Any eye surgery conducted to improve the refractive state of the eyes is called refractive surgery.
The dependency on glasses or contact lenses is reduced or eliminated after the surgery, which essentially consists of methods of surgical remodelling of the cornea or cataract surgery.
Refractive errors are treated and corrected surgically using LASIK surgery or by performing Intra-ocular surgeries –(implantable contact lens (ICL) /refractive lens exchange).
Between these two types, LASIK is the most popular and preferred method.
Who are interested for Refractive surgery?
• Those who don’t want glaries / Contact lenses.
• Those who are intolerant to contact lens.
• For certain outdoor sports where spects are not allowed.
• Those who want to join certain profession where refractive error is not allowed.
Wave front LASIK
Custom LASIK is also known as ‘Wave front LASIK’
Wave front LASIK surgery is considered a very safe LASIK surgery & takes advantages of the latest laser vision technology & uses 3 – dimensional measurement of the eye to enhance the LASER’s ability to reshape the cornea & correct aberrations.
In regular LASIK only refractive error is corrected and in Wave front LASIK both refractive error and corneal aberrations are corrected
Criteria for LASIK Surgery
- Patients age should be above 18 years
- Refractive error should be stable for at least 1 year.
- Patient should not be suffering from dry eyes.
- Plus number should not be above +6 D.
- Minus number should not be > 12 D
- Astigmatism Should not be > 5 D
- Absence of any other corneal diseases
- Non pregnant, non breast feeding
- Good and adequate corneal thickness and curvature
Preoperative evaluation-
- Pre-Operative Counselling
- Checking of refractive error
- Corneal Topography
- Pachymetry
- Dilated fundus evaluation
- Schirmer test –to evaluate dryness of cornea after all these investigations doctor decided whether patients are fit to undergo LASIK or not.
Postoperative care-
- 24 hrs goggle use for one week
- Avoid head bath for 1 month
- No Television, Computer use, reading & readings mobile messages for 8 days.
- Topical Steroid eyes drops for 2 weeks.
- Lubricating eyes drops for 3 months.
Possible complication and side effects
Fortunately complications are very rare and latest technology has reduced the risk even further
- Under correction
- Over correction
- Glare
- Contrast sensitivity problems
- Flap complications
- Incomplete flap (Very rare)
- Complete tear
- Partial tear
- Infection
Alternatives to LASIK
- PRK (photorefractive keratectomy)
- LASEK( Laser epithelial keratomileusis)
- Phakic IOL- also called as implantable contact lens (ICL) which is placed behind iris and in front of natural lens
- Clear lens extraction- with negative intraocular lens implantation