LASIK: Is it for me?

Laser in situ keratomileusis or LASIK in short, is the most widely performed laser refractive surgery worldwide. While millions have benefited from LASIK and the good vision that comes with the procedure, there are many still waiting at the sidelines. I have many patients asking me this question in my practice. The best way to answer this question is to have a good understanding of this procedure; what it is, how it is done, what the options are, how I would know I am suitable, what I can get out of it.

What is LASIK?

LASIK has opened up new horizons in the correction of refractive errors such as myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism. This procedure uses a precise, cool ultraviolet beam (excimer laser) to re-shape your cornea so that it can better focus light into the eye thus giving good clear vision without the need of spectacles or contact lenses.

How is it done?

LASIK is an outpatient office procedure lasting about 10 minutes. There are three main steps in LASIK. Firstly, a thin flap of corneal tissue is created with a specialised instrument. This corneal flap is folded to the side thereby exposing the bed of the cornea. Next, the laser is applied accurately at pre-determined spots and depth to re-shape the cornea. This is assisted by a highly efficient eye tracker that monitors the slightest eye movement to ensure maximum accuracy. Lastly, the corneal flap is re-positioned and left to heal. No sutures are needed. 

What are the options?

Blade versus Bladeless (All-Laser LASIK)

There are 2 methods of creating the corneal flap. The first method involves a hand-held mechanical microkeratome that uses an oscillating blade to make the cut. While it is very safe, it is sometimes associated with problems such as irregular or incomplete cut.

The second method uses a computer guided femtosecond laser (Intralase®) that delivers micron-level accuracy to create the flap. With this laser, one can create a corneal flap of exact diameter, depth, hinge location, centration and overall architecture. This method is particularly useful to those with thin or excessively flat or steep corneas.

Customised Wavefront LASIK

Unlike standard LASIK, Wavefront LASIK uses 3-dimensional measurements of how your eye processes an image to create an exact laser pattern for you. Everyone has unique minor optical imperfections. Wavefront technology detects these imperfections and customises the laser to treat them in addition to treating regular refractive errors.

Tissue-saving LASIK

In order for the laser to re-shape your cornea, one of the pre-requisites is sufficient corneal thickness. A cornea that is rendered too thin after LASIK can be unstable. Tissue-saving LASIK can correct the same amount of refractive errors by removing 15 percent less tissue compared to standard LASIK. This allows refractive surgeons to perform LASIK on those with relatively high refractive errors and thin corneas.

Aspheric LASIK

In conventional LASIK, the centre part of the cornea is flattened at the end of the procedure. Aspheric LASIK, a very new technology, is specially designed to retain the original curved shape of the cornea. This will translate to better vision and less glare and haloes at night for patients with high myopia.    

How do I know I am suitable?

Before you can have LASIK surgery, you must go thru a series of investigations and eye examinations to ensure that your eyes are healthy and suitable for the procedure. If you are using contact lenses, you will be instructed to discontinue usage for 1 to 2 weeks. If you are found to be suitable, your surgeon will explore the various options and advise you on the best method to treat your eyes

What can I get out of LASIK?

The main goal of LASIK is to reduce your dependency on spectacles or contact lenses. It does not always guarantee perfect vision. However, many do go on to obtain perfect 20/20 vision. LASIK is associated with a high level of satisfaction which accounts for its popularity.

In short, LASIK is a safe, efficacious, and predictable form of laser vision correction. It is a viable alternative for those who want to have good vision but do not want the inconvenience or hassle of spectacles and contact lenses.