Eye Care Guide after LASIK surgery to ensure perfect vision

Diligence is the mother of good luck

As Lasik surgery procedure involves a minimal cut, the healing process following LASIK surgery is quick and most patients experience little or no pain. In my practice at Centre for Lasik Surgery at Advanced Eye Hospital & Institute, most of new freedom earners undergoing surgery by Relex Smile lasik laser are able to resume normal activities and return to work within 3-4 days after the procedure. Hence the Adage at our centre: “Smile Lasik on Friday- Back to Work on Monday”

However it is imperative to follow post surgery care instructions for a safe, successful recovery after laser vision correction.

The basic philosophy is to ensure quick and safe recovery and to reduce the risk of Lasik complications. Eye infections, flap related troubles etc can happen if proper care and diligence is not adopted after the Lasik surgery.

Neha got her LASIK surgery done in Delhi and had to fly to Mumbai 3 days later for some important office project. She was asked to replace a colleague who fell sick just prior to the travel. She took the permission to travel from her LASIK surgeon. She was given a set of instructions and some eye drops to be instilled in her eyes. She had been very diligent about most things and had been using her eye drops properly. 2 weeks after her surgery she felt a minor irritation and her surgeon referred her to me. She was thoroughly examined at the Centre for LASIK surgery at the Advanced Eye Hospital and Institute. Her vision was still perfect but she had developed a small whitish area of post Lasik infection near the edge of LASIK flap. This being a serious situation, we immediately started her on treatment. She recovered fully although she required 2 months of continuous treatment.

We were all wondering what caused this infection since Neha seemed to be so diligent and careful. When we went through her last two weeks routine post lasik surgery, she told us that one hot evening she could not resist the temptation to take a plunge into the hotel swimming pool. This was about 12 days after her surgery. Her irritation started a few days after that. Basically she had developed a corneal infection due to swimming in the pool.  I think it was sheer callousness and not ignorance accentuated by the perception that doctors unnecessarily advice too many precautions after the lasik procedure!

After seeing this happen with Neha, I thought it would be wise to pen down some do’s and the don’ts to avoid post Lasik surgery complications:

• Avoid any form of dirty water or dust entering the eye for 3 weeks

1. Showering carefully to ensure no tap water or soap enters into the eye.
2. Hair spray and shaving lotion should not enter the eye, hence these products need to be used carefully for the first 3 weeks after Lasik procedure
3. Swimming in pools or lakes or sea or use of sauna and Jacuzzi should be avoided for 4 weeks after lasik surgery
4. Avoid hair colouring or perming for at least 2 weeks after laser vision correction
5. No exercise for two days after laser eye surgery and it is necessary to avoid sweat getting into the eyes for 3 weeks.
6. Avoid dirty/dusty environments for 2-3 weeks and use sunglasses outside the home or office for the first 3-4 weeks
7. Avoid eye makeup ( especially the old eye make-up) for 3 weeks
8. For at least 7 days after laser vision correction – hard work, gardening, grass cutting, working in your yard, dusting should be avoided

Avoiding activities which can cause Lasik flap related problems

1. Avoid rubbing your eyes for 2-3 weeks after Lasik surgery
2. Wear the eye shield/goggles while sleeping for the first 7 nights
3. Wear eye protection for at least the first month while exercising or playing after Lasik surgery
4. Watching TV, reading, and working on computer can be done but make sure that your eyes are well lubricated and you should blink your eyes frequently.
5. Make sure that you use eye drops as prescribed by the doctor for lubrication and also prevention of any infection.
6. Ensure that you do not miss your post-operative visits after the surgery. Normally one day and one week check-ups are mandatory. At our centre we advice 1 day, 1 week, 1 month and 3 months check-up.

With the advent of newer and safer Lasik Surgery procedures such as Femto Lasik and Relex Smile Lasik available at Centre for Lasik Surgery at Advanced Eye Hospital & Institute, India – the safety of Lasik has become even better and flap related problems even less common. While Femto-lasik is a bladeless and uses Femto Laser for making a more precise flap, Smile Lasik is a flapless Lasik (just a very small cut) procedure which has the fastest recovery.

Lasik surgery is a quick procedure and has a short recovery period. Most patients feel normal enough to perform day to day activities right from the next day itself. However like any other surgery, Lasik surgery also requires some care and precautions. These go a long way to ensure quicker, safer and best possible outcomes after laser vision correction.

So get the LASIK surgery after proper pre Lasik evaluation, choose the place for surgery diligently and after the surgery listen to your expert lasik surgeon and follow the post lasik instructions!

“When people talk, listen completely. Most people never listen.” 
― Ernest Hemingway

About Dr Vandana Jain:

Dr Vandana Jain is one of the Best Lasik Surgeons in India and has received training at LV Prasad Eye Institute and then at Harvard, USA. In her Lasik career spanning more than a decade, she has helped more than 5000 people get freedom from glasses permanently. Currently, the Chief Cornea & Lasik Surgeon at Centre for Lasik Surgery at Advanced Eye Hospital & Insittute, Navi Mumbai, India she spends time on helping prospective Lasik Wishfuls get their freedom. Dr Vandana Jain is also one of the few well trained and experienced Relex SMILE Lasik Surgeons in India.

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Complications of Lasik Surgery

I am full of fear and I do my best to avoid complications. I like everything around to be clear as crystal and completely calm- Alfred Hitchcock

Medical science is a field full of intricacies. Ambiguous and problematic situations may occasionally arise. Nobody can agree with it more than Shubham. Shubham had a successful LASIK surgery 1 year ago. According to his Lasik surgeon, he was a suitable candidate for the surgery. Everything was great for him until recently when he started noticing that vision in his left eye was progressively going down. That’s when he came to us for a detailed eye check-up at the Center for LASIK surgery at the Advanced Eye Hospital and Institute. Corneal topography, corneal thickness etc were carried out and he was found to have post-LASIK ectasia in his left eye. Post lasik ectasia refers to a condition where a weak cornea bulges forwards. Luckily it was detected early. Collagen cross linking was performed in his left eye to stop the progression of post-LASIK ectasia and arrest it an early stage itself.

With significant advancements in technology, complications associated with LASIK surgery procedure have declined significantly. However, Lasik complications can still sometimes occur.

This aim of writing this blog is not to scare anyone but to make sure that we understand all the good and the not so good aspects of LASIK surgery.

Complications during the Lasik surgery procedure

1.  Flap related problems– These are the problems that are related to the outermost flap which is created as the first step of LASIK surgery. Flap is created with either the motorized blade called microkeratome or by a more advanced and safer bladeless means using femtosecond laser- Femto Lasik.  Flap related problems like incomplete flaps, button hole, thin flaps, free caps etc are rare problems and can be managed with proper diligence. These problems can happen rarely during the use of microkeratome (Blade used for making flap) and almost never when using the femto lasik.  When flap related complication happens during the surgery, an experienced Lasik surgeon usually abandons the surgery at that point and re-plans after 3 months. The aim of waiting is to make sure that eye powers and surface has stabilized.
2. Intraoperative epithelial defects (scratch on the top layer of cornea)- These happen very rarely and may cause slight discomfort for a day or two. It can also pre-dispose to a little more reaction under the flap called DLK. ( discussed later)

Complications after Lasik surgery

1. Flap problems– The flap can develop minor folds called striae or may dislocate (shift) from its proper position. Mostly the flap striae do not cause any symptoms and are detected during routine examinations. However, minor visual aberrations may occur if striae are located over the central area of cornea (pupil). Factors which may increase the risk include excessive washing of flap during LASIK, poor repositioning of the flap at the end of procedure, thin flap, deep corrections due to higher minus numbers causing flap-bed mismatch. Striae become more difficult to remove over time so visually significant striae should be treated early. For treatment, flap is lifted, washed and placed back into position. A flap dislocation on the other hand happens due to eye injury or excessive eye rubbing and needs to be managed as soon as possible.
2. Epithelial ingrowth– It is a relatively uncommon problem especially the ones that causes symptoms.  In this condition top layer of cornea grows under the flap. If it grows centrally it may cause some decrease in vision. Femtosecond laser LASIK has the advantage of creating vertical side cut flaps thereby preventing epithelial ingrowth.  In case epithelial ingrowth is affecting the vision or may cause that in future then a simple procedure is required. Flap is lifted and ingrowth is scraped from both the sides.
3. Deep Lamellar Keratitis– It is a rare transient problem. Most patients are either asymptomatic or may have mild pain, light sensitivity and slightly decreased vision. Doctors usually notice a fine, white, granular reaction below the flap. This is usually seen at the edges of the flap. Mostly it settles down with just adjustment of topical medications (steroid drops) but rarely may require washing under the flap.
4. Infections– Infections are again a rare but if they occur can be a major complication after LASIK surgery. The incidence of infection ranges from 0–1.5%. Most infections happen due to poor sterility precautions during LASIK surgery, however, some may also be caused by poor postoperative habits and not taking care of the precautions explained. Many different bugs have been identified. The management is dependent on early diagnosis and treatment targeted towards the offending bug. Sometimes flap lift is needed for microbiological evaluation. The treatment may run into weeks to months. This rare problem brings home two very pertinent points; one is about choosing your surgical place very carefully and ensuring the quality standards. Secondly – please follow the post-operative instructions very carefully. These instructions are – no water splashing into the eyes, swimming or sauna, applying eye makeup and rubbing the eyes for at least two weeks.
5. Post-LASIK ectasia- Ectasia is major albeit rare lasik complication that can happen from a few months to even 3 years after LASIK. In this condition cornea increasingly thins and bulges out leading to progressive increase in minus and cylindrical powers. Risk factors include pre-existing corneal abnormality detected through pre-surgery corneal maps, younger age, thin cornea, correction of high minus numbers and lower residual corneal bed thickness. This highlights the importance of a detailed pre-LASIK evaluation by the Cornea and Lasik surgeon. Good news is that treatment has advanced a lot in the recent years. Collagen cross linking helps to stop the progression of post LASIK ectasia in the event that it develops. For vision improvement contact lenses, INTACS etc can be considered.

Advancements like Femto Lasik lasers to create LASIK flaps and wavefront-optimized excimer laser platforms, have improved the safety profile of the procedure a lot. LASIK has been producing excellent results worldwide, with an overall satisfaction rate of 95.4%. However, as with any surgical procedure, complications can and do occur. The first step to avoiding complications after LASIK is proper patient selection and second one being the proper Lasik Surgeon selection. Patient age, refractive error, corneal thickness, topography, keratometry and pupil size all need to be considered. In case a complication does occur, there is no substitute for diligence, timely reporting and proper management.

With the advent of Relex Smile laser lasik, flap related complications have completely gone as it is a bladelss flapless lasik

Dr Vandana Jain is an internationally trained Cornea and Lasik Surgeon. She is counted as one of the best lasik surgeons in Mumbai, India. She is also the director of Centre for Lasik Surgery at Advanced Eye Hospital and Institute where she trains people for lasik surgery and is a strong advocate of proper case selection and safety for lasik surgery. She feels that is the best way to minimize lasik complications and side effects. She can be reached at +912267313636 for appointments or contactus@advancedeyehospital.com or fill out this form and we will reach out to you.

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What is the right age for LASIK Surgery?

Disha, a 17 year old entered my room at Centre for Lasik Surgery within Advanced Eye Hospital and Institute Navi Mumbai and started complaining how she hates her glasses. Her friends tease her and she is not able to get the attention of the guy she likes because of her glasses. She came all alone for a consultation as she wanted me to convince her dad that she can undergo LASIK surgery and get rid of her glasses. Today’s youngsters demand and know more than we knew when we were their age.

On the other hand are the baby boomers who continue to redefine aging. As soon as Mr Sharma, a 60 year old gentleman, entered my room I was thinking he must have come for cataract opinion. But to my surprise he had come for a LASIK procedure opinion! He had craved for a glasses free life for years.

I thought to myself how even being an eye doctor I am getting into stereotypes!

So of course the broader question is what is the right age for LASIK surgery?

It is a question that needs an answer, and here we go!

Not before 18- Too young for LASIK!

Most Lasik surgeons tend to avoid LASIK surgery in children less than 18 years as eyes keep changing shape and size into early adulthood. A stable glass power for 1-2 years is also mandatory prior to LASIK laser surgery. We do make exceptions to this rule sometimes.  Younger people who are resistant to traditional treatment may benefit from LASIK. For example LASIK can be a viable alternative in children with a condition called anisometropic Amblyopia (where one eye has a very high power and poor vision compared to the other) who are intolerant to spectacle and contact lenses.

What about after 40 -Reading glasses?

The second fluctuation in a person’s eye happens around the age of 40. Soon thereafter, many people start to need reading glasses due to a condition known as presbyopia. LASIK surgery cannot correct two different numbers in the same eye (one for distance and one for reading) but can help with monovision. Monovision is a laser eye surgery that leaves one eye corrected for near vision and the other eye corrected for distance vision. Additionally one needs to remember that reading numbers continue to increase with age. Hence what has been corrected today will stand corrected but future gain in numbers will reflect.

50’s – Too Old for LASIK?

Its never too late for a lasik surgery but we must remember a few things about aging and the eye. At older age, the lens inside the eye may undergo changes and a cataract formation can start. However I have seen some adults who did not have cataract even at the age of 70 or 80 years. It’s possible that a 70-year-old without cataracts or other eye illnesses is actually a better candidate for a lasik surgery than a 30-year-old. The lens has to be clear and the patient must understand that LASIK procedure will not prevent a cataract from developing in the future

Special Considerations before Lasik surgery in older age groups

As with any other patient population, some issues need to be considered:

Pre-existing eye disease: Prior to moving forward with any LASIK surgery, it is imperative to rule out any pre-existing  retina and corneal conditions which can interfere with the outcomes. We also need to rule out a check out family for history of corneal disorders, diabetes and glaucoma.

Drug side effects: Some medications taken by older patients could pose a problem, for example Amiodarone is a drug taken for a heart condition. It can have some ocular side effects like photosensitivity, corneal microdeposits, hazy vision, and colored haloes around lights. Rare side effects include corneal ulceration, subcapsular lens opacities and nonarteritic ischemic optic neuropathy.

Person’s medical history and any prescription drugs need to be properly documented before even considering LASIK.

Cataract surgery: Those patients who have already started developing cataracts are better served with a cataract extraction followed by implantation of an IOL. These patients can always be evaluated for multifocal lens suitability. We all need to understand the real possibility of cataract formation months or years following the procedure. Previous LASIK surgery may make calculating a subsequent IOL power difficult. To address this problem, we often record a preoperative topography measurement prior to the LASIK procedure, and then keep this information on file. This baseline measurement taken before the surgery can be extremely helpful for the IOL calculation down the road when cataract surgery may be needed.
Finally a previous cataract surgery does not represent a contraindication for LASIK,

Age certainly influences one’s LASIK candidacy, but it by no means draws an absolute boundary.  Don’t let your age hold you back! If you are interested in freedom from glasses – do start investigating, it is never too late to improve the quality of your life. Only thing needed is a detailed medical and ocular evaluation to ensure you qualify for Lasik.

 

About the Author:

Dr Vandana Jain at Centre for Lasik Surgery, AEHI

Dr Vandana Jain is a renowned Cornea & Lasik Surgeon and owing to her experience in the field of Lasik Surgery is often an invited speaker at National and International eye surgery conferences. True to her vision of helping people with glasses, she has setup a state of the art “Centre for Lasik Surgery” at Advanced Eye Hospital & Institute in Navi Mumbai. The centre spread over 11000 sq ft has a unique distinction of housing the latest german technology in form of lasik, bladeless femto lasik and flapless smile lasik under roof. Dr Vandana Jain shares her experiences from patients she treats to the friends she makes in the process of giving them freedom from glasses.

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Even the moon has spots – A successful Lasik Surgery can have minor side effects

Lasik or Laser vision Correction has been around for two decades and more than 30 million people worldwide have said goodbye to contact lenses and spectacles – courtesy Lasik. The list of people who have undergone successful lasik surgery includes celebrities like Elton John, Cindy Crawford; sportspersons like Anna Kournikova, Tiger Woods and closer home Juhi Cawla and Jackie Shroff.

But all said and done Lasik is a surgery, albeit very non-invasive. Just like any other treatment such as  oral medications, placement of a new medical device, or surgery, Lasik can have its own set of side effects.  Hence, it is important for us to understand them prior to even making our minds for the lasik surgery treatment.

Being a Cornea Lasik Surgeon, I see hundreds of Lasik wishfuls every year right from 18 years old who don’t wish to be seen in glasses to 50 year old who want to embrace freedom. Even I myself underwent a Lasik surgery a few years back.

I tell my patients one simple example- if we leave our houses with our bags well packed and stomach well filled, we wont face any problems but the day we leave unprepared that is the day when we face difficulties. Hence a part of the preparation for Lasik Surgery procedure is to have a one on one chat with the expert lasik surgeon.

 

Information is all around us and today’s consumers are more aware than ever. Even before they land op in my Lasik clinic, they have consulted numerous numerous search engines and this before even making the appointment for the lasik check-up.

But this is not true for everyone- A few days back , a vibrant young lady, Ritika came in for an eye check-up with complaints of dryness and grittiness. Detailed check up in our Dry Eye Clinic at Advanced Eye Hospital and Institute (AEHI), Navi Mumbai disclosed that she had a moderate dry eye. She had a LASIK surgery done few months ago when she was visiting her parents in Rajasthan. She was not very particular about using the lubricating eye drops prescribed by her LASIK surgeon and was also a heavy computer user. In short, her life style had all the so called ingredients for dry eye such as 8-10 hours of computer usage, air conditioned atmosphere, poor dietary habits and lack of proper sleep. Her question to me was really straightforward- I had all these life style issues even before my LASIK surgery then why now my eyes feel dry and I get tired very easily! I probed further before answering her question about what she knew about the side effects of LASIK. She knew none! Her friends had LASIK surgery and they were all very happy to be free of glasses. She decided to go ahead with it without reading or discussing the side effects of LASIK with her treating surgeon.

Hmm, that prompted me to pen down this blog so that I can lay the facts out there.

A successfully performed LASIK can still have side effects such as:

1. Some discomfort and eye pain in the first 1-2 days after the procedure
2. Red spots called sub-conjunctival hemorrhage (minor beeding under outermost layer of the eyeball) may be visible after the procedure and may persist for week to ten days. These happen due to the application of the suction during the procedure and disappear by themselves.
3. Because each patient will heal slightly differently, results may vary slightly from patient to patient
4. Fluctuating vision especially in the first 1-3 months after the LASIK procedure
5. Night vision issues- such as haloes around light, double vision and glare from oncoming head lights- this may make night driving slightly uncomfortable initially. This tends to reduce few months after the LASIK surgery.
6. Dry eye symptoms- These are more in people who have pre-disposing factors like prior use of contact lenses, heavy computer usage, pre-existing dry eye etc. This is one of the reasons why we perform detailed dry eye evaluation like Schirmer’s test, Tear film break up time, eye surface staining patterns, lid condition etc as a part of pre-LASIK evaluation. To counter the dry eye problem lubricating drops are prescribed for a minimum of 2-3 months to one and all. If someone has other risk factors for dry eye then lubrication may need to be used for a longer period as well. Rarely, to counter the inflammation related to dry eye, anti-inflammatory drops like topical cyclosporine are also prescribed in some patients.

These are some of the minor side effects of the LASIK surgery which everyone should be aware of prior to making a choice for the surgery. Mostly these do not have a significant effect on anyone’s lifestyle if due care is taken.  Additionally a proper Pre-LASIK evaluation and a thorough discussion with the expert lasik surgeon plays a pivotal role in the safety and efficacy of LASIK surgery. Accurate lasik evaluation can reduce side effects associated with LASIK and potentially improve visual outcomes.

To know more about the complications associated with LASIK surgery, stay tuned. I will cover in the next blog.

About the Author:

Dr Vandana Jain is one of the best Cornea and Lasik Surgeons in the India. She is the Director of Centre for Lasik Surgery at Advanced Eye Hospital and Institute located on Palm Beach Road Sanpada, Navi Mumbai. Having trained at Harvard (USA) and LV Prasad Eye Institute, she brings a rick clinical expertise and in addition being lasik-freedom-earner a rare compassion to her practice.

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

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Retina checkup before LASIK Laser Surgery- it’s not only about the front of the eye!

When you get too close to a tree..

You may lose sight of the forest

This statement cannot be truer for patients who are planning to get a LASIK done. Courtesy of TV ads and other marketing blitzes, Lasik is now perceived as a quick 5 minutes procedure which can be planned during the office lunch breaks. While this is true of the actual lasik surgery procedure – it does take only 5 minutes with new generation Femto lasik machines, there is a lot more work which needs to be done by the lasik surgeon beforehand to get those 5 minutes spot on.

Just last week Roshan took an emergency appointment with me at Centre for Lasik Surgery @ Advanced Eye Hospital and Institute (AEHI). He was in Navi Mumbai for some office visit. A resident of Delhi; he had developed a sudden diminision of vision in his left eye. He had a LASIK done just 3 months ago somewhere in Delhi. He had planned the lasik surgery like a spa visit. He went to the doctor’s office and was out within 2 hours after initial tests and the procedure. Thankfully he took half a day off from work as he had some pain and watering in the eyes after the procedure. Next morning was a total bliss for him as he could see clearly without his heavy thick glasses. His joys knew no bounds and he had been on cloud nine ever since; well, until now!

Cornea examination done at AEHI showed no problems with the LASIK surgery site. On Retina examination by a Retina Specialist, we found that he had a big hole in the retina which had led to the retinal detachment. Retinal detachment is a condition where liquid enters the space below retina through the hole and detaches retina from its normal place. The loss of vision depends on the extent of the detachment.  When I probed further and asked about his last retina check-up considering that he had high power of glasses, he had never had one. His Lasik surgeon had suggested the retina check prior to his Lasik but then he would have had to schedule his surgery to another day. So he promised his doctor the retina check up at a later day after the lasik procedure. However that day somehow never appeared in his busy schedules.

Roshan was taken up for urgent retinal detachment surgery at AEHI which was quite successful in restoring his vision to near normal. The Retina Surgeon also found a large retinal hole in the other eye and performed Barrage laser procedure to seal that hole before it could cause retinal detachment. Thankfully it got detected at the right stage.

Though, saving time is important but certainly not more important than safety. As expert lasik surgeons, we need to have a Lasik safety checklist in which every box item needs to be ticked properly. In this respect, besides other tests a detailed meticulous retina evaluation is extremely important prior to LASIK. This indirectly means that LASIK cannot be done on the same day as the retina check and other pre-LASIK tests. Once the pupils are dilated for retina evaluation, we have to wait for a day for the pupil to come back to normal shape and size; otherwise it can interfere with the eye tracking function during LASIK.

During LASIK Surgery procedure itself, there may be several types of mechanical stressors on the eye:

1. Transient increase in eye pressure during the suction phase
2. Sudden decompression of the eye when suction is discontinued
3. Acoustic shock waves during the laser ablation phase

These mechanical stressors have the potential to damage the retina, macula and the vitreous if there are pre-existing risk factors which have not been thoroughly checked.

Keeping these in mind, when retina is examined prior to LASIK, retina specialists look for these things-

1. Status of Retinal attachment
2. Areas of degeneration
3. Health of optic nerve head
4. Health of macula- main area of the retina which is responsible for central vision
5. Peripheral retina to rule out holes, breaks and other areas of thinning like lattices
6. Any vascular malformations
7. Status of the gel of the eye for pre-existing degenerations and floaters( vitreous)

The aim of a Pre Lasik Retina Checkup is, thus, to identify those conditions which need pre-treatment. For example holes, breaks and lattices need to get Barrage laser 2-3 weeks prior to laser vision correction. If this is not done then patients are at increased risk of retinal complications after LASIK.

Some of these conditions may also have warning signals such as eye floaters and flashing lights mandating an urgent retina check-up. But in the majority these conditions may be silent and can only be picked up when looked for. Hence, a preventive retina check should always be done as a part of pre-LASIK evaluation. Only then we can have Best Results in Lasik Surgery.

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. Centre for lasik surgery at AEHI has the best lasik surgery machines for conventional lasik, femto lasik and smile lasik available at Navi Mumbai, India.

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

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

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Ensuring safety while achieving Freedom from Glasses by Lasik Laser Surgery!

Glasses have become ubiquitous, affecting almost 20% of human noses, at least in the cities.

Though glasses look smart on a lot of people but still they may be a hassle if the number is so high that you are incapacitated without them or if you want to live an outdoors life or just would love to be free of those things on your nose!

Freedom from glasses is something each of us would want if it can be done without a surgery or at the most with a safe surgery. The fear of the unknown is there in everyone’s mind and no one wants to get into a surgery and land up with long term vision issues.

At Centre for Lasik Surgery at AEHI, patient’s safety is always paramount to us. Let me share with you a recent case: Ira came to me for an opinion about LASIK surgery. She is the daughter of one of my physician colleagues. She is a smart young lady and is currently doing her MBA. She was very motivated for Lasik and we took her for a full round of AEHI Pre-Lasik Checkup. Tests showed a rare corneal abnormality in her eye called Fuch’s corneal endothelial dystrophy. This is a progressive disease and over a period of time can lead to lot of vision issues. Any surgery on such Cornea can hasten the onset of complications and actually worsen the outcome. We gave her all the information about her problem. She being a smart educated girl decided to not go for LASIK and rightly so!

Even though as LASIK surgeons we want to help each and everyone who wants to get rid of glasses but we cannot compromise on the long term safety of patient’s eyes.  At Advanced Eye Hospital & Institute, out of every 100 motivated people looking at freedom from glasses- we advise against LASIK surgery to almost 20% people as it may just not be safe for them. And our thorough Pre Lasik test module allows us to really screen very rigorously.

There can be multiple reasons where Laser Vision Correction may be unsuitable for someone’s eyes. Let’s understand some of the common reasons coming from our experience at Centre for Lasik Surgery at Advanced Eye Hospital & Institute at Navi Mumbai.

1. Unstable glass power– LASIK surgery is best done when eye power has been stable for atleast an year or two. What one needs to understand is that LASIK changes the curvature of the cornea in alignment with current eye power. If eye power is not stable and is bound to increase in future then some of the refractive error may come back in later years. To prevent that from happening we postpone the surgery to future years and plan upon power stabilization. In such cases when Lasik is done when power is unstable then people label that lasik has failed when actually the case selection was wrong. We cannot and should not blame a safe procedure like lasik if the case has not been selected properly.
2. Thin corneas– Lasik as a surgery entails making a flap on the cornea and then using the excimer laser to alter corneal curvature. This whole process makes cornea thinner by some amount which is dependent on patients’ eye power. So if a patient already has a thin cornea then the procedure may not be safe. The corneal thickness is measured by a test called pachymetry. If a lasik surgery is done on a thin cornea, it may become weak and bulge out later. This can even lead to complete loss of vision.
3. Abnormal corneal maps– Corneal topography gives us the surface and curvature maps of the cornea. It ensures that there is no underlying sub-clinical corneal abnormality such as Keratoconus or suspect Keratoconus which can become a full blown disease after Lasik surgery. So if topography maps show any abnormality, it is better to decline the procedure.
4. Advanced Glaucoma– For a patient who is a known case of glaucoma controlled on two to three medications and has advanced visual field defects or gets detected during Pre-LASIK evaluation, the lasik surgery should not be offered.
5. Squint or gross eye muscle abnormality– Anybody who has or is at risk of developing squint based on pre-operative evaluation may be advised to defer the LASIK surgery. In some selected cases we go ahead with LASIK knowing that patient may require a squint correction after LASIK surgery.
6. Severe Dry eye– People who are already suffering from severe dry eyes and produce lesser  or poor quality of tears are also advised to defer LASIK surgery. If the condition improves and we rule out any permanent reason for severe dryness then LASIK can be done in future.
7. Uncontrolled Diabetes or autoimmune diseases– These diseases can interfere with proper healing after LASIK and in fact increase the risk of corneal meting and infections. In these conditions we usually defer any form of non-urgent eye surgery.

Finale: So, from  a LASIK surgeon’s perspective, “long term safety of vision is the Mantra” driving us towards making sure that Lasik offers you freedom from glasses safely and thus becomes a source of joy for the rest of your lives. And now with SMILE lasik available at Centre for Lasik Surgery at Advanced Eye Hospital and Insititute (AEHI), we are the best lasik hospital in western India.

This is a brief capsule, there is so much more to share and tell. Do visit us if you want to discuss more or else watch out for our next blog.

Author:

Dr Vandana Jain is a renowned expert Lasik Surgeon trained from LV Prasad Eye Institute and then from Harvard, USA. She is counted as one of best Cornea & Lasik Surgeons in the country. Coming through an intensive training in Corneal diseases at LV Prasad Eye hospital and Harvard, she values the safety of cornea the most. Resultantly, she has emerged as one of the most vocal advocates of enhancing safety before anyone undergoes lasik surgery. She can be reached at Advanced Eye hospital and Institute, Navi Mumbai. AEHI has the best lasik surgery machine called Smile Lasik available at Centre for lasik surgery.

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 answering questions about Smile Lasik surgery- safest lasik surgery

Email: Contactus@advancedeyehospital.com

Call: +91-22-67313636

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Physician, Heal Thyself: A lasik surgeon’s own LASIK surgery experience!

Physician, heal thyself is a proverb found in The Bible (Luke 4:23)

“	23 Then he said, “You will undoubtedly quote me this proverb: ‘Physician, heal yourself’—meaning, ‘Do miracles here in your hometown like those you did in Capernaum.’

Meaning

The phrase alludes to the readiness and ability of physicians to heal sickness in others while sometimes not being able or willing to heal themselves. This suggests something of ‘the cobbler always wears the worst shoes’, that is, cobblers are too poor and busy to attend to their own footwear. It also suggests that physicians, while often being able to help the sick, cannot always do so and, when sick themselves, are no better placed than anyone else.

I started wearing glasses when I was ten years old and the number kept on increasing till I was 18 years and finally stabilized at a whopping -6.5D. By the time I was in medical school, I was totally incapacitated without my spectacles and would need to find them the moment I got up. Sometimes my younger brother would hide them for just troubling me and at other times, I would lose them and then search for them all over the house. Further, I could not go for swimming and felt limited in lot of other outdoor activities. The other option was to wear contact lenses which brought in their own procedural hassles.

Being a trained Cornea and Refractive surgeon for over a decade now, Lasik Surgery forms one of the most common surgeries in my practice. It has always been a source of joy and satisfaction for me on a very deep personal level to hear how this quick and painless laser vision correction surgery has changed the quality of lives of so many patients. While for some it has meant better marriage prospects, for others it has meant higher self-esteem and confidence and for still others the freedom to participate in activities which spectacles and contact lenses always inhibited them from. Surely LASIK surgery has the power to impact people lives.

Attesting to the above proverb, Physician Heal Thyself, I decided to get the lasik surgery for myself. Though, the thought of putting my eyes under the laser machine was scary to me also just like for anybody else, but being a cornea surgeon I knew exactly what lasik surgery procedure entails.

The biggest fear the ‘What if’ scenario – what if something goes wrong and I am left with a residual hazy or a little blurry vision after lasik. Being an eye surgeon, my practice involves eye microsurgeries where thin hair like threads & stitches are used under magnification. Even a bit of blur would have endangered my ophthalmology career. But it just seemed so right to get Lasik done myself and then be convinced one way or the other.

Circa 2009, I decided to undergo the latest type of Laser vision correction – called Femto Lasik which uses a special Laser machine called Femtosecond laser to create a corneal flap before the excimer laser is shot to correct the corneal curvature. In a traditional lasik surgery, a blade called microkeratome is used for making flap and Femtosecond laser is indeed more accurate than Microkeratome. When it came to my eyes, I was certainly not taking any chances and wanted the best lasik in town.

As a Cornea Surgeon, I knew Pre-lasik evaluation would be needed to ensure long term safety of my eyes after lasik surgery. I passed the tests with flying colours – jokes apart my corneal thickness, topography, eye pressures and retina all were in order and I was judged suitable for lasik surgery. With my husband in toe, we went to the centre. Both of us were very apprehensive but once we reached the eye hospital, the time passed very fast and everything became a blur. The lasik procedure was very quick and I didn’t feel any discomfort during the surgery itself – and now I knew that local anesthetic drops actually work very well. Ten minutes later, I was back to the ward and asked to rest for the rest of the day.

Truth be told, immediately after the lasik procedure I had some irritation and heaviness in both my eyes. I decided to sleep through my afternoon and evening which surely helped. My dear husband who accompanied me for the procedure kept putting the drops in my eyes at the recommended times which is usually 4-5 times a day. By evening, my vision was still a little blurry as if I was seeing through a dirty glass. But I was still happy that I could see the expressions on my husband’s face from a distance without glasses.

My eyes developed some redness due to surgically induced sub-conjunctival hemorrhage. This is a known post lasik side effect and anyways I was mentally prepared about it. I had two very important meetings with some top executives the next day and I was worried how this may impact my interaction with them! By the night I was feeling better and I got a very nice restful sleep throughout the night.

As soon as I woke up next morning, by the force of habit I stretched my hand to grab my glasses. I could not find them by the bedside. I asked my husband and he burst into a loud laughter. And then I saw him standing over my head smiling wearing my frame minus the glasses in them. And actually that frame looked great on him! And suddenly I realized that I could see everything very clearly! That feeling was priceless, to be able to see everything clearly without my glasses! After 20 years of wearing glasses finally I didn’t need them, I was free of them!

My post lasik surgery check-up on day one morning was great and I was informed that everything was normal and fine. And on the side note, my meetings day one post lasik went great and I didn’t care in the least about the red spots on my eye. My happiness and renewed confidence was so palpable. I walked with energy and a spring in my step all the day and the following week through.

It has been almost 5 years since my laser vision correction and I continue to enjoy a crystal clear vision. I have enjoyed every moment of this freedom and used it in every possible way. I tried my hand at learning to swim, sky diving and now I run on a regular basis. I do not have any difficulty or haziness when I am doing complicated eye surgeries like corneal transplants, cataracts, deep lamellar keratoplasty or limbal stem cell transplants.

To be honest I have forgotten how it was to wear glasses. Having taken this step myself, I am convinced that for suitable and motivated individuals, laser vision correction surgery is the way to go. It is safe, precise and has a long term excellent safety profile. It is even better with the availability of new bladeless lasik- Smile lasik surgery at Centre for Lasik surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India.

 

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 answering questions about Smile Lasik surgery- safest lasik surgery

For any other questions, please do feel free to come and meet us.

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Can Lasik surgery be done during pregnancy or early motherhood (breastfeeding)

Pregnancy is a wonderful period and particularly so as a woman becomes even more beautiful when she is pregnant. Often it is also the time when we slow down on our day to day activities. Some women take a break from work and concentrate on their and the growing child’s health. The free time makes some women want to utilize it better. Some of them who have been planning to get LASIK to get rid of the glasses and contact lenses think this is the perfect time. Their busy schedules never allowed them to get it done earlier and now their free time gives them ideas. “Let me get it done before baby is out and I get even busier” These situations are common especially for me as cornea and lasik surgeon and I have to deal with these from time to time. I feel and understand the issues of these women who due to their hectic and busy lives have not been able to spare time for lasik surgery. But pregnancy is certainly not the time for any form of eye surgery unless it is an absolute emergency! During pregnancy due to hormonal alterations a lot of changes can happen in the eye for example glass power can change, corneal curvature undergoes changes and to add to that we cannot prescribe some medicines after lasik eye surgery due to their potential harmful effect on the growing baby. Hmmm.. Let me explain more:

1. Cornea curvature and eye power changes An increase in corneal curvature and mild steepening can occur during pregnancy. These changes can also develop post pregnancy when mothers are breast feeding. But the good news is that corneal curvature is reversible upon cessation of breastfeeding.
2. Contact lens issues: Women who wear contact lenses should also be careful. Contact lens intolerance may occur during pregnancy as a result of a change in corneal curvature, increased corneal thickness or an altered tear film.
3. Changing glass numbers Due to all these changes, the glass number may fluctuate during pregnancy or breastfeeding. In any case, it is recommended that one should wait several weeks after stopping breast feeding before taking a new glass number. Additionally, decreased or transient loss of accommodation may occur during pregnancy or within the postpartum period. What that means is that pregnant women or breast feeding mothers may experience a difficulty in reading. Eye power stability as well as corneal curvature stability is important before planning LASIK surgery. Laser vision correction involves reshaping the corneal curvature but that is exactly what is not stable during pregnancy or breastfeeding. That is why planning a LASIK surgery during pregnancy or breast feeding period is not a good idea.

Now what is a good time for lasik

Good time to get assessed for suitability for LASIK is few weeks after stopping breast feeding. Good thing is that after LASIK surgery you can be back to your routines and work in 2-3 days.

Newer techniques- flapless and bladeless lasik?

Yes, newer techniques of laser vision correction such as Femto Lasik (bladeless lasik) and Smile Lasik (Flapless lasik) have enhanced the safety, applicability, accuracy of lasik surgery procedure and also shortened the recovery time considerably.

Last words: Pregnancy and early infancy are precious times for the baby and the mother, just sit back, relax and enjoy this time with the baby We are not going anywhere. Once you are well settled into the motherhood and ready for spectacle removal surgery  – do visit us at our Centre for Lasik Surgery at Advanced Eye Hospital & Institute in Navi Mumbai. We will make sure that you experience not only the best in lasik but the best in class service. All the best.

About the author: Dr Vandana Jain is a Cornea & Lasik Surgeon and has trained from prestigious Harvard University and LV Prasad Eye Institute. She is one of the best Lasik Surgeons in the country and heads the Centre for Lasik Surgery at Advanced Eye Hospital and Institute in Navi Mumbai. Having performed thousands of Lasik surgeries over last decade, her writings reflect her deep domain expertise and thought process in giving people a spectacle free life. Her patients travel from all over India and abroad to seek her counsel before planning a lasik surgery specifically as she is  a big proponent of a through Pre-Lasik evaluation (tests) to ensure long term safety of vision and eyes. Dr Vandana Jain is also one of the few SMILE Lasik Surgeons in India who has trained at Harvard, USA

Her appointments are available at +91-22-67313636 or contactus@advancedeyehospital.com or by filling up the contact form here

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Have questions about SMILE Lasik Surgery? Dr Jain answers a few common questions on SMILE Lasik:

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Laser vision correction with LASIK- Safety first, everything else later

Getting tired of wearing glasses and contact lenses?

Don’t we all wish if something could be done to get rid of these hassles. At the same time, the idea of getting a lasik surgery on the eye is scary to say the least; especially so when glasses and contacts are allowing us a clear vision. There is always that nagging fear – what if something goes wrong during laser vision correction surgery and there is a loss of vision.  This is what we often hear from patients and their very concerned families. And I can totally relate to that fear. I had the same feelings before I underwent lasik myself.

I think it is extremely important to be realistic about LASIK just like everything else in this world.  Just like we take all the precautions while driving a car to ensure that we don’t get into an accident similarly we need to understand all the safety aspects related to LASIK surgery. Whenever we get a patient who is desirous of getting rid of glasses, he or she is made to go through a battery of tests also called pre-LASIK evaluation to determine suitability for laser vision correction. At the heart of these tests is to determine safety of LASIK for a person’s eye.  LASIK is not for everyone or in other words performing Lasik on everyone is not safe. There can be number of reasons why LASIK may not be a safe option such as thin corneas, abnormal corneal curvature, glaucoma, uncontrolled systemic diseases etc.

• Comprehensive vision and power analysis are done first which includes rechecking the numbers to ensure that the numbers are stable. If eye power is not stable for atleast an year then it is better to postpone the surgery to a future year. Powers are also re-checked after putting the dilating drops to ensure we get the correct powers. Especially in younger eyes excessive muscle action inside the eyes can give false powers when tested only without the drops.
• Corneal topography where the surface of cornea is mapped. This test report is in the form of beautiful colorful maps. These maps inform us about the shape of cornea and if there is any hidden corneal disease. Again the aim is to ensure that we rule out any corneal disease which may make LASIK unsafe
• Corneal thickness measurements ( Pachymetry) where we ensure that the thickness of cornea is within normal range. Again there is no magic number that we look for but we look at thickness in conjunction with the eye power that needs correction and the map of the cornea. Sometimes a 520 micron may be thin and sometimes a 480 may be normal.
• Pupil size measurements especially in dim light conditions to ensure that we know how much bigger it becomes in dim light. We decide the zone of correction from this reading
• Wave front analysis is done to study aberrations due to the optical system some of which warrants consideration and correlation with other tests.
• Contrast sensitivity analysis which is done to understand the optical system and quality of one’s vision especially under conditions of low  contrast such as dim light conditions
• Muscle balance tests are done to ensure and find out any hidden muscle weaknesses. If significant we may have to treat them first with exercises etc prior to planning a Lasik surgery
• Tear film tests are done to assess the state of surface of eyes. Current lifestyles due to excessive use of computer and excess exposure to air conditioned atmosphere affect our eye surface and cause dryness. We need to treat that and often modify our work habits to ensure a healthy well lubricated eye surface prior to LASIK
• Length of two eyes. This is checked by using a machine called IOL Master and is important in patients where the eye power in two eyes is different to understand the reasons for the difference in the eye power. One eye larger than the other warrants some considerations and often modifications in surgical plan.
• Retina and Optic nerve assessment to ensure that these other parts of the eye are also normal. Some patients who are detected to have holes in the peripheral parts of retina are advised retinal lasers to seal these holes prior to LASIK surgery
• A detailed history is always taken to rule out any body related disease which may cause problems in healing post surgery

I am sure you must be thinking these tests must be taking a hell lot of time. Well not exactly, the advanced machines and the trained professionals make our job very easy and all we need is 1-2 hours to determine safety and suitability.

So despite the fact that LASIK surgery has been shown to improve the vision and daily life of millions across the world, please ensure it will do the same for you by undergoing these tests. These tests are required for all lasik surgeries whether it is conventional lasik surgery, Femto lasik or smile lasik. Enjoy a glass free world!

About the author:

Dr Vandana Jain is a Cornea & Lasik Surgeon and has trained from prestigious Harvard University (USA) and LV Prasad Eye Institute. She heads the one of the best eye hospital and lasik centres in India, Centre for Lasik Surgery at Advanced Eye Hospital and Institute in Navi Mumbai, India. Having performed thousands of Lasik surgeries over last decade, her writings reflect her deep domain expertise and thought process in giving people a spectacle free life. At AEHI, Dr Jain is one of the first lasik eye surgeons in India to start offering the best lasik surgery – Smile lasik procedure to patients looking for freedom from glasses. You can read more about Smile lasik here: SMILE LASIK AT AEHI, NAVI MUMBAI, INDIA

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 answering questions about Smile Lasik surgery- safest lasik surgery

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