The term LASIK is an acronym for Laser-assisted in situ keratomileuses. It is a minor surgical procedure that helps you reduce or dispense with your dependence on eyeglasses or contact lenses and gives you a convenient choice of not using eye spectacles or contact lenses at all. Across the world, LASIK is by far the most preferred surgical procedure to choose for a spectacle-free life or reduce one’s dependence on eyeglasses.
How LASIK works? LASIK procedure
The eye’s outer transparent part, CORNEA, helps our Eye focus on incoming light rays onto the Retina to form an image. When the cornea does this correctly, we see a clear picture; however, if it doesn’t, the resulting vision could is blurred. This is because of the bending and focusing of the incoming light rays called Refraction. If the cornea’s shape is imperfect, it leads to refraction errors and blurry vision because of out-of-focus images.
LASIK procedures are done to correct the corneal shape (refractive errors) of the Eye’s cornea. With the help of special surgical Lasers, the shape of the cornea is corrected to help form the correct image by removing the refractive errors.
Who needs LASIK?
People with refractive errors like myopia, hyper myopia, Astigmatism, or a combination of these can go for LASIK. This is to either reduce their usage of eyeglasses and contact lenses or if they wish to live a spectacle-free life. People not interested in wearing eyeglasses or using contact Lenses need LASIK surgery. However, one must be aged 20 or older, and LASIK requires stable eye power for the last 12 months before considering surgery.
Not all persons can opt for the LASIK procedure! Specific Eye diagnostic tests like Corneal topography and Eye biometry and clinical assessment by your eye surgeon are required to assess your eligibility for undergoing LASIK treatment. If your test reports come ok and your eye surgeon finds your cornea suitable for the LASIK procedure, you can go ahead for LASIK, allowing you to get rid of your spectacles, eyeglasses, or contact lenses.
For some medical reason, if you are not fit for LASIK but still want to dispense with your eyeglasses, then there are several LASIK alternatives. But first, consult a good refractive eye surgeon for medical advice to determine the best method for a spectacle-free life. Remember, for LASIK, you must have stable eye power for at least a year and should be aged 20 or more.
LASIK surgery – What happens during the procedure?
Once you are found ok for Lasik, your eye surgeon will put you on a mild sedative medication a few hours before the actual procedure. Post your medication, you are made to lie comfortably on an operating table by a staff member inside a LASIK OT. Next, you will be given eye drops to numb your eyes. After that, your outer eye layer flaps are made using a blade or Laser to make way for corneal tissue correction. Once the corneal curvature is corrected with a special Laser called an excimer, your flap is placed back in its proper position.
The procedure typically takes around 10 minutes for each eye, and depending on your chosen method ( Blade or Bladefree), your healing time varies between a couple of days to a few weeks.
In most cases, however, you can resume work in only a few days. Please note that during the entire Lasik procedure, the patient is mainly conscious and moves independently.
Types of LASIK
Since there is no One-fit-for-all choice when it comes to reducing or getting away with spectacles /Eyeglasses or contact Lenses, your Eye surgeon may advise you one among the following after performing your clinical assessments as well as considering your lifestyle & budget.
LASIK ( Laser-assisted in situ keratomileuses)
By far the most preferred choice of adults worldwide, LASIK is a time-tested method for eyeglasses removal. Lasik involves creating a thin & precise corneal flap and then firing excimer laser pulses to get the desired corneal curvature to let your Eye focus correctly. After the Laser correction, the flap is repositioned back into the groove. One may experience mild discomfort; however, with the latest hi-precision safe lasers, femtosecond laser procedures are painless, bladeless, and injection free, with instant vision recovery. Resuming your normal life activities is possible in just a day or two, with certain recommended precautions for a week or so.
Photorefractive keratectomy (PRK)
As an alternative to Lasik, PRK is used in cases where desired corneal thickness for Lasik is inadequate. Here, instead of making a flap, the top surface -epithelium is scraped away. Healing and recovery are slow compared to Lasik, and corneal abrasions usually take three or four days. During this time, one may experience moderate pain and short-term blurred vision. But generally, in the long run, results are pretty encouraging for suitable candidates.
The technology was introduced at the beginning of the millennium. In such procedures, the epithelium and stroma are removed in a single step. Traditionally this is done with Alcohol assisted chemical process; however, in recent years, Lasers are also used for PRK. Since the process doesn’t require Flap creation, this is also promoted as Flapless LASIK Touchless LASIK. Results are generally as stable as Lasik; Nonetheless, full vision recovery takes much longer than LASIK.
Laser-assisted subepithelial keratectomy (LASEK), also known as Blade Lasik
The procedure is almost similar to LASIK procedures; however, a flap is created using a blade (microkeratome) that peels off the top layer, often exposing the cornea to ethanol. In such procedures, the surgeon’s skills play a vital role as the risk factor of corneal damage is high. On the plus side and if done by an expert eye, LASEK procedures require removing less cornea, hence a preferred Lasik alternative for people with thin corneas. However, LASEK typically has no significant advantages over LASIK; the recovery is slow, and one may experience pain with gradual healing.
Epithelial laser-assisted in situ keratomileuses (Epi-LASIK)
With this method, an eye surgeon segregates the epithelium ( 40–60 μ) from the middle part of the cornea (stroma) with a mechanized blunt blade device called an epi keratome. Your eye surgeon then reshapes the cornea using a special laser. This procedure is similar to LASEK except for how the flaps are produced. There is no alcohol solution used during epi-LASIK either.
Implantable Phakic IOLs
As an alternative to the LASIK technique, Corrective lenses are surgically implanted in the Eye (intraocular lenses) to correct the vision. This procedure is relatively standard among cataract surgery patients, substituting the dysfunctional cloudy natural lens with an artificial lens. In addition, Phakic IOL is an alternative to LASIK for old-age patients in need of cataract surgery in the future. Compared to LASIK, the risk factor is higher since they are implanted in an area of the patient’s Eye deeper than the area treated in LASIK. On the positive side, your cornea remains intact with no tissue ablation.
Femtosecond Laser Robotic Laser
Approved by the American FDA, Femto Lasik uses a twin laser to create a flap and make refractive corrections in a patient’s Eye. The technique uses low pulse laser with higher precision and predictability factors that enhance Eye’s safety profile.
Safe Lasers: Femto laser surgeries have become quite popular recently, given their hi-Laser precision, reduced healing time, and minimal post-operative complications. In addition, the ultra-fast low-pulse Laser creates very thin and smooth flaps, and excimers are used for vision correction.
100% painless & Blade free: The Femto Lasik procedure is easy, fast, bladeless, and a totally pain-free all-laser procedure. Patient (Eye) data points are fed into the machine, and with artificial intelligence, minimally invasive lasers are fired using a robotic arm instrument. Femtosecond Lasik is synonymous with AI-assisted Robotic Laser surgery.
Types of refractive Errors that LASIK can correct:
Refractive errors are of three main types: Near-sightedness or Myopia, Farsightedness or hyper myopia, and Astigmatism.
People with near-sightedness (myopia) have difficulty seeing distant objects. Those with farsightedness (hyperopia) find it hard to see near objects clearly. While as Astigmatism is caused by tissue irregularities in the Eye’s cornea or lens, leading to distorted image formation on the Retina. Generally, Combinations of myopia ( Near-sightedness) and Astigmatism or hyperopia (Farsightedness) and Astigmatism are common. To correct these conditions, eyeglasses, and contact lenses are used to compensate for these refractive errors. Now in recent decades, Laser procedures have been done to rectify such refractive errors by reshaping the corneal tissues – such procedures are known as refractive vision corrections.
Small-incision lenticular extraction (SMILE)
The Latest addition to the LASIK surgery technologies is that a surgical-grade Laser is used in reshaping the cornea to make a lens-shaped slice of tissue (lenticule) underneath the cornea surface. After the lenticular has been used to reshape a patient’s cornea, it is then plucked out through a minimal incision, much like a slice of cheese is plucked from a sandwich.
Here your eye surgeon uses a combination of one or more LASIK techniques, such as intraocular lenses and LASIK, to correct (myopia) near-sightedness or (Hyper myopia) farsightedness.