Bladeless, Femto Lasik in Gurgaon

LASIK is currently one of the best method of correction of refractive errors. It is accurate, effective and safe. In LASIK, a very thin (90 to 120 micron) layer of the cornea (the central transparent part of the eye) is raised. Using computer controlled Excimer Laser, (Argon Fluoride 193nm) the cornea is then reshaped into a predetermined curvature. This leads to correction of myopia, hypermetropia, and astigmatism. The procedure is short, simple and being computer controlled is highly accurate.

Yes, you are, if:

• Refractive error is Myopia between -1 to -10 diopter and Hypermetropia up to + 6 diopter

• Astigmatism of up to 6 diopters

• Above 19 years

• Refraction should have been stable for last 1 year

Presence of keratoconus, thin corneas, corneal inflammatory diseases, herpetic keratitis, autoimmune diseases, pregnancy & lactation makes a person unsuitable for LASIK.

In first OPD Visit:

• Refraction under cycloplegia

• Corneal topography-measurement of corneal thickness/ anterior posterior curvature

• Aberrometry Ultrasonic & optical pachymetry (to measure thickness of cornea)

• Detailed tear film & slit lamp examination, Intraocular pressure

• Retina examination

LASIK is performed under eye drops anesthesia, so no injection is required. TeneoLASIK machine has a high speed eye tracker device which constantly monitors the position of the eye and realigns the Laser to the exact position on the eye during treatment . Following are the steps :

1. After putting the eye drops for anaesthesia,. an eyelid speculum is then applied to hold the eyelids and the patient has to look at a blinking green light.

2. A vacuum ring is placed around the cornea, which stabilizes the eyeball and also acts as a platform for the microkeratome. When vacuum is activated, the vision becomes hazy and pressure on the eye is felt.The automated Moria Microkeratome dissects through the superficial layers of the cornea and the corneal flap is folded back.

3. Excimer Laser ablates/reshapes thecornea stromal bed to a desired curvature. What makes the Excimer laser so well-suited for corneal ablation is its ability to remove tissue with accuracy of up to 0.25 micron with each pulse. At this time patient needs to concentrate on the blinking fixation light.

4. The corneal flap is then repositioned, smoothened out and allowed to dry for a few minutes. The flap self-seals without the need of sutures.

5. The whole procedure does not take more then 10mins .

6. Antibiotic and other eye drops are prescribed. The patient is instructed to rest for half an hour with eyes closed after which he is asked to report back the next day.

A typical schedule for LASIK patient is as follows:

• Day 1 - Detailed eye examination in opd

• Day 2 - LASIK Surgery (2-4 hours spent in the centre/ actual procedure on table 10 mins )

• Day 3 - Review opdvisit

• Day 7 - Review opd visit (optional for international patients flying back earlier). Patient may travel between days 3 and 7.

One can get the surgery done after the age of 18 years with stable power of glasses for atleast a year . There is no upper age limit of refractive correction but one has to keep in mind that LASIK is for distance correction. After 45yr of age , the reading number (presbyopia) will persist with routine LASIK. For people above 45yrs of age , who want both correction of distance & near we perform SUPRACOR procedure .This is most suitable for hyperopes with presbyopia.

• Avoid swimming and splashing of water on the eyes for 2 weeks

• Avoid rubbing the eyes for 2 weeks.

• Use sunglasses to avoid bright sun, dust, wind and air pollution for a week

• Avoid excessive viewing of TV or work on computers for 3 days

• Use eye drops regularly as advised

• Consult your eye surgeon in case of any problem

Yes, they are safe and one of the most advanced surgeries in the world.

No surgical procedure exists without any complication,however LASIK is a very safe technique for correction of refractive errors There is very rare possibility of complications like glare, minor over & under correction, decreased contrast sensitivity, epithelial in growth etc. Flap related complications on the table etc.

Results are generally very satisfactory and it has been reported that in carefully selected cases more than 95% achieve unaided visual acuity of 6/9 to 6/6 or better. Its a software generated procedure and acting at micro level on cornea so sometimes rarely there can a minor under or overcorrection but never due to a degree of large error. Also note that there is a subjective difference in the degree of satisfaction among the patients.

PRK is different then LASIK in the way cornea epithelium is removed before excimer laser. In PRK, weremove just epithelium (50 to 60microns) and not lift the corneal flap (90 to100 microns) as in LASIK .This leaves behind greater amount of tissue in the corneal bed and hence used in thinner corneas .Although it is possible to correct greater amount of refractive error ,the recovery is slower than LASIK .

No, the patient does not experience any pain. The procedure is safe and painless and the patient only experiences a slight pressure sensation for few seconds during flap making. The procedure itself is very comfortable for the patient.

The recovery is very fast owing to the simplicity of the procedure. One can resume the normal activities as early as after 24-48 hrs of the surgery with only a few basic eye hygiene precautions.

No, the power never comes back. In few cases there may be remodeling of corneal tissue depending on its elasticity and cause flattening effect on cornea to become less leading to small power coming back again. This is called Regression and happens to a very small number of patients specially in ones the spectacles power was very high to begin with.

No, never. minor issues with this procedure can always be handled well.

The chances of the complications happening are rare but in the event of any such complication occurring, our surgeons are very competent to take care of them.

Yes, the treatment is designed to last a lifetime. Only after theage of 42 to 45 years, does a person require reading glasses. Rarely, the altered shape of cornea (due to its elasticity )starts loosening its effect and few people may get a small amount of spectacles power back and is called regression. This can be corrected by repeating LASIK at any age.

Any LASIK procedure basically has two main steps, first is to create a very thin CORNEAL FLAP (can be created either by blade-microkeratome or bladeless-femtosecond laser) and then treat-ablate the remaining corneal bed by EXCIMER Laser to reshape the cornea in order to nullify spectacles power.

Hence it is only the first step of creating flap which is different in blade and bladeless Lasikthe rest procedure of glasses correction by Excimer Laser is same in both.

FEMTO Laser : A Femtosecond is one millionth of a nanosecond or 10 -15 of a second and is a measurement used in laser technology. The femtosecond laser is used to create flap of cornea with varied specifications, which gives the surgeon more control, precision and increases the SAFETY FACTOR:

• Flap Shape Planar (better then microkeratome flap)

• Good Visual Procedure Control

• Customised: Flap Thickness & Diameter Control – By Computer

• Cut Pattern - Raster/Spiral-happens under direct visualization

• Side cut angle – can be customized to 90 prevents epithelial ingrowth, decreases chances of epithelial folds, allows snug fit of flap on cornea bed.

• The suction ring creates an intraocular pressure (IOP) of approximately 40 mm Hg which is lower then created by microkeratome -60mmHg, hence safer for patients with ocular hypertension or borderline well controlled glaucoma patients.

• The uniform thickness and vertical cleavage plane fits the flap like a manhole cover on stromal bed, minimizing the chance of flap slippage or wrinkling if accidentally rubbed or bumped during healing after surgery.

• If the surgeon encounters a loss of vacuum during flap creation with the femto laser, the flap creation can be repeated immediately with no known adverse affect.

• Because the femto laser software enables the laser to produce flaps with vertical edges, it is more difficult for epithelial cells to migrate down under the flap into the interface since the length of the route for those cells is increased.

Advantages:

1. Reduced incidence of flap complications like buttonholes, free caps, irregular cuts etc.

2. Greater surgeon choice , customization and control over flap diameter and thickness, side cut angle, hinge position and length

3. Increased precision with improved flap safety and better thickness predictability

4. Capability of cutting thinner flaps to accommodate thin corneas and high refractive errors

5. stronger flap adherence, decreased incidence of epithelial ingrowth under flap

6. less increase in IOP so better for ocular hypertension & borderline glaucoma cases.

7. lesser incidence of dry eyes

8. Loss of suction during FS laser LASIK flap creation is easier to handle and the suction ring may be reapplied and treatment resumed immediately in many cases

PATIENTS GAIN CONFIDENCE: The higher degree of comfort and safety, virtually almost no risk of complications, and more predictable outcomes increase patient satisfaction in their experience and outcome. Patient Comfort is good as surgical procedure is fast hence there is no trauma to the eye and patients tend to be very relaxed during the procedure.

However, the technique presents with its unique set of disadvantages and related complications: Opaque bubble layer (OBL) , Transient light sensitivity syndrome (TLSS), Lamellar keratitis , Femto laser flaps are slightly more difficult to lifT in case of retreatment required, increased cost due to added machine cost. Studies have shown FS laser to be safer while the visual and refractive outcomes of FS laser LASIK are equivalent to microkeratome LASIK. Your surgeon will guide you as to which procedure is better for you after examining your eyes.

We are a centre of excellence offering you simple & safe long term solution for various spectacles issue.

• LASIK SUITE has State-of-the-art infrastructure with advanced LASER including Femto bladeless and Supracor options.

• Specially designed operation theatre for maximum sterility

• Comprehensive pre-LASIK screening to assess the fitness criterion of the candidate before the surgery

• Use of advanced corneal topographic system to map detailed architecture of cornea to plan a personalized laser vision correction.

• Single use disposable consumables for high precision, accuracy, sterility and safety of the each patient.

• Highly skilled and experienced surgeons, supported by qualified staff who work in relaxed friendly environment.

• Bladeless Femtosecond LASIK - 95,000 INR for both eyes.

• SUPRACOR (for presbyopia correction>50yrs age)- 85,000/-

• ZYOPTIX -HD Customised LASIK 70,000 INR for both eyes

• Standard LASIK (Proscan) 50,000 INR for both eyes

• Preoperative- scans/investigations : 3500 INR