“Am I suitable for Laser eye surgery?” – Lasik Suitability Information from the best Lasik Surgery Center in Navi Mumbai

 

I have been constantly receiving emails from people exploring the option of LASIK eye surgery. They want to look at the possibility of getting rid of their glasses. But they do not want to travel unless they are sure that laser vision correction is a safe and the right option for them. I know it is difficult to spare time from our busy schedules to travel for Lasik surgery only to be told that you are not the right candidate for Lasik surgery. I understand the dilemma surrounding the suitability for Lasik. Overall Lasik surgery has progressed a lot in the past decade with all the new options of Femto Lasik, ReLex Smile Lasik, Advanced Surface Ablation, Customized Lasik and Blended Laser vision correction. Now we can offer one or the other type of Lasik surgery to more than 90% people and only 5-10% people are truly not suitable for Lasik surgery. It is often difficult for us to determine suitability unless a detailed pre-Lasik evaluation is done. However, there are a few other common indicators which, if present then Lasik surgery should be postponed and not planned at that time. Fortunately, some of these conditions are temporary and you may become suitable for Lasik surgery in the future.

Let’s understand the commonest reasons why someone may not be suitable for Lasik surgery at that moment: –

1. Pregnancy and lactation

If you are currently pregnant or breast feeding the baby, then you should not plan to get your Lasik surgery right now. Pregnancy and lactation related hormonal changes can cause fluctuations in eye power and changes in corneal curvature. Some of these changes are just temporary and stabilize once the hormonal status normalizes. Eye power and corneal curvature stability are important before planning LASIK surgery. That is why planning a LASIK surgery during pregnancy or nursing period is not a good idea. Right time, to get assessed for suitability and plan a LASIK surgery, is a few months after breastfeeding is discontinued.

2. Changing Glass Power

It is important to ensure that your glass and contact lens power are stable and hasn’t changed in the last 1-2 years. This is something which is frequently seen in teenagers and sometimes even in young adults. That is why a minimum age of 18 is recommended. It is a rough benchmark to ensure some eye maturity and power stabilization. However, if the eye power is not stable even after the age of 18 then it is better to wait for at least a year till the last power change. Some of the conditions which cause hormonal imbalances, diabetes and sometimes due to no identifiable reasons the eye power can undergo changes. If there is a concern around a constant power change, then a detailed eye and sometimes an endocrinologist evaluation may be needed.

3. Poor health and active systemic diseases

Patients who are going through any illness or recovering from any major illness or surgery should not consider Lasik surgery at that time. People with uncontrolled diabetes, active collagen vascular diseases or any other condition which affects the body immunity or healing power should also postpone their Lasik surgery. It is imperative to wait for a period when all these diseases are in remission and the body is in a state of stability. One may become suitable to undergo Lasik surgery in the future.

On that note, in case you plan to travel to someplace in order to get your LASIK done, it is always a good idea to discuss about your general health related parameters with your Lasik surgeon before planning your travels to avoid a repeat visit.

Anita, an active social worker from the U.S. had visited us some time back. She had come over to be with her mother but then decided to also get a Lasik surgery done while she was here. During the consultation, it was found out she was diabetic. She had been diagnosed with diabetes just a few months ago and wasn’t aware that her current situation was not the ideal one for undergoing a Lasik surgery. After a detailed discussion and as was advised she decided to visit us once again the coming year after having followed a proper, tight, long term diabetic control to finally get her Lasik done.

In conclusion all I will say is, good health, stable hormonal status, balanced mental condition and stable eye powers are the overall general parameters that decide suitability for Lasik surgery. Even so, it is necessary to perform a detailed pre-Lasik evaluation to confirm absolute suitability of an individual for the selected Lasik before proceeding any further.

 

Expert Lasik Surgeon

About Dr. Vandana Jain: Dr. Vandana Jain is an expert Cornea and Lasik surgeon. She has vast experience of performing laser vision correction procedures over a decade. She is well versed with all the latest techniques and advancements in laser vision correction procedures like LASIK, Femto Lasik, Smile Lasik, PRK, etc. Dr. Jain ensures that all the patients undergo a detailed pre Lasik evaluation and then the best procedure and the technique is chosen for the patient to get satisfying results and to ensure long term safety.

 

Lasik Surgery Center

About Center for Lasik Surgery at Advanced Eye Hospital and Institute:  Center for Lasik Surgery at Advanced Eye Hospital and Institute is one of the best LASIK surgery centers, a modern, well-equipped advanced center for all those who wish to get a laser vision correction procedure done.  A very detailed protocol based and meticulous pre-Lasik evaluation is done for all the patients. The advanced equipments like corneal topographer, corneal tomographer, IOL Master, A scan, B scan and OCT machines help us with detailed measurements. The aim is to choose the best procedure for all the patients. AEHI caters to patients from all over Navi Mumbai such as Vashi, Nerul, Kharghar and Panvel besides people traveling from all over western India and the World.

Advanced Eye Hospital And Institute (AEHI) can be reached at (O): +91 22 67313636, (Emergency): +91 9167360360 or even through Email: contactus@advancedeyehospital.com

Or you can make an appointment online through this link: BOOK AN APPOINTMENT

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“Blindness after a Laser Eye Surgery – Myth or Reality?” LASIK Surgery Information from the Best LASIK Surgery Hospital In Western India

Advanced Eye Hospital and Institute, Sanpada – Navi Mumbai is the best super specialty eye hospital in western India having highly qualified Doctors and advanced technologies for all forms of eye care services and eye surgeries.

One of the most common question I get to hear is “Doctor, Is blindness after a laser eye surgery a reality? Can I really go blind if anything goes wrong?” Hence I decided to write up this article to provide relevant information about LASIK Surgery.

Statistics shows that almost 20-30% young adults wear glasses out of which almost 30% wear contact lenses. In this 30 %, women wearing contact lenses are more than men, probably for cosmetic reasons. Many of these people are tired of glasses or feel inhibited due to glasses and contact lenses. They want to get a LASIK surgery done but have a lot fears which prevent them from getting a laser eye surgery for glass removal. I can completely understand the basis for fears. More often than not either they directly or someone among their friend circle would have heard something negative about Lasik. The problem with this kind of information is something similar to Chinese whispers. As the information travel from one person to another a minor problem may get distorted by a large magnitude.

So I think in these kinds of situation rather than taking that information as the truth base on hear-say it is better to discuss them with your eye doctor.

There are 3 main components to addressing the fears related to Lasik laser eye surgery.

 

1. Knowing about newer Lasik surgery options

Lasik surgery is a laser based vision correction which changes the curvature of cornea and reduces the eye power. It has been around for many decades. The good thing about the technology is that it has really undergone innovations over the years. Now Lasik surgery is not just one size fits all! It can be customized to the patient’s lifestyles, eye parameters and profile. With newer options like Customized Lasik, Epi Lasik,

Femto Lasik, ReLEx Smile Lasik, LasikXtra the recovery period and the risk of complications are reduced and also the outcomes have improved. ReLEx Smile Lasik is like a laparoscopic key-hole Lasik surgery and it not only reduces the risk of serious complications like Lasik ectasia but also shortens the recovery period. So it is imperative for the patient to visit and chose the Lasik center where all the newer options are available and they can be rest assured that the most preferred option will be customized to their eye parameters.

 

2. Detailed pre-Lasik evaluation to rule out unsuitability for the procedure

Not everyone is eligible for laser eye surgery. People who are healthy, not pregnant and breastfeeding may be good candidates for Lasik surgery. Besides body parameters eye parameters are also important. For that we do a battery of tests like corneal thickness, corneal topography, dry eye tests, eye muscle balance, retina and nerve checking. This detailed pre-Lasik evaluation helps us to identify those candidates where Lasik surgery should not be done as there is a greater risk of side effects and complications. Secondly the eye parameters help us customize the type of Lasik surgery best suitable for patient’s eye.

Anuj recently visited Center for Lasik Surgery at Advanced Eye Hospital and Institute for an opinion. He was advised conventional Lasik surgery elsewhere and he wanted a second opinion. After a detailed pre-Lasik evaluation he was found to be unsuitable for Lasik due to borderline corneal thickness. In Lasik surgery we create a flap on the cornea and in patients with borderline corneal thickness it can induce a weakness in the cornea. This weakness can marginally increase the risk of post Lasik ectasia. I advised him PRK where no corneal flap is created, only the epithelium (top layer) of the cornea is removed and hence this better preserves the rigidity of the cornea.

These kinds of cases illustrates the value of a detailed pre-Lasik work-up and visiting a center where all the different types of Lasik surgeries like Lasik, PRK, Femto Lasik and Smile Lasik are available.

 

3. Discuss in detail about side effects, recovery period, do’s and don’ts with your Lasik surgeon

It is important to ask plenty of questions and clear all your doubts during your pre-Lasik consultation.  One really needs to have confidence in their Lasik surgeon that he/she will do everything possible to decrease any risk of LASIK complications. In the rare chance that something is not perfect your surgeon should be able to manage any post-operative symptoms you have. It is important to remember that LASIK is a surgery and like with any surgical procedure, unexpected complications can occur. Millions of LASIK procedures have been performed worldwide with very high levels of safety and effectiveness. It is extremely unusual for anyone to go blind after LASIK.  This is especially true if you follow your surgeon’s instructions and attend all follow-up visits as directed.

The estimated risk of losing vision in one eye is about one in five million. So really comparing with anything in life chances of anyone going blind after Lasik is highly unusual. Additionally contact lens users need to know that cumulative risk of going blind due to the use of contact lenses is higher than with Lasik performed for suitable eyes. It is important to not blindly believe rumors, get a detailed pre-Lasik evaluation and have a candid discussion with your Lasik surgeon.

 

Dr Vandana Jain – Lasik Surgeon expert

About Dr. Vandana Jain- Dr Vandana Jain is an expert Cornea and Lasik surgeon. She has vast experience of performing laser vision correction procedures over a decade. She is well versed with all the latest techniques and advancements in laser vision correction procedures like LASIK, Femto Lasik, Smile Lasik, PRK etc. Dr. Jain ensures that all the patients undergo a detailed pre Lasik evaluation and then the best procedure and the technique is chosen for the patient to get satisfying results and to ensure long term safety.

 

Lasik Surgery Center

About Center for Lasik Surgery at Advanced Eye Hospital and Institute-  Center for Lasik Surgery at Advanced Eye Hospital and Institute is one of the best lasik surgery centers, a modern well-equipped advanced center for all those who wish to get laser vision correction procedure done.  A very detailed protocol based and meticulous pre-Lasik evaluation is done for all the patients. The advanced equipments like corneal topographer, corneal tomographer, IOL Master, A scan, B scan and OCT machines help us in detailed measurements. The aim is to choose the best procedure for all the patients. AEHI caters to patients from all over Navi Mumbai such as Vashi, Nerul, Kharghar and Panvel besides people traveling from all over western india.

Advanced Eye Hospital And Institute (AEHI) can be reached at (O): +91 22 67313636, (Emergency): +91 9167360360 or even through Email: contactus@advancedeyehospital.com

Or you can make an appointment online through this link: BOOK AN APPOINTMENT

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Eye measurements before lasik surgery: Pupil diameter, horizontal corneal diameter, length of eye ball and depth of front part of eye- Pre-LASIK tests no 4

In the earlier two blogs on pre-Lasik evaluation we discussed the importance of measuring corneal thickness and corneal topography prior to considering LASIK. In this blog we will understand the importance of some of the other measurements.

Suniti visited me at the Center for LASIK surgery at Advanced Eye Hospital and Institute in Navi Mumbai, India. She had got her LASIK laser vision correction done 2 years back in Mumbai. She had beautiful blue green eyes. She was getting troubled by the glare and haloes at night. Her power prior to the surgery was -4D. The power was not very high and by itself not enough to contribute to the glare problem at night. There can be several factors which contribute to night glare like large pupil (small round black front aperture which allows light to enter the eye) in dim light, dry eyes, presence of ocular aberrations and smaller zone of laser treatment. In her case there was a striking difference between the zone of her laser treatment on cornea and pupil size in the dim light conditions. Her pupil was quite big in dim light but her lasik laser had been done in a smaller area only in centre. When I explained the reason to her, on one hand she was reassured that there was no complication but on the other hand she was disturbed that why these measurements were not performed prior to the Lasik surgery. Irrespective of the type of laser vision correction procedure such as conventional Lasik or bladeless Femto LASIK or ReLEX SMILE Lasik, these measurements help plan the best type of LASIK surgery for the patient, understand the results, counsel the patients and set the expectations. Some measurements like pupil diameter, corneal diameter, eye ball length are a very important part of Pre-Lasik evaluation

1. Pupil Diameter– It is very important to know the pupil diameter in normal light conditions and in dim light conditions. Some people especially those with light colored eyes (iris) have large pupil in dim light conditions. If the zone of laser treatment during LASIK surgery is smaller than the scotopic (dim light) pupil diameter, then at night, light will enter the eye from 2 different zones. One from the laser treated zone on cornea and one from untreated cornea. This phenomenon leads to night vision issues like glare and halo etc. So knowing the pupil diameter is very important to plan the LASIK surgery better. Either we can plan the larger optical zone of laser treatment or we can chose other modes of treatment like smart aberration profile with larger transition zone or wave front guided treatment etc.

2. Corneal Diameter– This is measured to know the horizontal extent of the cornea (front transparent part of the eye). Laser vision correction procedure is done on cornea and it is the change in the corneal curvature which reduces the eye power. Corneal diameter helps us in making a decision about the size of the microkeratome suction ring in cases of conventional LASIK, or the size of the cup that we choose during bladeless femto lasik or ReLEx SMILE lasik. For example a smaller cornea will require a smaller ring and a smaller suction cup. Corneal diameter can be measured manually using manual or digital calipers or by the corneal topographer or the IOL master machine

3. Size of two eye balls– Ridhi is a Biomechanical engineer and lives in Mumbai. She wanted to get the best Lasik done. During her pre Lasik evaluation at the Center for LASIK surgery at Advanced Eye Hospital and Institute in Navi Mumbai, she took keen interest in all the tests and the machines that were used for those tests. When we were checking her eye ball length, she got very confused and enquired regarding the need for measuring the eye ball length before lasik. She asked “Isn’t the laser vision correction procedure performed on the cornea?”. I was very impressed by the depth of her thinking. She was absolutely right. It has no direct bearing on the Lasik surgery technique for most patients. But a few of us have very different eye powers in both the eyes. If the reason for different powers in both eyes is longer eye ball length in one eye then we may need to modify the planning for Lasik laser vision correction. Otherwise it can cause difference in image size between the two eyes after the laser vision correction procedure.

Length of the eye ball can be measured by either the eye ultrasound machine called A-scan or with the help of IOL master.

4. Depth of the Anterior chamber (front part of the eye) – Again this is one of those measurements which has no bearing on the laser vision correction procedure. However this is the measurement I need to know if I have to suggest an alternative procedure like ICL (Implantable contact lens) for someone who is not suitable for laser vision correction procedures. Rahul had come to the Center for LASIK surgery and had a power of -16D in both eyes. This much power cannot be safely corrected by even the best of the LASIK laser vision correction procedure. Luckily for him, the depth of the anterior chamber was 3.2mm. This was in the normal range and he successfully underwent ICL implantation in both the eyes and now enjoys a life free from glasses.

It is often said that we cannot plan if do not analyze and measure. This is no less true for pre Lasik evaluation. So even though the whole pre-Lasik evaluation takes up to 2 hour but it is required for proper planning, and better counseling, to get best Lasik surgery results and to ensure long term safety.

About Dr. Vandana Jain–

Dr. Vandana Jain

Dr Vandana Jain is an expert Cornea and Lasik surgeon. She has vast experience of performing laser vision correction procedures over a decade. She is well versed with all the latest techniques and advancements in laser vision correction procedures like LASIK, Femto Lasik, Smile Lasik, PRK etc. Dr. Jain ensures that all the patients undergo a detailed pre Lasik evaluation and then the best procedure and the technique is chosen for the patient to get satisfying results and to ensure long term safety.

About Center for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai- Center for Lasik Surgery at Advanced Eye Hospital and Institute is one of the best lasik surgery centers, a modern well-equipped advanced center for all those who wish to get laser vision correction procedure done.  A very detailed protocol based and meticulous pre-Lasik evaluation is done for all the patients. The advanced equipments like corneal topographer, corneal tomographer, IOL Master, A scan, B scan and OCT machines help us in detailed measurements. The aim is to choose the best procedure for all the patients. AEHI caters to patients from all over Navi Mumbai such as Vashi, Nerul, Kharghar and Panvel besides people traveling from all over western India.

Watch Dr Vandana Jain, Cornea and Lasik Specialist perform SMILE Lasik – the most advanced and the best laser vision correction surgery in the world. Watch Dr Vandana Jain, Harvard trained Cornea & Lasik Surgeon at Advanced Eye Hospital and Institute (AEHI) in Navi Mumbai, India answer frequently asked questions on SMILE laser vision correction surgery

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Eye Muscle testing before LASIK surgery- Diagnosing eye muscle weakness and Squint before laser vision correction: Pre LASIK Test No 3

Sofie got her LASIK surgery done 3 months ago in Dubai. She presented to the Center for Lasik Surgery at Advanced Eye Hospital and Institute in Navi Mumbai with complaints of headache and eye pain after working on computer for more than an hour. This was severely affecting her work efficiency and she was constantly troubled because of that. She was certain that her LASIK surgery led to some complications. We did a detailed eye evaluation for her. Her LASIK surgery had been done and had healed perfectly. However, on her eye muscle power checking, we found that she had severe convergence insufficiency. Basically the muscles in the eye which allow near work were weak. On closer questioning, she revealed that prior to getting her LASIK, she used to remove her glasses while working on the computer. The habit of removing glasses during near work caused her eye muscles to slowly develop weakness. When people like Sofie who have minus eye power do not wear glasses for near work, they are at risk of developing muscle weakness called convergence insufficiency. This can be missed before LASIK operation if muscle balance testing is not done prior to LASIK surgery as a part of pre LASIK evaluation. In patients like Sofie, eye muscle exercises can strengthen the muscles and then LASIK surgery can give best results without any muscle imbalance.

Just like Sofie there are a lot of us who have some or the other muscle imbalance or mild squint which needs to be detected prior to LASIK surgery. Eye Muscle balance, eye alignment and binocular function remains unchanged after LASIK laser surgery in most patients except those who have pre-existing muscle weakness, big difference in glass power between the two eyes and those with some post Lasik surgery factors like those where monovision surgery (one eye corrected for distance and one for near) is done.

A detailed muscle balance testing (orthoptic evaluation) goes a long way to detect those who are at risk of developing muscle balance related issues after different types of Lasik surgery like conventional Lasik, Bladeless Femto Lasik or ReLEx SMILE Lasik.

So, what are tests done during pre LASIK evaluation to detect muscle imbalance?

1. Accommodation– This is the ability of the eye to see near objects clearly. Usually the normal ability to accommodate reduces after the age of 40 and that’s when we need reading glasses to read near objects clearly. Occasionally young people may have accommodation abnormalities and may not see near objects clearly at the distance normal for their age. It is important to identify the type of problem and recommend exercises prior to going ahead with Lasik. This is to ensure best results and satisfaction after Lasik surgery.
2. Convergence– This is the ability to see near objects clearly without experiencing eye strain or doubling of objects at the right distance. Sometime a lot of people have convergence insufficiency which can get aggravated after LASIK. This is more likely to happen in those who wear thick glasses or those who do near work after removing their minus powered glasses. Thick glasses can sometimes mask the weakness due to minor prismatic effects.
3. Minor Squint– Sometimes people have an obvious or hidden squint. Leena had a type of squint called Intermittent Exotropia–a condition that would become obvious sometimes, specifically when she was tired. Usually it is possible to have LASIK in this condition if you are not wearing any prism correction in your eyeglasses. It is important for the LASIK Surgeon to perform muscle balance testing both with eyeglasses and contact lenses to see if the potential for the squint to worsen increases with contact lens wear. In another young woman, Lata, who had a power of -10D in her eyes, her squint was worsening when we checked her with contact lenses. This gave us the indication of what can happen to her squint after her LASIK laser surgery. Our squint surgeon decided to perform her squint surgery first. The recovery after the squint surgery was quick and she was back to work within a week. She got her bladeless Femto Lasik surgery done 3 months after her squint surgery. Today she is not just free from glasses but also free from her squint problem.
4. Fusional Amplitudes (Strength of eye muscles)- This test also gives us an indication of the muscle weakness and the possibility of squint development after Lasik surgery. If someone’s fusional amplitudes are poor it is better to give them eye exercises prior to considering their Lasik surgery.
5. Stereopsis (Depth Perception)-Vinod wanted to be a pilot in the armed forces and he wanted to get rid of his glasses for that. All the tests done for pre-Lasik evaluation were normal but his depth perception was abnormal. To ascertain the cause he was referred to our squint specialist. He was diagnosed to have microstrabismus. He was informed that he may not be able to clear the tests to be the fighter pilot as depth perception may be an important criteria for that! He still got his ReLEx Smile LASIK done and got rid of his glasses. Even though we could not treat his depth perception problem but at least he was aware! It can be disappointing if one realizes that later and not before their Lasik.

As LASIK surgeons we are glad that with all the advancements and newer best LASIK procedures like SMILE Lasik, we have the ability to reduce eye powers safely. For the best of Lasik surgeons, we desire is to treat your eyes holistically. Muscle imbalance or presence of squint needs to be evaluated as a part of pre LASIK evaluation. If required either muscle exercises or squint surgery needs to be planned either before or after laser vision correction procedure.

About Dr. Vandana Jain:

Dr. Vandana Jain- Lasik Surgeon

Dr Vandana Jain is an expert cornea and LASIK surgeon. She manages and treats patients from Mumbai, Navi Mumbai and all over Maharashtra who develop complications like infections etc due to contact lenses. Due to her dual expertise in cornea and LASIK, she is in a great position to decide and chose the right lasik procedure for these patients who develop corneal infections and then want freedom from glasses. She always cautions and educates her patients who are using contact lenses to maintain healthy contact lens care practices. Dr. Vandana Jain is a fellowship trained Cornea and LASIK surgeon. After having performed more than 5000 Lasik procedures, she is counted as one of the best Lasik surgeons in India. She believes in following a systematic scientific approach towards evaluating the patients for LASIK or Femto LASIK or the latest ReLEx Smile. She ensures that a detailed pre LASIK evaluation is done for all patients. According to her a detailed Orthoptic evaluation ensures that patients do not get eye fatigue or develop squint after their LASIK surgery.

About Center for LASIK surgery at Advanced Eye Hospital and Institute Navi Mumbai- Center for Lasik surgery at Advanced Eye Hospital and Institute is one of the most advanced centers for LASIK surgery in India. Proper protocols are followed for all the patients. A detailed pre LASIK evaluation is done with the help of all the advanced machines which are part of the center. A separate vision therapy and orthoptic clinic supports the orthoptic evaluation of all the patients prior to their LASIK. A squint surgeons consult is taken in all cases where any abnormality is detected. Patients from all over Navi Mumbai like Vashi, Kharghar, Nerul and Panvel visit AEHI for lasik evaluation and treatment.

Center for Lasik Surgery at Advanced Eye Hospital and Institute is a modern well equipped center for managing all kinds of complicated clinical situations. All the great diagnostic machines like corneal topography, corneal tomography, corneal pachymetry, OCT and IOL Master and associated clinics such as dry eye clinic and orthoptic clinic ensures a meticulous and protocol based pre Lasik evaluation. Besides this there are advanced machines for laser vision correction which allows all the different LASIK surgeries like wave front optimized LASIK, FemtoLasik, PRK, ReLEx SMILE and LasikXtra.

Videos

Watch Dr Vandana Jain, Cornea and Lasik Specialist perform SMILE Lasik – the most advanced and the best laser vision correction surgery in the world.

Watch Dr Vandana Jain, Harvard trained Cornea & Lasik Surgeon at Advanced Eye Hospital and Institute (AEHI) in Navi Mumbai, India answer frequently asked questions on SMILE laser vision correction surgery

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ReLEx Smile Lasik surgery after contact lens infection- A girl from Navi Mumbai got permanent freedom from glasses with Best LASIK technology

ReLEx SMILE Lasik is an advanced laser vision correction procedure which allows glass power reduction in the safest possible manner. It is a flapless, bladeless Lasik which preserves the corneal strength and reduces the chances of dryness and infections after the procedure. Most people can get back to their regular lifestyle in a day or two. Well, that’s not all- it makes laser vision correction possible in cases where any other Lasik would not have been possible.

Case

Jitakshi is a smart beautiful young woman who was used to wearing contact lenses for long hours. Her grueling MBA schedules left her no time to care for her eyes. Her contact lens care habits were not very healthy and she was over wearing contact lenses. In 2014, she presented at the Advanced Eye Hospital and Institute with redness in her right eye.

Her eye evaluation revealed that she had a very bad corneal infection (Figure 1). She was advised to stop using her contact lenses and was prescribed eye drops to cure the corneal eye infection. Thankfully with the right treatment and compliance from her side, the infection slowly subsided and a small corneal scar remained. Luckily for her, the scar was located away from the center of the cornea and hence did not affect the vision. She was advised to be off her contact lenses after that. However she was soon getting fed up of wearing glasses and wanted freedom from her glasses. After a few months she underwent a detailed pre-Lasik evaluation at the center for Lasik surgery at Advanced Eye Hospital and Institute in Navi Mumbai. Her corneal topography (surface map of cornea) was normal (Figure 2 and 3) and did not show any abnormality secondary to the scar on her cornea as that was away from the center.

She was suitable for all the types of laser vision correction procedures like LASIK, Femto Lasik and ReLEx SMILE Lasik. She chose the best Lasik and decided to undergo ReLEx SMILE Lasik. She got great results and was a happy girl after that. The Lasik procedure took only 5 minutes and she was able to go home in 15 minutes after the Lasik treatment. Next day here checkup after Lasik showed 6/6 vision and she was overjoyed.

 Jitakshi said “I was very worried after I developed bad eye infection and I realized the importance of not over using contact lenses and maintaining proper care routines. I probably got a little negligent in managing my contact lenses. I was really relieved when Dr Vandana Jain reassured me and treated my corneal infection due to contact lenses well. But as I was not allowed to wear contact lenses again, I found it very difficult to manager daily schedules with glasses. It was like an obstacle for my day to day work. So when my pre-Lasik evaluation revealed that I can undergo LASIK safely, I was very happy especially I could get ReLEx Smile Lasik done which is a bladeless Lasik. I felt safe and taken care of as Dr. Jain took great pains in explaining everything to me in detail about SMILE Lasik procedure. The do’s and the don’ts, post SMILE Lasik recovery, chances of any complications etc were explained in great detail. I was glad and happy that I was undergoing the best, most advanced and the safest Lasik on my eyes. The SMILE Lasik surgery experience was wonderful. It was painless, quick and very comfortable. I still remember first day after Lasik surgery when I woke up and could see the whole world very clearly without my glasses! My post Smile Lasik check-ups revealed that eye was healing well and that everything was perfect

Dr Vandana Jain adds – People like Jitakshi who misuse contact lenses often develop contact lens related problems.  Right from dry eye to eye allergies and severe corneal infections can happen due to over use of contact lenses. Maintaining good contact lens hygiene and cleaning rituals are very important for contact lens users. A lot of people develop intolerance to contact lenses and then they are forced to look for alternatives like Lasik to get rid of their glasses. It is very important to plan options for getting freedom from glasses before and to not wait for complications to happen due to contact lenses. One of my earlier patients, Sukita, developed multiple episodes of corneal infections as she paid no heed to the instructions given by her eye doctor in Mumbai. Finally when she was seen at the Advanced Eye Hospital and Institute, she had a very bad infection right in the center of the cornea. Luckily it got cured but it left behind a very bad deep scar right in the center of her cornea. Anterior segment OCT revealed that the depth of her scar was more than 250 microns. She was no longer suitable for any form of Laser vision correction procedures like LASIK or Femto Lasik or Smile Lasik. Any of the Lasik procedures on her eye could lead to complications and cause an irregular astigmatism after the procedure. This is due to the fact that laser ablation is different for normal corneal tissue and scar tissue. If it is away from the area of laser then LASIK can be considered like in case of Jitakshi. Sukita was therefore advised to plan Implantable contact lens (ICL) implantation to get freedom from her glasses.

About Dr. Vandana Jain:

Expert Lasik Surgeon

Dr Vandana Jain is an expert cornea and LASIK surgeon. She manages and treats patients from Mumbai, Navi Mumbai and all over Maharashtra who develop complications like infections etc due to contact lenses. Due to her dual expertise in cornea and LASIK, she is in a great position to decide and chose the right lasik procedure for these patients who develop corneal infections and then want freedom from glasses. She always cautions and educates her patients who are using contact lenses to maintain healthy contact lens care practices.

About Center for LASIK Surgery at Advanced Eye Hospital and Institute, Navi Mumbai–

Dr Vandana Jain – Lasik Surgeon expert

Center for Lasik Surgery at Advanced Eye Hospital and Institute is a modern well equipped center for managing all kinds of complicated clinical situations. All the great diagnostic machines like corneal topography, corneal tomography, corneal pachymetry, OCT and IOL Master and associated clinics such as dry eye clinic and orthoptic clinic ensures a meticulous and protocol based pre Lasik evaluation. Besides this there are advanced machines for laser vision correction which allows all the different LASIK surgeries like wave front optimized LASIK, FemtoLasik, PRK, ReLEx SMILE and LasikXtra.

About Dr Vandana Jain:

Dr. Vandana Jain, MS (Gold Medalist), DNB, MNAMS, FLVPEI, FICO (Harvard USA), MBA (Stanford USA) is a Cornea, Cataract & Lasik Surgeon. She is the Director & Co-founder of the Advanced Eye Hospital. She has more than a decade of experience in Ophthalmology apart from exhaustive training and a vast number of research publications to her credit.

Videos

Watch Dr Vandana Jain, Cornea and Lasik Specialist perform SMILE Lasik – the most advanced and the best laser vision correction surgery in the world.

Watch Dr Vandana Jain, Harvard trained Cornea & Lasik Surgeon at Advanced Eye Hospital and Institute (AEHI) in Navi Mumbai, India answer frequently asked questions on SMILE laser vision correction surgery

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Can Lasik surgery procedure be done to correct vision in Lazy eye (Amblyopia)

Lazy eye also called as Amblyopia is a disorder of sight in which one eye has poor vision that otherwise looks and appears normal or has a visual defect that is out of proportion to the structural problems of the eye. Hence the impact on vision is much more than predicted. In lazy eye, the brain suppresses the visual processing of one weak eye for a prolonged period of time to prevent double vision. This suppression starts early in childhood due to poor vision in one eye as a result of causes like high glass power, squint, and some opacity in the optical system like cataract or corneal scar etc. Due to lack of treatment at the right stage, it persists forever and can be corrected only till early teens. (Squint is best corrected before 5 years of age.) An estimated 1-5% of total population suffers from Amblyopia. Earlier detection of Amblyopia and treatment of the underlying cause of weak vision with glasses or surgery improves the suppressed vision with better long term outcomes.

One of the common causes for lazy eye is high glass power in one eye. Because of this differential power in the two eyes, our brain prefers the images received from the better eye and processing from the weak eye is suppressed. This suppressed transmission of visual images from the eye with higher power (weak eye) to the brain happens for a sustained period of time. This causes permanent hardwiring issues with brain and the sight on the affected side gets permanently reduced. This is something which can be restored only in childhood and cannot be corrected in adulthood. So no surgery can be done to make the eye see normal vision in adulthood if the amblyopia was not treated as a child.

Now with advances in the awareness and the treatment more and more children get diagnosed and treated at the right time. However some unfortunate ones who could not get treated at the right time continue to have the problem in adulthood as well. My mother is an example of the same problem. She had -14 D in one eye and -1 D in the other. It never got diagnosed when she was a kid and she resultantly is left with a lazy eye.

Recently a smart young man came for LASIK evaluation to the Center for LASIK surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India. He wanted to join Navy and one of the pre-conditions was a perfect sight in both the eyes. He knew that he had a higher glass number in his left eye and even with glasses his vision was only 40% of normal vision. He came with the expectation that LASIK surgery with all its new advances like RELEX SMILE LASIK will not only remove his glass power but his vision will also come back to normal. I could understand his plight and where his beliefs stem from! We all expect that newer advances will someday take care of all our troubles. Hopefully some day we may have a good option for adult patients with lazy eye. However LASIK or SMILE Lasik can be great option to remove the glass power but we must understand that removing the glass power will not correct the vision to normal in the lazy eye as suppression is at the brain level even though it started at the eye level.

The other side of the problem with lazy eye is also due to different powers in both eyes.  Due to high glass number in one eye, high power spectacle correction cannot be prescribed only in one eye as it can lead to imbalance between visions of two eyes. The eye with the higher power most of the time has to be given a lower power than actually required with the objective of balancing the power in both the eyes.

Now, what are the better solutions for adults with Amblyopia (Lazy eye):

Contact lenses: One of the solutions for such patients is to wear contact lenses. With contact lenses we can give full power prescription to the patient as chances of imbalance even with different powers in both eyes are less. Contact lenses can allow their eyes can see the best they can. In these people, one or two line vision improvement on the vision chart can make a lot of difference in day to day activities like driving etc.

Lasik surgery procedure: LASIK in cases of lazy eye due to different eye powers confers a lot of advantages. It allows even the lazy eye to get corrected of the number and hence see the best it can. This is especially beneficial for those who do not want to wear contact lenses. So a lot of times if these patients after their pre-LASIK evaluation are suitable for Lasik, we can consider LASIK or Femto LASIK or SMILE Lasik.

Visual limitations of Amblyopia are lifelong and hence it is very important to screen young children for lazy eye. We at Advanced Eye Hospital and Institute recommend school eye check-ups to be performed regularly to screen and diagnose these children at an early age. People older than 18 years having lazy eye due to high glass number in one eye can get themselves evaluated for LASIK. LASIK will not make the vision return to normal but will offer the best chance that the eye sees as well as it can!

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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

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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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For more information on Relex SMILE Lasik, visit http://www.smilelasikmumbai.com

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Concerns and Queries while deciding about SMILE LASIK LASER (Relex Smile) SURGERY

“If we are creating ourselves all the time, then it is never too late to begin creating the bodies we want instead of the ones we mistakenly assume we are stuck with.” 

― Deepak Chopra

People who have worn glasses or contact lenses often desperately want to get rid of the dependence on glasses. As a SMILE LASIK surgeon I get to hear and understand people’s concerns about LASIK laser surgery very often. Just yesterday a 30 year old man got himself evaluated under our care at the Center for LASIK Surgery at Advanced Eye Hospital and Institute, Navi Mumbai, India for SMILE LASIK laser (also called Relex Smile). All his tests as a part of pre SMILE Lasik evaluation were normal. However I could sense his anxiety and concerns which we discussed at length. At the end of the consultation I asked him to tabulate these on a slip of paper and give them to me. These questions and answers about Smile Lasik surgery form the substance of this blog. I hope this will benefit people who are looking for information about Smile Lasik surgery whether in India or abroad:

1. Which LASIK laser is best and why?

SMILE Lasik (Relex Smile) is the most advanced LASIK lasers in the current times. In this procedure, femto laser makes a small 3-4 mm incision (keyhole) is made in the periphery of cornea. Then with the help of a machine called Visumax, laser creates a very thin disc of tissue (lenticule) inside the intact cornea, size and thickness of which is dependent on patient’s spectacle/ contact lens power. This lenticule is then extracted through the peripheral key-hole incision. Unlike LASIK or Femtolasik no flap is created during this type of laser vision correction. Hence Smile Lasik laser is a procedure which is very quick and precise, does not disturb the cornea much and keeps it intact and stronger. Additionally SMILE Lasik does not induce any spherical aberrations as the zone of disc cutting is very well defined and no laser energy is lost in the peripheral part of the treatment. This makes Relex SMILE Lasik one of the safest, quickest and most comfortable (for patient) Lasik lasers.

2. Are there any risks to my eye with SMILE Lasik ?

SMILE Lasik laser is one of the safest Lasik lasers. The risk and probability of post operative complications is least with SMILE Lasik amongst all lasik lasers. Since it is a key-hole procedure and not an open surgery like LASIK where full flap is created, safety profile is the best.

1. Cornea stays biomechanically stronger so the chances of future problems like post LASIK ectasia (bulging of the thin weak cornea in an irregular fashion causing high cylindrical powers to appear) is near nil. Unlike Lasik or FemtoLasik, no case of post SMILE Lasik Ectasia has been reported anywhere in the world! Isn’t this incredible and gives so much re-assurance and a good night’s sleep to cornea Lasik surgeons like me.
2. During SMILE Lasik corneal nerves are left intact unlike in flap based Lasik where superficial nerves are transected during the creation of flap. Healthy corneal nerves are responsible for reducing the eye dryness. So after SMILE Lasik chances of increased dryness are minimized. For young professionals who have to work for several hours in front of computers this may be very important as they may be already suffering from computer related dry eye.
3. Chances of infection are minimized as no flap is created
4. Post operative discomfort is minimal as there is only a small keyhole incision. So literally within a few hours patients feel normal.
5. Avoiding a flap prevents complications such as flap displacements which can happen during ball sports or contact sports, so most people can play normally without worrying about their eye injuries risk due to previous LASIK.

3. How Expensive is this surgery compared to other LASIK

SMILE Lasik laser is more expensive when compared to other types of LASIK lasers like Conventional LASIK, Custom lasik, waverfront guided lasik, FemtoLasik, Epi-Lasik etc.  Major proportion of the cost is due to the license cost that the company charges for each and every procedure being performed. However if we really look at the big picture, the cost-effectiveness is maximum with SMILE Lasik. Let’s look at an example to understand this. After any Lasik surgery there is no need to buy glasses or contact lenses. On an average we spend Rs. 5000 Rs per year on these alone. Hence over 20 years this means the same sum of money saved by getting a Smile Lasik done. Further, the number of eye drops that we need to purchase for dryness after Smile lasik is negligible. Number of doctor followup visits is less saving lot of time.   Besides the monetary value, the safety profile of Smile lasik surgery is priceless as SMILE Lasik is a very safe Lasik.  Spending that little extra now ensures short term comfort, saves time and ensures long term safety of eyes after Smile lasik as compared to other LASIK surgeries.

4. How many days will I have to miss work and stay away from computer?

As I discussed earlier, in SMILE Lasik surgery we have a tiny keyhole incision. So actually no one needs to miss work for more than a day or two. Hence the motto at Centre for Lasik Surgery at AEHI- SMILE Lasik on Friday and back to work on Monday. Compared to Conventional LASIK or Femto Lasik where we do not recommend swimming or eye makeup for almost a month, after SMILE Lasik swimming and all the other day to day activities can be performed within 14 days. Due to less risk of dryness, working on computer is also not a problem and most people are comfortable in 1-2 days after SMILE Lasik.

5. What are the chances that I will get some numbers again?

LASIK/ SMILE Lasik is a mechanical procedure which reduces eye power by changing the curvature of the cornea with the help of laser. The procedure does not alter anything inside the eye.  When we are performing any LASIK laser, the idea is to induce a permanent correction in eye power for that particular date. If the number is not stable and increasing still then it will increase and can be perceived that the number has come back. That is why it is recommended and strongly followed by Lasik Surgeons at Centre for Lasik Surgery at Advanced Eye Hospital and Institute, Navi Mumbai that SMILE Lasik laser should be done only when eye power has been stable and there has been no change in glass power for the last 1-2 years.

Secondly, dry eye can cause regression of numbers and some small numbers may come back in future if one is not diligent in taking care of dry eye in daily lifestyle. This is very important for people who work in front of computers for long hours as they are at a risk of computer related dry eyes. Taking frequent breaks from computer/mobile phone work, blinking frequently and using lubricating drops are some of the required precautions among many others. In this situation again, SMILE Lasik may be better as there will be less associated dry eyes.

Thirdly people who have high powers and undergo deep corrections have some minor inherent risk of regression. This risk increases further if the treating surgeon chooses small optical zone to save the tissue. I personally advise people to look for alternative options of power correction if numbers are higher than -10D.

And last risk factor is the excessive near vision related activities such as non-stop computers, mobile video games and chatting and reading etc. Even though not proven by research but there are speculations that excessive non-stop near work can cause eye powers to be unstable. So it is for us to make sure that we take frequent breaks and give relaxation to our eye muscles. This may prevent instability of eye powers and reduces the risk of numbers increasing in future.

It is fine to have anxiety and concerns about a procedure as long as you understand the nuances of the surgery. It is very important to choose carefully your lasik surgeon, the place for the lasik surgery and the different laser vision correction options available.  I cannot stress enough the value of pre LASIK evaluation, understanding different LASIK laser options and finally discussing all the concerns and queries before the surgery with the LASIK surgeon.

About the author:

Dr Vandana Jain is a Cornea and Lasik surgeon and currently heads the Centre for Lasik Surgery at Advanced Eye Hospital and Institute at Navi Mumbai India. In her practice, she has performed more than 5000 successful lasik surgeries and is a big advocate of ensuring long term safety of vision before going ahead with laser vision correction. Having trained in Cornea, she is able to assess Cornea health very well in minute details before giving a go ahead for lasik surgery. She is also one of the first surgeons in India to start Relex Smile lasik laser surgeries. She is an expert in other lasik surgeries such as Femto Lasik, PRK (Epi Lasik), Custom and Wavefront guided lasik and Lasik Xtra. She can be reached at 02267313636 or contactus@advancedeyehospital.com

About the author:

Dr Vandana Jain – Lasik Surgeon expert

Dr Vandana Jain is a renowned Cornea and Lasik Surgeon practicing in Navi Mumbai, India. Due to her extensive training at Harvard, USA & LV Prasad Eye Institute and expertise, she is counted as one of the best lasik surgeons in Mumbai, India. She heads the Cornea and lasik surgery department at Centre for lasik surgery within Advanced Eye Hospital and Institute (AEHI), Navi Mumbai India. Her work involves various lasik surgeries such as Smile Lasik, Femto Lasik, Custom Wavefront guided lasik, PRK and Lasik Xtra. AEHI is one of the few centres in India which has all these facilities under one roof and thus is one of the best lasik surgery centres in western 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

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

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.

2. 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!

3. 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:

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.

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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.

Dr Vandana Jain an be contacted by filling up this form and someone from her team will contact you very soon

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Lasik Surgeon expert

Watch Dr Vandana Jain talk about SMILE Lasik:

 

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

 

Testimonials of AEHI Patients: