conduct various tests to determine your candidature using the latest available technology. After all, today, it does not really matter if you are found unsuitable for LASIK as other alternatives may give you better results.
  • Pre – evaluation: The pre – evaluation done by our surgeon, himself, will determine which is the most suitable procedure for you and you would be advised accordingly. During your evaluation you need to discuss health concerns even if it is not directly associated with the eye.
  • Open communication: A complete health disclosure would help in overall assessment and treatment.

With the usage of the latest technology and techniques of Concerto 500 Hz  and VisuMax Zeiss laser,  various other advanced options are available to give you the best. The other different laser vision options we offer apart from wavefront LASIK are:

  • Wavefront Bladeless Epi-LASIK : Epi-LASIK is safe and effective procedure. We offer Epi-LASIK for those with thin corneas and this procedure combines the benefits of PRK and LASIK and does away with the disadvantages of LASIK.
  • Wavefront Trans Epithelial Surface Ablation
  • Topography Linked LASIK
  • BLADELESS FEMTO LASIK: This reduces further enhancement procedures following LASIK and post – operative induced astigmatism.
  • ReLEx SmILE: ReLEx SmILE is flapless and safer with stable results. It takes care of LASIK disadvantages of corneal ectasia and dry eyes.

Do get in touch with us to know your suitability and expectation to enable you to take a wise informed decision for further treatment.

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Dry eyes after laser eye surgery

Laser eye correction has a great success rate nevertheless like any surgical procedure laser eye surgery too has some problems associated with it.  The risk factors for such procedures are greatly reduced to almost negligible depending on the type of surgery performed, the experience of the operating surgeon and the technology of the laser being used.

At our centre we perform surgery only after through pre examination and pre operative testing done by the operating surgeon himself so as to identify those who are more prone problems such as dry eyes. The dry eye test is not just a qualitative test to check the nature of tears, but also a quantitative test to score the dryness on a scale of 1 to ten. This helps to ascertain your candidature for the right type of laser treatment. If needed, it may even be postponed until the time your dry eyes are treated.

We keep you informed of the potential side-effects that you may face, be it dry eyes or night vision issues and accordingly help you choose the best suitable laser procedure, whether it is custom wavefront LASIK, Advanced surface treatments like EpiLASIK or the third generation of laser procedures like ReLEx SmILE.

Lasik and Dry eyes: One of the most commonest post Lasik problem that one reads about or hears of is “dry eyes”.  The scientific reason behind this dryness, is due to the fact that for a LASIK procedure, one needs to create what is called a “flap”.

This flap is a necessary step in all LASIK procedures, regardless of kind or brand of laser used. The corneal flap is made so that the laser procedure is painfree, and so that the laser can be applied on the inner layers of the cornea and not on the very sensitive superficial part (typically where one would position their contact lenses).  This corneal flap is the lifted and the exposed cornea is then reshaped with an excimer laser, the flap being replaced back at end of the procedure.

As the flap is made by using a ‘cut’ on the cornea, the corneal nerves which supply the cornea are also cut, this reduces the sensitivity of the cornea for a few weeks post LASIK. Dry eyes can be further aggravated if the occupation of the person undergoing it is more of computer work. This affects tear production thus making the eyes dry without sufficient lubrication. In some cases this dryness may be temporary and mild while in some cases it could be severe.

As there is a risk of aggravating dryness after LASIK, the Dry Eye Tests need to be performed thoroughly beforehand. You may have dry eyes before surgery due to other factors as well such as thyroid etc however it should not stop you from seeking a LASIK treatment. Dry eyes after LASIK is generally a temporary issue and resolves in few weeks, during which time you are prescribed lubricating eye drops or artificial tears.

In most cases this spontaneously resolves even without medication as the corneal nerve endings regenerate and tear production gets back to normal relieving you from the symptoms. In case of any issues regarding dry eyes do consult for further treatment as soon as possible.

Symptoms of Dry Eyes post LASIK:

  • On and off hazy vision usually after long hours of computer work
  • Foreign body sensation
  • Occasional discomfort
  • Watering or tearing

Remedies to resolve dry eyes caused by LASIK:

Most common ones are as noted below:

  • Artificial tear drops
  • Punctual plugs
  • Anti inflammatory eye drops

Understanding how the world cannot function without computers in any field and having proven that computers are a factor in inducing dryness, the latest third generation of laser procedures – ReLEx Smile work by reducing risk of dry eyes significantly.

ReLEx (Smile and Flex) and Dry Eyes: In ReLEx (Smile and Flex) procedure as there is no flap created and due to absence of tissue ablation, it results in not disturbing the corneal nerves and its sensation.  Hence this procedure greatly reduces the complication of LASIK specifically the dry eyes issue.

Here, in this high precision procedure it preserves the strength of the cornea as 1/5th the size of a bladeless flap is made. This treatment is good for those already suffering from pre – operative dry eyes and other eye conditions like short sight, thin corneas, contact lens intolerance, etc. Moreover as least number of corneal nerves affected compared to LASIK, so dry eyes are significantly less or near zero.

Excellent expertise and experience is required for lenticule creation in ReLEx procedures hence it is important that you get this treatment done in the right place.

Points to note after ReLEx procedures:

  • You may return to work in a day’s time
  • Eye drops will need to be used for a few days
  • Lubricating eye drops may be required in some for more weeks

Do get in touch with us to know more on the most suitable treatment option for you.

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What is relex smile

ReLEx Smile is an advanced eye correction treatment procedure in corneal refractive surgery.

What happens in a ReLEx Smile procedure?

In a ReLEx Smile procedure the femtosecond Laser creates a “lenticule” in the cornea in order to treat the spectacle powers. This lenticule is extracted through a micro access point without needing a ‘flap’ on the cornea like that in LASIK. This access is far smaller (less than 80%) than the incision made for a flap.

How is ReLEx Smile different from other procedures when compared to Conventional LASIK, Bladeless LASIK and ReLEx Flex?

In a Conventional LASIK a microkeratome is used to make the flap; whereas in Bladeless (Femtosecond) LASIK, the job of flap creation is taken care by the femtosecond laser.

The next process of ablating the cornea in both conventional LASIK and Femtosecond Bladeless LASIK is done using a common excimer laser. Hence, in Femtosecond or Bladeless LASIK, 2 lasers are used- one to create the flap (Femtosecond laser) and another (the excimer laser) to treat your powers.

In ReLEx Smile, the entire process is done using a single laser- the Femtosecond Zeiss laser.

The major difference with ReLEx Smile compared to LASIK procedures  is that there is NO flap, NO cut.

Why go for the ReLEx Smile method?

Safety. Faster recovery: The natural structure of the cornea is preserved. As there is no flap, physical activities can be resumed much earlier without the fear of any “flap related complications”.

Reduced dry eyes: The dryness caused by LASIK is much reduced in ReLex Smile, as corneal nerves are not cut, like they are during the making of the ‘flap’. Hence, also more preservation of corneal sensations as compared to LASIK-treated eyes.

Bladeless:  Femtosecond laser uses high precision with minimal action on corneal cells hence it is painless. Anterior stromal nerves left intact preserving corneal sensation.

No tissue ablation : ReLEx Smile is a  femtosecond ‘flapless’ refractive procedure, where there is no tissue ablation. In this procedure a lenticule (corneal tissue) is created by the Zeiss VisuMax laser and extracted through a small incision. The whole process is performed by a single laser.

No flap: As there is No flap creation, so no question of flap related complications such as displacement or dislodgement.

Time saving: Unlike other procedures like Conventional LASIK here the same laser is used thus saving time. The entire procedure lasts for few minutes.

Better refractive post operative satisfaction: This is because it supports better corneal biomechanics.

Am I suitable for ReLEx Smile?

  • Those between age 18 years to 40 years are ideally suited.
  • Myopia of about -10.00D
  • Highly recommended to those indulging in contact sports or those activities that have high risk for injury.

Suitability is best decided after a detailed eye examination and consultation, however not all patients are suitable for ReLEx Smile.

At Shroff Eye Hospital this gentle procedure is performed by VisuMax Carl Zeiss Laser resulting in high precision 3D shaped incisions. With ReLEx smile, you can now relax and smile.

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