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    By Dr Harshwardhan Ghorpade

    Laser eye surgery, popularly known as LASIK, began in India during the 1980s. Since then, this treatment has come a long way in which various eye conditions are treated, with the end motive being improving vision quality.

    During LASIK surgery, particular types of lasers are used to change the shape of the cornea. The cornea is a clear window in the front of the eye, comprised of tough and transparent tissue. Besides protecting the eye from dirt, germs, and other particles, the cornea plays a vital role in helping a person to see correctly. Further, when light enters the eye, the shape of the cornea refracts (bends) it, enabling a person to focus on objects that are either close or far away.

    Since LASIK surgeries are less invasive than traditional surgeries, it is apt for the delicate layers of the eye. It is also an effective treatment method for reducing complications and recovery time post-surgery. Further, while many believe that laser surgery is generally used to correct vision problems, it can also help treat other eye-related conditions like cataracts, diabetes-related retinopathy, glaucoma, and cancer.

    How many types of LASIK surgeries are there? Medical professionals use lasers to destroy, remove, or reshape eye tissues to help address specific conditions like those stated above. These surgeries can be conducted either through laser technology or by equipment guided by lasers.

    The following are various types of laser vision correction methods:

    • Femto LASIK: During this procedure, a surgeon uses two different lasers. The first laser opens a flap in the cornea’s surface, while the other helps reshape the cornea. After this, a protective flap is put over the eye, which stays in place without stitches after the surgery.
    • SMILE: In this technique, a surgeon uses a laser to reshape the cornea through a small incision. After the procedure, the incision is sealed.
    • Surface laser treatments (PRK, LASEK, and TransPRK): A surgeon removes the layer of superficial cells covering the cornea before reshaping it. Over some time, the superficial layer grows back naturally.

    Does doctors’ experience matter in LASIK surgeries? The surgeon’s skill is essential since a LASIK procedure requires experienced hands to utilise lasers and effectively modify the corneal tissue.When opting for LASIK surgery, it is essential to consult an eye surgeon with relevant experience and expertise. Since LASIK surgeries cannot be ‘one-size-fits-all’, it is vital that proper consultation is done before any surgery is finalised.

    Take, for instance, the case of Vijay Gupta, a 25-year-old man with extremely high myopia or nearsightedness. He had been diagnosed with a very high myopia number of minus 18. Due to this, he had been rejected by multiple centres for laser vision correction and was not considered a suitable candidate for lens-based surgery. However, due to the latest technological advancements, he was clinically assessed again, after which he underwent the latest TransPRK procedure.

    Since these procedures are done on state-of-the-art laser machines by expert technicians and surgeons who, through technical planning, arrived at the type of treatment to be done, the operation was highly successful. After the surgery, the patient could see clearly without glasses for the first time.

    What kind of equipment is used in TransPRK eye surgery? In typical cases, a solid-state laser is used to conduct TransPRK surgeries. These machines do not produce damaging heat, which helps ensure faster recovery and minimal complications. Further, they have quite a few benefits over traditional laser equipment, including the following:

    • Since TransPRK is a flapless all-laser procedure, it is much safer as there are no chances of intra-operative flap complications or late flap dislocations.
    • These procedures do not require any surgical instrument (microkeratome blade, etc) to touch the eye other than the laser touching the eye.
    • No high-pressure suction is used to stabilise the eye as there are no chances of subconjunctival haemorrhage or severe complications like retinal detachment.
    • These surgeries reduce corneal damage as nearly 90 to 160 microns of corneal tissue that would have been lost to the flap can now be avoided. It also means this procedure can be safely used in patients with thin corneas and high errors.

    The biomechanical stability of the cornea is very high compared to other procedures. As a result, patients can play contact sports like rugby and boxing once their recovery is completed. Since TransPRK is a topography-guided procedure with enhanced transition zones, it also ensures that patients have good night vision.

    Conclusion: Everyone is not a candidate for eye surgery; with time, eyesight worsens, even after successful surgery. Whether a person should choose to have eye surgery is a decision best taken after consultation with an eye surgeon, as each condition/situation of a patient can vary greatly.

    Dr Harshwardhan Ghorpade, Cornea, Cataract & Refractive Surgeon, Hiranandani Hospital, Vashi-A Fortis Network Hospital

    (DISCLAIMER: The views expressed are solely of the author and does not necessarily subscribe to it. shall not be responsible for any damage caused to any person/organisation directly or indirectly).

    • Published On Dec 3, 2023 at 03:24 PM IST

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