Yes. Currently we are the Wavelight Concerto 500 Hz laser, the fastest and a more advanced laser system than our earlier laser, the Wavelight Allegretto Eye Q 400 Hz laser system. The Conceto is one of the most respected lasers amongst refractive surgeons. It also is one of the fastest lasers in the world today. It has various advantages over other laser systems.

Wavefront-guided LASIK or custom LASIK is the most advanced LASIK method today. But it can be performed using various lasers. The speed of the laser and its application are very important in delivering results. Today, we use one of world’s fastest lasers the 500 Hz whereas most other lasers are 50-100 Hz and some 200-250 Hz. Many older lasers are only upgraded for Wavefront-guided treatments whereas the WaveLight is built from scratch for incorporating wavefront principles. That is why the WaveLight has near-zero night vision problems like glare and haloes, which may still occur with other systems. We also check your pupil size to ensure a more customized treatment zone. We have no recorded night vision problems, one of the reasons why many of our patients are from other countries. This laser is available at very few centres in the US.

Further, the US FDA has stated the WaveLight laser to be the only laser to improve night vision.

Any procedure on the eyes needs the eyes to be kept open. In LASIK the anaesthesia is in the form of eye drops. The eyes are kept open with a clip. This does not hurt. Some do feel a 'kind of stretch' on their lids for a few seconds. There is no pain. You are able to keep the eyes open without feeling the urge to close your eyes due to the effect of anaesthesia.

What makes LASIK pain-free and what was invented 20 years ago is the LASIK flap. It is created with a microkeratome before the laser removes the numbers. The thickness of the flap to be taken is determined during your evaluation process. We work best with the Moria M2 microkeratome, a completely automated and very safe device for creating the flap.

You are asked to come for a check the next day, wherein you will be examined for complete healing and 20/20 vision. In very few patients healing takes longer, sometimes weeks. A simple check determines if there is any number that needs fine tuning or enhancement.

You are given a kit containing antibiotic and anti inflammatory eye drops to be used for a week only. Lubricating eye drops are used for a month or two, after which it is need-based.

We check every patient for dryness before the surgery (during your LASIK evaluation). If you have severely dry eyes, LASIK is discouraged until the dryness is treated. If the dryness is mild, EpiLASIK is the choice. However, temporarily for some days to some weeks (upto 6 weeks) one can feel 'dry'. Using lubricating eye drops decreases dryness for those sitting on the computers for very long hours [computer vision syndrome].

Most overseas patients are in Mumbai for about 5 days from the time they undergo their check up. We plan better so that they arrive a day earlier to the procedure date for the check up and hence are in Mumbai for at least 3 days after LASIK. Upto 7 days is ideal.

We usually perform LASIK on Wednesdays and Saturdays and therefore better to see us a day earlier.

We can send you details of hotels close by. They have a special rate different from their rack rate for our hospital, hence ask them for the same.

I do appreciate your concerns about the procedure. These are your healthy normal eyes we are talking about! That is why we use the finest technology and deliver successful results!
What may help is visiting some sites like the US FDA website. This will help you at least identify centers with older lasers and you can learn more about the laser technology and how success rates differ for each type of technology. We too have this simplified on our site www.lasikindia.in in the safety link.

This is the reason why with our strict protocols and way of working we have never had any case of infection. Complications of LASIK include those from the technology like night vision problems. Since our laser system is most advanced it has near zero night vision trouble. In fact with our experience and reputation we have corrected complications of other centers. Since Dr Shroff is primarily a corneal surgeon doing corneal transplants for many years even before doing LASIK, it helps us give excellent results. Other complications are more consequences of doing LASIK on an unsuitable candidate such as one who has dry eyes. So, dry eyes are another problem that you will read about. Again in our center, we check all patients with a special dry eye test. If any patient is found to have dry eyes, then depending on the severity appropriate treatment is advised to the patients. For mild to moderate dry eyes we suggest Epi LASIK, a new procedure that you can read more information on our website www.lasikindia.in.

The laser technology we use is important not to give you any disadvantages such as night vision problems, haloes and glare, which exist with other systems. In addition, using complete disposables, we never have encountered infection. In fact we have a strict infection control group within the hospital itself.

The only thing that we prepare our patients for is the event of needing a touch-up [retreatment]. In spite of having done our best and taken all predictable variables, we still rarely cannot predict corneal healing. It sometimes can heal leaving behind a small number. In our experience we have seen 0.50 D to 1.00D usually. However, this is treatable and we offer to re-treat this number free of cost when we have identified it in the immediate post procedure period. It only means that in rare cases LASIK may be in two steps. The rate of this re-treatment or fine-tuning in our center is less than 1%, which in most centers is 5 to 20%.

The success rates vary in different centres. Like I mentioned earlier success depends on a combination of doctor’s experience, technology the doctor is using and the general practices of sterilization, disposables etc.

A good laser alone is not the only criteria. The experience of the surgeon is equally or more important. Dr Shroff is a very skilled doctor and is one of few course instructors training new users of the Wavelight laser from many different countries at WaveLight’s HQ in Germany.

You can face lights the same way that you can face them now. We recommend not facing harsh lights or bright sunlight for a few days.

These may be specific to your lifestyle which can be discussed during your visit.

Hormones not only in pregnancy but sometimes even higher doses due to hormonal imbalance like in hirsuitism etc can lead to slightly fluctuating numbers. However, this does not happen to everyone, and neither is there any predictor in whom it may happen. Studies indicate that those on hormones, even oral contraceptive pills and pregnancy can have slight variation in numbers. In our practice we have not seen this happen. The possibility of needing an enhancement or re treatment has to be then explored.

The US FDA gives a baseline of 250 microns cornea to be left behind after the laser treatment. Our centre believes in leaving at least 300 microns. Your calculation will be done during evaluation. It should leave at least 300 microns behind on the cornea after the laser treatment is completed.

The cornea is like the door to your eye and the stronger or thicker the door, the better it is for you.

The Wavelight Concerto 500 Hz laser which we use has its advantages in this respect of corneal saving as this laser saves upto 40% of the cornea compared to other lasers. In simple terms it means that another laser would remove far more corneal tissue to remove the same number. Also, when creating a 90 micron flap, which we do using the Moria single use head, it leaves even more cornea after the procedure. This a great advantage for people with high numbers or people which other laser centres cannot treat.

When instruments come in and out of your vision, at times you do not see the green light we ask you to focus on. When the microkeratome is also applied for a few seconds you cannot see the focus light. ‘Black out’ sounds more like unconsciousness which it is not. In our centre the procedure is very smooth and soothing. There are no shocks or surprises. Dr Shroff is in conversation with you throughout to make you feel comfortable during the process.

What is the worse case scenario?

Again differs from centre to centre. In our centre we have the longest experience with wavefront-guided LASIK in India. We have one of the most advanced technologies in the first and only eye hospital in India to be given JCI accreditation. We prepare you for just one thing. Less than 1% of the time to max 2% of the time, the treatment may need fine tuning. This is called enhancement. We use all your eye maps to predict all your number to have been removed. However, we cannot predict corneal healing a 100% and sometimes there is a small refractive error of say 0.50 D upto 1.00 D that needs a touch up.

Like I mentioned earlier, it will depend from centre to centre. Some use old technology, some have inexperienced surgeons, some centres reuse disposables, hence, its always best to visit the centre you feel more comfortable with and go through the process of research and get your queries answered.

Rubbing of the eyes:  Once the initial recovery period is over – say 1 month, it is but natural that we would be touching our eyes (washing, using eye makeup, threading…), swimming and rub them when they itch sometimes.  E.g. sometimes, when the wind blows, a few strands of our hair can get into our eye. Would all that be ok and normal rubbing as long as it’s not such vigorous rubbing?  If Lasik is meant to give us a new pair of eyes, it should not affect in the sense that our eyes should still be normal and healthy eyes after the 1st month, right?  How quickly does the flap heal?

The flap heals overnight. Then it takes vigorous amount of rubbing to displace it, which most are careful about. We have never seen a case of displaced flap. We also give protective eye wear for the immediate post procedure period.

Rest, you can wash your face, gently clean the eyes from the next day itself. In some, microscopic healing goes on for a couple of weeks.

Our overseas patients visit their optometrist at the end of 3 to 6 months and definitely as their annual visit, nothing special.

The doctor will guide you after the procedure. However, on average, 3 months is fine using a good quality coloured lens.

What happens if someone has cataract later in life?  I understand patients who’ve had Lasik can still be treated for cataract?

All you need to do is inform the cataract doctor who will need to calculate the power of the lens to be implanted accordingly. The cataract surgery itself does not differ.

The iris recognition and registration is a marketing stunt for the Bausch and Lomb laser. It means that you have taken the correct patient and are operating on the correct eye. I think that that is basic knowledge; you better know this as a doctor and don't need any laser to tell you that!

Active eye tracking is one of the most important aspects of the laser technology as this entire procedure is done under topical or local eye drop anaesthesia. You will be able to move the eyes and hence even the slightest inadvertent movement must be tracked so that the laser shot applies where it is supposed. This makes the treatment accurate. We have the fastest eye tracker in the world today.

This may not pose a problem for us as we have a two-fold advantage of a laser which saves 40% cornea compared to most others and using a special kit which saves 90 microns more or performing EpiLASIK. However, if you can send us the exact pachymetry (corneal thickness) result, it will enable us to know which procedure is more suitable for your eyes.

We can treat numbers as high as -14.00 D but even say 'no' to smaller numbers as the suitability for LASIK is not just dependent on numbers alone.

We can answer the part of suitability for your eyes when our doctor has examined you. However, in all the patients we have done, whether EpiLASIK or LASIK, we achieve what we aim for, rarely; this has to be done in two steps, which is less than 1% of the time. Then we need to fine -tune our treatment to achieve 20/20. This we include in your fees for the first full year. If a patient chooses not to enhance or fine tune the procedure then contact lenses or glasses can be used. However, since all patients are aiming 20/20 vision, very few would opt out of it.

The LASIK procedure does not have any long term effects from all studies so far done. Any event in your life which would have changed your optics such as getting a cataract in your 50's or a retina problem due to age, diabetes etc. would affect vision. But these events would have happened even if you did not do LASIK. These are events which happen inside the eye, while in LASIK and EpiLASIK we work on the surface.

This has never been faced in our Center. We are very strict about not only our protocols, using complete disposable kits and tight infection control, we also use very sensitive tools which help us screen the candidates thoroughly.

Most of our patients are computer users for many hours. Yes, you will be able to work well. For the first few days you may feel a bit of strain, which will settle. However, to avoid getting a shift in getting any number you will be taught how to sit correctly in front of the PC. There is more about this on our website www.shroffeye.org about Computer Vision Syndrome.

The reasons for numbers ‘coming back’ are many, depending on technology and expertise. Older technology or unsuitable patients for that particular technology may result in having some numbers ‘coming back’ or ‘left behind’. This does not happen with advanced treatments with good expertise, hence we make all our enquiries aware that the results will not be the same in all LASIK centers and hence to research and choose well. In fact, we use specific Top-Link customized treatments for such patients to re treat them. However, other factors like use of a computer indiscriminately or poor visual habits or hereditary factors which affect eye sight are not in our control. If you pose a high risk for any of these, you must discuss the same with the doctor to clarify your specific doubts. Some visual changes in your life would be independent of the LASIK procedure as it could happen in some part of the eye which has no correlation to LASIK, eg Cataract, Retinopathy etc.

Yes, even today the IOL surgery has changed, not so much for the surgery part, but for the implants used. Today we can offer Multifocal lens implants for patients of cataract and even the same for people with glasses over the age of 50 years even if they do not have a cataract. This is called PRELEX or Presbyopis Lens Exchange. The suitability of what is best is usually done by our cornea and refractive surgeon who performs both the procedures. If we have details of your age, numbers you are using the kind of lifestyle you need, we could even discuss this by e mail.

To answer your query of the possibility of undergoing IOL surgery after LASIK....nothing changes, the surgery would be the same. The only point to remember would be to inform your doctor doing the IOL surgery that you had undergone LASIK. This is because the IOL also has a certain power, measured specific to your eye. Today's implants are aiming to not just treat a cataract alone, but also correct the numbers, so the calculation of what implant goes in depends on the measurements taken by the doctor who will need to adjust the same considering you have undergone LASIK. Besides this, the recovery etc remains the same as for anybody else.

Over 40 years of age everyone gets reading glasses, no one is exempt of it. Some people get this 'plus' or 'reading glasses' after 50 years, hence this depends from person to person, different race, heriditary factors etc. But all get it at some point, if this happens after 40 years it is an acceptable natural change in the optics of your eyes, called 'Presbyopia'.

If one has myopia (minus numbers for distance), it helps you push the need for reading glasses behind by a year or so. Hence, if a Myopic who is not using glasses for reading were were to do LASIK today, yes he/she would need reading glasses, depending on when they would have naturally got them.

Now, the reading glasses is something that one can never avoid completely, so eventually it Myopics will need to use bi- focals.

Monovision is an option wherein we correct myopia completely for one eye and leave behind a minor number in the other. It sounds odd, but over time one learns to read the distance with the eye good for far vision and reads near for comfortable print by the eye left behind with a small number. This is accepted by most who wear contact lenses where their optician has given them this monovision trial in their lenses, ie. one lens has the actual number so you read clearly with this and the other lens is slightly undercorrected so you read near with this. Now, when one wants to do extensive near reading it may be a strain. So, we recommend them to use near glasses as per what is required for their age when they are doing near work for a long time.

When we have performed monovision for people who have never undergone the monovision trial, we have found that they are neither happy for far, nor happy for near.

My suggestion to you is to see your optician and get contact lenses which will give you a trial and see how you feel with this for about 2-3 weeks if you plan on monovision.

This will give you an idea of what your vision will be like after LASIK with monovision correction.

Hence, if you are over 40 years of age, most times it helps to learn a bit about your lifestyle and suggest what would be best, after the examination, but it certainly helps you plan better keeping all options of treatment in mind.

LASIK is performed on the cornea which is a superficial part of the eye. The floaters exist in the vitreous (inner part of the eye) and hence no laser surgery on the eye can help the floaters. LASIK can be performed if you have no other indication which deems you unfit. However, one must keep in mind that the floaters may not improve after LASIK and if they worsen, it again has no link to this procedure.