Refractive Surgery Services
A brief explanation of the eye may be of assistance in understanding the procedure. The cornea is a clear tissue located on the front of the eye. The cornea, in combination with the natural lens of the eye, focuses the incoming light onto the retina in the back of the eye. Refractive errors (myopia, hyperopia, and astigmatism) usually result from a disparity in the shape of the cornea in relationship to the length of the eye.
Emmetropia is the condition of the normal eye when parallel rays are focused exactly on the retina and vision is perfect.
AMMETROPIA- Refractive error
When light doesn't focus directly on the retina, the eye has a refractive error and will cause blurred vision. The appropriate corrective lenses are used in front of eye, to focus incoming rays on the retina, which will give clear vision.
Types of Refractive errors:
Myopia or Nearsightedness:
Myopia is caused either by an abnormally long eye or by a steep curvature to the cornea. Light entering the eye does not focus on the retina, but instead focuses the image to a point in front of the retina. The result of myopia is that distant objects appear blurry, while objects near to the viewer may be seen in focus.
Concave glass is used to focus them on retina.
The Excimer laser can flatten the corneal curvature allowing objects to be in focus in the distance.
Hyperopia or Hypermetropia or Farsightedness:
Farsightedness is caused by an abnormally short eye or by an excessively flat cornea. Light entering the eye focuses the image to a point behind the retina. The result of hyperopia is that objects near to the viewer appear blurry while objects in the distance may or may not be seen in focus. Convex glass is used to focus them on retina.
The Excimer laser can increase the corneal curvature(steepening) allowing objects to be in focus in the distance.
In the normal eye, the cornea is curved the same in the horizontal and vertical directions, like a baseball. When light rays hit the cornea, they focus at a single point.
In astigmatism, the curve of the cornea is not the same in the horizontal and vertical directions. The cornea looks like a football, with a steep curve on one side and a flat surface on the other. As a result, light rays entering the cornea do not focus at a single point, causing distorted vision.
Most people with myopia or hyperopia have some degree of astigmatism.
The Excimer laser can adjust the corneal curvatures allowing objects to be in focus.
Normally, when viewing a near object, the shape of the natural crystalline lens is altered. This change in the lens allows us to focus on the object closer to eye. As we age, the natural crystalline lens of the eye may lose some of its elasticity and thereby its ability to focus on close objects. This condition, known as presbyopia, usually begins around the age of 40 and will keep on progressing till you become 60 years of age. Generally, reading glasses are prescribed to correct Presbyopia.
Supracor or Intracor procedure can help you reading without glasses.
Vision problems resulting from refractive errors (myopia, hyperopia, and astigmatism) may be corrected with either eyeglasses or contact lenses. A description of the available surgical procedures is listed below.
Laser In-situ Keratomileusis (LASIK)
Laser In-Situ Keratomileusis or LASIK, which is a permanent vision correction procedure, is available for treatment of mild to moderate amounts of myopia, hyperopia, and astigmatism.
LASIK surgery can be performed by using blade (Microkeratome) or 100% bladefree (Femtosecond/Intralase laser)
At Jeevan Jyoti Netralaya, LASIK(All lasers) is performed by using two different lasers to treat myopia, hyperopia, and/or astigmatism. The first laser (a femtosecond laser) creates a flap about one fifth of the corneal thickness within the cornea. This flap remains attached on one side-hinge. The femtosecond laser flap is a very safe accurate way to lift the flap. The flap can also be created with a mechanical blade-Microkeratome instead of a laser. The flap is lifted and folded back by the surgeon and then a second laser (an Excimer laser) removes ultrathin layers from corneal stroma to alter the curvature of the cornea. Following laser ablation, the flap is laid back in place.
Photorefractive Keratectomy (PRK)-Surface Ablation
PRK or Surface ablation is another way to correct refractive error. Like LASIK, PRK uses an excimer laser to reshape the cornea. In PRK, the surface of the cornea is treated rather than creating a corneal flap. Here we remove first layer of cornea (epithelium) and then an Excimer laser removes ultrathin layers from corneal stroma to alter the curvature of the cornea.
PRK is available for treatment of mild or low amounts of myopia, hyperopia, and astigmatism. The final visual result with PRK is similar to LASIK; however, due to the need for the corneal surface to heal, the visual recovery is usually slower than with LASIK.
INTACS is available for the treatment of mild amounts of myopia (1-3 diopters). INTACS consist of two small, transparent crescents (arcs), each having an arc length of 150 degrees. The segments are made out of clear medical plastic. This material has been used in the intraocular lenses used to for cataract surgery for nearly 50 years. Different sizes of INTACS are used for different levels of myopia. Unlike LASIK, INTACS segments may be removed. Scientific studies have demonstrated that removal of the INTACS segments usually returns the patient's eye to their pre-operative state; however, a small number of patients may still describe a persistence of visual symptoms.
Refractive Lens Exchange-RLE
RLE is available for the treatment of moderate and high levels of myopia and hyperopia. In these procedures, an ultrasonic device is used to remove the natural crystalline lens. An intraocular lens (IOL or "implant") is inserted. The intraocular lens power can be calculated so that once implanted; it can reduce or eliminate the eye's refractive error.
Phakic Intraocular Lens Insertion or ICL- Implantable Collamer Lens
ICL/IPL is available for the treatment of moderate and high myopia.
In this procedure, an intraocular lens is inserted into the eye. The intraocular lens works to compliment the natural crystalline lens to allow for improved distance vision.
Contact lenses can change or distort the shape of the cornea. Before having a comprehensive eye exam for the LASIK procedure, the cornea must be allowed to return to its natural shape. If you wear gas permeable or hard contact lenses, you must discontinue wearing the lenses at least 2-3 weeks for every decade of wear prior to the comprehensive eye exam. For example, if you have worn hard lenses for 20 years, they need to be out for 4-6 weeks (2-3 wks x 2 decades of wear). Our staff may recommend a longer time period depending upon the length of time that you have worn rigid lenses. Patients who wear daily wear soft contact lenses must stop wearing their lenses at least 7 days prior to the examination. For toric soft contact lenses (correct astigmatism), the lenses must be out for 2 weeks. You must confirm compliance with these requirements prior to undergoing LASIK. The period required to stabilize the natural shape of the cornea may be longer for some patients. You should tell your surgeon and eye care provider if you suspect that your vision is continuing to fluctuate as your eye returns to its normal shape following removal of your contact lenses.
The LASIK Procedure
During the pre-operative evaluation, a comprehensive evaluation of your eyes will be performed. Your eyes are measured and mapped, and the information is reviewed to detect and isolate any irregularities in the shape of the cornea.
Types of Lasik:-
It only treats your lower-order aberrations and induces further vision errors, known as spherical aberrations during the procedure, which can lead to potentially poor quality of vision after LASIK.
It is able to treat both your lower and higher order aberrations but it can induce spherical aberrations during the procedure, possibly causing symptoms like glare and halos after LASIK.
LASIK FAQ AND QUESTIONS
How do I know if I'm a candidate for Laser Vision Correction?
This is the most asked LASIK question. We recommend you come in for a free evaluation with our refractive counselor. Our refractive counselor and staff will discuss your particular situation and help determine if you are a good candidate for laser vision correction. At jeevan jyoti netralya, our goal is to provide you the best eye care and best technology procedure that is right for you.
What is the difference between RK and LASIK Laser Vision Correction?
RK and LASIK Laser Vision Correction are procedures to correct refractive error by reshaping the cornea to allow light rays to properly focus on the retina. RK requires the use of a diamond blade to create radial incisions on the surface of the cornea. With LASIK, Drs at jeevan jyoti netralya. reshape the cornea using cool waves of ultraviolet light that gently sculpt away nearsightedness, farsightedness and astigmatism with microscopic precision using the VISX Star Excimer Laser.
What is the difference between PRK and LASIK?
PRK was the first Excimer laser procedure approved for use in the United States. With PRK, the surface of the cornea (epithelium) is scraped or ablated along with the corneal tissue underneath. This sculpting removes microscopic layers of the cornea to correct refractive error. In contrast, LASIK reshapes the inner layers of the cornea to correct nearsightedness, farsightedness and astigmatism. A special instrument called the microkeratome gently folds back and lifts a thin layer of the cornea . The laser then precisely reshapes the inner surface of the cornea to enable light rays to focus more directly on the retina so images are in better focus. LASIK is the most widely used refractive procedure performed in the United States. Because the corneal surface is left virtually intact, most patients report a very high comfort level following the procedure and almost instantaneous improvements in visual acuity.
Are all patients who wear glasses and contacts candidates for LASIK?
Most patients who wear glasses are good candidates for LASIK. Patients with virtually every degree of nearsightedness are enjoying good outcomes with LASIK. We are able to treat mild to moderate degrees of nearsightedness, farsightedness and astigmatism. For more extreme nearsightedness and farsightedness, lens implants may be an option. Our counselor will discuss this procedure with you during your free evaluation.
How long have your doctors been performing refractive surgery?
jeevan jyoti netralya Drs are among the top refractive surgeons in the country . Refractive procedures have been available at jeevan jyoti netralya since 2006. Combined, our surgeons have performed nearly 1000 LASIK procedures for patients from across the country.
As recognized leaders in refractive surgery, our surgeons are involved in laser technology research and continue to be clinical investigators for advanced Laser Vision Correction procedures.
What kind of laser do you use?
Investing in the most advanced technology is part of jeevan jyoti netralya commitment to provide our patients with the highest level of patient care. That's why we were among the first to purchase the new VISX STAR S4 ActiveTrak Excimer Laser System that incorporates an active eye tracking system, in addition to many other benefits.
How long will the procedure actually take?
You will be at jeevan jyoti netralya approximately two hours. The time in the surgery suite with the doctor is 15 to 20 minutes. The actual laser treatment time is approximately one minute per eye.
Is the laser painful?
The procedure itself is not painful since medication is administered to make you feel comfortable. Post operatively, most patients experience little or no discomfort. After the procedure, your eyes may feel scratchy, gritty, or watery. These are temporary symptoms and are not a problem for most patients.
What kind of vision can I expect the day after surgery?
Many patients notice improved vision immediately after the procedure. Most patients are functional without their corrective lenses at the one day post operative exam. Patients continue to see a gradual increase in their visual acuity during the first five to seven days after the procedure.
Do you have financing plans?
There are various financing plans available, and we'll work with you to develop a flexible payment plan to meet your requirements. Our counselors will be happy to go over the details with you when you come in for your free evaluation.
Does insurance cover refractive surgery?
Most insurance companies consider refractive surgery an elective surgery and it is not usually a covered benefit. However, it is certainly worth checking with your insurance company and we encourage you to call them.
Can both eyes be done at the same time?
Because of the advanced technology associated with Laser Vision Correction, both eyes are most often treated at the same time. It is possible that the second eye may be done anywhere from one day to a few days to months after the first eye. This can be discussed with your eye doctor.
Do the results last?
Refractive surgery, or Laser Vision Correction, is considered to be a permanent procedure. However, refractive surgery will not prevent any age related conditions such as presbyopia or cataracts, and they would be treated in their normal matter.
How much work will I miss?
Most patients return to their normal activities the day after the procedure. The refractive counselor can give you more details on what you can expect when you come in for an evaluation.
What are the risks of refractive surgery?
One of the most important LASIK questions. Again, the counselor can discuss with you the benefits, risks, and side-effects of the surgery, and what you may be able to expect from the procedure.