Procedure:

The laser technique involves working on the corneal bed, under the Bowman layer where there are no cells or nerves which can lead to scarring. With the LASIK procedure, a small 8mm diameter flap with a thickness of 130-160 microns, is cut from the surface of the cornea. This flap is not totally cut off and is still attached to the cornea with a small hinge. After the flap is flipped to the side, the corneal stroma is ablated with the Excimer Laser after the computer has been programmed with the patient's refraction and corneal thickness.

The excimer Laser removes corneal stroma at 0.25 microns per pulse (a 1/4 of a 1/100th of a millimeter). The aperture of the laser changes with every ablation and thus by removing the tissue layer by layer a perfect lens cut into the corneal stroma is achieved. The flap is then replaced on the ablated area and takes up the curvature of the new ablated cornea. In normal circumstances the corneal epithelium heals within 10-12 hours.

Am i A good Candidate for LASIK?

You must have a complete eye exam - refractive surgery is not for everyone. There are general LASIK requirements, these include:

  • No eye infection
  • No injury in the past year
  • Eye must have developed properly and be mature; the ideal candidate is at least 18 years old
  • No scarring may be present on the cornea to be considered for LASIK
  • Prior to surgery, vision must have been stable for at least one year
  • Candidates must understand the risks of LASIK surgery and have realistic expectations regarding the results that can be achieved
  • A LASIK candidate may not be nursing or pregnant on the date of surgery
  • Helps to rid the patient of spectacles and contact lenses
  • Quick and safe procedure done under local topical anaesthetic
  • Both eyes are done at the same sitting
  • Recovery is quick
  • Long term side effects are minimal
  • The corneasis not weakend as compared to the old Radial Keratotomy procedure
  • Over-correction & under-corrections. Though these occur in less than 15% it depends on the initial refraction.
  • The higher the refractive error is the greater the chance of having under-correction. Enhancements may be done three months or later if the cornea is thick enough.
  • Infection. There is a small risk of infection, but antibiotic drops are instilled after the procedure and for a week after the operation
  • Night glare. This is normally present for the first few months after the operation but usually is settled by four to six months. A degree of night glare may persist depending on the optical zone of the laser which is required for the specific treatment This complication has all but been eliminated by using the most modern type of laser at the Pretoria Eye Institute since 2005.
  • Haze. The incidence of haze for Lasik is very low. For PRK it is higher and that is why surgeons at the Pretoria Eye Institute prefer to do Lasik.
  • Post-Operative pain. This is usually not a problem, sone patients may experience varying degrees of discomfort. If the eyes are painful one should take normal pain killers & lie down with the eyes shut. Normally by 24-48 hours all discomfort has been cleared up.
  • Corneal flap complications. The incidence of this is small. They include flaps that are too small or short, inadeqaute thickness, inadeqaute quality & smoothness, or a loose flap. If one of the above occurs surgery is normally abandoned after replacing the flap. A few months later the procedure can safely be repeated.
  • Epithelial ingrowth. This occurs when surface cells grow in underneath the flap. Minor degrees of this are not treated and do not cause problems, but if there are large areas the flap is lifted and the cells are scraped .
  • Youn may have a light breakfast on the day of the surgery.
  • On arrival report to admissions on the 3rd floor.
  • Approximately 2 hours before the surgery you will be given eye drops. Some patients also may be given a mild sedative.
  • For LASIK a topical anaesthetic eye drops is applied.
  • The skin around your eye will be cleanded and sterile coverings will be placed around your head.
  • You may be able to see light or movement. Your face is covered with a light sterile drape.
  • You will spend 20-30 min in the laser room.
  • The eyes are covered with a transparent plastic shield for the first night. This is only a precautionary measure.
  • Antibiotic drops are used for a week afterwards.
  • The vision will be slightly blurred for the first few days after the operation, but usually patients are able to perform their daily activities the day after the operation.
  • Light sensitivity and glare at night normally disappear within six months.
  • If there is regression, enhancements can be done within three to six months after the operation.
  • Care must be taken not to rub the eyes.
  • No contact sport for three months.
  • No swimming for ten days post-operatively
  • No deep sea diving for one month post-operatively
  • Normal exercises such as running, aerobics, gym training may be started within two days.
  • No mascara or eye liner for one week.
  • Follow-up appointments will be scheduled as required

Cataract

It is an opacificaion of normal lens of the eye leading to light scatter and poor vision. It is one of the major causes of blindness in the world. The cataractous lens is removed with phaco-emulsification and intra-ocular lens is implanted to correct the vision.

Cataracts are removed by the most modern techniques namely clear corneal sutureless incisions under local or topical anaesthesia. This is done on a day patient basis and restrictions of activities are minimal. This can also be combined with the international package deal.

Keratoconus

Progressive protrusion and thinning of the cornea

Eye diseases

Involving any part of the eye

Diabetes

Diabetes is not a contraindicaton for laser correction

  • After surgery your doctor will place a shield over your eye.
  • After recovery you will go to the patient liasion area where you will receive information on the after surgery care of the eyes as well as your medication.
  • The personnel will inform you when you can go home.