Q Risk or corneal scarring is more in epi lasik… (1-2%) as compared to less than 1% in lasik (flap surgery).Just needed an understanding of this.?
Ans. In fact not at all, as what is treated in LASIK is by making a ‘cut’ or ‘flap’ in the thickness of the cornea. In EpiLASIK there is no ‘cut’ on the eye. Corneal Haze is not seen in our centre, but also only possible in EpiLASIK if one has not used the eye drops as prescribed (as these need to be used for 12 weeks).
Q Patients with pupil diameter of more than 6.0 mm should be informed of the significant risk of night vision disturbances after epiLASIK. Generally, these symptoms abate over time. Just needed an understanding of this.
Ans. An important point to understand night vision issues. This is independent of LASIK and EpiLASIK but is more to do with the capabilities of the laser system. In our experience with the laser technology we use, we have never faced permanent night vision problem. In our practice, till date we have not seen glares, haloes etc. This also depends on one test which checks your pupil size dynamically in light and dark, which is part of your evaluation process with us. In fact our laser is one of the best for re correcting such issues of older lasers with Topolink treatments
Q Results are generally not as good in patients with very large refractive errors of any type. You should discuss your expectations with your doctor and realize that you may still require glasses or contacts after the surgery.
Ans. Again, this is to do with the laser being used. The Concerto Laser that we are using, has capabilities of treating powers as high as -12.00D to -14.00 D, and also the advantage of corneal savings. So, we can still treat some patients more safely than other lasers can.
Q For some farsighted patients, results may diminish with age. If you are farsighted, the level of improved vision you experience after surgery may decrease with age. This can occur if your manifest refraction (a vision exam with lenses before dilating drops) is very different from your cycloplegic refraction (a vision exam with lenses after dilating drops)
Ans. Excellent point, as this is what I mean by the doctor’s experience and processes in place. Dr Anand Shroff does all checks himself and fo him it is not just important that your power will be treated and that you become 20/20. He wants you to be 20/happy! Which is why he does the refraction himself with and without dilation and also one of the only doctors to apply wavefront guided technology by using the aberrometer which most centres do not have.
Q Long-term data is not available. LASIK is a relatively new technology. The first laser was approved for LASIK eye surgery in 1998. Therefore, the long-term safety and effectiveness of LASIK surgery is not known.
Ans. LASIK has been around since about 20 years in clinical practice. It was under clinical trials for long before this. Any effects on the cornea and the eye have been studied in great depth. With us, Dr Shroff would not do any procedure on healthy eyes unless he was sure of its effects. EpiLASIK is just a modification in the initial steps of LASIK using a special disposable kit, the laser used to treat the powers remains the same.
Ans. The anesthesia is in the form of ‘numbing eye drops’. There is no injection or any other form like general anesthesia for which you need to modify your meal timings. Please eat a full breakfast in the morning but keep about an hour’s gap between its times with the procedure timing.
Ans. EpiLASIK is a superficial eye procedure. The laser does not enter the eyes. So, any age related changes or eye issues related to diabetes/ blood pressure, which may arise later in life will continue to do so, whether you do LASIK/ EpiLASIK, use glasses or lenses. However, today’s cataract procedures are also helped by using lenses which give you benefit for near and far vision. Hence, all you need to do is inform the treating doctor regarding the history of having undergone LASIK/ EpiLASIK and the doctor will use the appropriate formula to order your lens..
Q Will I have normal vision/ 20-20 vision post surgery? Chances of retreatment/ touch-up. i.e. if there is any residual correction to be undertaken, is that included in the package? Also what is the probability of the same to occur?
Ans. That is our aim too! And as long as you are enjoying 20/20 vision today with glasses or lenses, you can expect to have no compromise in that. In rare cases (usually higher powers and that too less than 1 of 300 patients) we need to fine tune the procedure in a second step which is called enhancement or re treatment. This rate is less than 0.4% in our centre. In the first year this is included in your fees as it would be directly related to the primary treatment. Later in life a change in prescription may only happen if you are a serious computer user and for this we advise you to wear computer prescription glasses which Dr Shroff will be prescribing post procedure..
Q Are Epi-LASIK surgeries also commonly performed at the hospital vis a vis a ‘normal’ lasik operation. Apart from the longer rest period, an epi-LASIK generally safer right?
Ans. Yes, EpiLASIK makes an already safe treatment like LASIK much safer. However, due to the recovery period being more uncomfortable and longer by 4 days, eye drops also need to be used diligently for 3 months, besides this the visual recovery remains similar. So, due to patients compliance, you find more patients opting for LASIK, but this is also changing as people are getting more aware and eager to know the exact details of technology and techniques.
Q The 4 days rest period post-the surgery? Discomfort/vision level, the general movement i am allowed, etc. Time frame I will have to be off work? (Can I after about 5-7 days go to my sites, im an architect/interior designer by profession), etc?
Ans. Yes, usually the rough days are Day 1 and 2 where we do not expect you to feel like doing anything related to work. However, after that its easier and by the end of the week you feel normal to resume full work, visit sites/ offices etc. Only activity we ask you to avoid for 7 days is driving.
Ans. Cash or credit card (there is no surcharge). If cheque payments are made, then they need to be cleared a few days before the procedure date.
Ans. Usually, the data taken is valid for 3 months; however we always check your records with Dr Anand Shroff and revert back if he wants to see you once again.
Q Post surgery, when can I resume activities like swimming? & if I need to take a flight- long/short distance, does it effect the complete recovery period, which is said to be a few weeks/months
Ans. You may resume swimming in about 3 weeks time, also taking care to use swimming goggles when doing underwater laps. Some of our patients have flown on Day 4 after EpiLASIK. The flight itself is not the issue, we only ask them to use the lubricating eye drops more often on long flights in case of a ‘dry eye’ feeling.As long as the prescribed drops and instructions are followed, you may fly out in the first week itself.