LASIK stands for Laser-Assisted In-Situ Keratomileusis. It is a form of laser vision correction which requires the creation of a corneal flap. With LASIK, a flap is created and temporarily lifted off, the corrective laser is then applied to reshape the cornea and the flap is then gently placed back into position.
In conventional LASIK, the corneal flap is created using a sharp blade (microkeratome). With bladeless LASIK (a.k.a Femto-LASIK or all-laser LASIK), the corneal flap is created using a femto-second laser hence bypassing the need for any surgical blades.
Benefits of LASIK include:
- Freedom from glasses and contact lenses
- Quick recovery with minimal downtime (1-2 days)
- Minimal pain and discomfort during the recovery period
- Minimal disruption to work schedule
- Short period of post-LASIK eye drops needed (typically 1 week)
A thorough assessment should be done before proceeding with any laser vision correction. In general, a suitable candidate for LASIK surgery includes patients who:
- More than 18 years old
- Healthy corneas
- Stable vision and refractive errors
- Keen to be free of glasses or contact lenses
- Keen to avoid the discomfort related to post PRK surgery recovery
- Keen for a laser vision correction procedure with minimal downtime
LASIK surgery is quick, taking about 10-15 minutes for both eyes. Recovery is generally comfortable with minimal discomfort. Antibiotic and steroid eye drops are given after LASIK for about a week to prevent infection and minimise inflammation. Many patients are able to return back to normal activities in 1-2 days.
Risks of LASIK surgery include:
- Glare and halos
- Dry eyes
- Vision fluctuation
- Under or over-correction
- Flap related complications: e.g interface inflammation/infection, epithelial ingrowth
- Corneal ectasia
Recovery from LASIK surgery is quick with minimal downtime with many returning to work in 1-2 days. It is important not to rub your eyes during this early recovery period. A medical certificate is issued cover any absence from work after LASIK surgery.
During each follow up consultation after LASIK surgery, the recovery process is assessed and advise given on when returning to exercising is suitable. Most patients are able to return to running, jogging and gyming within a week. Swimming should be avoided during the early recovery period.
LASIK surgery itself is painless due to the numbing eye drops given before surgery begins. After LASIK surgery, there may be some discomfort immediately after the procedure, this largely resolves by the following day. A special contact lens is placed to aid healing and reduce this discomfort.
Significant improvement of vision is expected after LASIK surgery compared to the previous unaided vision without glasses or contact lenses. About 99% will no longer need glasses or contact lenses to meet legal requirements for driving.
During LASIK surgery, you will be given a target light to focus on. This may be a blinking green or red light. Focusing on this target light keeps your eyes perfectly aligned for the corrective laser to be accurately applied.
Modern day lasers come equipped with an eye tracker which can track your eyes in up to 7 dimensions. Any movement of the eye out of the defined treatment zone instantly stops the laser from firing until the eye is properly positioned again. Gentle blinking during LASIK surgery is acceptable as long as there is no effort to tightly squeeze the eyelids closed.
After LASIK surgery, it is important to avoid eye rubbing and to keep the prescribed eye drops going as planned. Goggles are given and should be used at night to prevent eye rubbing during sleeping hours.
LASIK surgery is able to treat hyperopia (long-sightedness), myopia (short-sightedness) and astigmatism.
There is a role for LASIK surgery in treating presbyopia and achieving glasses freedom. This is in the form of monovision where one eye is corrected for distance vision and the other eye corrected for near vision. Patients may simulate this with a trial of contact lenses before undergoing LASIK surgery.
During an assessment, a detailed history will be taken from you and specialised test to gather data on suitability will be done. This includes checking your visual acuity, refraction, cycloplegic refraction, corneal thickness, corneal topography, pupillometry, eye anterior segment examination, dilated fundus examination. Based on the assessment results, Dr Val Phua will then have a detailed discussion on the various options for laser vision correction and recommend a suitable treatment to meet your vision goals.
Collagen cross linking involves adding a serum of riboflavin vitamin to the eye during the LASIK surgery and shining a UV (ultraviolet) light to cause collagen fibers of the cornea to cross link and strengthen. It may be indicated in cases where there are signs of a weaker cornea such as high astigmatism or thin corneas.
In some cases, mild residual refractive errors may be present after LASIK surgery or may come back with time. The previously created corneal flap can then be lifted and a corrective laser applied to again reshape the cornea and restore vision.
In LASIK surgery, a laser is used to reshape the cornea and correct any refractive error present. This correction is permanent. However as a person ages, there may be some changes to the eyeball that comes along with it. Some patients may find that the myopia or astigmatism “comes back” and may require an enhancement to re-correct this residual degree.