Lasik Eye Surgery, More Than Meets The Eye

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Lasik Eye Surgery, More Than Meets The Eye
September 03
20:20 2016

Article Highlights

  • For appropriate refractive errors and eye anatomy, it offers the high expectation of freedom from glasses and contact lenses
  • LASIK permanently recontours the cornea (clear front part of the eye) in order to redirect light so it is correctly centred on the retina
  • Not all corneas are of the ideal curvature for optimum visual acuity

It’s by far the most popular form of corrective eye treatment. More and more people are discarding their glasses, along with their permanent and disposable contact lenses, embracing the proverbial wave of the future. You can have LASIK eye surgery at 18 or when your prescript ion is stable.

“For appropriate refractive errors and eye anatomy, it offers the high expectation of freedom from glasses and contact lenses,” said Dr. Howard Gimbel, an ophthalmologist at the Gimbel Eye Centre in Calgary.

LASIK (laser in-situ keratomileusis) eye surgery was patented in 1989 and 25 years later, approximately 28 million people worldwide have undergone the procedure. It is generally performed by an ophthalmologist to enhance overall vision, but specifically corrects near- and farsighted vision problems, as well as astigmatism (blurred vision).

However, this surgery is not for everyone. Dr. Gimbel distinguished which patients would not be approved for LASIK.

“Patients with thin corneas, irregular astigmatism, [and those] with any but very superficial corneal scars or corneal conditions like keratoconus. A slightly deeper layer of the cornea is involved in the surgery than surface ablation, so it cannot be used on as thin a cornea as surface treatment (PRK).”

Essentially, LASIK permanently recontours the cornea (clear front part of the eye) in order to redirect light so it is correctly centred on the retina. Once the eye is anesthetized, the surgeon will cut a flap in the cornea with a laser, lift the flap and utilize a computer-directed laser to eliminate or vaporize exact quantities of tissue from the inner cornea. Once completed, the flap is set back in place, and the eye is left to heal. Patients will generally be examined by their surgeon a day or two following the procedure and asked to return for scheduled visits in the subsequent six months.

Once the patient has been evaluated to have adequate corneal thickness and approved for the procedure, LASIK is generally considered a safe surgery with only slight discomfort. Prior to surgery, patients will be asked to avoid wearing contact lenses, and then meet with a specialist to evaluate their medical history and eye condition. They should also not wear any hats or hair accessories so that the laser will not be hindered by their head placement. There is generally some minor irritation following the surgery, and people should wait at least 12 to 24 hours for eyesight improvement. However, you will not need any bandages and can go home after the procedure.

Though infection is extremely rare, there is always a possibility of complications, such as dry eyes, halos and glares. It might prove difficult to see clearly enough to read or drive at night for the first 24 to 48 hours following surgery. Glares and halos can result from residual astigmatism and dry eyes after surgery, but your surgeon should be able to complete a cycloplegic refraction before considering additional laser treatment if the blurriness is considerable. Alphagan-P (brimonidine) eye drops can be used in dim illumination conditions to treat halos and glares. It should be noted however that symptoms might not be a result of the surgery, and could be due to a medical issue, such as cataracts, glaucoma or epithelial ingrowth. A thorough eye examination is crucial in such an instance to ascertain the symptoms, and your surgeon can map the eye surface and determine the next course of action.

Dr. Gimbel elaborated on these potential impediments, such as an imperfect flap made at surgery or wrinkles in the flap that resulted after repositioning it, cells growing under the flap and an inflammatory cell build-up under the flap in the early healing period.

A new tool for eye surgeons is the Wavefront Analyzer, which projects waves of light into the eye and then maps it from the light waves bouncing out of the eye. With the ability to map your eyes and total refraction, surgeons can determine a much more precise examination and clear-cut corrections for weakened vision.

“Not all corneas are of the ideal curvature for optimum visual acuity,” Dr. Gimbel explained. “The Wavefront Analyser measures any irregularity and gives the surgeon and the laser the information to modify treatment and attempt to correct this irregularity.”

Nevertheless, the majority of those who undergo LASIK eye surgery will have exceptional vision the day after the procedure is performed. Yet, whenever contemplating any surgery or medical procedure, one must always do their due diligence to find the right and qualified surgeon. It is always important to consider what’s best for one person might not necessarily be what’s right for you.

Dr. Gimbel emphasized that people should pursue surgeons with experience, good judgment, who are considerate and will present to patients all of the options suitable for them, and have available the diagnostic and surgical equipment to provide the appropriate procedure.

“Some patients are not suitable for LASIK, and surgeons and clinics that are able to provide other procedures, like Implantable Collamer Lens (ICL) and Refractive Lens Exchange (RLE), are able to give the most balanced advice and appropriate treatment options. Some patients may be suitable for any of the procedures, and the surgeon can help the patient decide which procedure suits them best; others are only suitable for one or two procedures. The risks and benefits of each must be clearly explained so that the patient can make an informed choice.”

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