Refractive eye surgery - what to ask your doctor

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BewiseHealthwise:

INTRODUCTION

Now a days any one who wishes to get rid of his or her glasses is presented with two options : Plain LASIK OR BLADELESS LASIK.The purpose of this website is to educate the patients regarding both the procedures ,since , lack of understanding of the procedures makes people vulnerable to aggressive marketing practices prevalent in this segment.


Laser in-situ keratomileusis, or LASIK is generally a safe and effective treatment for a wide range of common vision problems. Specifically, it involves the use of a laser to permanently change the shape of the cornea, the clear covering of the front of the eye. LASIK is a quick and often painless procedure, and for the majority of patients, the surgery improves vision and reduces the need for corrective eyewear.


LASIK PROCEDURE


The procedure for LASIK whether with blade or bladeless is almost the same with a single minor modification , in LASIK a corneal flap is made .The flap is lifted from its base and the  cornea underneath the flap is shaped using a laser to correct the patients refractive error .

The only difference between the two is that in LASIK the surgeon uses avery fine blade known as a microkeratome to make the  LASIK flap whereas in bladeless LASIK the flap is made using newr generation lasres like ilasik or  femtosecond laser .



BewiseHealthwise: What to Ask Your Doctors?

Refractive eye surgery helps improve nearsightedness. If you are nearsighted, you have trouble seeing things that are far away.

Below are some questions you may want to ask your doctors or nurses.

Questions:

 

  1. Will this surgery help my type of vision problem? Answer: Yes.Your dependence on glasses or contact lenses will be reduced significantly.
  2. Will I still need glasses or contact lenses? Answer: It will depend your pre-operative magnitude of number of glasses, your type of vision requirements & type of your profession.In most cases, you may not require glasses for low to moderate pre existing myopia.
  3. Will it help with seeing things that are far away? Answer: You can can see far away objects with or without optical aids.
  4. Will it help with seeing things close up? Answer:Your near vision will improve if you are below 35-40 years of age.
  5. Can I have surgery on both eyes at the same time? Answer: Yes.
  6. What are risks for having the surgery? Any surgery involves risks. In this case, it is minimal. It will be prudent on your part to ask your treating surgeon specifically.
  7. How do I prepare for this surgery? Answer: Ask your treating surgeon to explain in details. In most cases, no specific preparation is required.
  8. Do I need a physical exam by my regular doctor? Answer: Yes.
  9. Can I wear my contact lenses before the surgery? Answer: It is advisable to stop using contact lenses before surgery. Ask your treating Surgeon to explain you more.
  10. Can I use makeup? Answer: No on day of surgery. Yes after few months of surgery.
  11. What happens during the surgery?
  12. During whole procedure you will be conscious & awake. Few eye drops will be put in your eyes to make surgery pain free. You will be directed to focus on laser beams.Whole procedures just takes few minutes.It is most trouble free surgery.
  13. Will I be asleep or awake? Answer:As told above you will be conscious & awake during whole procedures.
  14. Will I feel any pain? Answer: No.
  15. How long will the surgery last? Answer:Usually, less than 15 minutes.
  16. When will I be able to go home? Answer: After,half an hour of surgery.
  17. How do I take care of my eyes after surgery?Answer: Treating surgeon will be best in position to explain you precautions after surgery. Usually, these are simple & doesn't cause you inconvenience.
  18. What type of eye drops will I use? Answer: Few eye drops are prescribed to promote your healing after surgery.
  19. Can I touch my eyes at all? Answer: No for few weeks after surgery.
  20. Can I take a shower or bath?  Answer: No for few weeks.
    Can I swim? Answer: No for few weeks.
  21. When will I be able to drive, Work, Exercise? Answer : After few days of surgery.
  22. Are there any activities or sports that I will not be able to do after my eyes are healed? Answer: As such no bar to perform any type of activities or sports.Highly technical occupations may have different yardsticks for their prospective employee. Better to contact your treating surgeons.
  23. What will my eyesight be like right after surgery? Answer: In most cases, your dependence on glasses or contact lenses will lessen & you will be able to see clearly & your eye sight improves.
  24. Will I have any pain? Answer : Mild pain or discomfort will be taken cared by prescribed medicines.
  25. How soon  my eyesight gets better? Answer: You will notice improvement on daily basis till few weeks when your vision will be stabilized.
  26. Do I need any follow-up appointments? Answer: Yes, for few visits.
  27. For what problems or symptoms should I call the doctor? Answer: If for any reasons you suffers from excessive watering,pain,diminution of vision-you should contact your treating surgeon immediately.

 
USEFUL LINK:
  http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures 
  /SurgeryandLifeSupport/LASIK/default.htm


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BewiseHealthwise: iLasik



BewiseHealthwise:

1) MYTH : Bladeless LASIK involves no cutting of the cornea

     TRUTH :  Bladeless LASIK term is accurate in the sense that instead of a blade a laser is used to make the corneal flap but the implication that it is less painful than WITH blade LASIK or that it involves no cutting of the cornea is absolutely  false.

 

2) MYTH : Bladeless LASIK is faster and gives faster recovery than WITH BLADE LASIK

    TRUTH : Bladeless LASIK takes longer than WITH BLADE LASIK since the flap is made under one laser first and the patient is then shifted to another laser to finish the procedure . moreover with the modern day MICROKERATOMES being used for WITH BLADE LASIK the flaps made are much smoother than that made with BLADELESS LASIK and hence the recovery is much faster with ‘WITH’ BLADE LASIK than BLADELESS LASIK.

 

3) MYTH : Bladeless LASIK has no complications and is much safer than WITH BLADE LASIK

    TRUTH : There are a number of complications of bladeless lasik including transient light sensitivity in many patients but usually these are not mentioned to patients due to aggressive marketing.

http://www.articlesbase.com/vision-articles/bladeless-lasik-vs-lasik-1125112.html

the above is an artcle referring to the complications of bladeless lasik.

here is another one which talks about their safety profilles.

http://www.sciencedaily.com/releases/2006/05/060503203214.htm

 

4) Myth - Only bladeless LASIK makes planar flaps i.e. flaps with equal thickness in the center and the periphery of cornea.

    Truth - The current generation microkeratomes and particularly the carriazo pendular keratome in use makes absolutely planar flaps which are no different from the ones made with BLADELESS LASIK.

 

5) Myth - Bladeless LASIK is safer since it does not cause buttonholing ,free flaps and other kinds of corneal damage .

  Truth - Bladeless LASIK is safe but its not ‘safer’. The truth is that with modern microkeratomes free flaps, buttonholes and other keratome related complications are a thing of history . Infact WITH BLADE LASIK is as safe as bladeless lasik plus with the benefit of half the cost .

6) Myth - Bladeless LASIK flaps are smoother than those with micro keratome  and hence lead to faster recovery and less patient discomfort.

     Truth -The femtosecond laser used for bladeless lasik is not a cutting laser. It generates air bubbles in the cornea and these air bubbles expand and lead to tearing of the cornea . Hence the flap is not cut but torn. So in reality the femtosecond flaps are not as smooth as those made with a microkeratome and hence the recovery is slow in patients with bladeless lasik . The increased operating time in a bladeless lasik procedure plus the fact that the flap is not very smooth leads to increased patient discomfort .

7) Myth - You pay more for a bladeless lasik procedure since it is safer than the other lasik procedures

    Truth - You pay more for a bladeless lasik procedure since the doctor has invested heavily in the machine . In essence you pay more than double for a procedure  which is more of a marketing gimmick to make people pay more .

Don’t be fooled by marketing gimmicks . Make an informed choice as to what procedure you want to undergo.

 


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