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Eye Surgery — Laser Eye Surgery (LASIK)

Eye surgery is a surgery that helps correct vision impediments. Laser eye surgery, also referred to as LASIK (laser-assisted in situ keratomileusis) is a refractive surgery to help correct vision problems and provide a long-term alternative for eyeglasses and contact lenses.

Laser eye surgery (LASIK) is a commonly performed eye surgery to treat farsightedness, astigmatism and nearsightedness. The procedure reshapes the cornea to allow light to enter the eye to be properly focused on the retina for clearer vision.

Who is a good candidate?

A complete eye exam prior to considering having eye surgery is essential in order to determine if you are a suitable candidate for Laser Eye Surgery. However, generally, the candidates for eye surgery are people who can fulfill the below:

  • Be willing to accept that whilst very rare, complications can arise during Laser Eye Surgery
  • Have had a good record (1 year) of stable eye health (e.g. without eye disease such as significant retinal degeneration, corneal, severe dryness of the eye, Keratoconus or any other complicated diseases such as SLE which affect the ability of the eye to heal)
  • Consider that certain autoimmune disease such as rheumatoid arthritis and lupus can affect healing post surgery
  • Are not (or are willing to discontinue) participating in contact sports (e.g. boxing, wrestling)- this is due to the risk of LASIK flap dislocation if there is extreme trauma to the eye
  • Be of a good age for the procedure- noting that those people aged 18 years and under are usually not stable enough for Laser Eye Surgery and older people may begin to develop eye health issues such as cataracts and other following the procedure.
  • Not be pregnant
Eyelid

Preparation

Prior to the procedure, a surgeon will perform a comprehensive eye exam to ensure that your eyes are stable enough for the procedure. This exam will evaluate the thickness and shape of your cornea, refractive errors (astigmatism, hyperopia, and myopia), pupil size and any other eye conditions.
The moisture levels in your eyes will be assessed and you may be given treatments to prevent you from developing dry eyes following the LASIK procedure. A “map” of your cornea will be developed.
Your surgeon will confirm the results that can realistically be achieved and outline the complications that can occur. It is also your obligation to advise your surgeon of any important medical information that could affect your surgery and/or increase your levels of risk.
The type of medical information that you should disclose includes medical complications, previous surgeries, current and recent medications and family disease.
You may be advised to discontinue wearing contact lenses for a set period of time as advised by your surgeon (normally it is around 2 weeks) before the eye exam and before the LASIK surgery, as contacts can change the natural shape of the cornea.

How the Procedure is Performed

Prior to the procedure, numbing eye drops are administered to ensure your comfort during the procedure. You may also be given some medication to assist in you relaxing.
A special instrument, called a keratome is used to create a thin flap in the cornea without touching the epithelium (tissue). The cornea flap is lifted and the excimer laser is used to reshape the cornea. The flap is then closed. Your eye will be situated under the laser and an instrument called a lid speculum is used to keep your eyelids open. An ink marker is used to mark the cornea prior to creating the flap.
In order to avoid eye movements or loss of contact which could affect the quality of the flap, a suction ring is applied. Once the corneal flap is created, the surgeon adjusts the excimer laser for your particular requirements.
You will be asked to view a light for a short period, while the surgeon watches your eye via a microscope as the laser casts pulses of light to your cornea. This technique reshapes the cornea. This part of the procedure is painless but you may feel some pressure on your eye. Each eye is worked on separately and takes about 5 minutes for each procedure.

Limitation’s and Risks

There is risk in all surgical procedures and it is important that you are aware of the risks involved in your procedure before going ahead with the surgery.
During your appointments you should discuss any concerns with your surgeon and not be afraid to ask questions. Your surgery will be unable to proceed unless you sign a pre-surgery consent form.

Every patient is different with risks for each person varying based on different factors. The below risks can occur with undergoing eye surgery:

  • Some patients with higher ranging astigmatism and myopia (-10.00 and above) may still need further minor correction to facilitate the ideal and most comfortable vision possible. An enhancement may then be performed and usually occur with approximately 6 to 15% of patients
  • You may still need to wear contact lenses or glasses following this procedure (noting that your prescription level will be much lower than what it was prior to the procedure)
  • A small proportion of people will need a “touch up” procedure, a few months following the procedure to reach satisfactory visual acuity.

Side Effects

As with any surgery, there are always possible risks and potential complications. These may include:

  • Infection
  • Night glare (halos or starbursts that are most visible when you are viewing lights at night- for example, when you are driving)
  • A temporary itching or burning sensation immediately following the procedure
  • Some haziness and blurry vision immediately post surgery (by the next morning this should have cleared up)

Recovery Time

You will be unable to drive until your surgeon confirm that your vision meets the legal standard for driving.

You should avoid rubbing your eyes as this can result in the flap dislodging before it has healed and adhered more tightly to the underlying cornea. Your doctor will also provide you with instructions on how to take care of yourself following the procedure.

Potential patients should be realistic about their surgery and success following surgery, knowing that their vision will not appear clear immediately following the procedure. For some patients, this may be the best possible correction to be achieved. A characteristic of this procedure is fast visual recovery, however for some patients it can take several months to experience their ultimate improved vision using LASIK. Research has shown that a number of patient’s vision continued to be enhanced for up to 6 months post surgery.

Returning to work:Can usually occur the next day (depending on the visual demands of your job and your own desire to return to work).
High impact activity:Normal activities can be resumed within 2 weeks. Exercise can be resumed within 3-4 weeks after surgery.

Note: This information acts as a guide to your possible treatment. Your individual concerns and specific medical history will need to be shared and discussed with your surgeon during your initial consultation.

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