Lasik surgery
Lasik stands for laser assisted in situ keratomileusis. This technology offers new hope for sight without complete dependence upon corrective eyewear. We employ the latest wave-front technology to perform customized surface ablation in order to ensure maximum patient satisfaction.
You will be given only topical anaesthesia, with an oral sedative preoperatively. During the Lasik procedure an instrument called a micro-keratome folds back a thin flap from the cornea ( the front window to your eyes ).
With the Excimer Laser the doctor directs the laser beam with precision control onto the exposed section of the cornea to vaporise precise amounts of corneal tissue. The result is a change in the shape of the cornea. After the treatment the flap or hinge is returned back into position. No stitches are necessary.
Not everyone is a good candidate for Lasik. Factors including the degree of your refractive problem, the thickness of your cornea and age, must all be taken into consideration before any decision can be made.
Risks of Lasik
Lasik is entirely an elective procedure. As with any medical procedure there are risks involved. Serious complications following the Lasik procedure however are rare . After Lasik, it is possible that the operation may not correct the refractive error completely. In some cases a second operation may be necessary. You may experience problems with glare and increased sensitivity to light immediately after surgery. Lasik may result in a loss of some or all of the vision of the operated eye. This is unlikely to occur and has never happened in our Laser Center.
As with any surgery there is the risk of infection. The procedure is performed in theatre under sterile conditions and antibiotics are used before, during and after surgery to fight against infections.
Although the chances of these risks happening are very slight, it should be kept in mind.
Potential benefits
Lasik may possibly end your dependence upon glasses or contact lenses. People in occupations that require good vision without glasses such as fire-fighters, pilots and policemen may benefit from the Lasik ( although certain occupations may restrict the use of the Lasik ).
The need for good vision without any correction dates back to the early Chinese civilisations. People with nearsightedness (myopia) used sandbags at night on their eyes to correct their nearsightedness. The pressure effect of the sandbags on the cornea changed the curvature, which focused the eyes for a short period the next morning. This was a temporary measure to correct myopia.
The development of spectacle lenses and contact lenses was a big step forward in the correction of refractive errors and this helped patients to lead a “normal life”. With the changing lifestyles the necessity grew to achieve good vision without any artificial means. Especially people in certain professions need good vision without any correction e.g.: police officers, fire brigade personnel and professional divers. Even the wear of contact lenses is not suitable under certain circumstances because of atmospheric conditions for example in farming. The weight of thick lenses also causes a pressure effect on the bridge of the nose, which can obstruct the nasal passages of sinus sufferers.
Professor Sato of Japan led the revolution in refractive surgery by operating on patients during 1953 to correct their myopia. His operations were not completely successful over the long term. With the development of technology the procedure was improved and it was Professor Fyoderov from Russia who first performed radial keratotomy (RK) surgery. The Americans refined this procedure and the popularity grew world-wide. It soon became clear that RK surgery was not suitable for all patients. Especially patients with high astigmatism and hypermetropia could not be helped with RK surgery. The advancement of technology however enabled us to help patients with refractive errors to have good vision without any correction.
The development of the Excimer Laser technology in 1983 led the way to the newer treatments of refractive errors. For the past six years photorefractive keratectomies (PRK) with the Excimer Laser have been performed in North America, South America and Europe. Since 1993 it has been done in South Africa. This procedure however has certain disadvantages for example the development of haze (membrane formation) in certain patients led to a change in technique. Findings showed that the formation of scar tissue and membrane formation developed because of the destruction of the membrane of Bowman during the laser treatment. Dr. Luiz Ruiz (Bogota, Columbia) began to do the laser treatment not on the surface of the eye but directly on the middle layer (stroma) of the cornea.
The different layers of the cornea are maintained and the incidence of scar tissue formation disappeared more or less completely.
The improved operation, which evolved out of the PRK procedure, is the LASIK operation. This operation consist of two parts
- The first part of the operation consists of removing a thin layer from the front surface of the cornea. This procedure (lamellar keratectomy) dates back to 1949. Professor J. Barraquer (Bogota, Columbia) performed it as part of his keratomileusis-in-situ procedure. Dr. Luiz Ruiz improved upon the keratome with which the cornea is cut. This new keratome enables us to cut a very thin flap from the front surface of the eye
- The cap is flapped over and the Excimer Laser treatment is done directly on the bed of the flap (the stroma). The stroma is the thickest part of the cornea. A very thin layer of the cornea, more or less two-thirds the thickness of a human hair is removed with the Excimer Laser machine. This leads to the change in the curvature of the eye. Light rays are now focused on the retina. The cap is then replaced on its bed without the need for any sutures.
The LASIK procedure is therefore a combination operation during which a thin layer of the cornea is partially removed. This is followed by Excimer Laser treatment on the stroma. All the different layers of the cornea are thus maintained and the normal anatomical structure of the cornea is kept in tact. This prevents the development of haze and scar tissue formation. The visual rehabilitation is much quicker. Post-operatively the patients experience far less pain.
As with any operation and also refractive procedures, INFECTION is always a possibility. Due to this, the procedure is performed in theatre. The eye is treated with antibiotic eye drops before, during and after surgery.
The possibility of PENETRATION of the eye with the keratome is present but with the newer apparatus the thickness of the slice op die cornea is predetermined and fixed in the machine. The penetration of the eye is thus prevented. The flap could be lost or wrinkles could occur after surgery if the eye is rubbed. If the quality of the flap is not adequate the procedure may be aborted and postponed. After four months a new flap could be cut again and the operation completed. It is therefore very important that the eye should be kept covered for the first twenty-four hours and the eye should NOT BE RUBBED during the first two months after the operation.
If any of these complications should occur in a severe degree, it is certainly possible that the eye could lose vision. This however rarely happens and the chances of it occurring are very small. It is imperative to follow the instructions before, during and after the surgery to reach the best possible post-operative result.
Who qualifies for lasik treatment?
- Patients with myopia up to -8D, astigmatism and long-sightedness (hypermetropia) up to +3.5D.
- The eyes should be stable for the past two years.
- Patients older than eighteen years.
- No other eye diseases may be present.
Advantages for the Lasik procedure!
- The normal layers of the cornea are maintained and no scar tissue formation takes place.
- High degrees of myopia can be treated, even as high as -8,00 diopters.
- The vision does not fluctuate.
- Contact lenses could be worn again if there is any residual refractive error present and follow-up laser treatment is not possible.
- Follow-up treatment is possible in most cases to correct residual refractive error and to bring the eye into sharper focus
- The eyes should be comfortable enough for the patient to return to work after one week.
- Swimming and exercise are restricted for the first two weeks. After two weeks the patient may resume exercising and swimming but should not dive into the water for the next two months.
Please feel free to discuss any of the above and other questions that you may have, with Dr. Slazus or his staff.
Excimer Laser
Through a unique combination of advanced features, innovative engineering, and user -friendly software the LASERSCAN LSX provides repeatable, predictable ablations. Advanced ergonomics provide greater comfort and convenience.
State-of-the-art technology for greater accuracy, control, and reliability. The patented LASERSCAN LSX scanning system delivers a high-resolution, 1-mm, low-energy “flying spot”. The efficient beam precisely removes tissue to smoothly and accurately reshape the cornea.
High-frequency pulse is programmed to move and overlap, eliminating the problems of rings or ridges produced by older, broad-beam technologies.