The joy of perfect vision without glasses or contact lenses is irresistible. However, before making the big decision to go for surgery to enjoy this freedom, you should be empowered with the right information. I know for a fact that most people are faced with questions such as pain, danger, recurrence and possible complications.

Just with any form of surgery, there is always a risk incurred be it simple or complicated. Any surgery and counseling of the patient should always be done diligently by the surgeon. Surgeons are qualified to examine, explain and treat the patients. It should never be undertaken by any sales person.

It is important to secure the right information and ask relevant questions before going for a surgery.

• Do I qualify to undergo LASIK Surgery?
• How is LASIK performed?
• Surgical procedures involved are...
• What are the complications?

Do I qualify to undergo LASIK surgery?

You should consult a surgeon at an eye specialist centre for an indication. A few tests will be carried out, namely:

1. Check on the power of your glasses and degree of vision you possess.
2. Corneal topography – a three dimensional view of the surface of your eye ball. It will provide information on your corneal thickness, curvature, diameter and so on. It gives the parameter of your corneal structure.
3. Pupil size
4. Tear flow
5. Full examination of your eyes both at the front and back, including the intra ocular pressure.
6. Underlying medical history such as rheumatoid arthritis, autoimmune diseases, severe dry eyes or any other contraindications.

With these information, you will know if you are a suitable candidate for surgery.

 top

How is LASIK performed?

For any good result, the right concoction is:

1. A good machine with predictable track record. The latest machine may not be predictable as you are being used as a ‘guinea pig’. It is more of a marketing strategy. Besides you can’t trade your eyes in time to come when some fashionable centres decide to discontinue or make the technology obsolete.
2.  A surgeon with proper training and years of experience.
3.  A well informed and cooperative patient
   
    top

Surgical procedures involved are:

It is a 10 minute surgery for both eyes. The patient must not apply any perfume to avoid the alcohol interfering with the optics of the laser machine.

1. Surgery is to some degree uncomfortable but not unbearable. Topical anesthetic drops is applied before hand. Both eyes are thoroughly cleaned with antiseptic solution. A clamp is used to keep the lids wide apart to avoid blinking.

2. Flap creator ring called microkeratome is gently applied over the surface of the cornea and suction is turned on Vision will then be temporarily lost as the vacuum comes on. During this time, a very thin flap is created. This flap is rolled up to expose the mid corneal tissue before laser is applied to remove away a certain amount of tissue. This is accurately done with the assistance of a computer. The higher the power, the bigger the amount of tissue is removed. Of course the titration can only be up to a certain limit depending on the power and corneal thickness.  Hence, not everyone is suitable for surgery.

3. The flap is irrigated and replaced. It will eventually seal down quite like a stamp on an envelope. The surgery is then continued on to the other eye undergoing the same process.

4. Immediately after the surgery, the patient will rest for a brief moment before being discharged.

5. The visual acuity will be a little foggy, reaching about 40 – 50% due to water accumulation, but this will slowly subside over the next few hours.  The eyes will be tearing and gritty, like having a foreign body sensation.  The best option is to sleep during this duration. Avoid squeezing, rubbing and any contact with water. Within a couple of hours, vision will improve to almost 80% or so. The next day, vision reaches over 90% and the patient can drive to the clinic for a check-up. Patients generally return to work the following day. Vision will eventually reach normal within a couple of days.

 top

What are the complications?

1. Infections – they are rare but not impossible.
2. The rate is only a small fraction compared to that caused by contact lens wear, but it is nevertheless the most feared complication to encounter.
3. There will be complains of pain, blur vision, redness, discharge and intolerance to light.

Urgent treatment is an absolute necessity to prevent irreversible damage to the eyesight. Any clinic providing LASIK treatment should always emphasis on this, and also offer ‘one eye at a time treatment policy,’ should there be a request.

4. Flap creator – no equipment is fool proof. Creation of a good flap is vital for a positive result of the surgery.  If the flap is not up to satisfaction, be it incomplete or partial, the surgery is to be postponed until the corneal is totally healed.  This is also rare, but without irreversible damage.
5. Recurrence – the intention of the surgery is to improve the lifestyle without total dependency on glasses.  There may be a slight degree of power regressing, but this can be overcome by lifting the flap to apply a further elimination of tissue later on.
6. Dry eyes – depending on individual response, this is temporary and normally lasts for days with some dragging a few weeks longer.
7. Decentered application of laser – it is rare unless there is too much movement involved during surgery.
8. Glare and halo – these can be avoided if the treatment area is larger than the pupil size. Accurate calculation can be made prior to surgery to enhance a proper outcome.

 top