14 must know facts before having Lasik laser procedure ( refractive surgery) for myopia.

People often opt to have the Lasik laser procedure without knowing what exactly it is and why should they to have it. These are 14 important facts , you must know before having Lasik laser procedure for myopia.

It’s a surgical procedure involving an eye which is done to enable a person to see without glasses if he/she can see with the help of glasses before the procedure. It’s often done for myopia. It’s neither the cure for myopia nor prevents progression of myopia. Details of the procedure are shown in the video below.

Ability to see clearly without requiring thick spectacles.

Scientific studies have proven that majority of patients (91-98%) have satisfactory improvement in vision without glasses, quality of vision and overall quality of life. after Lasik laser procedure.

“Ability to see clearly without requiring thick spectacles “does NOT mean that the procedure is absolutely trouble free. A small percentage of patients might have few issues like …

Need for glasses after the Lasik laser

• Small amount of refractive error may be left behind which may require spectacles of small power.
• After forty years of age , person will need glasses for near.

Few patients may have glares or halos after surgery, which may persist for a longer time.

Dryness in eyes.

Sight threatening complications are rare, not impossible.

Glasses and looks

Researchers are really divided on the fact of whether glass really affects the self-esteem of the person. Most of the studies done in the west show that it actually gives an intelligent and gentle look to a person. Adolescents are more sensitive to the looks may have some issues with self-esteem, but then glasses removal surgery is not done in adolescent patients. Glasses removal surgery is done after the progression of myopia has stopped which is often after 21 and sometimes unto 26. By this age, the presence or absence of glasses hardly make any difference to the self-esteem or global self-worth or the person.

• Uncomfortable with glasses of contact lens use. (4/5)
• Cosmetically concerned (1/5)

In conservative societies like India, glasses are generally associated with physical weakness and often seen as a negative attribute for matrimonial prospects. This can be explained with the larger frequency of girls getting closure to marriageable age, opting for these.

Most of the patients opting for these procedures do not have the details of the procedure and the possibility of the complications to actually make an informed decision. The scientific data available on the internet to actually frame an opinion regarding the procedure safety is scientifically too complex for a layman. Plus it is extremely difficult for the patient to get the details of the machine, technology, and safety record.

Lasik laser and refractive surgeries are considered cosmetic and are not covered by insurance anywhere in the world. Myopia is not considered as risk if it is less than 6 D. In India, some insurance companies provide cover in patients with myopia of more than -6 TO -7 D. The cover is for treatment of complications resulting from myopia like cataract, retinal detachment etc. Lasik surgery in not treatment of myopia. It is considered as cosmetic surgery as it simply removes the need of glasses to used by patients. So whether companies provide cover for Lasik laser for cases more than -7 D is to be confirmed by the insurance company only.

It is not advisable before 18 years of age. That does not mean, you can have it, if you are more than 18 years. All the conditions given below should also be met.

Progression of myopia (glasses number increase) should have stopped.

•  It should  not increasing for at least one year. If not so, some glass number will come after the surgery.

Central corneal thickness is more than 500 micron.

“most bizarre compliment given to me by a doctor is how thick my cornea is and i’m eligible for up to two or three more lasik surgeries….

— (@bowicha) August 12, 2017

Procedure involve some thinning of the central cornea. If the cornea is already thin, further thinning will cause weakening of cornea, and associated long term complications.

Your glasses number is within the appropriate range

1. Myopia -1 to – 8 D ( depending on technology/machine)
2. Hypermetropia +1 to 6 D
3. Astigmatism +1 to 6 D

You are free from associated eye or systemic diseases

Dry eyes, corneal disorder, Keratoconus, Amblyopia, autoimmune disease etc.

Lasik laser is not advisable in pregnancy

You have realistic expectation. 

ofc they are successes i’ve seen patients with perfect vision without any complications from lasik so its ultimately up to you

just dont have the expectation it’d be 100% safe like most ppl do

— cko (@fuyumijun) January 15, 2018

Its a surgical procedures, and the outcome is not always predictable. Under correction and over correction is possible in of the some patients. Complications, however few, are associated with every procedure, including Lasik laser.

Dry eyes

Dry eyes is a common problem after Lasik laser but it  is temporary. patients aye relieved by artificial tear supplements.

Inadequate correction

Inadequate correction of refractive error. Glasses number is not completely removed and patient might need glasses of a smaller number.

Difficulty in night driving

Glare, Halos, difficulty in night driving are possible in few patients.

No, except for dry eyes, which is often temporary.

Long term studies demonstrate excellent safety, efficacy, and stability of these procedures with long term refractive stability for far-sighted (hyperopic) patients less certain than for myopic patients.

Eye infections ( keratitis)

There are lower risk of eye infections ( keratitis) in people having Lasik laser as compare to the those using contact lens.

Dry eyes

Dry eyes is a known long term complication associated with the Lasik laser procedure.

Cost of the surgery

Often the rates of the procedure are comparable among the different center, larger center have slightly higher price. Price should never be the deciding factor in this procedure.

It can be repeated  under certain conditions but like any other surgery, it’s the surgeon’s decision to advise its indication and appropriateness. Usually it’s not.

• Qualifications and experience: There is no separate degree for this surgery. Surgeons are MS in ophthalmology. There are fellowships / certificate courses in lasik and refractive surgery. Years and total patients experience in lasik laser are important to be skilled in this technique.
• Referral: Reputation, capabilities and surgical results of a surgeon are often known among the fraternity members. High volume surgeons practicing in a group are usually better skilled. You should consult your local ophthalmologist to actually inquire about who is doing good in your area. This is probably the best way to select an Lasik laser surgeon.
• Surgeons associated as a group with specialized Lasik laser centres usually give better results. These seen with larger centres with multiple surgeons with different specializations.

Cost of the surgery.

Often the rates of the procedure are comparable among the different centre, larger centre have slightly higher price ( 40-60K). Price should never be the deciding factor in this procedure.

All the available machines/technologies have FDA approval. Recent scientific studies have failed to establish superiority on one technology on others in terms of overall outcome and patient safety after different type of Lasik procedures. Quite like mobile phones, newer technologies and machines keep coming in the market and are often promoted as most advanced or the best. All new machines have some advantages over the previous ones and have different set of complications associated with them. Femto-Lasik , Z-Lasik, wave front Lasik, Custom LASIK, Epi-LASIK , Contoura Vision, are few of the technologies/machine currently available.

There are high risk of complications in the patients engaging in contact sports like boxing , wrestling,  karate etc. If possible the Lasik procedure should be avoided.

CONCLUSION:

1. LASIK LASER is a surgical procedure done on eye (cornea) to remove the requirement of  the spectacles to see clearly. It neither cures myopia nor reduces its progression.
2. It is very safe procedure, Suitable candidate as patient and in the hands of a experienced surgeon.
3. Cost varies from 40 K TO 100 K ( for both eyes) , and should not be deciding factor.
4. Local ophthalmologist is best person to ask for the right Lasik laser surgeon in your city.
5. INSURANCE COVER : NO
6. Long term complications are few but not Zero.
   1. Sight threatening complications are rare but possible.
7. Expectations should be realistic as it’s a surgical procedure

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