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LasikVision Correction By lasik or ICL or IOL

  • Small wonders why many of us find life with glasses less exciting! And why not? Nature is so beautiful and bountiful and it is only natural to view it with plain eyes and not with glasses or contact lenses. While the latter sends a vague sense of awkwardness, nothing beats the former. Here's to this discomfort. We aim at providing a non-glassy touch and a 'non-glassy cut above the rest'. Moreover the state-of-the art technology to achieve this end is economical and easily available. We are talking about Lasik, which was till yesterday a dream, a dream come true and in the years to come will become a dream revisited. Lasik is considered by virtually all refractive surgeons and worldwide to be the safe procedure of choice today. Lasik or LASer In-situ Keratomileusis or laser assisted In-situ Keratomileusis -means laser treatment inside the tissue of the cornea to give it a desired shape.




    Refractive errors:

    If the image in the eye is formed in front of retina - {myopia or near sightedness} minus power; behind the Retina {hypermetropia or far sightedness} plus power or image is stretched between two locations {Astigmatism} cylindrical power with axis :,then to see clearly we need correction of refractive error. Commonly specs or contact lenses are used. Surgical correction- What is done in surgery : anterior curvature of cornea is either flattened to correct myopia or steepened to correct hypermetropia.To achieve this we have big list of options LASIK, LASEK, PRK, R.K.{Radial Keratotomy} , A.K.{Astigmatic Keratotomy} , Clear Lens Extraction , Phakic IOL , Specs , Contact Lens , INTACS{Corneal Rings},LTK {Laser Thermo Keratoplasty}, CK {Conductive Keratoplasty} , ALK{Automated Lamellar Keratoplasty}. Laser assisted correction: LASIK, LASEK, PRK Safety is proportional to corneal thickness & retinal strength But it is also a fact that every person with refractive error is not fit for surgical correction Then who is fit:- Good stable vision with specs, low to medium refractive error; in the healthy eye of an adult more than 18 years of age, willing to get rid of specs by surgery understanding the possibility of complication attached with any surgery. It is good only for low to medium refractive error -12.0 is the limit in most of cases of myopia In some cases it may be -2.0 and in some cases -15.0. In hypermetropia +5.0 is limit in most of the cases.If the vision with specs are not good then there must be some or other associated problem in cornea, lens, retina or optic nerve, which cannot be corrected by lasik. It does not correct or stop presbyopia [near vision defect after 42 yr of age Eye should not be suffering from recurrent redness, watering etc. One year before & after delivery it should be avoided, that means pregnancy should be avoided for next three months after surgery. Final evaluation is made by considering pupilometry, refractive correction , keratometry, Intraocular pressure measurement ,pachymetry, topography and retinal assessment.

    The goal of vision correction :

    It is to achieve working vision or decreased dependence on specs. It does not guarantee the total correction in all cases but 95% correction in 95% cases. In 5% cases specs of very small power may be required if patient has a job requiring very precise vision.

    SURGICAL PROCEDURES :

    PRK- [ photo refractive keratotomy]It is good up to -7.00D .In this case epithelium is removed, some times epithelium grows too much or grow abnormally ,particularly in high correction more than -8D which may result in haze or regression. LASEK- [laser assisted sub epithelial keratomileusis] is good up to -9.00D.Epithelial flap is raised with the help of alcohol. Here the part of Bowmens membrane and epithelium are preserved , so problem related with overgrowth or abnormal growth of epithelium is very minimal. There is no use of microkeratome or blade .After surgery ,even laser expert can not easily detect ,recovery is slow like PRK. it is safer, easier but slower than Lasik & suitable only for mild to moderate myopia. It is recommended for all less than -9.00 D myopic keeping in mind that is slower & safer than myopic. LASIK- It[laser assisted in situ keratomileusis] is good upto -12D myopia & + 5.00 D hyp. Superficial 1\3 rd of cornea is raised with the help of micro keratome to treat the stromal bed by laser most popular because fast recovery within four hours. One day after surgery one can attend out door works & after 4 days one can attend table work, after 2 months one can start driving .

    SAFETY & COMPLICATION :

    It is very safe & painless procedures; complication rate is very low which may require medical or surgical treatment. Excimer laser surgery was first performed in 1988. LASIK is a more accurate variation from ALK, which has been performed for over 25 years, and has been proven safe in long-term studies. Extensive testing has been performed around the world by many different sources and it is now firmly entrenched within the medical arena that there are no long-term health problems to the eye from these procedures. Earlier one dreaded intra-operative complication was perforation of eye by microkeratotome head requiring corneal grafting & Iol implantation. It is no more now a days because all microkeratotome head are manufactured today with base plate incorporated, no chance of mistake in assembly. Chance of infection is very rare because bacteria & virus cannot sustain the laser energy, even it has occurred post operative it is easily cured with medicines. It is extremely rare that infection not cured then it may require corneal grafting. In modern surgery every body know that incidence of infection are very low & management is very effective. Few patients will experience optical aberrations during the initial healing phases including glare & haloes.

    CONCLUSION :

    It is very safe & useful but not for all. It is very good procedures to remove corneal opacity occupying less than 20% of total thickness. Earlier these patients had to go for corneal grafting. CAST OF THE PROCEDURES- It is the high tech procedure requiring very costly equipments, costly consumables like blade & gas and very high maintenance cost of the laser. Price war and low cost will certainly be at the cost of quality, so one must control the temptation to look into low cost.