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Enhancing LASIK Safety and Precision: Innovations, Corneal Dynamics and Informed Decision-Making for Optimal Outcomes

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Dr. Ajay Sharma with the vision and mission of giving eye care to all including the common man at affordable cost and at the level of tier II, tier III & IV cities started a chain of Eye hospital. He has made significant contributions to the field of ophthalmology in India over the course of his 25-year career. He obtained his MBBS degree in 1990 and his Master of Surgery in Ophthalmology in 1994 from PGIMS, Rohtak. In 1995, he served as a Senior Resident at Safdarjung Hospital in New Delhi.

In conversation with Charulatha, Correspondent, Siliconindia magazine, Ajay expressed his perspectives on the technological advancements in LASIK over the years that have enhanced its results and heightened patient satisfaction.

1) How do surgeons ensure the safety and accuracy of LASIK procedures, particularly in terms of minimizing side effects and complications?
Surgeons take several measures to ensure the safety and accuracy of LASIK procedures. They conduct thorough pre-operative assessments to determine a patient's suitability, considering factors like corneal thickness and overall eye health. Advanced diagnostic technologies, such as Pentacam and wave front analysis, help create detailed maps of the eye for precise customization.

During surgery, eye-tracking systems are often used to account for any involuntary eye movements, enhancing accuracy. Additionally, femtosecond lasers are employed for flap creation, reducing the risk of complications associated with traditional microkeratomes.

SILK (Smooth Incision Lenticular Keratomileusis) is a latest technology by Jhonson & Jhonson which is performed by ELITA machine. It is a bladeless and flapless procedure which removes power by extracting a lenticule from the corneal layer. It is highly advanced, safe and accurate procedure.

Post-operative care involves monitoring and prescribing medications to minimize inflammation and prevent infection. Regular follow-up appointments allow surgeons to address any concerns promptly, contributing to overall safety and reducing the risk of complications.

Femtosecond lasers are now commonly used for both flap creation and corneal reshaping, reducing the risk of complications associated with traditional methods


2) What advancements or technological innovations have been made in LASIK over the years that have improved its outcomes and patient satisfaction?
Advancements in LASIK technology have significantly improved outcomes and patient satisfaction over the years. Some key innovations include:

1.Wave front Technology: This allows for a more personalized treatment by mapping the unique characteristics of each person's eye, leading to better visual outcomes.

2. Bladeless LASIK: Femtosecond lasers are now commonly used for both flap creation and corneal reshaping, reducing the risk of complications associated with traditional methods. These high-precision lasers replace the traditional microkeratome blade, enhancing the precision of flap creation during the procedure.

3. SILK procedure: SILK (Smooth Incision Lenticular Keratomileusis) is a latest technology by Jhonson & Jhonson which is performed by ELITA machine. It is a bladeless and flapless procedure which removes power by extracting a lenticule from the corneal layer. It is highly advanced, safe and accurate procedure.

These technological innovations collectively contribute to safer, more precise, and individualized LASIK procedures, resulting in improved patient satisfaction and faster recovery.

3)How does the cornea play a crucial role in the success of LASIK, and what changes occur during the procedure to correct vision?
The cornea plays a crucial role in the success of LASIK (Laser-Assisted In Situ Keratomileusis) as it is the transparent front part of the eye that focuses light onto the retina. During LASIK, the cornea's shape is altered to correct refractive errors such as near sightedness, farsightedness, and astigmatism.

Here's a simplified overview of the LASIK procedure and the changes that occur to correct vision:
1.Flap Creation: A thin flap is created on the cornea's surface using a microkeratome blade or a femtosecond laser. This flap is lifted to expose the underlying corneal tissue.

2.Corneal Reshaping: An excimer laser is then used to precisely remove microscopic amounts of corneal tissue based on the patient's refractive error. For myopia, tissue is removed from the center and for astigmatism, tissue is removed in specific areas to reshape the cornea.

3.Customization: Advanced LASIK procedures often incorporate wave front technology or corneal topography to create a personalized treatment plan, addressing individual variations in the eye's optical system.

4.Laser Accuracy: The excimer laser used in LASIK is known for its precision. It can reshape the cornea with accuracy down to fractions of a micron, allowing for highly customized vision correction.

5.Flap Repostioning:After the corneal reshaping is complete, the corneal flap is carefully repositioned. The natural suction of the cornea helps the flap adhere without the need for stitches.

By altering the shape of the cornea, LASIK aims to improve the eye's ability to focus light directly onto the retina, thus reducing or eliminating the need for glasses or contact lenses. The success of LASIK is dependent on factors like accurate preoperative measurements, precise laser technology, and proper healing of the corneal tissue. Patient selection, thorough preoperative evaluations, and adherence to postoperative care are also critical for successful outcomes.

"During surgery, eye-tracking systems are often used to account for any involuntary eye movements, enhancing accuracy"

4) What are the potential risks and complications associated with LASIK, and how are these risks mitigated during the procedure and recovery process?
LASIK (Laser-Assisted in Situ Keratomileusis) is a widely performed eye surgery to correct vision problems. While it's generally safe, there are potential risks and complications. Some include:

1.Dry Eyes: LASIK can cause temporary or persistent dry eyes. Artificial tears and other measures are often recommended to manage this.

2.Visual Disturbances: Some people may experience halos, glare, or double vision, especially at night. These usually improve over time.

3.Under-correction or Overcorrection: The surgery may not correct vision as intended, leading to the need for further procedures or continued use of glasses/contact lenses.

4.Infection: Though rare, there is a risk of infection after LASIK. Strict hygiene protocols are in place to minimize this risk.

5.Corneal Flap Complications: Issues related to the creation and healing of the corneal flap can occur, but advancements in technology and surgeon expertise have reduced these risks.

6.Regression: Vision improvements may regress over time, necessitating additional procedures.

To mitigate these risks:
-Thorough Screening: Rigorous preoperative screening helps identify individuals with a higher risk of complications. Like Pentacam, Schirmir’s test, retina examination etc.

-Advanced Technology: The use of modern lasers and equipment reduces the risk of surgical errors.

-Experienced Surgeons: Choosing a skilled and experienced surgeon is crucial for a successful outcome.

-Postoperative Care: Following postoperative instructions, including medication use and follow-up appointments, is vital for a smooth recovery.

Before opting for LASIK, it's important to discuss potential risks with your eye care professional and weigh them against the potential benefits based on your individual situation.

5)What advice would you give to individuals considering LASIK as a vision correction option, and how can they make an informed decision regarding their candidacy and the procedure itself?
Before considering LASIK, consult with an eye care professional to determine if you're a suitable candidate. Factors like age, overall health, and specific eye conditions play a role. Research reputable clinics, read patient reviews, and inquire about the surgeon's experience. Discuss potential risks, benefits, and realistic expectations with your eye care provider. Remember, individual results vary, so make an informed decision based on thorough research and professional guidance.