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Common
LASIK FAQ'S and their answers.
Includes queries asked by those travelling from abroad |
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How
many days can I expect to stay in Mumbai? |
| A |
We usually advise you to reach at least a day before the procedure
so that the evaluation and examination can be done. This examination procedure
takes about an hour in our office and the only important instruction you need
to follow is to be off soft contact lenses for about a week before the examination
and off hard or semi soft contact lenses for about 3 weeks.
The LASIK procedure
is usually planned once or twice a week and you need to inform us a week before
for scheduling the date.
The procedure time is not more that 8 minutes per
eye and you are sent home in 15 minutes after explaining the medication eye drop
schedule.
We need to see you for a post LASIK check up the next day and at
least 3-4 days later. Those who live close to Mumbai usually are sent home the
next day after their examination and then seen again after 7 to 10 days. |
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Do
I need any follow up when I leave your country and reach my hometown? |
| A |
Like I said above you can travel anywhere after 3 days of the
procedure and need not be seen by us again unless convenient to you. You will
be asked to follow up in your own city and we give you a detailed report of the
same. Usually the follow up need not be done at an eye surgeon as a consultation,
but just a routine examination with an optometrist in your city, that too after
3 months of the procedure. Most of our patients visit us again when they come
back to Mumbai and we do not charge for these follow-ups. The regular follow up
schedule if convenient to you would be … the next day, after 7-10 days, after
3 months and then after a year. |
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| Q |
Can
I travel within India on a holiday? |
| A |
Yes, as I said above you can travel anywhere after 3 days of
the procedure, go on a nice vacation WITHOUT glasses! Usually, most people prefer
to do the LASIK procedure before their vacation, so that they may enjoy the same.
Also, since most come back to Mumbai before flying out, they get a chance to come
for a follow-up check up again. However we leave it up to you to plan your procedure
during your trip and would help you schedule the dates for the same. |
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What
precautions do I need to take and what activities should I not do after LASIK
on my trip? |
| A |
The precautions are fairly simple and would be similar to all
irrespective of LASIK done. The fear is of catching an eye infection. The first
week after LASIK you will be on eye drops which are antibiotics so that aspect
is anyways taken care of. However, some general and basic rules of hygiene such
as not rubbing your eyes with unclean hands, carrying a hand sanitizer to keep
the hands clean etc helps. We ask you to wear a pair of good UV protecting sunglasses
when outdoors to protect your eyes from dust, strong sunlight and allergens. Only
swimming underwater is to be avoided for a few days. Those looking forward to
enjoy our beaches can swim in the sea or pool, but with swimming goggles for protection. |
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| | Q |
Is
it safe to do this procedure in India? After all you do hear of unsanitary conditions
and poor hygiene? |
| A |
The success of laser vision correction or LASIK depends on
a multitude of factors, primary being the expertise of the doctor along with a
good laser technology in an International standard set up of hygiene and care
with stringent eligibility criteria.
Many doctors today budget the LASIK and
discount LASIK prices esp in India. This is only possible if one can cut costs,
but that would be at the cost of compromising quality, re using blades, working
with older cheaper technology etc. Many use the Nidek and Mel lasers which give
problems in night vision and glares in over 50% of their patients. These lasers
do not have wavefront technology either. In the USA the FDA has even proven that
most complications arise in discount LASIK centres.
We are proud to say that
within a JCI hospital, with strict protocols on hygiene, a completely
disposable centre and with a Wavelight Concerto 500 Hz laser, available in India only at Shroff Eye Mumbai, using
wavefront or custom LASIK technology, we offer a far superior, safe and reliable
technology at affordable comparable prices. |
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| Q |
How different are you
from other laser / LASIK centres or What are the advantages
of Wavefront Analysis? |
| A |
Dr. Anand Shroff, Chief Surgeon, at the Shroff Eye Hospital,
Bandra, Mumbai, has several years of experience in LASIK and
is among the country's longest-standing users of the benchmark
'flying-spot' laser technology. He also is the first to use
the WaveLight Allegretto 200 Hz excimer laser in India before
the Allegretto Wave Eye-Q 400 Hz was launched at our Eye Hospital.
We are now using the most advanced laser system in the world-
The Wavelight Concerto 500 Hz laser,
being the only ones in India and few in the world to offer
this technology
Wavefront LASIK or custom LASIK is the most advanced LASIK method today. It can be performed using various lasers. The speed of the laser and its applications are very important in delivering results. Today Wavefront technology has been
around since 1998. It is specifically for those patients who would end up unhappy
if a standard LASIK procedure is done on them. These patients are detected during
their LASIK screening and evaluation, by certain specific indications which would
arise on the topography and aberrometry tests. It is also a technology for those
who have undergone LASIK on poor obsolete lasers or have undergone PRK or RK [other
techniques for removal of spectacle numbers] and are having problems.
We believe in the best, having always stood for distinction in eye care.
After
working on different lasers and being offered other lasers still entering the
market, we went ahead with the Wavelight wavefront 500 Hz laser because of its
superior technology. Most lasers are retrofitted for wavefront or to simply put
upgraded whilst this laser has been developed for wavefront from scratch. The
detailed research in the laser system took into account the needs of the surgeon,
patient as well as looked after the many drawbacks of the other laser systems.
To put it simply, the ' wavefront' is the way the natural light pathway goes
in the eye thru the entire optics. This is supposed to be a smooth path in an
ideal eye. As the light travels thru the other optical system inside the eye,
like the lens, vitreous jelly etc. it undergoes further degradation. This is acceptable
to a certain extent and that is why the eye surgeons have reached a 6/6 or 20/20
criteria as normal sight. However, when these errors or 'higher order aberrations'
as they are known, exist to an extent in which they need to be treated then wavefront
treatments [Custom LASIK] are a must for such patients. Earlier lasers
without wavefront technology can only correct the spectacle number, which arises
from the curvature irregularities of the cornea. Our laser can treat the entire
optical system errors. Further, when we treat these optical errors by doing wavefront,
some patients actually gain lines of sight, better than 6/6 OR 20/20.
Then again, that is not our aim alone. We want to give quality of sight. By which
I mean good contrast sensitivity and good night vision. In the night the pupil
expands or dilates to let in more light for visibility. If a laser treats a zone,
which is smaller in diameter than the diameter of expansion of the pupil, then
what you have is an untreated rim of cornea, which in the night is going to disperse
light in various directions resulting in haloes or glares of light. This is the
problem most of the West ie. USA is facing, because most of their lasers treat
a 5 mm zone only and because of lighter colored eyes, their pupils [in US] can
dilate upto 7 mm. Our laser can treat wide pupils and has a near zero percent
of night vision problems in our experience. There is a lot more of this
laser, which helps the patient and the doctor. We can now treat higher numbers
with more accuracy, re- treat earlier laser unhappy patients to get better night
vision etc. and include patients who would have been poor candidates for earlier
technology. This is why our success rates have been good from the beginning, as
we have been thorough in our patient evaluation and stringent in our eligibility
criteria. |
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| | Q |
How
do I find out which laser system is good? |
| A |
The laser systems should possess specific features for higher
quality visual results. The Wavelight company [our laser company] was
the first laser to have done the worldwide wavefront LASIK treatment which others
have modified or upgraded in their already existing lasers. |
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Features of our Laser
comparing with other Lasers |
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1. Laser
Spot Size |
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The small laser spot size is mandatory to produce fine complex
treatment patterns. Smaller the size, finer the treatment. Ours is the smallest
in the world so far… viz 0.68 HM |
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2. Speed |
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Shortens
ablation/ treatment time remarkably. To the benefit of the surgeon and to the
comfort of the patient, Because shortened corneal exposure time allows faster
visual recovery.
The rapid rate is vital to maintain corneal hydration intra-operatively,
especially in wavefront guided procedures with larger optical zones where a prolonged
treatment time could adversely affect the planned treatment profile. A simple
principle in laser refractive surgery is to keep the eye as physiologically hydrated
as possible intra-operatively for a faster visual recovery.
Hence, faster
speed lasers have better visual outcomes. Our is the fastest in the world so far…
viz 500 Hz keeping in mind the safety limit as well. |
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3. Optical
Zone |
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Ideally the laser should have the widest treatment area that
also removes the least tissue possible, which is what our laser supports. Most
Other lasers in order to treat a wider area, take out more corneal tissue. This
also results in night vision problems. In the night the pupil expands or dilates
to let in more light for visibility. If a laser treats a zone, which is smaller
in diameter than the diameter of expansion of the pupil, then what you have is
an untreated rim of cornea, which in the night is going to result in haloes or
glares of light. Most lasers treat upto a 5 mm zone to 6 mm only , ours can treat
upto 7 mm.
In cases of patients with night glare due to earlier treatments,
the ability of our laser to retreat is highly beneficial. |
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4. Eye
Tracking speed |
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The eye is kept fixed with the laser during treatment. However
there are fine saccadic eye movements not seen by naked eye. The Wavelight Concerto
500 Hz is better than any other excimer laser system as it tracks the eye at 500
times a second and allows for spot on treatments. Most other lasers have an eye
tracker which if the eye moves even to some extent during treatment, then the
laser stops. |
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5. Topography
Link treatment |
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Is necessary for a customized laser treatment. Especially in
re treatments when undergone earlier LASIK and patient is unhappy.
For topography-linked
retreatments, the Wavelight Concerto 500 Hz laser has the best capabilities at
present. |
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| Q |
Is this considered blade or bladeless surgery? |
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We do have EpiLASIK where no 'blade' is used on the cornea, or it is a modification of the LASIK procedure for those who fear the use of the blade.
' Intralase' is not advised by us currently for various reasons.
Basically, Intralase does not treat your numbers, it only creates a flap. However, the frequency and other profiles with which it is working currently is under an upgrade programme since it is resulting in some issues, hence until then, we are not in favour of the same.
Your concern is treating your eye numbers ACCURATELY WITH SAFETY. The numbers are treated by another laser technology, and if this old, then you will not have the desired outcome. The VISIX laser which it currently combines works with is a far older machine and has only been upgraded to customized wavefront treatments, not built from scratch for wavefront principles as our laser, The Concerto 500 Hz
Basically treating your numbers has two steps:
Step 1 to create a 'flap' to make this procedure painless and heal well. That is its only objective.
Flap creation requires the skill of the surgeon as well as the use of a good equipment to be free from flap related complications.If Centers face Flap related complications due to reasons like multiple users (doctors), new inexperienced surgeons or using poor equipment creating flaps then to reduce these complications one looks at using the Intralase which uses a laser beam to make the flap. So, Intralase does not treat your numbers, it only creates the flap.
However, this itself is not free from its own set of issues (as addressed in the attachment). The frequency and other profiles with which Intralase is working currently is under an upgrade programme since it is resulting in its own complications, hence until then, we are not in favour of the same.
Further, the cost of this laser (Intralase) used just to create the flap is passed on to the patient which is an extremely high fee.
Most users of Intralase are using the VISIX laser to treat the numbers (Step 2 of LASIK). The VISIX laser, is a far older machine working at a speed of just 60 Hertz compared to the advanced systems today working at 500 Hz (such as ours). However, it is sold together as a unit as it is made by the same company.
Hence till Intralase is more well established, we work best with the Moria M2 microkeratome to create the flap and the Wavelight Concerto 500 Hz laser system with complete disposable kits.
If you have any fear of the 'flap' we too can do the bladeless procedure with EPILASIK, but it takes more time in recovery.
Step 2 to treat the numbers completely, accurately with safety
Your concern is treating your eye numbers ACCURATELY WITH SAFETY. The numbers are treated by another laser technology (other than the Intralase), and if this old, then you will not have the desired outcome. VISIX or Zyoptix usually used with Intralase and has only been upgraded to customized wavefront treatments, not built from scratch for wavefront principles as our laser, the Wavelight Concerto 500 Hz.
It is very important for one to focus more about the laser technology being used to treat your numbers rather than the pre steps of using the blade or bladeless, unless the center is having some complications in these pre steps, for which one would try to reduce the same by the bladeless method.
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| Q |
Regarding humidity and dry environment |
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This does not affect the LASIK outcome, but for better recovery initially in the first 3-4 months we do advise using lubricating eye drops or artificial tears. |
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