Laser surgery: In clear sight

A hassle-free procedure can make your eye sight as good as new.


January 26, 2014

The days of struggling with spectacles and contact lenses may be behind us. Lasik — a short and painless procedure can now restore your vision to its original crystal clear form. But here are some things you need to know:

The preparation

The approved age of the patient for this procedure is 18 years and above. However, it is important that the eye sight number has stabilised for over one year, which ensures that the number will not return. In some cases, the eyesight weakens again over the years because of poor care or ageing but another minor procedure can be performed to correct that.

The patient is also asked to stop wearing contact lenses usually for one and in some cases six weeks prior to the surgery. “Contact lenses in a normal case should be completely avoided for the last five days before the surgery,” advises Dr Aziz Ali, an ophthalmologist at the Abbasi Shaheed Hospital in Karachi. Some contact lenses can hinder the oxygen absorption of the cornea which results in an increase in the size of the blood vessels. Even with modern RGP and soft silicone oxygen-absorbing lenses, the patients are advised to not over wear them.

This surgery can be a bit costly, ranging from Rs40,ooo to Rs50,000 so the patient needs to be aware about it beforehand.

Post-operative care

Dr Jamshed Anklesaria recommends three days of complete rest without leaving the house, minimal use of the phone and watching television. “It is important to stay indoors because dirt and dust which is very typical of Pakistani weather can cause infections and sunlight can stress or harm the sight. Also it is important to make sure to never rub your eyes, splash water or move around an area where you can bump into people and hurt your eyes. Even at home.”

Anti-inflammatory, antibacterial and lubricating eye drops are given to the patients to put in the weeks that follow and the patients are asked to rest. Sleep goggles are also sometimes given to prevent rubbing your eyes during sleep.

The operative procedure

1. Creating the flap: A soft corneal suction ring is applied to keep the eye in place after which a flap is created using a mechanical microkeratome or a femtosecond laser. A hinge is left at one end of this flap. The flap is folded back, revealing the stroma, the middle section of the cornea. The process of lifting and folding back of the flap can sometimes be uncomfortable.

2. Laser remodeling: The revealed stroma is treated with a laser that vaporises the tissue in a finely controlled manner without damaging the adjacent stroma. No burning with heat or actual cutting is required to ablate the tissue.

3. Repositioning the flap: After the cornea is reshaped so that it can properly focus light onto the retina, the cornea flap is put back in place and the surgery is complete.

Risks

Patients usually associate starbursts, ghosting and halos with lasik. However, these are more closely related to pupil size and thanks to high advancement Lasik rarely causes this. These are all conditions that are related to the eye sight and are not corrected by glasses but rather by eye drops and minor procedures. Many times the patients have these conditions even before the surgery. 

Noreen Mumtaz is a student at the Limkokwing University, Malaysia.

Published in The Express Tribune, Sunday Magazine, January 26th, 2014.

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