LASIK****(LASER IN SITU KERATOMILEUSIS)
In the olden days, Refractive errors and other Visual Handicaps such as Short Sight, Long sight and Astigmatism used to be solely treated with Life Long Spectacles to be used as an Visual Aid.
- While it is well known that spectacles are not a cure for refractive errors and only serve to optically compensate the refractive error, it also induces certain additional disturbances like Minification/ Magnification of the object size depending on whether you are wearing -/+ prescriptions.This leads to alterations in depth perception and may lead to errors in daily activities like visualizing and estimating the distance of the humps in the roads and braking accurately.
- Image jump/ Image displacement occurs in bifocal glasses which leads to difficulty in climbing stairs etc. Progressive lenses restrict the visual field forcing the patients to turn their neck to visualize peripheral objects instead of rotating their eyeballs and shifting their gaze. This induces neck pain on prolonged wearing along with other complaints like Browache, Double Vision, Inappropriate size of the object etc from patients.
- Other effects like Prismatic Effect for Paraxial and Peripheral rays of light, Image Deviation due to non customized Pantoscopic tilt etc were among some of the many reasons why patients used to search for alternatives to Life Long spectacles.
- Cosmetic reasons such as Unsightly appearance due to poor selection of Spectacle Frames , High Powered Thick Lenses due to High refractive errors may alter the appearance where the eyes may look defective to outsiders while wearing spectacles inspite of normal appearance without glasses. To reduce the thickness of the spectacle lenses, Expensive High Index Materials are used which induce a high degree of chromatic abberation for which an Anti reflective coating becomes necessary. The life of these coatings is unpredicatable and last for anywhere between 30 days to 6 months depending on many factors like usage, Sweat Salt Index, Exposure to Heat/ Cold (Climatic Variation), effect of applied cosmetics, etc resulting in Poor Vision Quality after a few months of purchase. As these lenses are expensive, the recurring cost of these below par Life Long Visual Aids is an enormous burden on the financial resources of the patients in the most productive years of their lives.
Contact Lenses while taking care of many of these problems temporarily also do not provide permanent relief from these problems and can be worn maximally for a duration of 10-12 hrs comfortably as increased wearing time compromises the oxygen supply to the cornea and createsmisty or Foggy vision. The remaining time these patients are forced to wear glasses in spite of their lack of inclination to do so. These patients either abuse the contact lenses by overwearing them or try to manage most of their work without either contact lenses or spectacles resulting in other problems like asthenopia, Headache, etc. Many patients alter their lifestyle such that they do not do any useful tasks after they remove contact lenses leading to social withdrawal..
Most patients today, want permanent correction of their short sight, long sight and astigmatism to the extent of allowing them to perform their normal day to day activities independently without having to depend on their glasses as a visual aid.
More than 95% of Lasik Laser patients have a successful outcome allowing patients spectacle free life. The remaining 5% of the patients who have a unsuccessful outcome such as overcorrection, undercorrection, etc are those who need to be diagnosed preoperatively and refused Lasik treatment. The challenge for most Lasik centres is to accurately diagnose this 5 % population and counsel them towards other options like Refractive lens surgery/ Prelex, Phakic IOL implantation etc which are more successful in restoring spectacle free life in these patients, even though they may be more expensive than LASIK.
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