For over 25 years doctors placed incisions in the cornea to
treat nearsightedness, farsightedness, and astigmatism. In
the early 1980’s, they began looking at lasers to improve
the precision and predictability of altering the shape of
the cornea.
Researchers found that the Eximer laser could remove tissue
with up to 0.25 microns of accuracy. Now, in its second decade
of use, the technologically advanced Eximer laser has added
a tremendous amount of precision, control and safety to the
surgical correction of vision errors. Using this remarkable
technology, the cornea is reshaped to conform to your glasses
or contact lenses’s prescription, thereby reducing or
even eliminating a lifetime of dependence on corrective lenses
for hundreds of thousands of people every year. Mediscapes’s
ophthalmologists use the latest generation lasers
and all of them have performed thousands of Lasik procedures.
Lasik, or Laser in-Situ Keratomileusis, offers a number of
benefits because it is performed under a protective layer
of corneal tissue. As a result, there is less surface area
to heal, less risk of scarring, less risk of corneal haze,
less postoperative discomfort, less postoperative need for
medications, and vision returns more rapidly, often within
a day or so. Lasik can treat a high range of vision errors.
Although postoperative results vary, most patients are able
to pass a drivers license test without their glasses or contact
lenses. This procedure is very successful and has been described
as "magic" for the patient and the surgeon.
The results of Lasik are as follows: For prescriptions of
up to –6.00 diopters, 98% of patients fall within 1
diopter of normal (emmetropia or 0 diopters). For prescriptions
of –6.00 to –10.00 diopters, 94% of patients fall
within 1 diopter of normal, and for prescriptions above –10.00
diopters, 40-50% of patients fall within 1 diopter of normal.
Although Lasik can usually be performed for prescriptions
above –10.00 diopters, contact lens implants are often
the preferred procedure of refractive surgery, because it
gives better results. These are just general guidelines as
your surgeon will determine just how effective Lasik will
be for you. South African Lasik practitioners are amongst
the best in the world.
Zyoptix is a new excimer laser technology, where a personal
and unique laser vision correction is designed for each individual
eye. Up till now, a –2.00 diopter treatment for 2 different
people, has been the same. But no 2 people’s corneal
curvatures and aberrations are exactly the same, and with
Zyoptix this uniqueness is taken into account when designing
a personalized laser pattern. It therefore makes sense that
better results are expected for each individual with this
program, especially for those with irregular astigmatism.
Special equipment, namely Aberrometry is used to measure
the unique aberrations of each eye. This information, together
with other specialized tests like the Orbscan II corneal topography
is then used to calculate and design the individual laser
pattern.
Advantages of Zyoptix include fewer problems with night driving,
less chance for revisions, and less cornea has to be lasered
for the desired effect.
Who may have LASIK?
- People who are nearsighted, farsighted or astigmatic
- People of 18 years or older
- People whose prescription has been stable (without significant
changes) for at least 12 months
- People who have had previous RK (Radial Keratotomy) and
who have not attained their desired results are also possible
candidates for Lasik
The decision to have Lasik is an important one that ultimately,
only you can make. It is important that you have realistic
expectations and that your decision is based on facts, not
hopes or misconceptions. The goal of Lasik is to reduce your
dependence on corrective lenses. Lasik does not always create
20/20 vision, and results cannot be guaranteed.
It cannot correct a condition known as presbyopia, or aging
of the eye. Presbyopia is a normal age related change in the
eye that starts around the age of 45, and affects everyone.
It causes difficulty focusing close-up and requires reading
glasses. Monovision, where the dominant eye is fully corrected
for distance vision and the non-dominant eye is undercorrected
for near vision, is an option, which will reduce your dependence
on reading glasses. People who are normal sighted in the distance
but are presbyopic, may wish to have one eye done to make
it moderately nearsighted so they are able to read with that
eye.
Who is not suitable for LASIK?
Patients with the following conditions, or using the following
medications, are not suitable for Lasik:
The procedure
First a basic evaluation is done. Depending upon the surgeon,
there will be one or two comprehensive evaluations (including
a medical check-up from our in–house physician). These
may include watching a short explanatory video, the recording
of patient history, measurement of visual acuities, autorefraction,
keratometry, tonometry, corneal topography and pachymetry,
manifest refraction and cycloplegic refraction. Then the surgeon
will do a final assessment for suitability for Lasik, although
in the majority of cases your suitability will have been determined
before your arrival in Cape Town.
A Mediscapes staff member and a driver will accompany you
for the first evaluation appointments, because your pupils
will be dilated and your vision will therefore be blurred
for ± 8 hours.
If you wear contact lenses, they must be removed before the
first evaluations and not be worn even for a few hours* for
the following periods of time:
- Disposable soft contact lenses: at least 3 days
- Permanent soft contact lenses: 2 weeks
- Hard / RGP contact lenses: at least 3 weeks
*Contact lens wear causes swelling of the cornea, which will
give inaccurate test results.
If both eyes need surgery, they are usually done on the same
day, unless the surgeon chooses to do them separately.
There are no restrictions on eating, drinking or medications
before surgery. Alcohol and medications that may cause drowsiness
should be avoided. No eye make-up is permitted on the day
of surgery. Wear comfortable clothing. Keep in mind that the
operating theatres are air conditioned, and it is therefore
advisable to bring a long sleeved top.
You will be given a specific admission time, and you will
be at the clinic for ± 3 hours and a Mediscapes Staff
member and driver will accompany you.
Eye drops will be administered one hour before the procedure
time. These will include drops to anaesthetize the eye, to
prevent infection (antibiotic) and to reduce light sensitivity.
It is very rare to have a reaction to any of these eye drops.
After your eyes have been completely numbed using the eye
drops, you will be taken into theatre. You will lie on the
patient bed and have your untreated eye covered. The bed is
then adjusted to align your eye with the aiming system. Here
an eyelid holder/speculum will be placed between your eyelids
to prevent you from blinking. This is painless.
The surgeon will talk you through each step of the procedure.
He will mark the area where the surgery will be performed
with a circular zone marker.
Next, an instrument known as a microkeratome makes a protective
flap in the superficial cornea. During this procedure you
may feel some pressure on the eye, but no pain. The flap is
then lifted and you will be asked to look directly at a target
light. Although the laser is equipped with an eye tracker
to compensate for slight movement of the eye, it is very important
to keep the eye absolutely still during this time.
The laser is a cool ultraviolet laser, which is non-thermal.
There is no burning. The laser makes a clicking or snapping
sound and produces debris, which has an unpleasant smell.
The laser is performed in a few small steps, each taking 5
to 20 seconds. This technique helps provide a better contour
for the cornea. The total time taken to complete most surgical
procedures is less than 30 seconds of laser per eye.
After the laser has been completed, the flap is placed back
into position where it bonds securely without the need for
stitches. Now the eyelid speculum will be removed. The laser
will now be reset for your other eye, and the whole procedure
is repeated on your other eye.
The total time spent in theatre is ± 20 minutes.
You will spend some time in the recovery room after which
you can go home.
After the procedure
Follow-up appointments will be made for 1 day, and 1 week
after the procedure. After these follow-up visits, the surgeon
wants to see you once a year for a peripheral retinal examination
or will refer you or revert back to your own specialist for
appropriate follow-up intervals. You should plan on staying
in Cape Town for 10 days if you are considering Lasik.
You will be off work for 3 days after the procedure. If you
need an illness certificate for work, please ask the surgeon
for one.
You will be given eye drops to use after surgery to prevent
infection and to reduce swelling of the cornea. Instructions
on how to use these drops will be given on the day of surgery.
Although most people don’t experience any postoperative
pain other than slight discomfort, you will also be given
painkillers to use should it be necessary.
The most important thing is not to rub, touch, bump or to
have any pressure on the eye after surgery. You will be given
plastic eye shields/covers, which must be placed over the
eyes before you go to sleep at night, to prevent accidental
rubbing or pressure. Sleep with these shields for at least
one week. You will also be given a Solarshield, which you
must wear for 6 weeks after surgery whenever you go outside
into bright sunlight.
What you may experience
- Your vision will be a bit blurry for the first few days
and you may experience some difficulty with reading
- You may feel that your eyes get tired more quickly during
the first week or two, especially after prolonged close-up
work like reading or computer work
- You will experience some light sensitivity and your eyes
may tear more than normal
- You may experience some problems with night glare and
halo’s around lights
- Your eyes may feel a bit scratchy and dry during the first
few days
- Your vision may fluctuate during the first few weeks
- Visual recovery is rapid and relatively painless
All of the above mentioned symptoms are normal and any discomfort
you have will become less each day as the eyes heal.
Possible side effects and complications
- Postoperative pain may occur in some individuals. Take
the painkillers as prescribed.
- A few patients will report poor night vision, but this
is unusual especially with the latest generation lasers.
- As with all surgical procedures there is always a possibility
of infection, although the chances are very slim. If you
should get an infection in the eye, it will be treated with
additional eye drops.
- With LASIK, as with all other refractive surgery procedures,
there is a possibility that the desired refractive outcome
is not attained, leaving you with the need for repeat lasik
or corrective lenses. Results thus cannot be guaranteed.
If your eye/s show a yellow discharge or if you experience
severe pain or reduction in vision, contact the surgeon or
Mediscapes staff immediately.
For further information contact Mediscapes
or
visit
www.lasikinamerica.com
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