Laser-Assisted in Situ Keratomileusis (LASIK): Cost & Effects

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What is LASIK? 

LASIK is an eye surgery that corrects certain eye conditions such as nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. LASIK is a precise and controlled removal of corneal tissue using a special laser that reshapes the cornea and changes its focusing power.

After undergoing this procedure people can actually get rid of their glasses and change their lifestyle. 

How is LASIK surgery done?

LASIK surgery includes the following steps: 

  1. In this procedure, anesthetic eye drops will be applied to your eyes at the outset.
  2. The ophthalmologist then uses an instrument called microkeratome to create a thin flap which enables him to lift the outside layer of the cornea.
  3. A vacuum ring, or an eyelid holder, is placed between your eyelids to prevent eye movement or blinking while creating the flap.
  4. Once the hinged flap is created, it is folded back to reveal the middle layer of your cornea, which the surgeon then reshapes using an excimer laser.
  5. Once the procedure is complete, the surgeon will reposition the corneal flap on your eye. The created flap sticks to the eye, without the need for any stitches and serves as a natural bandage for the eye as it heals.

The same procedure is then repeated with the other eye, while the operated eye is covered with a patch. 

The whole process takes around 10 minutes for each eye. LASIK is an outpatient procedure. 

LASIK surgery is performed to correct short-sightedness, long-sightedness, and astigmatism. However, LASIK surgery is not an effective treatment for presbyopia, though, monovision LASIK does help this condition to a certain extent. Presbyopia is an eye condition which occurs with age. It is the gradual worsening of near vision, making it difficult to read, use the computer, do needlework and the like, which requires clear near vision. 

Am I eligible to undergo LASIK surgery?

You are an ideal candidate for LASIK surgery if:

  • you are above 18 years of age,
  • you possess good general health
  • you do not suffer from ailments such as uncontrolled diabetes, allergies, autoimmune or collagen vascular disease,
  • you do not take any medication such as steroids and immunosuppressants,
  • your vision has been stable for at least one year before the surgery day.

You are not eligible for LASIK surgery if :

  • you have a thin cornea,
  • you suffer from eye diseases such as keratoconus, glaucoma, cataracts, corneal disease, herpes simplex, herpes zoster, and retinal / optic nerve diseases.
  • you have suffered from eye injuries.
  • you suffer from, dry eye condition, amblyopia (lazy eye), strabismus (muscle imbalance) or are prone to keloids.
  • if you are pregnant or nursing.


It would also be good to let the doctor know in advance if you suffer from any mental health problems.  

It would be advisable to undergo an eye evaluation with an ophthalmologist and discuss the pros and cons of the operation at length before you take any decision. 

Are there any side effects of LASIK surgery? 

Typically, during the first 24-48 hours after the surgery, a slight discomfort is felt in the eyes. This usually resolves by itself. 

Other side effects that you may experience within the first six months, post-surgery include:

  • dry eye symptoms which may persist for a few years in some patients (This may be due to corneal nerve damage which can occur during the flap cutting.)
  • a sudden appearance of small red blotches on the whites of both eyes
  • sensitiveness to light
  • seeing halos around objects
  • hazy vision
  • foreign body sensation in the eyes
  • watering

These conditions usually resolve within a period of six months. 

Corneal flap complications may also occur such as:

  • flap dislodgement
  • Misalignment
  • flap wrinkling or folding
  • flap instability
  • epithelial growth or inflammation under the flap. In case of growth or severe inflammation under the flap, a minor surgery may be required.

Poor night vision and difficulty with night driving is another common complaint among patients who have undergone LASIK. It is a risk of undergoing the surgery. In such a case a pair of glasses specifically for night driving is a solution.

Another side effect that may occur is overcorrection or undercorrection of eyesight. When overcorrection occurs nearsightedness gets altered to farsightedness, and it is vice versa for undercorrection. These residual power error conditions can be corrected through enhancement or retreatment surgeries. However, if your cornea is found to be thin or steep, the surgeon may advise you to not go in for additional surgeries and will instead prescribe you glasses or lenses to correct your vision.

Irregular astigmatism may occur in cases of LASIK surgery, due to laser correction which is not properly centered in the eye, or even due to irregular healing. Such a case would require revision surgery. Another side-effect of LASIK surgery is epithelial ingrowth, a condition where cells from the outer layer of cornea grow under the flap, leading to blurred vision. A minor surgery will be required to remove the cells. 

In rare cases, corneal ectasia may occur. A corneal ectasia is a group of eye disorders characterized by abnormal corneal thinning or irregular thickening from the center of the cornea to the periphery.  

Keratoconus, which falls under the corneal ectasia group of eye disorders, can occur after a LASIK surgery if too much tissue is removed from the cornea, or if the cornea was already thin prior to surgery.

Some patients also require reading glasses after undergoing this procedure. 

Though infrequent, the possibility of not achieving absolute clear vision after a LASIK surgery exists.  Should you experience it, you will be recommended to go in for an additional minor surgery to achieve a sharper vision. 

A fact to be kept in mind is that if you have very large refractive errors, chances are, you may still require contact lenses or glasses after the surgery. It would be wise to discuss your condition at length with your doctor, so that you may have realistic expectations from the surgery. 

Are there any pre-surgery guidelines to be followed before the LASIK procedure? 

Before going for an evaluation by an ophthalmologist, it is highly advisable to stop using contact lenses for four weeks and switch to glasses. Constantly wearing contact lenses changes the shape of the cornea, and it takes time for the cornea to assume its natural shape. It is similar to how a watch band leaves an imprint on the hand when worn for a long time. An evaluation and surgery based on the cornea which has not assumed its natural shape can have negative implications. 

During the evaluation you need to discuss in depth with your doctor about whether you are a good candidate for LASIK surgery, what are the alternative surgeries you can opt for, what are the risks and complications involved, what can you expect after the surgery, and what are the pre and post surgery guidelines. 

A day prior to the surgery you need to stop using any creams, lotions, makeup, and perfumes. 

Are there any post-surgery guidelines? 

Post the surgery you will be advised to:

  • not rub your eyes
  • avoid any form of exercise, such as heavy lifting, or swimming, that could result in eye injury for at least a month
  • refrain from driving till the doctor deems it fit
  • wear sunglasses for a week after the surgery, even while indoors
  • avoid applying any makeup or lotion on the face, and avoid any situation involving dirt for 7-10 days.
  • be careful not to get face wash or soap in your eyes while washing your face, or showering. (In fact, you need to keep water and shampoo away from your eyes for at least 7 days after the surgery)
  • avoid swimming and hot tubs for at least a month after the surgery
  • apply eyedrops in your eyes at regular intervals as prescribed by the doctor

What is the cost of LASIK surgery in India? 

The cost of LASIK surgery in India varies from Rs. 45,000 to Rs, 1,20,000. 

Are the results of LASIK surgery permanent? 

In most cases, it is seen that the result of LASIK surgery is long-lasting, as long as the patient remains healthy. Patients usually achieve a 20/20 vision, but in some cases reading glasses may be required. 

If you experience a sudden onset of certain health conditions, such as diabetes, it may affect the quality of your vision.  

Also, the term “permanently” in a way cannot be applied to our eyesight whether we undergo LASIK surgery or not, as natural deterioration of eyesight which happens with age, cannot be halted by LASIK surgery. 

More Topics on Opthalmology Procedures

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References

1. Randleman J, Russell B, Ward M, Thompson K, Stulting R. Risk factors and prognosis for corneal ectasia after LASIK [Internet]. 2018 [cited 6 April 2018]. Available from: http://www.aaojournal.org/article/S0161-6420(02)01727-X/abstract

2. K.F. Tabbara ,  H.F. El-Sheikh, C.L. Vera-Cristo, Complications of Laser in Situ Keratomileusis (LASIK) [Internet]. 2018 [cited 6 April 2018]. Available from: http://journals.sagepub.com/doi/abs/10.1177/112067210301300204

3. Hammond, Stephen D Jr; Puri, Anil K; Ambati, Balamurali K, Quality of vision and patient satisfaction after LASIK : Current Opinion in Ophthalmology [Internet]. LWW. 2018 [cited 6 April 2018]. Available from: https://journals.lww.com/co-ophthalmology/Abstract/2004/08000/Quality_of_vision_and_patient_satisfaction_after.9.aspx

Would you like to consult a doctor for Laser-Assisted in Situ Keratomileusis (LASIK) ?

Questions answered by trusted doctors

Verified User
After LASIK is eye sight problem can be faced after some year...?? If yes then what one should do.. Again LASIK or something other treatment..??
Dr. Jatin Wadhwa
Ophthalmologist/ Eye Surgeon, Faridabad
It is possible that some refractive error may appear after some time or maybe residual after Lasik surgery. It is possible that refractive surgery can be done again to correct the refractive error but only after the error is stabilized. You must visit your ophthalmologist and get your refractive error checked and once your doctor feels it stabilized and does your pre Lasik checkup again, and finds that the refractive error can be corrected with refractive surgery. You can go for a refractive surgery again.
Verified User
Hi All,

I am Harish Adkane. On Aug 2016 , I got recommended for INDIAN NAVY for an officer entry. After selection , I underwent stringent medicals. I was fit in all areas, but they declared me unfit because I have a small refractive error of -0.75 for both the eyes and my vision is around 6/9 for right eye and 6/12 for left eye.  They require  6/6 for both the eyes.

Though LASIK surgeries are prohibited in Indian armed forces. They won't tell you directly , but they allow candidates wid LASIK surgery done provided it should be done an year ago ..or it should not be detected while medical examination. So i want to do a surgery which is non recognisable and could be healed over a time.

As per my research , I came across some variants if LASIK  such as PRK , TRANS -PRK,  Epi LASIK, Trans Epilasik, TEMLA. After 2 months, another Advt will be open,  and I am planning to apply for it again but this time for pilot entry, which again requires 6/6 vision.
please guide me on this.

Dr. Vishal Arora
Ophthalmologist/ Eye Surgeon, Gurgaon
PRK would be a recommended procedure for you. As the number is quite less the result might be unpredictable. For your information PRK does not involve flap formation. Also if one looks world over recruits of the us army do undergo prk if they want glass removal.
Dr. Arjun Kumar Singh
Ophthalmologist/ Eye Surgeon, Patna
I will never advise you to go LASIK for 6/9 Vision,, don't try to  cheat medical board  &you will get spoil your career ,not difficult to detect  who ever has advised you is not your well-wishers ,there is not Congress govt at centre where you do anything with help of money,with regards
Dr. Vaibhev Mittal
Ophthalmologist/ Eye Surgeon, Sangrur
Hello

PRK once done cannot be recognised by even doctors

Other option would be SMILE LASIK...Here also flap is not made and so not easily recognised.

Otherwise normal LASIK is other option

Verified User
I want to know is Lasik safe and how much should it cost?
How much rest should one take after Lasik.
Dr. Susheel Deshmukh
Ophthalmologist/ Eye Surgeon, Mumbai
Safety would depend on the power, your corneal thickness and shape determined by test called topography..
If the number is not too big,then LASIK remains very safe.
Thanks
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Did you know?

Cost of LASIK in India

The cost of LASIK surgery in India varies from Rs. 45,000 to Rs, 1,20,000

Discomfort during the first few days following LASIK surgery

During the first few weeks following the LASIK surgery you may experience, halos, glare and starbursts in low-light environments, especially at night, dry eye symptoms, hazy vision, and reduced sharpness of vision. In majority of cases the problems are temporary and disappear completely within three to six months.

Flap complications during LASIK procedure

Studies indicate that flap complications occur in from 0.3 to 5.7 percent of LASIK procedures. If the LASIK flap is not created correctly, it may fail to adhere properly to the eye's surface. Microscopic wrinkles also known as striae may develop in the flap causing opticalĀ aberrationsĀ and distorted vision.

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The LASEK procedure is suitable for anyone with a very thin or very steep cornea. This surgery is a slight variation of the LASIK and PRK procedures.

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