Uncovering Some Facts Around Lasik: Read This Before You Plan Your Surgery!

Prior to the era of Lasik glasses or contact lenses were the only methods used to correct refractive errors. As Lasik was introduced in the early 90's it became a very popular way to improve vision without the need to use spectacles. Lasik surgery stands for ‘Laser-assisted in situ keratomileusis'. In simple words, it means reshaping of the surface of cornea using laser. It is the most common surgery performed today to improve vision so that one can get rid of spectacles. There is confusion and several questions that still exist in people's minds regarding this treatment. This article aims at addressing some of these common questions.

Who is eligible for Lasik?

1. Anyone above 18 years of age
2. Should have an appropriate corneal thickness for surgery
3. Have stable refractive power for at least a year
4. Should not have any eye infection or scar
5. Should not have had any previous eye surgery
6. Should not be suffering from autoimmune diseases like HIVs, AIDS, Rheumatoid arthritis 
7. Should not be pregnant or nursing

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Why is Lasik not recommended before the age of 18 years?

Though the shape of eye changes throughout life for some people, it changes the most during adolescent years. It is during this period that one's refractive power changes the most. If surgery is performed during this period, then there is a high chance that error may come back soon and the purpose of surgery may fail. So, Lasik is not recommended to anyone under 18 years.

Why is Lasik not recommended after 40 years of age?

There is an onset of presbyopia after 40 years and need for near vision glasses which defeats the purpose of surgery which is removal of spectacles. These people can benefit from a different surgery known as Refractive lens exchange.

Why is Lasik not recommended in pregnant or nursing women?

Hormonal fluctuations can cause fluid retention that can cause changes to a woman's vision during pregnancy. Hormone changes can also lead to dry eyes during pregnancy and breastfeeding.

What refractive errors are corrected by Lasik?

Lasik can correct short-sightedness (myopia), long-sightedness (hyperopia)and astigmatism. However, it can correct all these errors only to a certain extent. Very high powers cannot be corrected.

Why is suitable corneal thickness important before the surgery?

Lasik involves ablation or surgical removal of a part of the cornea to cause it's reshaping. More corneal ablation needs to be performed to correct higher refractive error. That's why it's important to have suitable corneal thickness before the surgery as excessive thinning of cornea can lead to complications in the future.

How long does the effect of Lasik last?

The effect of Lasik lasts forever but certain causes can change vision following Lasik like change in the shape of eye, development of cataract, onset of presbyopia, eye infection or scarring or any progressive eye condition like glaucoma.

Can Lasik cause dryness of eyes?

Lasik can cause dryness in some people. If someone has symptoms of dryness before the surgery, then there is a chance that it might worsen. This happens due to corneal denervation which occurs during corneal flap creation and stromal ablation during the surgery. Most people who have dryness after the surgery have the mild form that can be easily treated with lubricating eye drops.

Is there any pain felt during or after Lasik surgery?

The eyes are made numb before the surgery using anaesthetic eye drops and there is no pain felt during the surgery. Pain can be felt after the surgery once the effect of the anaesthetic drop wears off. This is a prickly pain that usually lasts only upto 24-48 hours.

How long does recovery take after Lasik?

It usually takes up to 24-48 hours for eyes to recover after the surgery in terms of pain. But full recovery takes one month. During this period one is required to use steroid eye drop that has an anti-inflammatory effect.

When can one join work after Lasik surgery?

Work after surgery can be joined as soon as one is comfortable and has no pain which usually after 24-48 hours. However routine drops and precautions will need to be followed as advised by the surgeon. Usually, one is expected to avoid any eye contact with water up to 1 month as this could lead to eye infection.

In nutshell

More and more young people especially girls are wanting to undergo Lasik surgery sooner than 18 years of age. Most of the times these young patients are brought into the clinic by their parents who support the idea of surgery. This is mostly due to peer pressure and changing beauty standards on social media. It is very important to understand that like any other surgery Lasik also has its own complications and side-effects and can rarely cause irreversible eye damage. It is imperative to have realistic expectations from this surgery. Each patient heals differently, and healing depends on multiple factors including any known systemic condition like diabetes etc. In summary, Lasik is an excellent procedure when performed on the right patient. Consult your ophthalmologist to discuss these issues if planning on this surgery.

(Dr Aprajita Sinha, Ophthalmologist at Worcestershire Acute Hospitals NHS Trust, UK)

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