Tag Archive | expert lasik surgeon

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

Sep9

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

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:

 

Can lasik surgery be done for very high number (high myopia)?

Jul6

Myopia is a condition of short sightedness where vision is clear up close but blurry in the distance. It is a fairly common condition of the eyes and starts appearing at an early age, often in childhood. Last year a study done by our eye hospital in Navi Mumbai, India- Advanced Eye Hospital and Institute (AEHI) – showed that myopia affects almost 15-20 % of school kids.

Out of all people with common myopia, people with high myopia are a unique subset and have requirement of very high correction often more than 8 D. These are the people who are totally dependent on their glasses or contact lenses and the first thing which they seek the moment they get out of the bed is their glasses. They are literally blind as a bat without the glasses or contact lenses. This perception of day to day handicap motivates them to seek a freedom from glasses and their motivation for LASIK procedure is high. At Centre of Lasik Surgery at AEHI, one of best lasik surgery centres in India, we get to see people with high myopia very frequently. Besides visual handicap, patients with high myopia have a very high risk for other eye diseases like early cataract, glaucoma and more particularly retinal conditions such as retinal holes, retinal detachment, degeneration etc When a patient with high myopia considers getting freedom from glasses, we must check the eye thoroughly for these conditions as well and ensure a detailed pre LASIK evaluation. From an expert Lasik surgeon’s perspective, the additional challenge lies in deciding which is the best procedure for people with high myopia, whether Lasik or something else.

Dimple a young beautiful women almost stumbled into my room! I jumped out of my chair to help her thinking she must be not able to see well! She regained her balance and almost embarrassed, sat on the consulting chair. I saw her chart and realized that she indeed had a very poor vision. She had a vision of only finger counting at 2 meter. I saw that her glass power was -14D in both her eyes. On further discussion I recognized that she had never worn glasses or contact lenses in her life! My jaw almost dropped. She could sense my shock and quickly acknowledged that on her side of family it is a taboo for girls to wear glasses. Because of her poor vision she could not attend school and did not go out much. She got married while she was young and had a baby a year after her marriage. Now she was not able to manage an active child as she could not see what the child was doing.  So she convinced her husband to come for an eye check up and check if Lasik surgery is possible for her. She underwent a detailed pre LASIK evaluation at the Center for Lasik Surgery at the Advanced Eye hospital and Institute. The good news was that her pre LASIK evaluation was absolutely normal. But the big question mark in her case was how much number as a LASIK surgeon I could correct without endangering the safety of her eyes and if some other surgery was better to get her off glasses!

Let’s identify the options and the issues surrounding this topic-

An expert LASIK surgeon looks at multiple parameters before deciding how much number can be safely corrected. On one hand a patient with even a -6D may not be suitable for LASIK and on the other hand even -10D may get a green signal for Laser vision correction! There is really no prescribed magic number for correction by LASIK. Even if a patient’s corneal topography (corneal maps) and corneal thickness are absolutely normal and can support correction of very high powers, LASIK surgeons still try to restrict to an upper limit of -10 to -12 D. Correcting more than that even if everything is normal can result in post surgery regression (minus numbers coming back), dry eye, night vision issues besides the risk of post LASIK ectasia (where cornea becomes weak and bulges forward in an irregular fashion)! This is due to large amount of corneal tissue being lost during Excimer laser ablation.

So then what are the options for patients like Dimple who have eye power higher than what can be safely corrected by LASIK?

  1. Part Lasik and part glasses: One of the options is that we correct what we can by LASIK keeping patients eyes safety in perspective and then for remaining eye power patient can either wear glasses or contact lenses.
  1. Refractive lens exchange (RLE) with artificial lens implantation

Unlike LASIK which is an external procedure this is an internal eye procedure.  RLE is much like cataract surgery which is done when the natural lens inside the eye becomes cloudy, and needs removal and replacement with an artificial lens. In RLE a clear natural lens is removed and replaced with an artificial lens. The choice of artificial lens type and make is dependent on the patient’s age, requirements and the other factors. However RLE has a higher risk of retinal complications in high myopes, compared with other vision correction procedures. For these reasons, RLE typically is used only in cases of severe vision correction needs when none else seems to be the option and the need for power correction is dire!

  1. Phakic Intraocular lens (Phakic IOL’s)

 Phakic IOL’s are surgically implanted inside the eye and the natural lens of the patient’s eye is left as it is. These lenses work by bending light rays onto the retina to form a clear image. Many lenses with different designs are available. Phakic IOL’s are suited for people who have moderate to high myopia but are unfit candidates for LASIK surgery. Personally I do not favour the ones which are present in front of the iris (coloured part of the eye). They have a higher potential to cause damage to cornea and cause a long term reaction inside the eye. I prefer the ones which rest behind the coloured iris and just in front of the natural lens. Being an intraocular procedure there are some risks involved which fortunately are rare. Additionally the procedure is reversible and lens can be removed from the eye safely if required.

For Dimple, we chose to do Implantable contact lenses (ICL) which are a type of phakic IOL’s. Dimple has done very well after surgery and now can see her daughter playing far away.

Surgical treatment of very high powers for people with high myopia remains a big challenge for even the best of LASIK & Cornea surgeons. Selecting the safest and most appropriate technique for each patient and personalizing solutions ranging from various types of Lasik surgeries to lenses, we treat higher levels of myopia more safely and predictably at the Center for LASIK surgery at the Advanced Eye Hospital and Institute, Mumbai, India. Availability of better screening instruments which are used for pre LASIK evaluation and advanced machines such as Femto Lasik and Relex Smile Lasik also help us in our endeavor. More advanced lenses, expert eye surgeons and technology have allowed us to maximize visual quality and provide optimal solution in highly myopic eyes when LASIK treatment may not be appropriate.

 

About the author:

Best Lasik surgeon

Dr Vandana Jain- Cornea & Lasik Surgeon

Dr Vandana Jain is one of the best lasik surgeons in Mumbai, India. Having worked at eye hospitals of repute in India and abroad and with experience of over 5000 successful advanced lasik procedures under her belt, she has been a strong advocate of safety while reaching freedom from glasses.

Watch video of Dr Vandana Jain answer a few questions on Relex SMILE Lasik:

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

Dr Vandana Jain is also one of the few Lasik surgeons in India who has experience in can be contacted at AEHI helpline: +91-22-67313636 or by sending an email at vandana.jain@advancedeyehospital.com or by filling up the form below.