Choosing a lasik surgeon for Lasik surgery procedure – best practice guide for patients

It surprises me to no end when I see the way people including my friends and family, choose their doctors even in the present era. I have asked them many times what helps them make a decision how to choose the best doctor for particular problem? Is it the recommendation from a friend, from a doctor or from internet reviews? Have they done their research about the qualifications and the experience of the doctor in treating their problem?

These same questions apply to anyone who is thinking about LASIK treatment and wants to make a decision about where to get the surgery done and from which lasik Surgeon.

Hence, I decided to pen my thoughts as a LASIK surgeon about how one should choose a lasik surgeon for the surgery.

Choosing the BEST LASIK surgeon

1. Surgeon training and qualifications–

Whether your surgeon comes recommended by your general physician or a friend/colleague or you got to know about the doctor from your internet search, please do not take your surgeon’s qualifications for granted. It is very important to know about their post graduate eye surgery training, their fellowships and any other qualifications. If th lasik surgeon has received a formal training in managing cornea diseases, it helps as then the surgeon can diagnose early problems in cornea which will be a contra-indication for a lasik surgery.

Besides it is important to ensure that they are registered with the local medical body. It is also good to know if they have any scientific publications, do they speak at the national and international conferences. These are indirect indicators that their knowledge is up to date and their work is at par with other good surgeons.

Please also ensure that your surgeon is versatile and competent in all different kinds of eye power correction procedures. LASIK isn’t the only option, and it isn’t the best procedure for every person.

Now we have so many other great options like Epi-LASIK, PRK, FemtoLasik, SMILE Lasik, Refractive lens exchange, phakic IOLs’ etc. It is good to choose the best surgeon who is comfortable and experienced with all these procedures and the latest technology. That will also ensure that your surgeon will choose the procedure that will be best suited to your eyes.

2. Asking the right questions from the LASIK surgeon–

Come prepared with your list of questions on your first consultation with the LASIK surgeon. Write down all your relevant questions and concerns and ask them during your first consult.

In India we are sometimes afraid to ask too many questions lest the doctor gets annoyed or may not have the time to answer too many questions. It is a matter of your eyes and it is your right to get comfortable and get your queries answered prior to going ahead with LASIK surgery.

Some pertinent questions can be-

1. How many such procedures have they done and what are their complication rates compared to reported rates
2. How are their results and how they compare to reported outcomes
3. What kinds of checks they have in place to reduce the scope for errors
4. How many and what type of tests will be done to ensure safety of lasik surgery
5. What percentage of their patients need a repeat procedure
6. Do they charge for a repeat procedure and if not then for how long that applies

3. Trust –

The most important criteria for choosing your surgeon is your ability to trust the doctor. You need to feel comfortable with what your surgeon says, how he or she says it, and how relaxed and confident you feel with the level of care.

To sum up, the most important criteria of a quality surgeon include experience, great credentials, feeling of trust and willingness of the doctor and the staff to work with a patient to help him/ her achieve freedom from glasses.

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About the author:

Dr Vandana Jain is a renowned Cornea and Lasik Surgeon heading the Centre for Lasik Surgery at Advanced Eye Hospital & Institute, Navi Mumbai, India. She is one of the best lasik surgeons in India and is an expert in Pre-Lasik tests, Corneal evaluation pre lasik and has done more than 5000 Lasik surgeries in her career spanning more than 12 years. At her centre, which is the best lasik surgery centre in western India, she offers counsel and advice for Custom lasik, femto lasik, Relex Smile lasik

Dr Vandana Jain- Lasik Surgeon expert

Watch Dr Vandana Jain perform Relex Smile lasik laser – 

Interview of Dr Vandana Jain about Smile lasik

Video of a Smile lasik journey for freedom from glasses

Dr Vandana Jain can be contacted at contactus@advancedeyehospital.com or her appointments are available at +91-22-67313636

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How to choose the best eye hospital for Lasik surgery procedure: A guide

When it comes to Medicine, it is all about information and communication. The whole paradigm of information seeking avenues and behaviour has changed. Hence, today’s patients ideally should be very well informed. Besides family and friends, now there is the Internet which can really help people get information and become more aware.

At the Center for LASIK surgery at Advanced Eye Hospital and Institute, we get a lot of young lasik hopefuls walking in for a second opinion for Lasik surgery treatment. And we often find that:

• A good percentage of these patients are not suitable for LASIK surgery but have been advised to go ahead with lasik procedure elsewhere. Some of these have early changes in their cornea which pose a later risk of loss of eye sight or other complications.
• Some of them had not even undergone a thorough pre-LASIK evaluation without which no lasik expert can decide whether LASIK surgery should be performed or not. Millions of people have undergone lasik safely but we must understand that a pre-lasik checklist is a must to ensure a safe outcome.

While this can happen when the lasik centre does not have full facility for a complete pre-lasik checkup before lasik surgery, it can also happen when the lasik surgeon is not well trained in cornea and lasik surgery. Some people can also argue about the basic fabric and the unethical behaviors. However, that is a deep philosophical question and probably a topic of future discussions.

Hence, I decided to put down my thoughts as a LASIK surgeon about how one should go about choosing a LASIK surgeon for the surgery.

Choosing a Hospital–

1. LASIK surgery center location- It is good to know whether the LASIK surgery center is a part of the eye hospital or the eye doctor is going to take you to some other centre for the surgery. Surgeons who have a LASIK center in their own eye hospital are more likely to have considerable experience because they perform enough lasik procedures to support a center of their own. If a surgeon needs to travel to an outside surgical center or share a laser, then this may be an evidence that he or she performs fewer refractive surgery procedures.

Secondly,if the LASIK surgery center is not a part of the hospital, it is difficult to ensurethe quality of lasik machines and the practices followed.

Lastly it is good to enquire if the surgical center that the surgeon uses had any serious infection outbreaks. With strains of antibiotic-resistant bacteria on the increase, it’s essential that the surgical center personnel observe impeccable standards regarding sterilizing instruments and equipment.

2. Lasik centre equipments:

Ideal world class lasik centre would have all cornea diagnostic equipments for pre lasik checkup such as pachymetry, OCT, topography, trained cornea & lasik surgeon and other staff. Some of the best lasik centres in Mumbai also have Relex Smile lasik, Femto Lasik besides conventional custom lasik machines. The more well equipped the centre, better choice you can make about the type of lasik which will work the best for you.

2. Accreditations:

Accreditations such as ISO certification ensure better and safer processes for the patient. Hence, it may be a good idea to know if the hospital where the doctor is working and will be performing the surgery has any accreditations.This also ensures that the hospital follow the best practices.

2. Personal touch and the comfort with staff:

Most LASIK surgeons will give you enough time but at the end of the day their time is limited. Most good eye hospitals recognize the importance of having friendly, competent staff that is available to spend time and address any concerns or queries. Friendliness of the staff at “front desk” may be an important indicator of how comfortable you will feel as you go through the remaining steps of pre-LASIK evaluation, consultation and scheduling your lasik surgery.

It is good to assess beforehand if the staff at the hospital is friendly, are they competent or disorganized? Are they willing to take the time to answer your questions? Assessing the presence of that “personal touch” is very important to ensure that you will get the satisfaction, necessary time and attention and overall a good experience.

Be wary of the deals that many eye hospitals put up on the  deal sites offering really cheap lasik surgery. These kinds of deals should make you suspicious. In healthcare nothing of good standard and quality comes cheap. I am a strong proponent of not getting lured by these deals when it comes to your eye surgery. It is better to wait to save money if finances are a problem rather than taking chances with your eyes. Some hospitals may use a single lasik blade on many patients to cut the prices.

So in nutshell, good lasik machines and equipment are the most important indicators of a good hospital. This brings us to the next question: How does one select a Lasik Surgeon? More about this in the blog to follow…

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About the author:

Dr Vandana Jain is a renowned Cornea and Lasik Surgeon heading the Centre for Lasik Surgery at Advanced Eye Hospital & Institute, Navi Mumbai, India. She is one of the best lasik surgeons in India and is an expert in Pre-Lasik tests, Corneal evaluation pre lasik and has done more than 5000 Lasik surgeries in her career spanning more than 12 years. At her centre, which is the best lasik surgery centre in western India, she offers counsel and advice for Custom lasik, femto lasik, Relex Smile lasik

Dr Vandana Jain- Lasik Surgeon expert

Watch Dr Vandana Jain perform Relex Smile lasik laser – 

Interview of Dr Vandana Jain about Smile lasik

Video of a Smile lasik journey for freedom from glasses

Dr Vandana Jain can be contacted at contactus@advancedeyehospital.com or her appointments are available at +91-22-67313636

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Dry eye and Lasik laser surgery: Does Smile Laser surgery (Relex Smile) cause less Dry Eye?

Dry eyes have become a very common problem even without lasik surgery. What earlier used to affect some select few and mostly was a problem of older age groups with some systemic diseases has now become a common problem. We now give treatment for dry eye to children who are glued to mobile and computer screens, young professionals who work twenty four seven on the computer monitors and ofcourse older people who have dry eye due to other reasons. So I am really talking about no age being excluded from the problem of dry eyes.

Every week at Centre for Lasik Surgery @ Advanced Eye Hospital and Istitute, Navi Mumbai, india we see young professionals who visit us to explore the option of getting LASIK laser surgery. And given that dry is so common, a lot of them have dry eyes.  On top of that dry eye is even more common in regular contact lens users.

So what is the connection between Dry eye and lasik laser surgery? Does it affect recovery from lasik surgery?

1. Dry eye is the most common problem after LASIK and virtually all patients experience dry eyes after LASIK for the first 3-6 months. This happens due to damage to the corneal nerves while corneal flaps are being made as a part of the conventional or FEMTO LASIK procedure.
2. Dry eyes can delay normal healing after the LASIK surgery
3. Dry eyes after LASIK can cause both discomfort and less than optimal visual outcomes.
4. Long standing uncorrected dry eye after Lasik can cause regression ( some numbers to come back)

Since the post procedure stakes with dry eyes are high, we make sure provide best treatment for dry eye before lasik surgery. A battery of dry eye tests is performed to assess the presence and grade the severity of dry eyes during Pre LASIK evaluation. Both the quality and quantity of tear film is evaluated.

Various tests for dry eye before lasik surgery that are performed include–

1. Schirmer’s test- In this test a thin strip of special paper is putting under the lower lid to measure the amount of tear production.
2. Tear break up time- This is done with the help of a special dye which is put on the eye surface and then tear distribution and break up is evaluated
3. Surface staining- This is also done with the help of the dye and any areas of surface staining are studied.
4. Imaging- to assess the anatomy of the gland in the lids called Meibomian glands

While assessing the possible candidate for a LASIK procedure, we also try to rule out if there is any underlying condition that might be causing dry eyes.

Sheila, a young housewife wanted to learn swimming and found her glasses a big hindrance to that. She decided to get rid of her glasses and came to us for evaluation at the Center for LASIK surgery at Advanced Eye Hospital and Institute, Navi Mumbai. All her pre-LASIK evaluation was completely normal except for moderate decrease in her tear secretion. We noticed the slight crookedness of the fingers. On further probing she revealed that sometimes she gets pain and swelling in her fingers but she has not taken any treatment for it. We ordered some blood tests and she turned out to be a case of Rheumatoid Arthritis. This causes dry eye and can hamper normal healing after LASIK. She was advised against LASIK as there would have been risks of lasik surgery in long term.

Who are the people who are most at risk of developing dry eyes after LASIK?

1. Pre-existing dry eye (for example long term contact lens users)
2. People with very high myopia who need deeper tissue ablation during LASIK
3. Autoimmune diseases like Rheumatoid Arthritis, SLE, Sjogrens syndrome, skin diseases
4. Post menopausal women
5. People on some systemic medicines like Allergy medications

Can lasik be done if someone has dry eye?

All patients who have dry eyes may not be unfit for lasik. If the dry eye is mild to moderate, we may consider treatment for dry eye prior to LASIK. In some cases we put punctual plugs, small plugs to block the tear drainage from the eye and hence enhance the eye lubrication, at the time of LASIK laser surgery.

Which is the best lasik surgery for people with dry eye?

As lasik surgeons, we regularly make a choice when managing patients who have dry eye prior to lasik treatment such as:

• Surface Ablation (PRK, LASEK, Epi-LASIK) and SMILE LASIK (also called Relex Smile) are better options to prevent and reduce dry eye problem compared to LASIK.
• SMILE LASIK vs Lasik/ Femto Lasik, where no flap is created and is bladeless, causes minimal damage to corneal nerves during the procedure compared to LASIK where due to flap creation more corneal nerves are damaged. Hence, dry eye is less after Smile lasik.

To summarise:

• All people who are keen on LASIK should get a detailed pre LASIK dry eye check up done. Hence, it is a routine at Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai.
• Mild to moderate dry eyes require best treatment for dry eye before lasik surgery procedure.
• Newer, more advanced options like Relex SMILE LASIK have best results and reduce the problem of dry eye after the laser vision correction.

 About the Lasik Surgeon:

Dr Vandana Jain is a renowned Cornea Surgeon and one of the best Lasik Surgeons in India. She has been trained in Cornea and refractive surgery at LV Prasad Eye Institute Hyderabad and then at Harvard USA. She has performed more than 5000 successful Lasik Surgeries and heads one of the best lasik centres in India- Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India. Centre for lasik surgery at AEHI has the best lasik surgery machines for conventional lasik, femto lasik and Relex smile lasik available in India.

Dr Vandana Jain – Expert Lasik Surgeon

Watch dr Vandana Jain perform Smile lasik Surgery – the best Lasik surgery at Centre for lasik surgery, AEHI, Navi Mumbai, India

Watch video of Dr Vandana Jain, Best Lasik Doctor, answering questions about Smile Lasik surgery- safest lasik surgery

Dr Vandana Jain can be contacted at contactus@advancedeyehospital.com or her appointments are available at +91-22-67313636

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SMILE LASIK (Relex Smile) in Mumbai India, INDIA- Is it the best bladeless lasik laser surgery?

Every once in a while comes a newer medical technology which takes the world by storm and eases lives of millions of people across the globe. 30 years back when excimer Lasik started, it helped people get freedom from glasses and since then has helped more than 30 million (whopping number!!) get free of spectacles and contact lenses since then. In the field of eye surgery, lasik surgery would surely rank as one of the biggest innovations ever.

Old has to make way for the new and that’s how smartphones made digital cameras also obsolete. Similarly, advanced lasik surgery called Relex Smile lasik is now here to make old conventional lasik obsolete. It took more than a decade of pathbreaking research to overcome the limitations and problems with conventional lasik and start Smile lasik.

Dr Vandana Jain is a renowned Cornea and Lasik Specialist trained from L.V.Prasad Eye Hospital and Harvard, USA. She is one of the best lasik surgeons in India and is an expert in Lasik, Lasik xtra, Femto Lasik and Relex Smile lasik surgery in Mumbai, India. She is Chief Cornea & Lasik surgeon at Centre for Lasik Surgery in Advanced Eye Hospital and Institute (AEHI), the best eye hospital and the best lasik centre in Western India. Patient from all over western india such as Pune, Thane, Ahmedabad, Nasik, Kolhapur, Surat, baroda travel to meet her and experience freedom from glasses at AEHI.

People often are sceptical whenever a new lasik laser technology get launched, hence we conducted a video interview to ask her a few questions on Relex SMILE Lasik Surgery.

What is SMILE Lasik surgery and how is it done?

SMILE Lasik (also technically called Relex smile) is a flapless, bladeless laser vision correction surgery which is done to achieve freedom from glasses. This (lasik) surgery is performed with the help of a platform called Visumax from Carl Zeiss. Now, in this surgery, with the help of Femtosecond laser, instead of a flap we create a small tissue lenticule within the cornea and then we remove it with the help of a small incision which is just 3-4 mm long.

How much time does SMILE Lasik surgery take?

Compared to any other Lasik which may take a little bit longer, since here the entire procedure is just performed on one machine, it just takes 5 – 10 minutes for each eye.

Is SMILE Laser surgery painful?

In this (Relex SMILE Lasik) procedure, prior to the procedure, we put the numbing drops on the patient’s eye. And also additionally in this procedure, there is no excess pressure on the eye. So patient actually literally feels nothing. And within five minutes, the surgery is anyway over.

How many days does it take to recover from SMILE Lasik surgery?

The recovery period after Relex SMILE Lasik is actually really quick. So let’s say a patient comes to us on a Friday, on Monday they can actually go back to work. That’s one aspect of it.

Secondly, given that in this procedure, we are not actually creating a flap, all the safety issues because of which in conventional Lasik, we allow the patient (to resume) swimming only after 3 weeks, in this procedure within 10 days, the patient can actually go back to swimming and all the normal activities that they do in their day to day lifestyle.

All the women for example, who do cooking, can actually start doing their cooking within 3-4 days.

What are the tests done before SMILE Lasik surgery?

There are multiple tests that are done before SMILE Lasik Surgery. One group of tests is to ensure the long term safety and the other group of tests is to plan the procedure. Corneal thickness, Corneal Topography, the length of the eyeball, the horizontal measurements of the eyeball, the pupillary diameter in the light and dim conditions and the dry eye tests are some of the major (eye) tests that are done prior to any (lasik) surgery.

How is SMILE Lasik better than Conventional Lasik?

Conventional lasik has been around for many decades and millions of patients have benefitted from this procedure. However, having said that, technology continues to improve and we continue to see newer and better advancements in all the procedures including laser vision correction. Now let’s assume that we are doing an open surgery vs a laparoscopic surgery. So literally, that is the difference between a normal conventional Lasik and a Relex SMILE Lasik.

• No Flap- No blade: In conventional Lasik, we create a flap, which we can create either with the help of a blade or with the help of Femtosecond laser. Once the flap is created, then we use the excimer laser ablation to ablate the tissue. Whereas in SMILE Lasik, we are not creating a flap. We are not using any blade at all.
• The risk of flap displacement, which is there in conventional Lasik, that risk is literally not there with SMILE Lasik.
• Stronger Cornea: The cornea stays biomechanically stronger.
• Less dry eye after smile lasik: For people who are working on computers and have dry eye issues, since we are not cutting the nerves in the SMILE Lasik surgery, as much as we do in conventional Lasik surgery, even the dryness issues are far less in Relex SMILE Lasik surgery.

Concluding remarks:

Smile lasik surgery is the gentlest (smallest cut and no flap or blade), safest lasik surgery. It is a bit expensive and cost is more than double the conventional lasik and 1.5 times the femto lasik but you get lasik surgery only once and your eyes are surely worth the extra money which relex smile lasik costs. Smile lasik shall surely keep your eyes smiling for the years to come.

Watch the video interview of Dr Vandana jain about Relex Smile laser:

 

Watch video of Relex Smile Lasik laser surgery by Dr Vandana Jain at Centre for Lasik Surgery at AEHI:

 

We hope this video helped you understand a little bit more about SMILE Lasik. If you have any more questions, you can join us at Advanced Eye Hospital and Institute where we regularly organise Lasik Forums which are interactive sessions to help people understand benefits, risks, complications of lasik surgery better. You can register by sending us an email at contactus@advancedeyehospital.com or you can call us at 022 67313636.

Patient testimonials about AEHI and Dr Vandana Jain:

 

You can also fill up the enquiry form here and we will surely contact you soon. Take care and keep smiling…

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What is SMILE Laser (Relex Smile) surgery and is it better than other Lasik?

Smile LASIK or ReLex Smile procedure has been an amazing breakthrough in refractive laser vision correction for people with minus and cylindrical numbers. Even though conventional LASIK procedure has been around for decades and continues to benefit millions of people around the world but it has its own limitations. Research over the years has aimed to make lasik surgery procedure safer and more effective. This research has culminated into the latest generation laser vision procedure called SMILE Lasik procedure.

SMILE (Small Incision Lenticular Extraction) Lasik Surgery

SMILE is a novel form of ‘flapless’ laser vision correction surgery and is technically also known as Relex Smile laser. In conventional Lasik a flap is created on the cornea (either with blade or with femtosecond laser) and excimer Laser is used to flatten the cornea.

 

How is SMILE Lasik done:

Instead of a full corneal flap, while doing Relex SMILE a small 2-4 mm incision is made in the periphery of cornea by the femto laser. With the help of a machine called Visumax we create a very thin disc of tissue (lenticule) inside the intact cornea, which can then be extracted through the small 2-4 mm incision. An excimer laser is not required. This is akin to key-hole surgery.

Step 1: The VisuMax Femto laser creates a tiny key-hole incision measuring 2- 4 mm (Talk about precision!) and a refractive lenticule in the cornea in the same step.

Step 2: The lenticule is removed through the tiny key-hole incision. As no flap has been made, there is minimal disruption of the cornea.

Step 3: As the lenticule is removed, the curvature of the cornea is changed. This creates the required change to remove the eye power.

Smile LASIK where no flap is created is like a key-hole surgery compared to LASIK/Femto LASIK where flap is created and is like an open surgery. For the first time we have a glass removing laser surgery procedure that provides great benefits to patients with the least possible intervention: the cornea of the eye remains intact as much as possible and the predictability of the correction is very good. Additionally due to additional safety patients can go back to work in just 2-3 days- Hence at Centre for Lasik Surgery, Advanced Eye Hospital & Institute, Navi Mumbai, India – we have a saying – Smile Lasik on Friday, Back to Work on Monday

Some highlights of Relex SMILE Lasik surgery-

•  No Flap related complications
• Small incision heals very quickly-virtually no precautions and hence the precautions required after the surgery are minimised to just a week or so
• Less dry eye- fewer corneal nerves are cut as no flaps are created
• Biomechanical stability better preserved leading to long term safety
• Treatment time not dependent on the refractive error-quick 5-10 min procedure
• No laser energy loss in the periphery of the optical zone – minimizes spherical aberrations

What SMILE Lasik surgery means for the young professionals

• No increase in dry eye especially as most of them may be already suffering from computer vision related dry eye which otherwise gets aggravated after conventional LASIK
• No productive days lost in terms of precautions and restrictions.
• Lesser chances of any complications in future since biomechanical strength of cornea is not compromised.
• Negligible chances of infection as no flap is created and no blades are used
• Avoiding a flap prevents complications such as flap displacements which can happen during ball sports or contact sports

In today’s world we all seek a solution which is not only safe but allows us to get back to work quickly, SMILE Lasik surgery is the perfect and the best lasik surgery procedure. It is a real revolution in the way laser vision correction is done. In the Center for Lasik surgery at Advanced Eye Hospital and Institute we have been performing SMILE LASIK and getting smiles from patients for excellent results. It is great to see patients get back to normal lifestyle and work within a few days after the Smile lasik procedure.

About the author:

Dr Vandana Jain is a renowned Cornea Surgeon and one of the best Lasik Surgeons in India. She has been trained in Cornea and refractive surgery at LV Prasad Eye Institute Hyderabad and then at Harvard USA. She has performed more than 5000 successful Lasik Surgeries and heads one of the best lasik centres in India- Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India. The centre is equipped with Visumax Femtosecond laser machine which offres Femto Lasik and Relex Smile lasik. She can be contacted at contactus@advancedeyehospital.com or her appointments are available at +91-22-67313636

Dr Vandana Jain – Expert Lasik Surgeon

Watch Dr Vandana Jain answer a few FAQs on SMILE Lasik:

Watch a Smile Lasik laser surgery being performed by Dr Vandana Jain at Centre for Lasik Surgery at AEHI:

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