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REFRACTIVE SERVICES

REFRACTIVE SURGICAL PROCEDURES

A Trip to Lasik Surgery

LASIK Pre-Operative Evaluation

Patients who wear soft contact lenses or rigid gas-permeable contact lenses should discontinue their contact lens wear at least 3 days or 3 weeks prior to the evaluation, respectively. Prior to the LASIK procedure, one or more careful refractions will be completed.

Contact lens wearing patients who are believed to have an unstable refraction will be asked to discontinue contact lens wear and return for a repeat refraction in one to three weeks. When back-to-back refractions are stable (equivalent), the procedure may be scheduled. Corneal topography, or a detailed surface map of the cornea, will also be completed to rule-out keratoconus and irregular astigmatism of the cornea. A complete and thorough eye examination including determination of eye pressure, slit-lamp examination, and dilated retinal evaluation will be completed.

Corneal Topography

Bausch and Lomb Orbscan IIz Corneal Analysis System in Nethradhama

This optical mapping or corneal topography system mapping system is a diagnostic tool that shows the overall architecture of the cornea including surface power, thickness, front and back shape. Using an illuminated ring pattern and a beam of light that is shined across the cornea, the image sensors in the Orbscan IIz acquire over 9000 points of data in less than 2 seconds. That data is transformed into a wealth of information about the architecture of the cornea. The Orbscan IIz is unique among corneal topographers in its ability to image the posterior surface of the cornea. Early signs of certain corneal diseases or abnormalities are seen first on the posterior corneal surface. On this map, you can see: Top two images: Shape maps of the surface elevation of the front and back of the cornea. Lower left image: A map of the surface power of the cornea. Lower right image: A representation of the cornea's thickness.

By identifying potential corneal problems pre-operatively, Dr. Sri Ganesh and the Supervision team can better counsel you on the safety of refractive surgery and which procedure would be the most appropriate for you.

The Lasik Procedure

1.	The LASIK procedure is completed under topical (eye drop) anesthesia and is typically entirely painless during and after the procedure. A few minutes prior to the procedure, anesthetic eye drops will be applied to numb the eye and prevent discomfort during the procedure.
2.	A speculum is placed to hold the lids apart, thereby preventing blinking during the procedure. The surgeon places a ring on the surface of the eye designed to hold the eye steady and increase the pressure in the eye.
3.	A microkeratome is utilized to create a thin flap of the corneal surface. The surface flap is gently folded to one side in preparation for the laser refractive "cut." The laser, being computer driven for accuracy and precision, is programmed based on the patient's refractive error (nearsightedness, farsightedness, astigmatism).
4.	The laser delivery is completed next, and takes less than one minute for most patients. Laser delivery may take slightly longer for patients with hyperopia (farsightedness). Finally, the surface flap is returned to its original position restoring the surface integrity of the eye.
5.	The surgeon will often observe the eye under the laser microscope for up to 5 minutes to be certain the flap is securely in position. The speculum is removed and the patient may typically leave the laser center within the hour. Many patients now have both eyes treated with LASIK on the same day.

Bausch & Lomb Zyoptix System is the world’s first fully integrated technology for personalized vision solutions. This system is US-FDA & CE approved (approved for clinical use in USA & Europe). The Technolas 217Z100 laser was found to be the most accurate laser (99.7%) and exceeded US-FDA benchmarks by 15 percent in the clinical trials.

VISUAL REPRESENTATION OF LASIK PROCEDURE

The surgeon uses a microkeratome to create the flap. The flap is then positioned to one side of the corneal "bed" as the Excimer laser beam (left) is applied.

The laser ablation is complete and the flap is being replaced. Once The flap is returned to preoperative position, the surgeon carefully checks and rechecks the flap to be certain it is secure and well-positioned.
Click here to view Pre-op/Post-op Lasik Surgery instructions

Postoperative Management

Post-operatively, most patients will be instructed to use antibiotic and anti-inflammatory eye drop medications for 3 to 7 days. Dark goggles is usually worn over the operated eye while sleeping for the first few days or week following surgery. The patient is also typically instructed to avoid rubbing the eye for the first few weeks following surgery.

Post-operative visits are typically minimal, but most patients will only require one to three post-operative evaluations, which take place in the first six months following surgery.

Click here for www.supervisionlasik.com

What to Expect After LASIK Surgery ?

1.	Your eye or eyes (if both are treated) will likely be quite blurry immediately after your LASIK surgery. Do not be alarmed. This is natural and expected.
2.	You will likely awaken the next morning after your LASIK surgery with much improved vision. Your vision should also improve over the first two to three weeks following surgery.
3.	It is best to carefully protect your operated eyes with shields or goggles while sleeping during the first week or as your surgeon advises. Also, be sure to use the eye drop medications in the manner that your surgeon prescribes.
4.	Be very cautious not to rub your operated eyes for the first month after surgery, as this may cause the flap to dislocate. In general, after the first few days, it is very unlikely that you could dislocate your flap by rubbing your eye, but be cautious nevertheless.
5.	LASIK patients do not generally have any postoperative discomfort. If your eye begins to hurt or your vision deteriorates rather than improves, contact your surgeon immediately.
6.	We now know that dry eye syndrome commonly follows LASIK procedures, at least transiently. This may make your eyes burn, sting, feel dry or gritty, or even blur your vision. Many surgeons advise using non-preserved artificial tears for the first few weeks after LASIK.

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